Sports Surgery

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Sports Surgery

• Mr Roger G Hackney
• FRCS (Orth) FFSEM (UK)
• Dip Sports Med
• Consultant Upper Limb Surgeon
• Honorary Senior Lecturer

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Training in Sports Medicine

• Faculty of Sports and Exercise Medicine
• Diploma/MSc in sports medicine
• University of Bath distance learning
• Sheffield, Wales, London
• Specialty training, 4 years London, Nottingham,
  sports physician
• Sports surgery, no formal training in UK
• Area of anatomical special interest
• Fellowship overseas

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Whats different about sports surgery?

• Some injuries not seen in general population,
  mechanism of injury
• Motivation
• Better yesterday
• Excuse for not competing cf kids
• Rehabilitation ends when fit to compete
• Need to understand the sport fully
• Not just dealing with high profile athletes
• Need to be a sports physician too!

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Sports surgery

• Advances in care for all patients
• Surgical
• Arthroscopic (keyhole) surgery
• Soft tissue knee surgery
• Shoulder surgery
• Tendinopathy
• Rehabilitation post surgery
• Anterior cruciate reconstruction
• Achilles tendon rupture

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Sports Physician/Surgeon

• Know the sport
• Training techniques
• Coaching techniques
• Technical aspects
• Equipment
• Helmet design in American football
• Rules of the sport
• Rugby scrum

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Running
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Shin splints!

• Chronic compartment syndrome
• Failure of compartment to expand with increased
  blood flow
• Shuts off outflow
• Increased pressure stops fluid/nutrient exchange
  at capillary level
• Muscle can die!
• Conservative measures dont work
• Treat by simple compartment release

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Shin Pain

• Medial tibial periostitis
• Site different to anterior compartment syndrome
• Insidious onset, severe pain
• Bone scan shows increased uptake
• Pathology uncertain
• Treat by modified training, insoles, expert
  rehabilitation to improve gait, muscle balance,
  core stability
• Surgery rarely used

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Shin pain

• Stress fracture
• Severe pain
• Can complete
• Treat with rest,
• modified activity,
• surgery

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SHOULDER AND ELBOW
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Throwing Sports

• Baseball pitcher
• Quarterback
• Racquet sports Tennis/Squash/Badminton
• Serve, smash, overhead
• Javelin
• Cricket ball
• Discus
• Hammer
• Shot putt
• KNOW YOUR ATHLETE/EVENT

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Throwing Injuries

• Throwing is a sequence of movements
• Kinematic chain
• Foot, Ankle, Lower leg, Knee, Thigh
• Groin, Hip, Pelvis,
• Trunk, Spine
• Shoulder, Elbow, Wrist, Hand, Fingers
• Injuries from training and throwing
• Running, weight training, plyometrics,
• Stretching