Sports medicine is a subspecialty of orthopedics that deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate the injury so patients can return to their favorite activities quickly, whether it’s Little League, recreational play, or a high school, college or professional sport.
ACL (anterior cruciate ligament)
The ACL (anterior cruciate ligament) is one of the most commonly injured ligaments in the knee. Running diagonally through the middle of the joint, the ACL works together with three other ligaments to connect the femur (upper leg bone) to the tibia (lower leg bone). People who play sports that are likely to damage the knee—such as basketball, football, skiing and soccer—are at greatest risk for injuring the ACL. Only about 30% of ACL injuries result from direct contact with another player or object. The rest occur when the athlete decelerates while cutting, pivoting, or sidestepping; lands awkwardly; or plays recklessly. About half of ACL injuries are accompanied by damage to the meniscus, cartilage, bone or other ligaments in the knee.
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Made of cushioning cartilage, the C-shaped meniscus performs many functions in the knee: it stabilizes the joint, helps it carry weight, facilitates turning in many directions, and keeps the femur (thighbone) and tibia (shin) from rubbing together. Athletic injury (trauma) or weakened tissue associated with aging or illness (degeneration) can tear the meniscus. Movements most likely to result in a meniscal tear are twisting the knee, pivoting, cutting and rapidly decelerating. A meniscal tear may occur at the same time as an ACL tear.
The shoulder is a "ball-and-socket" joint where the "ball" is the rounded top of the arm bone (humerus) and the "socket" is the cup (glenoid) of the shoulder blade. A layer of cartilage called the labrum cushions and deepens the socket. A dislocation occurs when the humerus pops out of its socket, either partially or completely. As the body's most mobile joint, able to move in many directions, the shoulder is most vulnerable to dislocation.
One of the most common causes of shoulder pain, impingement occurs when the front of the shoulder blade rubs against the rotator cuff as a person lifts his/her arm. The rotator cuff is a group of muscles and tendons that stabilizes the shoulder and permits lifting and rotating movements. If the rotator cuff weakens or is injured, the bone of the upper arm (humerus) can lift up, pinching the rotator cuff against the shoulder blade. The muscles can then swell further, creating a vicious cycle of pain and weakness that will not improve without intervention.
A shoulder is deemed unstable when it frequently dislocates or slips partially out of joint (subluxation). People with unstable shoulders may experience pain and limited motion in the joint and feel that moving in the wrong way will cause their shoulder to dislocate, which in turn may discourage them from participating in sports such as swimming, volleyball and baseball.
Shoulder instability most often develops from a traumatic injury such as a football tackle that stretches or tears the ligaments in the shoulder, or from a naturally loose joint capsule that does not hold the ball of the humerus tightly in its socket. Younger patients who experience a traumatic dislocation are more likely to develop shoulder instability.