SPORTS INJURIES Prevention, Treatment and Rehabilitation Fourth Edition SPORTS INJURIES Prevention, Treatment and Rehabilitation Fourth Edition Lars Peterson MD, PhD Professor Emeritus in Orthopedics, Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Per Renström MD, PhD Professor Emeritus in Orthopedic Sports Medicine, Department of Molecular Medicine and Surgery, Centre for Sports Trauma Research and Education, Karolinska Institutet, Stockholm, Sweden With valuable contributions by Tommy Berglund, Lennart Molin, Tommy Bolic-Eriksson, Ole Roos, Anna Frohm, Anette Heijne, Tommy Eriksson, Dale Reese and Erik Nexborn Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2017 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper Version Date: 20160822 International Standard Book Number-13: 978-1-84184-705-4 (Pack - Book and Ebook) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medi- cal science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging‑in‑Publication Data Names: Peterson, Lars, author. | Renström, Per, author. Title: Sports injuries : prevention, treatment, and rehabilitation / Lars Peterson and Per Renström. Description: Fourth edition. | Boca Raton : Taylor & Francis/CRC Press, 2016. | Includes bibliographical references and index. Identifiers: LCCN 2016037959 | ISBN 9781841847054 (hardcover : alk. paper) Subjects: | MESH: Athletic Injuries--therapy | Athletic Injuries--prevention & control Classification: LCC RD97 | NLM QT 261 | DDC 617.1/027--dc23 LC record available at https://lccn.loc.gov/2016037959 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents About the authors xii Acknowledgements for the fourth edition xiv Foreword xv Preface xvi Glossary xvii 1. Sports Medicine/Injuries in Sports and Society 1 Introduction 1 Injuries during sport, exercise and physical activity 3 Sports & Exercise Medicine in healthcare 5 Sports & Exercise Medicine background and history 6 Components of Sports Medicine and Sports & Exercise Medicine 7 Sports injuries 7 Prevention 8 Sports science 9 Ethical considerations in Sports & Exercise Medicine 10 References 12 2. Risk Factors for Sports Injuries 14 Individual risk factors 14 References 32 3. Prevention of Injury and Preparation for Sport 33 Sports injury prevention 33 References 38 4. Equipment in Sports – Principles 39 Shoes 39 Equipment and rules 41 References 54 v vi Contents 5. Braces and Taping Used in Sport 55 Support bandages 55 Orthoses and braces 55 Taping 61 The future of taping and development 78 References 84 Further reading 84 6. Injury Prevention in Some Major Sports 85 Running/jumping 85 Throwing sports 96 Tennis 99 Alpine skiing 108 Football/Soccer 112 Ice hockey 120 References 125 Further reading 126 7. Injury Management Options and Possibilities 128 Arena safety and contingency plan 129 Sports Medicine management and equipment at the arena 130 Very acute emergency care at the sports stadium 134 Acute care in the arena 134 Clinical treatment alternatives 141 References 146 Further reading 146 8. Treatment Principles and Options – an Overview 147 Skeletal injuries 147 Joint and ligament injuries 155 Joint cartilage injuries 158 Joint diseases 165 Muscle injuries 167 Injuries in the muscle–tendon complex 169 Tendon injuries 177 Contents vii Injuries of the bursa 185 Peripheral nerve injuries 187 Other injuries 189 Stitch (splenic stitch) – exercise-related transient abdominal pain (ETAP) 191 References 192 Further reading 192 9. Rehabilitation Principles 193 Movement therapy and physical therapy 193 Psychological aspects of injury and rehabilitation 195 References 211 Further reading 211 10. Shoulder Injuries in Sports 212 Investigation of the shoulder 216 Injuries and disorders related to acute and chronic shoulder instability 222 Clavicular injuries 244 Nerve injuries in the shoulder region 248 Brachial plexus injuries (Burner syndrome) 249 Rehabilitation of the shoulder and upper limb 250 Rehabilitation program 254 References 256 Further reading 256 11. Injuries to the Upper Arm 257 Functional anatomy 257 Further reading 263 12. Elbow Injuries in Sport 264 Functional anatomy 264 Elbow injuries in adults 266 Elbow injuries in children 267 Medial elbow injuries 273 Posterior elbow injuries 277 Anterior elbow injuries 279 Fractures and dislocations 281 viii Contents Rehabilitation program: elbow, wrist and hand 283 Reference 283 Further reading 283 13. Forearm, Wrist and Hand Injuries in Sport 284 Forearm injuries 284 Overuse injuries 284 Compartment syndrome 285 Fractures 285 Wrist injuries 285 Hand and finger injuries 298 Tendon injuries 305 Rehabilitation of the wrist and hand 307 References 309 Further reading 309 14. Head and Face Injuries in Sport 310 Head injuries 310 Facial injuries 316 Ear injuries 317 Eye injuries 318 Injuries to the mouth 320 References 321 Further reading 321 15. Throat, Chest and Abdominal Injuries in Sport 322 Throat injuries 322 Thoracic injuries 323 Abdominal injuries 324 Further reading 326 16. Back/Spine Injuries in Sport 327 Functional anatomy and biomechanics 328 Examination with back pain present 330 Neck/cervical spine 331 Thoracic and lumbar spine 338 Contents ix Reference 355 Further reading 355 17. Groin, Pelvis and Hip Joint Injuries in Sport 356 Functional anatomy 357 Groin injuries 358 Other causes of pain in and around the hip 368 Hernia 375 Inflammation of internal organs 376 Hip complaints in children and adolescents 380 Rehabilitation of hip, pelvis, groin and thighs 381 Reference 384 Further reading 384 18. Thigh Injuries in Sport 385 Muscle injuries to the posterior side of the femur 385 Injury to the front (anterior), outside (lateral) and inside (medial) of the femur 392 Less common causes of thigh pain 396 Reference 396 Further reading 396 19. Knee Injuries in Sport 397 Functional anatomy and biomechanics 398 Medical history and examination 399 Ligament injuries 401 Meniscus injuries 425 Articular cartilage injuries 437 Rehabilitation programs for knee injuries 463 Rehabilitation programs for specific injuries 465 References 471 Further reading 471 20. Lower Leg Injuries in Sport 473 Functional anatomy 473 Fractures 474 Anterior lower leg pain 476