Sports medicine focusing more on ‘prehab’

Dr Rajan: “We are emphasising prevention

Some 90% of sports-related problems such as knee injuries, shoulder pains and joints dislocations that most athletes suffer could be prevented, a renowned Indian sports injury and arthroscopic surgeon Dr David V Rajan has observed.
He was speaking to Gulf Times in an interview yesterday during his maiden visit to Qatar to attend to patients at the Doha-based Premium Care Polyclinic.
“If only athletes could take proper precautions by listening to their body reactions while doing sports, such as pains in the knee and other joints or if they feel loss of strength in their back muscle and around their shoulder blade muscles, then majority of the problems they suffer could be prevented,” he maintained.
He buttressed his point by citing examples of loss of balance in volleyball players and fall prevention in soccer and cricket players.
Dr Rajan, who has a Sports Injury and Arthroscopic Clinic at Coimbatore and Chennai, stressed that new knowledge in the field of arthroscopy is now focusing more on ‘prehab’ (preventing rehabilitation) rather than treatment and rehabilitation.
“We are emphasising prevention for most of our athlete patients nowadays and we are making them and their coaches as well as trainers realise that preventing trauma from happening should always be their mantra,” he said.
However, in case of any injuries or trauma, he suggested conditioning including exercising, strengthening and flexibility as well as balancing as important healing factors.
“Having positive imaging of their injuries is equally important as the morale of most athletes tend to be down during this time and some of them are always in a haste to return to their games, whereas their return to sports should be gradual,” he stated citing 15 minutes of play for a soccer player.
According to Dr Rajan, only 10% of injuries sustained by sportsmen or women requires treatment while about 5% may need surgery called the ‘key hole’ surgery or arthroscopy, mostly used to treat ligament injury in soccer players.
Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision.
Arthroscopic procedures can be performed either to evaluate or to treat many orthopaedic conditions including torn floating cartilage, torn surface cartilage and trimming damaged cartilage.
“The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Instead, for knee arthroscopy for example, only two small incisions are made — one for the arthroscope and one for the surgical instruments to be used in the knee cavity,” Dr Rajan explained.
He said that the procedure reduces recovery time and may increase the rate of surgical success due to less trauma to the connective tissue.
“It is especially useful for professional athletes, such as soccer players, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions,” he explained.
The surgical instruments used are smaller than traditional instruments.
Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments and menisci or cartilage, he said.
It is technically possible to do an arthroscopic examination of almost every joint in the human body.
The joints that are most commonly examined and treated by arthroscopy are the knee, shoulder, elbow, wrist, ankle, foot, and hip.