Sports injuries

At Coffs Harbour Orthopaedic Specialists, we focus on both surgical and non-surgical treatments for sports injuries. Our goal is to help you return to your sport or activity safely and as quickly as possible. Through evidence-based practices and tailored rehabilitation protocols, we aim to optimise your recovery while minimising downtime, ensuring that you receive the best possible care for a swift and effective recovery.

Sports injuries can vary from minor sprains and strains to more complex issues like ligament tears and fractures. Our approach focuses on a comprehensive assessment to accurately identify the nature and extent of your injury. We utilise advanced imaging techniques and diagnostic tools to ensure a precise diagnosis and develop a tailored treatment plan that fits your needs.

With a passion for helping athletes and active individuals, Dr Schwass specialises in diagnosing and treating a wide range of sports-related injuries.

Why choose us for your sports injury?

The Anterior Cruciate Ligament (ACL) is one of the four major ligaments in the knee and plays a key role in stabilising the joint. It prevents excessive forward movement of the tibia (shin bone) relative to the femur (thigh bone) and is particularly crucial in sports and activities that involve cutting, jumping, or pivoting movements.

An ACL tear typically occurs during high-impact sports or activities involving sudden changes in direction, rapid deceleration, or jumps. Common causes include pivoting or twisting motions, direct contact or trauma to the knee, and landing awkwardly from a jump. Symptoms of an ACL tear include a sudden popping sound at the time of injury, followed by pain and swelling in the knee. Many individuals experience a feeling of instability, as if the knee is “giving way,” and may also have difficulty bending or straightening the knee.

Diagnosis is made through a physical examination by a doctor, who will assess knee stability and function. An MRI (Magnetic Resonance Imaging) scan is also commonly used to confirm the tear and evaluate any associated damage to other structures in the knee.

Not all ACL tears require surgery. The need for surgery depends on several factors, including the severity of the tear, the patient’s activity level, and whether the knee feels unstable. Active individuals, particularly athletes, often require surgery to return to full function. Surgery is typically recommended if the knee feels unstable during activities or if there are other injuries, such as meniscal tears.

ACL reconstruction is a surgical procedure designed to replace the torn ACL with a graft. The graft can either be an autograft (tissue taken from the patient’s own body, such as from the patella tendon, hamstring tendon, or quadriceps tendon) or an allograft (donor tissue from a cadaver). The procedure involves making small incisions around the knee to reconstruct the ligament using the graft and securing it with screws or other fixation devices.

Dr Schwass performs arthroscopic ACL reconstruction using allograft tissue, a technique designed to reduce recovery time while providing reliable knee stability. This method allows patients to rehabilitate without the discomfort and potential complications of hamstring pain or weakness, and avoids the long-term anterior knee pain often associated with autografts. By using an allograft, recovery is quicker and less invasive compared to the traditional autograft method, which involves harvesting tissue from the patient’s own body.

In cases of revision ACL surgery or for patients with ligamentous laxity, Dr Schwass also incorporates an additional procedure known as extra-articular tenodesis. This technique reinforces the knee joint, significantly reducing the risk of re-rupture and providing a more robust, long-term solution for knee stability.

The recovery time after ACL reconstruction generally takes between 6 to 12 months. During this period, physical therapy is essential to restore knee mobility, strengthen the muscles surrounding the knee (quadriceps, hamstrings, and calves), and improve stability to prevent re-injury. Rehabilitation typically progresses from basic movements to sport-specific exercises, with therapy continuing for several months after surgery.

While ACL reconstruction is generally safe, there are some risks, including infection at the incision sites, blood clots (deep vein thrombosis or DVT), graft failure, and the possibility of re-tearing the ACL. There is also a risk of stiffness or loss of knee mobility, and, though rare, nerve or blood vessel damage can occur.

Most individuals can return to sports after ACL reconstruction, provided they follow rehabilitation guidelines and allow time for proper healing. Athletes typically return to activity between 9 to 12 months after surgery, depending on individual progress and the demands of their sport. However, returning to sport too soon can increase the risk of re-injury, so a careful approach to rehabilitation is crucial for long-term success.

If you have any questions about ACL injuries or are considering surgery, Dr Schwass and his team are here to guide you through the treatment and recovery process, ensuring the best possible outcome for your knee health.

Anterior cruciate ligament (ACL) reconstruction

1. What are sports injuries?

Sports injuries are injuries sustained during physical activity, including sports and exercise. They can range from mild strains and sprains to more severe injuries like ligament tears, fractures, or joint dislocations. These injuries are common among athletes and active individuals, but they can also occur in non-athletes who engage in recreational or high-intensity activities.

2. What are common knee injuries in athletes?

Knee injuries are prevalent in athletes and can involve several structures, including ligaments, tendons, cartilage, and bones. Some common knee injuries include:

ACL injury (Anterior cruciate ligament tear):
The ACL is one of the most commonly injured ligaments in the knee, especially in sports that involve sudden changes in direction or pivoting (e.g., soccer, basketball, skiing). Symptoms include knee instability, pain, and the sensation of the knee “giving way”. Treatment can involve surgical reconstruction of the ACL, followed by physical therapy.

PCL injury (posterior cruciate ligament tear):
The PCL is less commonly injured but is often involved in sports accidents like direct blows to the knee. Symptoms include swelling, pain, and difficulty with walking or running. Treatment may involve physical therapy or surgery in severe cases.

MCL injury (medial collateral ligament sprain/strain/tear):
The MCL is commonly injured in sports that involve contact, like football or rugby, where there is a force to the outside of the knee. Symptoms include pain on the inside of the knee and instability. MCL injuries are often treated with rest, ice, compression, and physical therapy. Severe injuries may require surgery.

Postero-lateral corner injury:
Injuries to the postero-lateral corner (PLC) of the knee are often associated with high-impact sports and involve damage to structures like the lateral collateral ligament (LCL) and popliteus tendon. Symptoms can include knee instability, pain, and difficulty bending the knee. Treatment may include physical therapy or surgical reconstruction in more severe cases.

Meniscal injury (meniscal tear):
Meniscal injuries involve damage to the discs that cushions and stabilises the knee joint. These tears often occur during twisting motions, deep squatting, or direct trauma and are common in both athletes and older adults. Symptoms include joint line pain, swelling, locking or catching of the knee, and a feeling of instability. Treatment can range from rest and physical therapy to arthroscopic surgery for repair or debridement, depending on the severity and location of the tear.

Chondral injury (articular cartilage damage):
Chondral injuries refer to damage to the smooth cartilage that lines the ends of the bones within the knee joint. These injuries can result from trauma, repetitive stress, or degeneration over time. Symptoms include deep knee pain, swelling, clicking, and limited range of motion. Treatment may include activity modification, physical therapy, or surgical procedures such as microfracture, cartilage transplantation, or other cartilage restoration techniques, depending on the extent of the damage.

3. What are common ankle injuries in athletes?

Ankle injuries are very common in sports, especially those that involve quick pivots, jumps, or changes in direction.

Ankle Sprain: A sprain occurs when the ligaments in the ankle are stretched or torn. It can happen when the ankle is twisted or rolled, typically during sports like basketball or soccer. Symptoms include swelling, bruising, and pain on movement. Treatment often involves the R.I.C.E. method (Rest, Ice, Compression, Elevation) and physical therapy to regain mobility and strength. Severe sprains may require surgery.

Achilles tendon injury: The achilles tendon can become injured from repetitive stress or sudden force, often in activities like running or jumping. Injuries can range from tendinitis to tendon tears. Symptoms include pain at the back of the heel, swelling, and weakness. Treatment may involve rest, anti-inflammatory medication, and surgical repair for more severe injuries.

4. What are common elbow injuries in athletes?

The elbow is often injured in sports that require throwing, hitting, or overhead motions, such as baseball, tennis, or weightlifting.

Tennis elbow (lateral epicondylitis): Tennis elbow is a condition that results from overuse of the forearm muscles, often caused by repetitive wrist extension during activities like tennis or racket sports. Symptoms include pain on the outer elbow, weakness in the wrist, and difficulty with gripping. Treatment typically involves rest, physical therapy, anti-inflammatory medications, and in some cases, corticosteroid injections or surgery.

Golfer’s elbow (medial epicondylitis): Similar to tennis elbow but affecting the inside of the elbow, golfer’s elbow is caused by repetitive use of the muscles responsible for wrist flexion. Symptoms include pain on the inner elbow, weakness, and stiffness. Treatment typically involves rest, anti-inflammatory medications, and physical therapy.

Elbow dislocations: An elbow dislocation often occurs from a fall onto an outstretched hand or a direct blow to the elbow. Symptoms include severe pain, inability to move the elbow, and visible deformity. Treatment typically involves reduction (putting the joint back into place), followed by immobilisation and rehabilitation.

5. What are common shoulder injuries in athletes?

Shoulder injuries are frequent in sports that involve overhead motions, such as swimming, tennis, and baseball.

Rotator cuff injury: The rotator cuff is a group of muscles and tendons that stabilise the shoulder. Tears in these tendons are common in sports that involve repetitive overhead movements. Symptoms include shoulder pain, weakness, and limited range of motion. Treatment includes physical therapy and, in some cases, surgical repair.

Shoulder dislocation: A dislocated shoulder occurs when the head of the humerus (upper arm bone) comes out of the shoulder socket, often from a fall or contact injury. Symptoms include severe pain, swelling, and inability to move the shoulder. Treatment typically involves reduction (putting the shoulder back in place), followed by rehabilitation to restore strength and mobility. In cases where soft-tissues or bone are damaged from the dislocation, or where more than one dislocation have occurred, surgery may be required.

ACJ (acromioclavicular joint) injury: An injury to the AC joint often occurs from direct trauma, such as a fall onto the shoulder. It can result in a sprain or separation of the joint. Symptoms include pain over the top of the shoulder, swelling, and limited shoulder movement. Treatment ranges from rest and ice to surgical repair for severe separations.

6. What are common injuries around the pelvis in athletes?

Pelvic injuries are less common but can occur in high-impact sports or activities that involve sudden movements, twisting, or direct trauma.

Groin strain: A groin strain occurs when the muscles of the inner thigh are overstretched or torn, often in sports involving sprinting, kicking, or rapid changes in direction (e.g., soccer, football). Symptoms include pain in the groin area, swelling, and difficulty with movement. Treatment includes rest, ice, and physical therapy.
Hip flexor injury: Hip flexor strains are common in athletes who engage in running, jumping, or kicking sports. Symptoms include pain in the front of the hip, tightness, and weakness when raising the leg. Treatment typically involves rest, ice, and physical therapy.
Pelvic avulsion fractures: Avulsion fractures of the pelvis are relatively common in adolescent patients. These involve strong muscles originating around the pelvis causing fragments of bone to be pulled away resulting in a tear of the muscle origin. Symptoms include severe pain, difficulty walking, and bruising. Treatment may involve surgery or non-operative management depending on the fracture type and severity.

7. How are sports injuries treated?

The treatment for sports injuries depends on the type, location, and severity of the injury. Common treatments include:

Rest: Avoiding activities that may aggravate the injury.
Ice: To reduce swelling and pain.
Compression: Using bandages or wraps to reduce swelling.
Elevation: Raising the injured area to reduce swelling.
Physical therapy: For strengthening muscles, restoring mobility, and improving function.
Surgery: For severe injuries, such as ligament tears, joint dislocations, or fractures.

8. What is the recovery time for sports injuries?

Recovery time varies depending on the injury. Minor injuries like sprains and strains may take a few weeks, while more severe injuries like ligament tears or fractures may take several months to fully heal. For injuries requiring surgery, rehabilitation may be necessary, which can extend the recovery time.

9. How can I prevent sports injuries?

Prevention is key in avoiding sports injuries. Tips include:

Warming up before physical activity to prepare muscles and joints.
Cooling down after activity to prevent stiffness.
Strengthening exercises to improve muscle strength and flexibility.
Proper technique and form during sports to reduce strain on the body.
Wearing appropriate footwear and protective gear.
Resting to avoid overuse injuries.

Our team can help advise how to prevent injuries, as well as planning a 'prehabilitation' exercise program to maximise your session.

10. When should I seek medical help for a sports injury?

You should seek medical attention if you experience:

Severe pain that doesn’t improve with rest or ice.
Swelling or bruising that worsens.
Inability to move the affected joint or limb.
Signs of infection (redness, warmth, or fever) in an open wound.
Numbness or tingling in the injured area.

Frequently asked questions (FAQ)