A Millimetre from Death?

The six nations provided the usual mix of dazzling highs and disappointing lows and, unsurprisingly, a pretty high injury rate. I didn’t manage to catch all of the games between having to gain clinic experience and exams/coursework, but I did watch the awesome Wales vs Scotland game at the Millennium Stadium that unfortunately saw Scotland’s Thom Evans suffer a spondylolisthesis to his cervical spine. 

A spondylolisthesis refers to the slippage of part or all of one vertebra on another which can lead to compression of the spinal cord or spinal nerves. It is rare for this to occur as a traumatic injury and it normally occurs to the lumbar spine, however it is possible for it affect any area of the spine. Initially Thom was unable to move his legs but he hasn't suffered any lasting paralysis and is now back in light training. Former Lions team doctor, and current team doctor for Scotland, James Robson suggested that any further movement of his spine could have resulted in paralysis or even death. He went on to say it was the worst injury he had ever seen – which says a lot for someone in his position. Thom himself believes that he owes his life to the treatment he received from the medical staff - to read an account of the injury from Thom's perspective check out this article very interesting reading... Also have a look at this excellent article from the Scotsman which gives information about the two operations Thom has had and also the rehabilitation necessary from this injury.

Whilst injuries to the likes of David Beckham and Ashley Cole make the headlines because of the profile of the players, this injury highlights the inherent risks involved with rugby but also the excellent quality of care provided by the medical staff. Because of the lack of first aid courses that address the specific nature of the injuries experienced in rugby the RFU developed the Rugby Pitch Side Immediate Trauma Care Course that meets the needs of both doctors and Sport Therapists/Physiotherapists working within rugby. The bottom line is you cannot work at the top level in Rugby without this qualification and the game is better for it. 

On the plus side at least Thom had company in hospital after the game as Chris Patterson (hospitalised with bruising to his kidney) and Rory Lamont (MCL Tear) joined him in Cardiff University Hospital that evening... Plus he gets to listen to the support from his more famous cousin on his radio show over the course of his rehabilitation. We wish Thom all the best in his recovery and look forward to seeing him on the pitch again next season. 

www.fitforsportlinic.com

Another Blue Day...

 Another difficult day for Portsmouth FC fans - not only does the loss to Spurs leave them one game away from relegation they have a lost a further three players to injury. It is too early to tell at this stage but it looks like the injury to Hermann Hreidarsson is quite serious. After the game Harry Redknapp told the BBC "that the players heard his Achilles snap like a gunshot". Several structures can cause loud sounds when they are injured so it is difficult to gauge what is injured at this stage - we'll update you in due course. 

Avram Grant praised the  excellent work being done by the medical staff (are they being paid?) in the light of the fact that they have lost seven players to injury this week alone and they currently have 11 first team players out injured. They only managed to name 13 first team players today so unless David James and Danny Webber only have minor knocks that leaves them with only 10 recognised players for the next game. Not a good week to be a Pompey fan.


We wish Herman Hreidarsson a speedy recovery and a better week for Portsmouth fans. 

www.fitforsportclinic.com 

Time Flies....

It has only been a couple of months but what a difference it makes. Gone are the days of three matches a week instead it is 0 games (well it should be 1 but as my Sports First Aid Certificate has run out….) statistical analysis and dissertation time. Oh for the happy days of January. A lot has happened in the intervening period; David Beckham has torn his Achilles tendon, the Six Nations has been and gone, Glebe FC are top of the league and I’ve seen some really interesting injuries. Most recently I’ve observed a stress fracture of the pars interarticularis in a young cricket player who presented with classic symptoms: unilateral low back pain, pain aggravated by lumbar extension, pain on extension whilst standing on the affected leg and pain/tenderness on palpation. Doesn't get much more textbook than that. 


What is more interesting with this case and some of the others I have seen recently (hamstring avulsion, grade 3 ACL tear and a meniscus tear) is the issue of referral for diagnostic imaging to confirm the diagnosis. Almost without fail each case has been knocked back by their GP and their local A&E department despite the referral from their physiotherapist. This shows the dichotomy in the treatment of elite performers who are rushed off to see the clubs preferred specialist within days of injury and the weekend warriors who have to wait weeks or months for referrals to be acknowledged and acted upon…By next week we are hoping for some better news.

Good to see some high profile publicity for Sports Therapy of late with London Metropolitan Alumna Jo Denby on show on BBC Three looking after Eddie Izzard on his epic Sport Relief journey around the British Isles and sports therapist Ellie Steele discussing David Beckham's tendon reconstruction on the BBC.  We're taking over!

Oh and good luck to everyone at uni in their last semester - almost there!

www.fitforsportclinic.com

Zamora Dislocates Clavicle

 

Zamora being helped from the pitch.

Fulham FC striker Bobby Zamora has reportedly dislocated his right clavicle (AC Dislocation) in Fulham's midweek game against Stoke.

 

Zamora following the challenge by Stoke's Abdoulaye Faye

Having personally had the misfortune of having this injury I can vouch for the pain he is feeling. Although I can say I enjoyed the laughing gas they gave me! The AC joint is a common site of injury amongst athletes however I have not seen it reported so often in football. Having said that Zamora is the second Fulham FC striker to dislocate his clavicle in 6 months.

 I was disappointed to see that Zamora walked off the pitch with his arm unsupported, compare that to Nani's shoulder dislocation last year and you see a different approach. They have not mentioned the severity of the injury and from the photo's you cannot see if he has the marked step deformity that typifies this injury. 

If Zamora is lucky enough to have a grade I or II injury he should be fit to return in 6-8 weeks, however if he has a grade III-VI he will need  surgery to reduce the joint and enable the ligaments to heal. 

 A typical AC surgical fixation.

I had a grade IV dislocation and surgery was required however I don't imagine Zamora will need to wait 18 months for both his operations like I did. We wish Zamora all the best for his rehabilitation.


www.fitforsportclinic.com

End of the Line

You don’t hear about career ending injuries so much anymore thanks to the medical advances that have been made over the years and the ready availability of horse placenta… Well perhaps not the horse placenta – or maybe there’s something I’m missing here? More about horse placenta another time.

West Ham and England striker Dean Ashton has recently announced his retirement from football at just 26 having failed to recover from a chronic ankle injury. Ashton originally broke his left ankle in 2006 during an England training session (following a heavy challenge from Shaun Wright-Phillips) and subsequently missed the entire 2006/7 season.

He returned to play 35 games in 2007/8 and made his England debut under Fabio Capello, however in training for the new season in September 2008 he sustained a further ankle injury that has led to his recent retirement. Ashton underwent 5 operations in a bid to prolong his career and is still unable to walk properly despite extensive rehabilitation and independent medical advice. We wish Ashton all the best for the future.

Rumors in the press over recent days have suggested that Ashton may be looking to take legal action against Wright-Phillips for ending his career. Unfortunately the precedent for legal action of this type is already there. Most recently it was seen in the case of the Manchester United player Ben Colett who was awarded £4.3 million following a career ending challenge from Middlesbrough's Gary Smith despite not being a first team player.

What I found unsettling about all this is that it has filtered down to the ambulance chasers (did someone say no win no fee?) who actively advertise on their sites about how dangerous sport is and how you can claim for an injury you have received. Not good.

www.fitforsportclinic.com