Sports-Related Injuries: An Emergency Medicine Doctor’s Perspective
Sports are fun, right? ճ’r also exciting for participants and spectators alike. But they can be tough on the body—and not just for professional athletes.
From young children to teens, young adults and weekend sports enthusiasts of every age, “we treat a wide variety of injured patients in the Emergency Department (ED),” says Dr. Justine Ko, Assistant Professor of Clinical Emergency Medicine and Assistant Attending Physician at ձavɫƬ.
What causes a patient to come to the ED rather than wait for an appointment with an orthopedist a few days later? What are the benefits of rapid diagnosis and treatment? Read on for answers to these questions and more in the following Q&A with Dr. Ko.
What are the most common sports-related injuries you see in the ED?
The most common musculoskeletal injuries are to the knee, shoulder and ankle. Sprains and strains are more common than fractures and breaks.
Which sports are responsible for most of these injuries?
Football and basketball are responsible for most of the sports-related injuries we see. Cycling and soccer also account for a fair share of injuries.
How do you diagnose a musculoskeletal injury in the ED?
An X-ray is the first step we take to evaluate the problem, Dr. Ko says. “If no fracture is found, we usually send the patient to an orthopedist for outpatient follow-up, including additional tests and a prescription for physical therapy, if warranted.
“If a patient is diagnosed with a fracture, we place a splint to stabilize and immobilize the injured area. Generally, we Dz’t apply casts in the ED, as we need to allow room for swelling,” she adds.
What role does a patient’s age play in their diagnosis and recovery?
Perhaps surprisingly, most of the patients with sports-related injuries seen in ձavɫƬ’s ED are between ages 5 and 24.
“A patient’s age can affect their diagnosis as well as their recovery,” Dr. Ko says—especially children and teens, who are vulnerable to growth plate injuries.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the growth plate is the area of tissue near the ends of long bones such as the femur (thigh bone) or the radius and ulna (the forearm bones). These close sometime during adolescence, when they’re replaced by solid bone.
“Pediatric fractures involve the growth plate up to 30 percent of the time, usually between ages 10 to 14,” Dr. Ko says. “Growth plate injuries can be diagnosed in the ED but often require additional follow-up.
“While most show up on an X-ray, some are diagnosed based on an exam and tenderness at the growth plate,” she continues. “Emergency medicine specialists can prevent further injury by having a high level of suspicion that a growth plate is involved; by providing adequate splinting; and by following up with a pediatric orthopedic specialist.”
Older adults may take longer to recover from a sports-related injury as well, due to arthritis or other chronic diseases or conditions, she says.
How are sports-related injuries in adults typically treated in the ED?
Most commonly, “we treat pain and swelling with pain control medications and ice. In addition, we protect the injured area with an elastic bandage, sling or splint as needed. Crutches may be required for those who ’t bear weight on their injured ankle or leg.”
What are the worst, most difficult injuries you treat?
“The most difficult ones are dislocations and complex fractures, as these may require sedation or orthopedic surgery.”
Please describe the transition from emergency care to outpatient care.
Most musculoskeletal injuries Dz’t require admission to the hospital or immediate surgery, she says. “If there’s a fracture, we immobilize the area of injury. Then, our patient services team can help to follow up with our orthopedic or ED sports clinic team, depending on the nature and severity of the injury.”
How do you advise patients to administer self-care after discharge?
“For pain management, we recommend alternating between acetaminophen (Tylenol) and ibuprofen,” she says. “And here’s a helpful mnemonic that will help patients remember how to take care of themselves once they’re home: It’s called PRICE.
- P – protect your injured foot, ankle or leg with limited weight bearing, and use crutches or a cane as needed
- R – rest
- I – ice 20 minutes at a time
- C – compress with with an ACE wrap or elastic bandage
- E – elevate
How soon after recovery can patients return to playing sports?
The timing will depend on the type of injury and whether surgery is required to repair it. “These issues are usually discussed with the sports physician or orthopedist during the follow-up appointment.
Dr. Ko offers the following example regarding ankle sprains: A low-grade (mild) sprain can take 1 to 3 weeks to heal, whereas higher-grade (more severe) sprains may take longer, depending on the patient’s symptoms and progress. “Your orthopedist or sports physician will determine when it’s safe for you to get back to playing the game you love,” she says.
For more information about emergency medicine at ձavɫƬ, visit the department’s website here.