It’s time for this week’s HSS Injury Report! Last week was busy with the World Cup finals and MLB’s fast approaching All Star Break. See below for a break down of some injuries that are getting lots of attention in the media.
To see last week’s injury report, click here. Check back next week for the next installment of the Injury Report!
The spinal column consists of a series of vertebrae (made of bone) attached to each other by discs (made of soft collagen) and stabilized by a complex arrangement of ligaments, muscles, and joints. In contrast to the lumbar spine, or the lower back portion of the spine, the cervical spine (neck portion of the spine) houses nerves that comprise the spinal cord. If the spinal column is subject to sufficient trauma, the bony elements of the spinal column can fracture (break). The stability of the spine following the fracture largely depends upon on the severity of the fracture and the integrity of the stabilizing structures. Unstable spines can be associated with an increased risk of the neurologic (nerve) damage. An unstable cervical spine can be associated with an increased risk of the spinal cord damage and can lead to weakness and dysfunction of the arms and legs.
Whether the cause is trauma or disease, damage to articular cartilage – the smooth cushion that lines the end of the bones where they meet at the joints – can cause significant pain and weakness. Articular cartilage lines the ends of our joint surfaces and is composed of cells called chondrocytes, with a matrix or scaffolding made of collagen and proteins. In healthy joints, this unique and durable material allows bones to move against one another with minimal friction. When areas of cartilage are worn away or torn away, exposing underlying (subchondral) bone, treatment is designed to fill in the missing area or defect with healthy articular cartilage and provide new protection for the joint surface.
Muscle injuries are commonly referred to as strains or pulls. Factors that can predispose an athlete to injury include older age, previous muscle injury, less flexibility, lack of strength in the muscle, and fatigue. When muscle is initially injured, there is significant inflammation and swelling. A significant amount of scar tissue forms where the muscle was injured. Over time, this scar tissue remodels, but the muscle never fully regenerates, making the muscle prone to a subsequent injury. Muscle strains can most often be treated successfully with rest, ice, compression, elevation (also known as RICE), and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Most injuries do not require surgery and a full recovery is expected in most cases. Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may susceptible to another injury at that location.