Sports medicine: diseases — симптомы, диагностика и лечение

The lateral, or collateral, ligaments run along the inner and outer surfaces of the knee and prevent the tibia from deviating to the sides. The internal ligament is damaged much more often: a blow to the outside of the knee or twisting of the leg when the shin goes out is enough. This is a typical injury for football players, skiers and wrestlers, but it also occurs in everyday life when falling. The good news is that the internal ligament has a good blood supply and in most cases heals without surgery. Another thing is important: with a severe injury, the cruciate ligaments and menisci can be damaged at the same time, and damage to the external ligament is often accompanied by injury to the peroneal nerve.

The Achilles tendon is the most powerful tendon in the body; it connects the calf muscle to the heel bone and is responsible for propulsion when walking, running and jumping. The rupture most often occurs suddenly, with a sharp start or jump, in people 30–50 years old who returned to sports after a break. The person feels a blow or click from behind above the heel, as if someone had hit him with a stick, and cannot stand on his toes. The pain is sometimes moderate, so the injury is often mistaken for a sprain. The missed gap heals with elongation, and the leg forever loses its repulsion force, so an examination by a traumatologist is needed in the first days.

The biceps brachii muscle is attached by two tendons above, at the shoulder joint, and one below, to the radius bone of the forearm. A rupture can occur in any of these places, but the consequences are different. A rupture of the long head at the top usually occurs in people over fifty due to long-standing wear and tear of the tendon: the muscle slides down and forms a characteristic roll on the shoulder, and strength is almost not affected. Severance of the tendon below, at the elbow, more often occurs in middle-aged men with a sharp lifting of weight and leads to a noticeable loss of flexion strength and especially rotation of the forearm. This option usually requires surgery, and in the early stages.

Osteochondritis dissecans is a condition in which a small area of ​​bone under the articular cartilage loses nutrition and separates along with the cartilage covering it. Most often, the medial condyle of the femur in the knee is affected; less commonly, the trochlea of ​​the talus in the ankle and the head of the condyle of the humerus in the elbow are affected. Mostly teenagers and young adults who are actively involved in sports are affected. While the fragment remains in place, vague pain and swelling after exercise are bothersome. If it separates, a loose body appears in the joint - the so-called joint mouse, which causes clicking, jamming and damage to the cartilage. In children with unclosed growth zones, the defect often heals on its own; in adults, surgery is more often required.

A knee sprain is damage to the fibers of one or more ligaments that hold the joint stable. Most often, the internal collateral ligament is affected when there is a blow to the outside of the knee and the cruciate ligaments when the body is sharply turned on a fixed foot. The severity of the injury is assessed by degrees: from micro-tears without loss of stability to a complete rupture, in which the joint becomes loose. Immediately after the injury, the knee swells, hurts and bends worse, and when the cruciate ligament is damaged, many people hear a click and feel that the knee has twisted. Correct tactics in the first days and subsequent rehabilitation determine whether the knee will return to its previous load.

The iliotibial tract is a dense band of tendon along the outer surface of the thigh that runs from the pelvis to the tibia and stabilizes the knee when running and walking. With repeated flexion and extension, its lower part compresses the soft tissue above the outer femoral condyle, and irritation and pain develop there. This is one of the most common causes of pain on the outside of the knee in runners and cyclists. A characteristic feature is that the pain appears at approximately the same distance or time of running, forces you to stop and quickly subsides with rest, only to return at the next workout. The condition does not destroy the joint, but without changing the training plan and strengthening the pelvic muscles, it stubbornly returns.

Tendinitis is damage to the tendon that occurs when a load exceeds the tissue's ability to recover. The tendon connects the muscle to the bone and works like an elastic spring, but with frequent similar movements, micro-tears accumulate in it. There is pain at a certain point, stiffness after sleep and a feeling that the tendon is “developed” at the beginning of the movement. The most commonly affected areas are the Achilles tendon, rotator cuff tendons, elbow, knee and wrist. Modern research shows that in most cases this is not classical inflammation, but tissue restructuring, so it is not rest and injections that work best, but a gradual dosed load.

Achilles tendonitis is a painful condition of the body's strongest tendon, which connects the calf muscles to the heel bone. Despite the usual name with the ending indicating inflammation, tendinopathy is more often the basis: overload leads to microdamage and restructuring of tendon tissue without classic inflammation. The typical picture is pain and morning stiffness in the area a few centimeters above the heel, which intensifies at the beginning of the load, subsides briefly when warming up and returns after training. The condition responds well to treatment, but requires time and regular exercise; If ignored, the risk of tendon rupture increases.

Chondromalacia patella is softening and damage to the cartilage on the inner surface of the kneecap. The patella slides along the groove of the femur, and if it moves off-center, the cartilage experiences excess pressure in one area. The pain is felt around or under the kneecap and worsens when going down stairs, squats, running, or after sitting for a long time with bent legs. Crunching and clicking sounds are often heard. The condition is especially common in teenagers, runners, and people who have increased their workload dramatically. In most cases, it is not rest or surgery that helps, but a properly selected exercise program.