Sports Injury Q&A
 Whether
you're a professional football player or a backyard badminton enthusiast, Paul
D. Fadale, MD, chief of sports medicine and an orthopedic surgeon at
Rhode Island Hospital, and an associate clinical professor at Brown
University Medical School, has answers to your questions about sports and
injury.
What are the most common injuries you treat?
Knee injuries, particularly anterior cruciate
ligament injuries and cartilage tears, are
particularly common.
What causes cartilage or ligament injuries?
Any twisting or turning event can cause an injury. Commonly, sports
activities and other accidents are to blame.
Which joints tend to be the most susceptible
to injury?
I think most physicians would agree that the knee is most susceptible
to injury because it sustains most of the pivoting and jerking motions
associated with sports activities. Amazingly, as more women become
involved in sports we're finding that women are at a significantly
higher risk-more than 5 times greater risk than men, according to some
studies-for ligament tears, especially ACL injuries.
When is surgery necessary?
For ligament tears, I recommend surgery if the patient has done further
damage to the joint because the knee feels "sloppy" or is
unstable. For cartilage repairs, surgery is necessary when the patient is
in constant pain. Of the 4,000 knee injuries I evaluate each year, several
hundred require surgery.
What is the recovery time after surgery and
what does it entail?
The average recovery time after cartilage surgery is two to four weeks.
Ligament surgery typically requires a much longer
recovery time, usually four to six months.
Are the treatments for children any different
than those for adults?
Cartilage and ligament injuries in children are rare, but they do
happen. Children require different treatment because their bones are still
growing, and adult surgical procedures would affect the bone's growth
plate. Surgically sewing in cartilage can repair cartilage injuries in
children, but ligament surgery must wait until the child is a teenager, so
we usually brace the leg and wait until surgery is possible.
What are some precautions people can take to
avoid ligament and cartilage injuries?
There is no gadget or gizmo you can attach to your body to prevent a
cartilage or ligament injury. Even braces have not been shown to
effectively prevent injury. Early studies on training programs that teach
athletes safer ways to jump and land are promising. There is also some
evidence that strengthening muscles and stretching before physical
activity can help prevent injury. The best advice I can give an athlete is
to stay within their "zone." For example, it's tempting if you're
a skier to try to tackle a black diamond, but if you haven't worked up
to that skill level, it's an accident waiting to happen. Getting in over
your head can cause strain and excess fatigue that may lead to injury.
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