Treatment Tips For Common Triathlon Injuries

By Mark A. Caselli, DPM

How To Handle Strains, Sprains And Fractures
Muscle strains. These are a result of a sudden overload of the musculocutaneous unit, causing the fibers of the muscle and tendon to tear. The signs and symptoms of muscle strain include pain over the site of injury, muscle spasm and loss of strength. Although it is difficult to differentiate between mild and moderate strains, severe strains often result in palpable deformities and the absence of function.
You should manage muscle strains with rest, ice, compression and elevation. This treatment reduces tissue damage from bleeding and swelling. Crushed ice in a plastic bag, held in place with an elastic bandage, may be applied for 20 to 30 minutes every one to two hours. Take extra caution when placing ice directly over subcutaneous nerves, such as on the dorsum of the foot, to prevent damage from cold exposure. Strains that are too painful for normal walking or that cause pain when the athlete moves the injured part should be protected and rested.
Ligament sprains. Ligament sprains, especially of the ankle, are common in endurance races such as triathlons. The management of a ligament sprain depends on the degree of injury.
For first-degree sprains, you’ll see the ligament is stretched but there is no loss of continuity of its fibers. Treatment consists of rest, ice, compression and elevation until the acute symptoms subside.
When the athlete has a second-degree sprain, you’re dealing with a partially torn ligament, which causes some increased laxity to the joint. You would follow the same treatment regimen as you would for first-degree sprains, but you may need to emphasize immobilization of the injured area as well.
Athletes suffering from third-degree sprains have a completely torn ligament, which results in instability of the joint. In addition to the initial acute on-site treatment regimen, these sprains may require either a longer period of immobilization or surgical intervention.
Fractures. Acute fractures are common among cyclists and can be expected at a triathlon. In the initial evaluation of a fracture, the most important factor to identify is the integrity of the overlying skin and soft tissues. This allows you to determine whether the fracture is open (compound) or closed. In an open or compound fracture, you’ll find that the overlying skin has been lacerated by the sharp bone ends protruding through the skin or by a direct blow that breaks the skin at the time of the fracture.
You may or may not see the bone in the wound. The wound may be only a small puncture or a gaping hole exposing much bone and soft tissue. In a closed fracture, the bone ends have not penetrated the skin and no wound exists near the fracture. Compound fractures are often more serious than closed fractures because they may be associated with greater blood loss. Since the bone is contaminated by exposure to the outside environment, the wound is highly susceptible to infection.

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