Treatment Tips For Common Triathlon Injuries
- Volume 15 - Issue 10 - October 2002
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When Fractures Are Less Obvious
When you are treating any athlete who has a history of acute injury and complains of musculoskeletal pain, you should suspect a fracture. While bone ends that are protruding through the skin or gross deformity of a limb makes recognition of fractures easy, many fractures are less obvious. Tenderness in a fracture is usually sharply localized at the site of the break. You can locate the sensitive spot by gently pressing along the bone with one fingertip. This “point tenderness” is a most reliable indication of an underlying fracture.
Another good indication that there may be a fracture is the athlete’s inability to use the extremity. An athlete with a fracture or serious injury usually “guards” the injured part and refuses to use it because motion or weight bearing increases pain.
Occasionally, nondisplaced fractures are not very painful and many athletes, especially those participating in triathlons, will continue to use a painful limb and “run through” the pain. Acute fractures are also virtually always associated with rapid swelling and bruising of surrounding tissues as a result of damaged blood vessels.
The management of fractures at the on-site medical area (before sending the athlete to the hospital emergency room) is similar to that of treating severe sprains and includes ice, elevation, compression and immobilization. You should first evaluate the area for arterial circulation and nerve sensation. Cover all open wounds completely with a dry, sterile dressing and apply local pressure to control bleeding. You should splint all fractures before the athlete is moved, unless the athlete’s life is immediately threatened.
Dr. Caselli is Vice-President of the greater New York Regional Chapter of the American College of Sports Medicine and is a Professor in the Department of Orthopedic Sciences at the New York College of Podiatric Medicine.
References 1. Athletic Training and Sports Medicine. Rosemont, IL, American Academy of Orthopedic Surgeons, 1991, pp 203-223. 2. Caselli MA, Chen-Vitulli J.Foot blister prevention: What you can recommend to athletes. Podiatry Today 15 (4) 2002 3. Collins K, Wagner M, Peterson K, Story M. Overuse injuries in triathletes. A study of the 1986 Seafair Triathlon. Am J Sports Med 1989 Sept-Oct; 17(5):675-80 4. Morelli MJ, Stone DA. Bicycling. In Fu FH, Stone DA (eds) Sports Injuries. Philadelphia, Lippincott Williams & Wilkins, 2001. pp 312-319 5. Mulrean JC, Davis SM. Maxillofascial Injuries. In Lillegard WA, Rucker KS (eds) Handbook of Sports Medicine. Boston, Andover Medical Publishers, 1993. pp 33-41 6. O’Toole ML, Miller TK, Hiller WDB. Triathlon. In Fu FH, Stone DA (eds) Sports Injuries. Philadelphia, Lippincott Williams & Wilkins, 2001. pp 778-790