D I A G N O S I S A N D T R E AT M E N T

O F S P O RT S I N J U R I E S I N E D
B O B B Y N N E LWA N , M D
O R T H O PA E D I C S P O R T S M E D I C I N E A N D A R T H R O S C O P Y
C H A I R M A N O F O R T H O PA E D I C S P O R T S M E D I C I N E A N D A R T H R O S C O P Y

S E C T I O N , R S PA D G A T O T S O E B R O T O , J A K A R TA
F O U N D E R A N D PA S T P R E S I D E N T O F I O S S M A ( I N D O N E S I A N O R T H O P E D I C
SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY)

SPORTS INJURIES

CAUSES

I N T R I N S I C FA C T O R S
E X T R I N S I C FA C T O R S

EXTRINSIC
FA C T O R

Equipment
Others players
Technique
Coaching or Instruction
Environmental Condition

INTRINSIC
FA C T O R S
Inadequate Warm up
Muscle Imbalance
Postural Defects
Overuse
Age
Poor Technique

GENERAL
ASSESSMENT
SIDELINE
H O S P I TA L

OR ED

SOFT TISSUE
INJURIES
Skin
Muscular
Tendon
Ligamentous
Bursal
Synovial

BONY
INJURIES

Fracture
Subluxation
Dislocation

SKIN INJURIES

T R E AT M E N T
Blister
Skin provides a natural barrier
Ice pack
Contusion
Ice pack
Laceration/Incision/Puncture
Stop the bleeding
Clean and Protect
Suturing

SPRAIN
LIGAMENT Injury

ACL/PCL/MCL/LCL Rupture
ATFL/CFL Rupture
pain around the affected joint
inability to use the joint normally or put
weight on it
swelling, bruising and tenderness
INSTABILITY

DEGREES OF SPRAINS
First degree
Little tearing, pain or swelling
Joint stability is good

Second degree
Broadest range of damage
Moderate to severe pain and swelling
Moderate instability

Third degree
Ligament is completely ruptured
Severe pain and swelling
Other tissues are often damaged.
Joint is unstable

STRAIN
MUSCLE or TENDON Injury

Hamstring/Biceps Muscle Rupture

Achilles Tendon Rupture
Swelling, bruising, or redness due to the injury
Pain at rest
Pain when the specic muscle or the joint in
relation to that muscle is used
Weakness of the muscle or tendons
Inability to use the muscle at all

DEGREES OF SPRAINS
First degree
Little tissue tearing
Mild tenderness, pain
Full range of motion.

Second degree
Torn muscle or tendon
Tissues; painful, limited motion;
Some swelling or depression at the spot of the injury.

Third degree
Limited or no movement;
Pain will be severe at first
May be painless after the initial injury

T R E AT M E N T

P R I C E

T R E AT M E N T

Avoid

HARM

Heat
Alcohol
Running
Massage

T R E AT M E N T

Pain Killer
Brace/Crutches
Further Examination
Send Home or Hospitalised

BONY
INJURIES

Fracture
Subluxation
Dislocation

F R A C T U R E A N D O R D I S L O C AT I O N

Closed
Open

T R E AT M E N T

Wound Care
Immobilisation

ED

Debridement
Reposition
Fixation

OT

INJURY

A C C O M PA N Y I N G D I S L O C AT I O N

Knee
Ligament Rupture
Haemarthrosis
Neurovascular injury (?)
Shoulder
Glenoid labrum injury
Hip
Acetabulum/femoral head

fracture

SHOULDER OR
H I P D I S L O C AT I O N

Reposition
Immobilisation

KNEE
D I S L O C AT I O N
Haemarthrosis
Vascular injury
Multi-ligament Injury

Knee Aspiration
Diagnosed and Treatment

Vascular problem
Immobilisation (Knee Brace)

Reposition

WILL THEY RETURN ACHIEVERS ?

TA K E H O M E M E S S A G E S

Know any injury in order to form a

precise diagnosis.
Handle the patient since court-side
Identify the cause of the injury:
Extrinsic factor
Intrinsic factor
PRICE is underlie the early action in

the emergency room

The patient will be returned

achievers again

Thank you
B O B B Y N E LW A N