From the ten Belgium inhabitants, seven participated in sports activities in 2018, an increase of almost twenty percent in comparison to 2011, when only five out of the ten actively engaged. Sport is healthy, it is beneficial that the general participation rate is going up, leading to e.g. healthy ageing and overall well-being, but accidents happen. The risk of developing an injury in a sports context is significant. According to sources examining incidence rate, such as ‘VeiligheidNL’, an estimated two injuries occur over the cause of a thousand hours’ sports practice. This seems reasonable, but adding these numbers leads to 3.7 million injuries on a yearly base for the Netherlands. With almost half of these injuries requiring intensive treatment, it almost becomes contra-intuitive to conclude that the costs outweigh the benefits.
Success is no accident but likely goes hand in hand with sacrifice and a lot of accidents. Multiple inspiring quotes by famous athletes lead to the belief that injuries occur only on the highest level and are almost necessary to achieve great success. It is true that competitive athletes are more frequently injured due to their intense training regimens but statistics show that the average Joe also acquires his share. Especially kids, who are still physically growing and developing are at high risk of acute or developmental disorders. Due to the broad range of sports and their dynamic character, multiple types of possible injuries can occur. Abrasions, bruises, bursitis, cuts, dislocations, elongations, fractures, sprains, strains, tears, tendonitis. A wide spectrum of distortions all with their respective treatment possibly including immobilization devices.
This article will provide an overview of the most prevalent injuries in sports, benefitting from orthosis implementation in treatment.
Estimations considering the prevalence of the ankle sprain vary from 17-30 percent of all sports injuries. With the incidence being so high, and the literature on this topic so overwhelming
it is necessary to include the ankle sprain in this overview, even though treatment does not necessarily include orthosis implementation. Conservative treatment of the ankle sprain can be done by one of two approaches. Functional rehabilitation is associated with faster return to physical activity and the activities of daily life, which led to the conclusion that functional rehabilitation has a preferable approach over cast immobilization. No doubt considering this approach exists for grade I and II sprains, but for grade III, the most severe variant, no consensus in literature has been reached yet. The popular belief is to neglect casts and immobilization in ankle sprain treatment although multiple review papers show mixed conclusions. Future research should focus on the newest techniques and treatments, e.g. Brostrom surgery with the respective immobilization cast used during revalidation.
Another frequent lower limb injury is the development of shin splints, approximately 13-17% of all running-related injuries. This overuse injury is regularly seen in an individual’s life who decides to shift from a rather inactive behavior to an active lifestyle, but it can happen to anyone, at any time. The faint pain along the inner edge of the tibia is caused by repetitive trauma to the surrounding muscle tissue. As for most of the sport trauma’s RICE, Rest, Ice, Compress and Elevate is one of the initial treatments, but this is especially interesting for shin splints since it is an inflammation injury. Braces are a commonly seen external medical remedy but also rigid orthosis and insoles are beneficial. They support the foot and correct biomechanical irregularities possibly causing the stress overload.
High demanding sports with a lot of twisting and turning are the origin for many knee problems and notably the anterior cruciate ligament tears. A rapid direction or speed change and direct contact can lead to completely rupturing the ligament. Individual needs determine the treatment but a completely torn ligament will not heal without surgery. Older patients may opt for a non-surgical, bracing based treatment with respect to their less active lifestyle but the active exercisers benefit from surgery.
Non-surgical and post-operative treatment integrates bracing strategies, but research is still ongoing whether these techniques restore normal biomechanics and protect the reconstructed ACL. Multiple hinged, as well as flexible braces, are on the market all with their specific positive and negative aspects. The dynamic posterior drawer brace has proven to improve the anterior knee laxity in comparison to functional rehabilitation without surgery.
Fracture incidence differs sport specifically, but an overall trend towards upper limbs damages can be extracted.
Repetitive movement of the patella against the thigh bone might damage the tissues underneath the kneecap resulting in the patellofemoral pain syndrome, also known as a runner’s knee. Runner’s knee is a collective name and also includes the iliotibial band syndrome, resulting from tendon friction lateral on the knee. Again, joint immobilization is not the primary treatment but application of orthosis can be a useful tool to heal and help prevent the problems resulting from a runner’s knee in the future. Insoles, for example, correcting the stance has proven to fasten the recovery and return to sports on the short term.
Movements requiring a shortening and elongation of the thigh adductors may result in a so-called groin pull. Kicking with the dominant leg is a frequently seen cause, but generally falls, or the lifting of heavy objects has also been reported as possible motives. Grade III injuries or groin pulls with damage to tendons might benefit from surgery with integrated bracing therapy afterward. Braces are likewise adopted by the less severe damages and non-surgical treatable disorders.
Muscles and tendons in the back of the thigh, popularly known as the hamstrings, are treated similarly. Braces are adopted in treatment and as preventive protection against recurrence.
Epicondylitis can express itself on the lateral and the medial side, respectively known as tennis - and golfers -elbow. The chronic tendinosis emerges from excessive use of the forearm muscles and results in 1.3-3% lateral and 1-5% medial cases in a sample population (30-64 yrs old). Braces and sleeves show immediate improvement but best results are obtained by implementation of the counterforce orthosis.
Fracture incidence differs sport specifically, but an overall trend towards upper limbs damages can be extracted. Distal radius and carpal bone fractures can occur during any activity in which the athlete accidentally falls and tries to break their fall to the ground. Include a high speed and a slightly better falling technique the collarbone becomes the next target. A fall to the shoulder, as often seen in competitive cycling, can lead to a fractured clavicle. Immobilizing casts around the clavicle cannot be placed accurately enough but most of the other sport induced fractures greatly benefit from immobilizing orthosis.
The contents of this article may not be used as a treatment prescription, they are written to offer an overview of possible orthoses implementation in common sport injuries. Always contact your general practitioner or doctor.
Anterior Cruciate Ligament (ACL) Injuries - OrthoInfo - AAOS. (2019). Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/
Brostrom L. Sprained ankles: V. Treatment and prognosis in recent ligament ruptures. Acta Chir Scand. 1966; 132: 537-50
Jacobi, M., Reischl, N., Rönn, K., Magnusson, R., Gautier, E., & Jakob, R. (2016). Healing of the Acutely Injured Anterior Cruciate Ligament: Functional Treatment with the ACL-Jack, a Dynamic Posterior Drawer Brace. Advances In Orthopedics, 2016, 1-7. doi: 10.1155/2016/1609067
Petersen, W., Rembitzki, I., Koppenburg, A., Ellermann, A., Liebau, C., Brüggemann, G., & Best, R. (2013). Treatment of acute ankle ligament injuries: a systematic review. Archives Of Orthopaedic And Trauma Surgery, 133(8), 1129-1141. doi: 10.1007/s00402-013-1742-5
Pijenburg ACM, van Dijk CN, Bossuyt PMM, et al. Treatment of ruptures of the lateral ankle ligaments: a meta-analysis. J Bone Joint Surg. 2000;82-A:761–73.
Vicenzino, B., Collins, N., Crossley, K., Beller, E., Darnell, R., & McPoil, T. (2008). Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: A randomised clinical trial. BMC Musculoskeletal Disorders, 9(1). doi: 10.1186/1471-2474-9-27
What is the prevalence of ankle sprains?. (2019). Retrieved from https://www.medscape.com/answers/1907229-95137/what-is-the-prevalence-of-ankle-sprains