Treatment for sports injuries

An overview

Acute injuries during sport or with banal injury mechanisms: fractures, muscle injuries, tendons, ligament injuries

Overuse syndrome: Overuse syndrome is often caused by a muscular imbalance that needs to be identified in addition to pain therapy in order to be able to treat it in a targeted manner.

As a sports orthopaedist, I specialize in sports injuries! Contact me for an appointment!

Cruciate ligament injury

Not every patient and not every cruciate ligament necessarily requires surgery.
This depends entirely on your individual requirements for your knee joint.

Are you young and athletic, with high sporting ambitions and not prepared to cut back on your sporting activities? Then you will clearly benefit from cruciate ligament surgery. We know from large-scale studies that very active patients with torn cruciate ligaments suffer premature destruction of the meniscus and cartilage tissue, even if no instability is subjectively noticeable. So if you play sports with a lot of rotational movements, e.g. ball sports of any kind, especially soccer, skiing or martial arts, a stable knee joint is essential.

I decide individually whether your cruciate ligament can be sutured (i.e. preserved) or needs to be reconstructed. It mainly depends on the type of tear, your age, your sporting ambitions and the location of the tear.

Meniscus tear

A freshly torn meniscus after an accident must be examined in detail. A magnetic resonance scan shows us exactly where the meniscus is torn, how large the tear is and the shape of the meniscus tear. Based on this visualization and together with the clinical examination, we can then decide whether an operation makes sense.

Not every meniscus needs to be operated on! This is an individual decision.

If surgery is necessary, I usually try to preserve the meniscus and suture the tear . The meniscus is ultimately an important structure in the knee without which premature wear and tear of the joint cartilage occurs. Due to the specific blood supply situation, the age of the meniscus tear and your own age, it is not always advisable to suture the meniscus. Therefore, damaged parts sometimes have to be removed to prevent further damage to the joint.

“Save the meniscus” is the motto. If possible, meniscus injuries should be sutured, as the pressure ratios increase exorbitantly after meniscus resection and premature cartilage damage with resulting osteoarthritis should be avoided.

Rotator cuff injuries

A tear in the rotator cuff(rotator cuff lesion) can occur as a result of an acute injury (e.g. shoulder dislocation), but degeneration or tear formation is much more common due to chronic wear and tear or irritation (e.g. impingement syndrome). This often progresses gradually and imperceptibly until symptoms suddenly appear, often as a result of minor trauma. Prolonged pain, calcification or irritation often precede the formation of tears.

In younger patients, a rotator cuff injury should be treated surgically. Partial ruptures, but especially complete ruptures (transmural ruptures) usually do not close during the course of the injury, as the traction of the affected muscle leads to further separation (dehiscence) of the tendon.

Cartilage injuries

Do you have cartilage damage and don’t know what to do?

It is always important to know how the cartilage damage occurred. Is it an acute injury or a sign of wear and tear? If a trauma has occurred, what was it and are there any concomitant injuries? Ligament instability (e.g. cruciate ligament rupture) or a missing meniscus are poor prerequisites for cartilage therapy. Similarly, an incorrect leg axis is not a good prerequisite for cartilage regeneration.

The leg axis, the meniscus status (in the case of cartilage damage in the knee joint) and ligament stability must be taken into consideration as part of cartilage therapy.

A distinction is made between conservative treatment with physiotherapy, nutritional supplements and infiltrations with hyaluronic acid or autologous plasma, and surgical treatment.

The following interventions are possible in cartilage therapy:

Runners Knee

(ITB syndrome, friction syndrome): Must always be considered in the differential diagnosis of lateral knee pain. This is an inflammation of the bursa between the femur (femoral condyle) and a fascial cord (iliotibial tract). Occurs more frequently in runners and cyclists, especially in patients with bow legs who also put the outer edge of the foot on while running. Therapeutically, in addition to stretching exercises and anti-inflammatory local and oral therapy, attention must also be paid to the correct footwear.

Jumpers knee (patella tip syndrome)

Results as an overload of the extensor apparatus and often occurs with positive and negative acceleration at the knee joint, such as in tennis, basketball, volleyball or other jumping sports. It is treated with local or oral administration of anti-inflammatory medication, but primarily with physiotherapy: transverse frictions, stretching of the extensor apparatus and restoration of the muscular imbalance. Taping and patellar tendon bandages prevent excessive tension at the tendon insertion.

Achilles tendon injuries

Achilles tendon ruptures usually occur a few centimetres above their attachment point, at the heel bone, where the blood supply to the tendon is at its worst. The acute injury is often described as a pop or noticeable tear. Clinically, a clear dent can be felt in the area of the tendon. Ultrasound can be used to determine the distance between the torn ends of the tendon, which is a decisive factor in determining whether surgery is necessary or whether conservative treatment is possible. Surgery is generally recommended for athletes.

Shin Splint

Usually referred to in medicine as MTSS (medial tibial stress syndrome) and describes a common overuse syndrome that frequently occurs in runners. It is a periostitis (periosteal irritation) caused by excessive tensile stress on the following muscles: tibialis posterior, flexor digitorum longus and soleus. Since overpronation is a risk factor and the posterior tibialis muscle plays a major role in both increased pronation and the development of “shin splint syndrome”, special attention must be paid to the position of the foot during treatment. The therapy is as follows: Training break, local cooling in the acute stage, tape bandages, physiotherapy, correct choice of sports shoes, stretching exercises

Autologous plasma therapy ACP

This is a new therapy method that can be used for tendon insertion irritation, muscle injuries and moderate osteoarthritis in the large joints. I use ACP technology in my practice as it is a closed system and no external contamination can occur. This is a significant advantage compared to other systems, as the safety of my patients is of the utmost importance to me.