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Ankle sprains can occur through either sports or activities of daily living, and individuals can be at higher or lower risk depending on a variety of circumstances including their homeland, race, age, sex, or profession In addition, there are different types of ankle sprains such as eversion ankle sprains and inversion ankle sprains. Overall, the most common type of ankle sprain to occur is an inversion ankle sprain, where excessive plantar flexion and supination cause the anterior talofibular ligament to be affected. A study showed that for a population of Scandinavians, inversion ankle sprains accounted for 85% of all ankle sprains Most ankle sprains occur in more active people, such as athletes and regular exercisers.
In a study comparing the prevalence of ankle sprains between age, race, and sex, individuals who were aged 10–19 years old had highest incidences of ankle sprains. It can be suggested that adolescents are more physically active, which leads to higher chances of ankle sprains. Since sports deal with high utilization of the ankle, over 50% of ankle sprains are due to sport related injuries.
Turf toe is named from the injury being associated with playing sports on rigid surfaces such as artificial turf and is a fairly common injury among professional American football players. Often, the injury occurs when someone or something falls on the back of the calf while that leg's knee and tips of the toes are touching the ground. The toe is hyperextended and thus the joint is injured. Additionally, athletic shoes with very flexible soles combined with cleats that "grab" the turf will cause overextension of the big toe. This can occur on the lesser toes as well. It has also been observed in sports beyond American football, including soccer, basketball, rugby, volleyball, and tae kwon do. This is a primary reason why many athletes prefer natural grass to turf, because it is softer.
The exact cause is unclear. Proposed factors include wearing overly tight shoes, family history, and rheumatoid arthritis. Some state that footwear only worsens a problem caused by genetics.
The injury can be debilitating for athletes of many sports who need to accelerate, quickly change direction, or jump. Use of the toes is not possible during the healing process. Since the toes are necessary for proper push-off when accelerating, those sorts of athletic activities should be almost completely curtailed. An extended healing period of one or more months is often required.
Because of the anatomy of the distal foot and the unique use of the foot, it is often impossible to properly tape or brace the joint. Although difficult, it is not impossible to tape the toe to limit extension (upward bend of toe). Additionally, wearing a shoe with a rigid sole (often a metal plate) and cushioned innersole will help minimize extension of the joint. Anti-inflammatory medication as well as physical therapy is recommended.
Turf toe is usually healed in about 2–3 weeks. It can become more serious if left untreated, and may cause serious problems for the athlete. Treating the injury includes icing of the area, elevating the foot, or possibly the use of custom orthotics.
In terms of overuse injuries a British study found that:
- 40 percent occurred in the fingers
- 16 percent in the shoulders
- 12 percent in the elbows
- 5 percent were the knees
- 5 percent back
- 4 percent wrists
One injury that tend to be very common among climbers is Carpal tunnel syndrome. It is found in about 25% of climbers.
Although strains are not restricted to athletes and can happen while doing everyday tasks, however, people who play sports are more at risk for developing a strain. It should also be noted that it is common for an injury to develop when there is a sudden increase in duration, intensity, or frequency of an activity.
A detailed history is the first step of a lameness exam.
1. Age: Foals are more likely to have infectious causes of lameness (septic arthritis). Horses just starting training may be lame due to a developmental orthopedic disease, such as osteochondrosis. Older animals are more likely to experience osteoarthritis.
2. Breed: Breed-specific diseases, such as HYPP, can be ruled out. Additionally, some breeds or types are more prone to certain types of lameness.
3. Discipline: Certain lamenesses are associated with certain uses. For example, racehorses are more likely to have fatigue-related injuries such as stress fractures and injury to the flexor tendons, while western show horses are more likely to suffer from navicular syndrome and English sport horses are more likely to have osteoarthritis or injury to the suspensory ligament.
4. Past history of lameness: An old injury may be re-injured. In the case of progressive disease, such as osteoarthritis, a horse will often experience recurrent lameness that must be managed. Shifting lameness may suggest a bilateral injury or infectious cause of lameness.
5. Duration and progression the lameness: Acute injury is more common with soft tissue injury. Chronic, progressive disease is more common in cases such as osteoarthritis and navicular disease.
6. Recent changes in management: such as turn-out, exercise level, diet, or shoeing.
7. Effect of exercise on degree of lameness.
8. Any treatment implemented, including rest.
The climbers most prone to injuries are intermediate to expert within lead climbing or bouldering.
According to the International Classification of Diseases, 9th Revision, Clinical Modification, ICD-9-CM, in 2008 the U.S. listed the diagonsis code for UCL injury as 841.1: Sprain ulnar collateral ligament. There were a total of 336 discharges of UCL injuries. Within the total discharges, separated by age groups: 18- to 44-year-olds; 165 people (49.17%). 45- to 64-year-olds; 91 (27.08%). 65- to 84-year-olds, 65 (19.35%) it shows that the ulnar collateral ligament injuries were more commonly found in men than women. There were 213 men compared to 123 women with ulnar collateral ligament injury. Most of these injuries were also paid through private insurance (170: 50.63%) and Medicare (70: 20.85%). The average estimated cost for the surgery also known as Tommy John surgery is $21,563.
The bump itself is partly due to the swollen bursal sac or an osseous (bony) anomaly on the metatarsophalangeal joint. The larger part of the bump is a normal part of the head of the first metatarsal bone that has tilted sideways to stick out at its distal (far) end.
Bunions are commonly associated with a deviated position of the big toe toward the second toe, and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal (which help the flexor tendon bend the big toe downwards) may also become deviated over time as the first metatarsal bone drifts away from its normal position. Osteoarthritis of the first metatarsophalangeal joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development. Atop of the first metatarsal head either medially or dorso-medially, there can also arise a bursa that when inflamed (bursitis), can be the most painful aspect of the process.
Several risk factors of CMC OA of the thumb are known. Each of these risk factors does not cause CMC OA by itself, but acts as a predisposing factor influencing the process of OA in some way. Risk factors include: female gender, suffering from obesity, repetitive heavy manual labor, familial predisposition and hormonal changes, such as menopause.
About 25% of people over the age of 50 experience knee pain from degenerative knee diseases.
About 1.8 million people go to the emergency department each year due to hand injuries.
CMC OA is the most common form of OA affecting the hand. Dahaghin et al. showed that about 15% of women and 7% of men between 50 and 60 years of age suffer from CMC OA of the thumb. However, in about 65% of people older than 55 years, radiologic evidence of OA was present without any symptoms. Armstrong et al. reported a prevalence of 33% in postmenopausal women, of which one third was symptomatic, compared to 11% in men older than 55 years. This shows CMC OA of the thumb is significantly more prevalent in women, especially in postmenopausal women, compared to men.
Gamekeeper's thumb and skier's thumb are two similar conditions, both of which involve insufficiency of the ulnar collateral ligament (UCL) of the thumb. The chief difference between these two conditions is that Skier's thumb is generally considered to be an acute condition acquired after a fall or similar abduction injury to the metacarpophalangeal (MCP) joint of the thumb, whereas gamekeeper's thumb typically refers to a chronic condition which has developed as a result of repeated episodes of lower-grade hyperabduction over a period of time. Gamekeeper's thumb is more difficult to treat because the UCL has lengthened and become thinner as a result of repeated injury. It is moderately painful compared to similar injuries.
In addition to skiing, this injury (resulting from forced abduction or hyperextension of the proximal phalanx of the thumb) is seen in a wide variety of other athletic endeavors. The most common mechanism of injury appears to be when a person extends the arm in an attempt to block a fall. The stress resulting from falling onto an abducted thumb produces a valgus force on the MCP joint of the thumb, resulting in a sprain or tear of the UCL.
In a recent study, 49% of UCL disruptions of the thumb were caused by a fall onto an outstretched hand. Sports injuries accounted for most of the remaining injuries, with only 2.4% acquired as a result of skiing injuries.
The Jersey Finger is a finger-related tendon injury that is common in athletics and can result in permanent loss of flexion of the end of the finger if not surgically repaired.
This injury often occurs in American football when a player grabs another player's jersey with the tips of one or more fingers while that player is pulling or running away.
In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases Hammertoe Surgery may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.
In the United States, more than US $3 billion is spent each year on arthroscopic knee surgeries that are known to be ineffective in people with degenerative knee pain.
In most people, ligaments (which are the tissues that connect bones to each other) are naturally tight in such a way that the joints are restricted to 'normal' ranges of motion. This creates normal joint stability. If muscular control does not compensate for ligamentous laxity, joint instability may result. The trait is almost certainly hereditary, and is usually something the affected person would just be aware of, rather than a serious medical condition. However, if there is widespread laxity of other connective tissue, then this may be a sign of Ehlers-Danlos syndrome.
Ligamentous laxity may also result from injury, such as from a vehicle accident. It can result from whiplash and be overlooked for years by doctors who are not looking for it, despite the chronic pain that accompanies the resultant spinal instability. Ligamentous laxity will show up on an upright magnetic resonance imaging (MRI), the only kind of MRI that will show soft tissue damage. It can be seen in standing stress radiographs in flexion, extension, and neutral views as well, and also digital motion X-ray, or DMX.
An advantage to having lax ligaments and joints is the ability to withstand pain from hyperextension; however, this is also a disadvantage as a lack of perceived pain can prevent a person from removing the ligament from insult, leading to ligament damage. This can also lead to death if you tear the wrong ligament. People with hypermobile joints (or "double-jointed" people), almost by definition, have lax ligaments.
The etiology of the Galeazzi fracture is thought to be a fall that causes an axial load to be placed on a hyperpronated forearm. However, researchers have been unable to reproduce the mechanism of injury in a laboratory setting.
After the injury, the fracture is subject to deforming forces including those of the brachioradialis, pronator quadratus, and thumb extensors, as well as the weight of the hand. The deforming muscular and soft-tissue injuries that are associated with this fracture cannot be controlled with plaster immobilization.
Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problems (e.g., a bunion can force the big toe to turn inward and push the other toes). It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot–Marie–Tooth disease, complex regional pain syndrome or diabetes. Hammer toe can also be found in Friedreich's ataxia (GAA trinucleotide repeat).
The classically used Leddy and Packer Classification classifies Jersey finger tendon injuries based on the degree of tendon injury, retraction, and presence of a concomitant fracture.
Often, surgical pins are inserted into the injured digit to stabilize the bone and tendon in their proper alignment. Post surgical complications can include infection, pin failure and nail and joint deformity. Surgery is often accompanied by a rehabilitation protocol to strengthen the injured muscle and help the patient regain as much range of motion (ROM) as possible at the affected joint. The finger may never return normal extension ROM.
This condition, which occurs in adolescents and adults, can be associated with previous trauma.
The true cause is not known. Most commonly, hallux rigidus is thought to be caused by wear and tear of the first metatarsophalangeal joint.
SLAC and SNAC are both caused by injury, for example a fall on an extended hand. SLAC is caused by rupture of the scapholunate ligament, SNAC is caused by a scaphoid fracture which does not heal and because of that will develop in a non-union fracture. SLAC is more common than SNAC; 55% of the patients with wrist osteoarthritis has a SLAC wrist. Although they have a different underlying pathology, they both lead to abnormal wrist kinematics which will eventually lead to osteoarthritis of the wrist.