Sports injuries

Current topics of information:

• Proprioception
• Anti inflammatories
• Cortisone injections
• ACC information available online
• Sports Medicine websites

Proprioception

Winter sports are with us with lots of knee and ankle sprains. Proprioception exercises can help prevent lower limb injuries and help to rehabilitate you if you are unfortunate enough to have one.

Proprioception is the body's awareness of exactly where it is in space. By practicing balance exercises you can strengthen muscles in the lower limb, improve their team work, agility and coordination.

For example if your brain knows exactly the angle your ankle is on before the foot hits the ground it can turn on the right muscles to support it as it takes the weight so you don't "roll your ankle".

Below are some exercises you can do on a Wobble board. We have Wobble boards for sale at the Practice. Come in and see us.

Anti inflammatories

Anti inflammatories are regularly prescribed by doctors to help your physiotherapy work.

The most commonly known brand names are Voltaren, Brufen and Naprosyn. Some of the newer ones being advertised are Vioxx and Celebrix which are reported to be gentler on the stomach.

If you are taking NSAIDS there are several steps you can take to reduce the risks of side effects - namely stomach pain, diarrhoea and stomach ulcers.

1. stop smoking
2. drink limited amounts of alcohol
3. do not take more than the doctor recommends
4. take them as prescribed - with food
   - milk and bread are good for lining the stomach
5. take a drug that may prevent ulcers (Zantac, Losec)
   

Did you know the following over the counter meds are also NSAIDS?

Don't Double up with your Voltaren!

• Disprin
• Asprin
• Cataflam
• Pirophen
• Codcomol
• Aspro
• Nurofen
• Coda Forte
  

Cortisone injections

Who hasn't heard a horror story about how much a cortisone injection hurts? Well below are some facts from the Arthritis Foundation of New Zealand.

Cortisone, is a substance similar to a natural steroid hormone produced by the body. It reduces inflammation, (pain, heat, redness and swelling) of joints and their surrounding structures. Special preparations are used to prolong its effect at the site of injection. Cortisone starts to act slowly over 25-36 hours and the beneficial effects may last for days or months.

When is a Cortisone injection given?

• When pain due to inflammation is prominent either in a joint or the surrounding structures.
• If only a few joints are involved.
• If specific joints are preventing activity.
• If other medication can not be used.
  

Local anaesthetic may also be given. This relieves pain immediately and lasts for 3 - 4 hours while the cortisone is beginning to work.

How Often?

Discuss this with your doctor.

As a general rule:

In a joint, no more than once a month, with a maximum of 3 - 4 cortisone injections in one year.

In the surrounding structures, no more than once every 2 - 3 weeks.

What are the benefits?

• Pain and swelling are reduced
• Mobility is increased
• Often, as the pain settles, other medication can be reduced
• It may be combined with other treatment such as physiotherapy.
  

After your treatment

• Rest the joint for about 24 hours
• Avoid excessive movement or stress on the joint for about one week.
  

• If there is pain:

1. Rest
2. Apply ice (in a plastic bag wrapped in a towel)
3. If the pain worsens over 48 hours and/or you feel unwell
   CONTACT YOUR DOCTOR WITHOUT DELAY
   

Side effects - How Cortisone injections differ from Cortisone tablets

As cortisone is injected infrequently into a specific site, very little enters the blood stream compared with the cortisone taken in tablets. Because of this "cortisone side effects" are minimal. However other joints may temporarily improve as the cortisone slowly enters the blood stream.

Cortisone side effects are very uncommon, they include:

• Flushing
• Swelling of fingers or face (oedema)
• Menstrual irregularity
• Mood change
• Raised blood pressure
• Thinning (atrophy) or altered colour of the skin at the site of injection. This rarely occurs with joint injection but may with injections of the surrounding structures e.g. Tennis Elbow
• Raised of unstable blood glucose levels in diabetes for several days following the injection.

More Information

For more information refer to ACC's wide range of brochures on Sports Medicine topics (by clicking on the following):

• RICE
• warm-up
• injury-management
• hydration-nutrition
• physical-conditioning
• screening
• technique
• environment
• protective-equipment

ACC also has online information on

• Concussion
• Hamstring Injuries
• Ankle injuries
• Shoulder injuries
• Knee injuries

at ww.acc.co.nz

The following websites may also be of interest:

http://orthom.com/index.phtml?nc=&dl=orthom.progs&s_s=4&dt=3
http://www.clinicalsportsmedicine.com/