Workshop On Sports Injuries & Prevention

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Workshop organized by BOTS on stretches that can be done before byking and sports injuries

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Workshop On Sports Injuries & Prevention

  1. 1. Workshop on sports injuries & prevention Dr Sushal Shanthakumar MS Orthopaedics
  2. 2. What s cooking … Stretching Getting the right fit Common problems/injuries The knee – an enigma to cyclists Why physiotherapy ? Question time !
  3. 3. Stretches U gotta stretch yo ! ! !
  4. 4. Why do we need to stretch ? ? “ just not merely a stretch of imagination ” To improve the flexibility To prepare for an imminent increase in activity Anatomy of stretching What is static & dynamic stretching What is best for us ???
  5. 5. anatomy & physiology of stretch All muscles at rest – contracted Cross bridges – less widely separated in rest Optimum stretch – max pre load Total tension = passive tension + active tension
  6. 6. Stretches for the upper limb DELTOID : stand with feet apart Keep shoulders square Pull arm across the body perpendicular to the ground
  7. 7. TRICEPS : Stand with shoulder flexed till ears Bend elbow so the hand rests b/w the shoulder blade Apply pressure on the opp. elbow with other hand
  8. 8. LEVATOR SCAPULAE: Sit/stand with shoulders square Look down towards opposite arm pit Apply slight pressure with the near hand
  9. 9. Stretches for the lower limb LOWER BACK STRETCH :
  10. 10. LOWER BACK contd ..
  11. 11. GLUTEAL STRETCH : Sit on the floor Bend the knee you are stretching and place it across over the opposite thigh Pull bent knee to your chest while keeping both buttocks on ground
  12. 12. HIP FLEXOR ADDUCTOR STRETCH
  13. 13. IT BAND STRETCH: cross your right foot over in front of the left most of your weight should be on your left foot reach your right hand overhead, and lean as far as you can to your left push your hips out while you are reaching overhead
  14. 14. QUADRICEPS HAMSTRINGS CALF STRETCH
  15. 15. Remember …. ‘feel’ the stretch slow & gradual stretch hold for 10-15 secs do not bounce or jerk repeat atleast once
  16. 16. Getting on the bike Get a good fit Be meticulous on choosing the bike Don’t go by opinions Every individual is different and so will his bike
  17. 17. Why is it important to get the right fit • EFFICIENCY – Aerodynamics 80% effort required to overcome air resistance at 25mph – Power Cannot let the legs do the pedaling if you’re not relaxed • COMFORT – Neck ache (bars too low) – Over-reaching to handlebars (neck/shoulder/elbow pain) – Pain Knee (saddle too low or too high) Perineum (saddle too high, too forward/back, tilted up/down) Lower back (saddle too high) • AVOID INJURY – Knee injury (damage to ligaments) – Tendinitis (neck/shoulder/elbow) – Male impotence (perineal nerve damage)
  18. 18. The right fit A myth or reality ? Anatomical or mechanical ?
  19. 19. Common problems & injuries Back pain Knee pain Hand & shoulder syndromes Foot pain
  20. 20. Low back pain Back – considered as the weak link for cyclists Any force directed into the pedals also goes up into the torso If the torso is weak, that force DOESN'T go into the pedals but is dissipated in flexing of the torso
  21. 21. CAUSES - 80% of low back pain arises because of poor posture Muscle spasms - inflexibility Medical problems TIPS- Strengthening of abdomen n back Stretching If nothing helps see a doc
  22. 22. Knee pain Most common problem – 90% have exp some kind of knee pain Irony ! ! ! Cycling is one of the better exercises for knee
  23. 23. Anatomy Stability – rather instability ! ! ! Bones are incongruent More emphasis on muscles & ligaments
  24. 24. Multitude of causes … ANATOMICAL - leg length discrepancy - wider pelvis - flat foot - muscle weakness
  25. 25. BIKE FIT - saddle too high - saddle too low - saddle too far forward - saddle too far back - internally rotated cleats - externally rotated cleats TRAINING - rapid increase in activity ( 10% rule ) - faulty techniques - early return to sports following repair
  26. 26. Variety of conditions .. Patello-femoral pain syndrome IT band syndrome Chondromalacia Tendinitis Bursitis Ligament & meniscal tears
  27. 27. Cruciates & Menisci CRUCIATE LIG - ACL & PCL - injury – how? - is surgery essential - if so when ? - results ? ‘an ACL deficient knee is the beginning of the end’
  28. 28. Meniscus Medial & lateral Avascular structures Functions Injury Is surgery essential ? Results ???
  29. 29. Menisci contd ..
  30. 30. Rehabilitation Extremely essential Tailor made to individual case Basic points - achieve full ROM within 2 weeks - strengthening hamstrings & quadriceps - earliest return to sports – 6 months - criteria --- quads & hams strength at least 80% of the normal leg no swelling
  31. 31. Foot & ankle FOOT : Numbness or burning – compression of nerves Due to tight shoes / road vibration Flat feet - is it congenital or acquired - flexible or rigid - all flat feet don’t require Rx - effect on cycling - ? - symptomatic – insoles , custom made shoes
  32. 32. ANKLE : Most often results from ‘ankling’ Cleats are wrongly positioned ACHILLES TENDINITIS: • Tendon on back of the foot • Indicates problem with pedaling technique • Ankling / cleats too far forward / saddle too high – toe pedaling
  33. 33. Hands neck & shoulder HANDS: Entrapment neuropathies – ulnar & median nerves Pressure of handlebars / overuse of wrist/ fractures of small bones of hand Numbness & tingling in hands Rx – padding , gloves , wrist splints , change of position , lowering the saddle
  34. 34. NECK: - neck pain - common due to riding position - overuse injuries - reassess your posture (saddle ht position distance) - r/o medical conditions - tips – stretches , freq change of hand position , relaxing elbows , varying head position ‘try not to ride with your neck in the same position for long periods of time’
  35. 35. Thank you & happy cycling

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