An orthopaedic injury can be any injury sustained by the musculoskeletal system. It can be caused by acute trauma or chronic repetitive stress by an external source to the bones, joints, and soft tissues. While not all of them are life-threatening, addressing the injury is crucial in the healing and complete recovery of such delicate injuries.
Risk factors
The chances of sustaining an orthopaedic injury are increased in certain individuals with the following risk factors:
1. Age
Older individuals are more susceptible to orthopaedic injuries due to a lowered bone density and muscle strength.
2. Underlying conditions
- Osteoarthritis – The cartilage between two joints can be worn down over time and cause the bones within to rub together. This can lead to chronic pain and restrictions in joint movement, and may even cause muscles to weaken.
- Osteoporosis – Osteoporosis is a degenerative bone disease that can cause a decrease in bone density and mass. These weakened and brittle bones are then more prone to fractures from minor bumps or falls.
3. Physically demanding jobs
Jobs in construction or manufacturing are associated with plenty of movement and heavy lifting, which can cause repetitive stress on the joints and ligaments. This can lead to increased wear and tear on the knees and result in a higher chance of getting osteoarthritis. Workplace accidents and falling hazards are also more likely to occur.
4. Sports
Overuse of certain body parts can cause repetitive trauma over time and result in a stress fracture. Fast movements or sudden impacts can also result in more serious and acute injuries.
5. Previous injury
There is an increased likelihood of sustaining a future injury in a similar location to a previous one. This could be due to an inadequate rehabilitation of the prior injury, resulting in a weakened joint or ligament.
Common injuries
Ankle sprains often occur due to a sudden twisting motion from a fall or awkward landing that causes the ligaments to stretch beyond the normal range. They can also occur due to improper footwear choices such as slippers or high heels that offer minimal support and may cause instability when walking.
Symptoms
- Pain, swelling, and soreness at the site of injury
- Popping sound or sensation at the time of injury
- Restricted range of motion
- Ankle instability
- Pain climbing up and down the stairs
- Knees “giving way” suddenly
Managing Orthopaedic injury
Minor ankle sprains can be managed with RICE (Rest, Ice, Compression, and Elevation) and anti-inflammatory medication or painkillers.
More serious sprains that involve the complete tear of a ligament or bone fracture require professional diagnosis. In addition to a professional diagnosis and podiatric care plan, your podiatrist will also assess any underlying causes, weaknesses, and history of ankle injuries to minimise the reoccurrence of future sprains.
Orthotics
Custom foot orthotics may be prescribed to help with the improvement of balance and stability and address underlying issues with gait or foot placement that may make one more susceptible to ankle sprains as well. The proper redistribution of weight during movement also ensures that there is less pressure on the arches, and the maintenance of proper posture will reduce the strain on the ankles.
Ankle foot orthotics (AFO) may also be issued in addition to stabilise the foot and ankle as a unit and offer proper support to loose and unstable ligaments.
Extracorporeal Shockwave Therapy
Extracorporeal shockwave therapy is a non-invasive form of approach for pain relief, and can be classified into two common forms, radial and focused. Radial Shockwave impacts the skin surface at its source and the pressure waves are weakened as they travel, spreading out to the targeted superficial tissues.
Focused Shockwave is designed to induce tissue healing at a rapid rate with fast impulse, concentrated beams that boast precision and deeper penetration to target a smaller area.
Both forms may be used to effectively target superficial areas and deeper tissues where the site of injury is located to ensure a full recovery.
Physical Rehabilitation
Your podiatrist will work with you on the appropriate rehabilitative exercises for strengthening and control of muscles, and overall balance. These can be performed once the pain from your injury subsides and should be carried out dutifully to ensure that normal function can be resumed as soon as possible.
Surgical intervention
The need for surgery is rare and should only be attempted as a last resort if there is significant bone and joint deterioration at the site of injury, or if there is no improvement after an extended period of care with conservative methods.
A fracture implies that a bone is broken, and is typically caused by an acute injury or chronic trauma. Contrary to popular belief, it is still possible to walk while sustaining a fracture, which may lead some to delay due to the dismissal of its severity. However, symptoms can be felt immediately in most cases.
Common Types
Simple
A simple or closed fracture is characterised as a broken bone that does not puncture the skin.
Compound
A compound or open fracture is where one or more bone fragments break through the skin. This is classified as an urgent situation with a high risk of infection and healing complications, and professional intervention should be sought immediately.
Stress
Stress fractures occur over time due to repetitive stress on an area, and normally show up in the lower limbs due to weight-bearing. These types of fractures can sometimes go unnoticed for months without proper care due to the delayed onset or lack of symptoms.
Symptoms
- Sharp pain
- Swelling or bruising
- Deformities
- Inability to put pressure on the area
Managing fractures
An X-ray or ultrasound is needed to determine the severity of the fracture so an accurate diagnosis and care plan can be made.
Immobilisation
Depending on the type and severity of the fracture, it may be required to use casts or splints to immobilise the fracture and ensure that it sets properly.
Custom orthotics
Custom foot orthotics may be prescribed to help with the improvement of balance and stability and address underlying issues with gait or foot placement. The proper redistribution of weight during movement also ensures that there is less pressure on the injury and prevents it from reoccurring.
Physical Rehabilitation
The appropriate rehabilitative exercises can be used to promote blood flow and prevent blood clots or stiffness while the injury is immobilised. This helps to promote healing and muscle maintenance.
Extracorporeal Shockwave Therapy
Extracorporeal shockwave therapy is a non-invasive form of therapy for pain relief, and can be classified into two common forms, radial and focused. Radial Shockwave impacts the skin surface at its source and the pressure waves are weakened as they travel, spreading out to the targeted superficial tissues.
Focused Shockwave is designed to induce tissue healing at a rapid rate with fast impulse, concentrated beams that boast precision and deeper penetration to target a small affected area.
Both forms may be used to effectively target superficial areas and deeper tissues where the site of injury is located to ensure a full recovery.
Surgical intervention
Open or compound fractures that are more severe may require corrective surgery to ensure that the bones are set in place.
Knee pain can vary in levels of severity and can be attributed to various reasons such as injury, or pre-existing medical conditions that can cause wear and tear.
Common Causes
Osteoarthritis
Deterioration of cartilage in a joint can cause the bones within to rub together. This abrasion can lead to the formation of bone spurs and pain and stiffness in the area.
Tears
Tears in the knee often occur due to hard muscle contractions, or sudden impacts during sports that cause the knee to bend irregularly. Most tears happen to the posterior and anterior cruciate ligaments that cross in the middle of the knee joint, and are responsible for stabilisation and back and forth motion.
Dislocation
A dislocation occurs when the bones in the knee are misaligned due to a sudden impact or disruption. Knee dislocations are rare but serious as they can damage important ligaments, blood vessels, and nerves.
Symptoms
- Inability to bear weight on the affected knee
- Swelling
- Deformities
- Inability to fully extend the knee
- Popping noises
Managing Knee Pain
Knee pads and braces
Knee pads and braces are the most common types of knee support and can be used for stability, strength, flexibility, and the prevention of knee damage during sports. They can also be used for the rehabilitation of knee injuries to unload weight on the damaged knee when pain is felt.
Orthotics
Custom foot orthotics may be prescribed to help with the improvement of balance and stability and achieve realignment by correcting the unnatural rotation of the lower leg. The proper redistribution of weight during movement also ensures that there is less pressure on the painful knee joint.
Extracorporeal Shockwave Therapy
Extracorporeal shockwave therapy is a non-invasive form of solution for pain relief, and can be classified into two common forms, radial and focused. Radial Shockwave impacts the skin surface at its source and the pressure waves are weakened as they travel, spreading out to the targeted superficial tissues.
Focused Shockwave is designed to induce tissue healing at a rapid rate with fast impulse, concentrated beams that boast precision and deeper penetration to target a smaller area.
Both forms may be used to effectively target superficial areas and deeper tissues where the site of injury is located to ensure a full recovery.
Physical Rehabilitation
Low impact exercises like gentle stretching can ease pain, strengthen muscles, and reduce stress and impact on the knees.
Surgical intervention
Knee arthroscopy is performed where conditions involving damage to the cartilage and soft tissues do not respond or have responded poorly to non-invasive managements. This procedure involves the insertion of a small probe with a camera to assess the damage. Long and thin surgical instruments are then inserted from a second incision site for the removal or replacement of torn ligaments, tissues, and cartilage.
A partial knee replacement only involves the removal of damaged bone and cartilage, leaving the healthy portion untouched. Removed areas are replaced with materials such as metal, ceramic or plastic, and preserves the natural anatomy of the knee. A successful partial replacement can delay or prevent the need for a total knee replacement.
A total knee replacement is usually considered when significant damage has been done and involves the complete removal and replacement of the femur, tibia, and kneecap. A successful total knee replacement surgery can provide substantial improvement in overall quality of life and may last up to 20 years, depending on the age of the patient at the time of surgery.
Tips for Preventing Orthopaedic Injuries
1. Stay fit
Strong muscles and joints are key to preventing injuries and can slow down or prevent the development of conditions like osteoarthritis. Take care to practice proper exercise techniques and that your body is supplied with adequate nutrients for healthy bones and joints.
Warm-ups
Jumping straight into a workout without a proper warming-up routine can increase the risk of muscle cramps, strains, and tears. Start slow with dynamic stretching and proceed with light physical activities that increase gradually in intensity.
Develop a strong core
Although often termed as a “six-pack”, your core consists of the diaphragm, pelvic floor, and multiple layers of abdominal muscles. A strong and stabilised core helps improve balance, coordination, and overall posture. Exercises like yoga and Pilates are excellent for strength training and minimising the risk of spine injury.
Work on your form
Take care to prioritise proper technique, especially when starting a new sport or exercise routine. Nailing basic posture and form before advancing to more complex movements can help minimise the risk of injury.
Incorporate a multifactorial exercise programme
All-rounded workout routines should consist of cardiovascular, strength, balance, and flexibility exercises, like Tai Chi. If you are new to strength training, it is advised to progress slowly from bodyweight to resistance bands and weights. The recommended cardiovascular exercises include walking, running, and swimming, while aerobics and resistance training are recommended for balance and flexibility.
Eat a nutrient-rich diet
A diet rich in calcium and vitamin D can help promote bone strength, while foods like whole grains, beans, and lentils have anti-inflammatory properties. Take care to limit the intake of processed and high salt content foods which can speed up the loss of calcium in the body.
2. Listen to your body
A personalised exercise programme that is tailored to your age, fitness level, and conditions ensures that the benefits of every workout are maximised. It is also important to know your boundaries, if unusual pain is felt during or after the workout, rest and consider lowering the weight or substitute certain exercises with others.
3. Proper footwear
Ensure that your shoes fit well and provide the appropriate arch support for the intended activities. Minimise the wearing of flip flops and high heels that do not offer as much stability and make it easier to sustain injuries.
4. Go for regular health check-ups
Older adults that are more susceptible to conditions like osteoporosis and osteoarthritis should take care to go for yearly check-ups to reduce the risk of orthopaedic injuries.
Orthopaedic injuries can lead to debilitating pain and serious complications if left unaddressed. If prolonged pain and discomfort persist even after the application of home remedies, consult your podiatrist and seek professional attention promptly.
