Sports Injuries: Knowing When to Seek Emergency Care

 

By Kris Abeln, M.D.

Leading an active lifestyle is an important tool in maintaining good health, but participation in sports can also lead to sports-related injuries.  According to the National Ambulatory Medical Care Survey & American Academy of Orthopaedic Surgeons, each year approximately 3.5 million visits are made to emergency departments for fractures and approximately 6.3 million fractures occur in theU.S.  In addition, men under the age of 45 are more likely to experience fractures than women.

Men often participate in more contact sports, such as football and lacrosse, and extreme sports like skateboarding, BMX racing, motocross, etc., which may be a contributing factor to their increased risk of fracture.

Some sports injuries, like a strain or sprain, may be minor, while others can be severe and require immediate medical attention.  Here are some tips to help you know when you should head to the nearest emergency room and what injuries can be treated by a physician during a regular office visit.

When to head to the hospital for emergency care:

  • If there is a deformity in a joint or bone, if it is crooked or feels out of place.
  • If a fracture is open, often called a compound fracture, where the skin is broken and bone is visible.  These types of fractures are generally severe and have an increased risk for infection.
  • For lower-body injuries, if you cannot bear weight on the injured bone or joint.
  • If you felt a pop, or others near you at the time of the injury heard a pop.  That “pop” can be a sign of a significant soft tissue or bone injury.

At the emergency room, expect a good physical examination, which may include x-rays of the affected area in order for the physician to determine if there is a fracture and the severity of the injury.  For more significant injuries, a CT scan or MRI may be conducted, but typically those tests are ordered by a specialist at a later date if needed.

A fracture may need to be treated in the ER by casting and some serious fractures can result in hospitalization and surgery.

For a typical fracture, an emergency room physician may apply a splint to the fractured bone in order to stabilize it and prevent further damage.  The physician will usually recommend a visit to your regular physician or a specialist on an outpatient basis in the next few days. The physician may also “reduce” the fracture, which is commonly known as setting the broken bone(s) back to their original positions.

While fractures are prevalent, the most common sports injuries are sprains to the ankle or knee. A sprain is a stretch or tear of the ligament.  If you have bruising, swelling and pain, but can put weight on the bone or joint, you may have a sprain. Try treating the injury with rest, ice, compression and elevation and make an appointment with your physician.

  • Rest. Reduce exercise and activities as needed.
  • Ice. Apply an ice pack to the injured area for no more than 20 minutes, approximately four to eight times a day.
  • Compression. Compression using elastic wraps, air casts or splints may help reduce swelling. Ask your health care provider for advice on which one to use.
  • Elevation. Keep the injured area elevated above the level of the heart to help decrease swelling.

Follow these four steps after injury and continue for approximately 48 hours.

After a sprain, the injured joint should be exercised again soon to avoid stiffness or muscle atrophy.

To prevent injuries, warm up before practice or a game, use good equipment and be weary of playing multiple games in a row – fatigue causes individuals to be at higher risk for injuries. To avoid re-injury, follow the advice of your care provider. Don’t return to activity before recommended.

For both men and women, there can be an unfortunate emphasis to tough it out or endure pain in order to minimize time off the playing field.  In reality, the sooner you seek treatment, the sooner you can heal and get back on the field.  If you have pain during a game or practice session, or at home afterwards, talk to your athletic trainer or physician. Delaying treatment can cause the injury to worsen and lengthen your treatment time.

Kris Abeln, M.D. is an orthopedic surgeon with Loeb Orthopaedic Group located at the  Jewish Hospital Medical Center Northeast. Dr. Abeln graduated from the University of Louisville School of Medicine. He did his orthopaedic surgery residency at University of Illinois in Chicago and completed a sports medicine fellowship with the Santa Monica Orthopaedic and Sports Medicine Group in Santa Monica, California. 

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