The document discusses various types of musculoskeletal disorders and sports injuries. It begins with an overview of degenerative bone disorders, bone infections, muscular disorders, disorders of the hand and foot, spinal deformities, and sports injuries. Specific injuries discussed in more detail include ankle sprains, strains, tennis elbow, ACL injuries, meniscal injuries, and overuse syndrome of the knee. Treatment options mentioned include RICE therapy, bracing, injections, exercises, and in some cases surgery. Risk factors and prevention strategies are also outlined.

1. Maria Carmela L. Domocmat, RN,MSN
Instructor
School of Nursing
Northern LuzonAdventist College
Artacho, Sison, Pangasinan

2. The common musculoskeletal disorders in athletes include neck
pain, upper, and lower back.[10] The conditions such as myalgia
pain, tendinitis, tendonitis, sprains, strains, and fractures are also
common. Compared to males, females present with more
musculoskeletal symptoms, with an estimated prevalence of
62%.

3. Overview
⚫Part 1: Degenerative &
Metabolic bone disorders
⚫ OA
⚫ Gout and gouty arthritis
⚫ Osteoporosis
⚫ Paget’s dse
⚫ Osteomalacia
⚫Part 2: Bone infections
⚫ Osteomyelitis
⚫ Septic arthritis
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⚫Part 3: Muscular disorders
⚫ Muscular dystrophy
⚫ Rhabdomyolysis
⚫Part 4: Disorders of the
hand
⚫ Carpal tunnel syndrome
⚫ Dupuytren’s contracture
⚫ Ganglion

4. Overview
⚫ Part 5: Spinal column
deformities
⚫ Scoliosis
⚫ Kyphosis
⚫ Lordosis
⚫ Osteogenesis imperfecta (OI)
⚫ Part 6 : Disorders of foot
⚫ Hallux valgus (bunions)
⚫ Morton’s neuroma (plantar
neuroma)
⚫ Hammer toe
⚫ Tarsal tunnel syndrome
⚫ Plantar Fasciitis
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⚫ Corn
⚫ Callus
⚫ Ingrown Nail
⚫ Hypertrophic Ungual Labium
⚫ Part 7: Sports Injuries
⚫ Sprain
⚫ Strain
⚫ Tennis elbow
⚫ Impingement and rotator cuff
tears
⚫ Knee injuries (ACL injury,
meniscal injury, overuse
syndrome)

5. Sports Injuries
⚫Sprain
⚫Strain
⚫Tennis elbow
⚫Impingement and rotator cuff tears
⚫Knee injuries (ACL injury, meniscal injury, overuse
syndrome)
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7. Sprain
⚫ A sprain is a stretched or torn ligament.
⚫ Ligamentsare tissues thatconnect bonesat a joint. Falling, twisting, orgetting
hitcan all causea sprain.
⚫ Ankle and wrist sprains are common. Symptoms include pain, swelling,
bruising and being unable to move your joint. You might feel a pop or tear
when the injury happens.
⚫ A strain is a stretched or torn muscle or tendon. Tendons are tissues that
connect muscle to bone. Twisting or pulling these tissues can cause a strain.
Strains can happen suddenlyordevelop over time. Back and hamstring muscle
strains arecommon. Many peopleget strains playing sports. Symptoms include
pain, musclespasms, swelling and trouble moving the muscle.
⚫ At first, treatment of both sprains and strains usually involves resting the
injured area, icing it, wearing a bandage or device that compresses the area,
and medicines. Later treatment might include exerciseand physical therapy.
⚫ NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.nlm.nih.gov/medlineplus/sprai
nsandstrains.html

8. http://www.mayoclinic.com/images/image_
popup/mcdc7_anklesprain.jpg

12. Ankle sprain
⚫An anklesprain is acommon injury to theankle.
⚫The mostcommonway theankle is injured is when
theankle is twisted inward (inversion injury).
⚫With this injury, ligaments that support the anklecan
be torn which lead to swelling, inflammation, and
bruising around theankle.
⚫An anklesprain injury may takea few weeks to many
months to fully heal.
http://www.nlm.nih.gov/medlineplus/ency/
imagepages/19577.htm

13. ⚫The mostcommonway theanklecan be injured is by
an anklesprain.
⚫When an ankle is sprained ligamentson theankleare
eitherstretched, partiallytorn orcompletelytorn.
⚫The mostcommon typeof sprain is an inversion
injury, where the foot is rotated inward.
http://www.nlm.nih.gov/medlineplus/ency/
presentations/100209_4.htm

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15. ⚫Anklesprains can range from mild, to moderate, and
severe.
⚫Type 1 ankle sprain is a mild sprain. It occurs when the
ligaments have been stretched or torn minimally.
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18. ⚫Type II ankle sprain is a moderate level of sprain. It
occurs when some of the fibers of the ligaments are
torn completely.

19. ⚫Type III anklesprain is the mostsevereanklesprain.
⚫It occurs when the entire ligament is torn and there is
great instabilityof theankle joint.

20. Grade III ankle sprain

21. ⚫Minor injuries likesprains may be treated at home if
broken bones are not suspected.
⚫Theacronym RICE is helpful in remembering how to treat
minor injuries:
⚫ "R" stands for rest,
⚫ "I" is forice,
⚫ "C" is for compression,
⚫ "E" is for elevation
⚫Pain and swelling should decrease within 48 hours, and
gentle movement may be beneficial, but pressure should
not be puton a sprained joint until pain is completelygone
(one to several weeks). http://www.nlm.nih.gov/medlineplus/ency/imagepages/
19396.htm

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25. Strain
http://www.nlm.nih.gov/medlineplus/ency/
images/ency/fullsize/19618.jpg

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29. Lateral epicondylitis
⚫Epitrochlear bursitis
⚫Tennis elbow

30. Lateral epicondylitis
⚫inflammation, soreness, orpain on theoutside
(lateral) side of the upper arm near the elbow.
⚫There may be a partial tearof the tendon fibers, which
connect muscle to bone. The tear may be at or near
where these fibers begin, on theoutsideof the elbow.

31. Causes, incidence, and risk factors
⚫Tendon - part of the muscle that attaches to a bone
⚫Muscles in forearm attach to the boneon theoutside
of elbow.
⚫When these muscles are used over and over again,
small tears develop in the tendon.
⚫Overtime, this leads to irritation and pain where the
tendon is attached to the bone.

32. Causes, incidence, and risk factors
⚫common in peoplewho playa lot of tennis orotherracquet
sports, hence the name "tennis elbow."
⚫Backhand is the most common stroke tocausesymptoms.
⚫However, anyactivitythat involves repetitive twisting of
the wrist (like using a screwdriver) can lead to this
condition.
⚫Common among
⚫ painters, plumbers, construction workers, cooks, and
butchers areall more likely to develop tenniselbow.
⚫This condition may also be due to constant computer
keyboard and mouse use

33. ⚫Tenniselbow is mostcommonlyseen in twogroupsof
people:
⚫Manual Laborers
⚫ People who work with their hands are at greater risk of
developing tennis elbow. Jobs that may lead to tennis elbow
includeplumbers, painters, gardeners, and carpenters.
⚫Sports Participants
⚫ Sports participants, especially racquetsport players, are prone
to developing tennis elbow. About a third of amateur tennis
players experience tennis elbow at some point in their careers.
In addition to racquet sports, tennis elbow is seen in golfers,
fencers, and other sports participants.

34. Symptoms
⚫Elbow pain that gradually worsens
⚫Pain radiating from theoutsideof the elbow to the
forearm and back of the hand when grasping or
twisting
⚫Weak grasp
⚫Pain over the outside of the elbow
⚫Pain when lifting objects
⚫Pain radiating down the forearm

35. Dx
⚫diagnosis is made based on signs and symptoms,
because x-rays are usually normal.
⚫Often there will be pain or tenderness when the
tendon is gently pressed near where it attaches to the
upper arm bone, over the outside of the elbow.
⚫pain near the elbow when the wrist is extended (bent
backwards, like revving a motorcycle engine) against
resistance.
⚫X-raysare rarely needed.

36. Treatment
⚫Rest arm
⚫avoid the activity thatcauses symptoms forat least 2 -
3 weeks.
⚫Put iceon theoutsideof elbow 2 - 3 timesa day.
⚫NSAIDs ( ibuprofen, naproxen, oraspirin).

37. ⚫If due to sports activity
⚫Ask aboutanychanges can make in technique.
⚫Check any sports equipmentclient is using to see if any
changes may help.
⚫Ask about how often client have been playing and
whether he/sheshould cut back.

38. ⚫occupational therapist
⚫can show exercises to stretch and strengthen the
musclesof forearm.
⚫special brace for tennis elbow
⚫Itwraps around the first partof forearmand takes some
of the pressure off the muscles.
⚫cortisone injection
⚫If the pain continuesafter 6 - 12 monthsof restand
treatment - surgery may be recommended

39. Surgical tx
⚫debridement of the diseased tissue of the extensor
carpi radialis brevis (ECRB) musclewith decortication
of the lateral epicondyle.
⚫performed through open, percutaneous, and
arthroscopic approaches.

40. http://orthoinfo.aaos.org/figures/A00068F01.jpg

41. Expectations (prognosis)
⚫Mostpeople improvewith nonsurgical treatment.
⚫The majorityof thosewhodo havesurgery showan
improvement in symptoms.

42. Complications
⚫Failure to improve with nonsurgical or surgical
treatment. This may be due to nerve entrapment in the
forearm
⚫Recurrence of the injury with overuse
⚫Rupture of the tendon with repeated steroid injections

43. Prevention
⚫Applyan ice pack to theoutsideof theelbow
⚫Maintain good strengthand flexibility in the arm
muscles and avoid repetitive motions
⚫Rest the elbowwhen bending and straightening are
painful

44. http://www.tennis-elbow.net/images/tennis-elbow-cure.gif

51. ⚫http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH00
01485/

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54. ACL Injury
Meniscal Injury
Overuse Syndrome
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65. Overuse syndrome
⚫is a condition where a part of the body is injured by
repeatedlyoverusing orexerting to much strain on that
body part.
⚫The term overuse syndrome identifies a large group of
conditions that result from using the body in a repetitious
way and causing injury by the amount it is done.
⚫These conditions are often focused on a joint and usually
affect the muscle, bone, tendon or bursa of the joint.
However other anatomical features and areas can be
stressed and theirresponse to that strain can bean injury.
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66. ⚫Somecommon examplesof overuse syndrome are:
⚫ Carpal Tunnel Syndrome
⚫ Tendonitis
⚫ Bursitis
⚫ Tennis Elbow
⚫ Trigger Finger
⚫ Blackberry Thumb
⚫ Vibration White Finger
⚫ Shin Splints
⚫ Calluses
⚫ Bunyan
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67. Bursitis
⚫A bursa is a fluid filled sac. Theyare located around
joints and reduce friction and ease movement as
tendonsor muscles passover bonesorskin.
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