Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

Damaged hips can cause great distress in carrying out daily activities, such as walking, getting dressed and many more. If you have damaged one or both of your hips, and it causes you great pain, you may require a hip replacement. It is a common form of surgery in which a damaged hip joint gets replaced with an artificial one. This is known as prosthesis.

Conditions which lead to hip replacement

Osteoporosis where the cartilage inside a hip joint gets worn out, and the bones rub with each other as a result
Rheumatoid arthritis, which is caused when the immune system attacks the hip joint lining by mistake
If the hip joint gets damaged severely during an accident or fall
The purpose of a replaced hip joint is to provide pain relief, improve the hip s function, improve your ability to carry out day-to-day activities and improve your overall quality of life.

Procedure
A hip replacement is usually carried out under general anesthesia. An incision is made in the hip by the surgeon and the damaged hip joint is removed through it. It is replaced with an artificial metal alloy or a ceramic joint. The surgery takes approximately 60 to 90 minutes for completion.

Recovery
After the surgery, a walking aid such as crutches is required for up to four to six weeks. You may enroll for an exercise program, which aims at regaining and improving the new hip joint functions. Regular activities can be restored within two to three months. A year is required for utilizing the new hip joint normally.

Risks of hip replacement
There may be several complications as a result of a hip replacement. They include:

Dislocation of the hips
Infection at the surgery wound
Injury to nerves and blood vessels
Difference between the lengths of two legs
Fractures
Alternative
Hip replacement surgery has an alternative type of surgery, which is called hip resurfacing. During this surgery, the damaged surfaces of the bones within the hip joint are removed and replaced with a metal surface. Less bone is removed in this surgery. However, the metal surface may cause complications and health hazards.

Hip replacement is being improved upon with the advent of technology. Stronger and newer materials are being developed for prosthetics, which will allow enhanced joint mobility and a longer wear. New cement-less implants are also being developed. Also surgery assisted by computer is being used for generating an image of the hip joint.

 Hip Replacement - An Overview!

Sciatica is a very common neuropathic pain that is caused by damage to the sciatic nerve, a large nerve that runs from the lower back region down the end of each leg. It is the largest single nerve in the body.
This condition affects around 4 out of 10 people at some point of their lives. The nature of the pain varies from a mild ache to a sharp stinging sensation and may cause feelings of numbness and extreme weakness.

Causes of sciatica
The causes for the onset of sciatica are numerous. Some of them are as follows:
-slipped lumbar disc
-muscle inflammation
-internal bleeding
-pregnancy
-obesity
-awkward sleeping position
-uncomfortable footwear
-spinal injury

How can physical therapy help?
There are many ways of treating sciatica, such as medication, acupuncture and surgery, which can provide relief. The most common and easy treatment method however is physical therapy. A progressive and controlled exercise routine that is specifically tailored to the nature of the condition in consultation with a physical therapist acts as an effective remedy in treating the problem. It alleviates pain and also eliminates the chances of relapse.

Physical therapy exercises used to treat sciatica are of many types. They are a combination of core strengthening, muscular stretching and aerobic conditioning routines, which aim at correcting the root of the problem.

The different types of exercises employed to treat sciatica include the following:
Strengthening exercises
These aim at strengthening the spinal column and the pelvic region, which includes the hips and buttocks. They help in making the muscles and ligaments in this region more robust and allow for improved flexibility and support. Lunges and squats are some of the examples.

Stretching exercises
These provide pain relief through improved agility and flexibility. The most important aspect of these routines is stretching and exercising the hamstring. Hamstring, stretches, calf stretches and tricep stretches are a part of stretching exercises.

Aerobic conditioning
These are cardiovascular exercises of low intensity, which provide pain relief through the release of endorphins and the facilitation of fluid and nutrient exchange. Examples of these are swimming and brisk walking.

Reduce Sciatica Pain With Physical Therapy

Shin splints' is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.


Causes
When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.


Some other causes of shin splints are 
1. Muscle imbalance in the glutes or the thighs
2. Anatomical deformity such as flat foot
3. Not using proper form during training
4. Lack of flexibility
5. If you wear improper shoes during workouts, then it may lead to shin problems
6. Running downhill may lead to excessive stress on the shin leading to shin splints


Symptoms
The symptoms of shin splints are: 
1. You may experience swelling in the lower leg
2. A dull pain in the front portion of the leg
3. Tenderness around the shin area
4. Numbness around the shin area
5. Inflammation in the shin area
6. You may experience severe pain while walking


Treatment
The basic treatment for shin splints is the rice (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition.

Causes and Symptoms of Shin Splints

A fall or an injury is among the most common causes of a fracture. For a fracture to heal; the bones must be set in the correct position and a cast may need to be worn so as to hold them in place. This allows the bones to grow new tissue and bridge the break. The food you eat can help you speed up this process. Some of the best foods to build strong bones and help a fracture heal are:

Milk: Milk is one of the richest sources of calcium and vitamin D. It is also rich in proteins. These three elements are crucial to building strong bones. Proteins help the body release amino acids which in turn come together and create new tissue for the bones. Calcium is, of course, the building block of our bones. However, it is vitamin D that enables the body to absorb this calcium and utilize it. If you do not like the taste of milk, you could substitute it with yogurt. This dairy product is considered equally rich in proteins, calcium and vitamin D. In addition, it also contains amino acids such as glutamine and lysine that helps the bones absorb calcium.
Kale: Kale is known as a superfood. One of the reasons for this is the amount of calcium it contains. Kale is one of the few vegetables that are rich in this mineral. Thus, lactose intolerant people can get their required calcium from this vegetable. Kale can be eaten raw or cooked. Kale can also be juiced. However, to benefit fully from the vitamins and minerals in this vegetable, it is best to eat it raw.
Spinach: Spinach is another green leafy vegetable that is rich in calcium. It also contains zinc. Zinc helps stimulate the chemical reactions needed to bind calcium and other minerals together to create new bones. In addition, spinach is also a rich source of vitamin K. While this vitamin does not play a direct role in healing bones, it helps speed up the healing process.
Broccoli: Broccoli is a cruciferous vegetable that is rich in vitamin K1. This is very beneficial to your overall health and bone health. Vitamin K1 aids in the mineralization process of fusing broken bones together and building new bone tissue. Thus, it helps the bones set correctly.
Citrus Fruits: Fruits such as oranges are chock-full of vitamin C. This nutrient helps build a strong immune system and aids in the fracture healing process. Vitamin C also helps the body create collagen that surrounds the broken bones and allows it to heal faster.

Food Items That Help You Recover From Fractures!

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

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