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| The last column discussed what sports injuries are and how to assess their severity. This column will tell you what to do when you have an acute sports injury. The three main goals... read more |
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| Acute Sports Injuries are traumatic in nature. Some are very dramatic such as when Mike Foligno broke his leg at centre ice the season before last. Although his was a bone injury m... read more |
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Dr. Ian
Cohen |
Dr. Cohen has been practicing Sports Medicine since 1988. He has been involved in the care of amateur, elite and professional athletes as well as a far greater number of weekend wa... read more |
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Prevention | Tuesday, April 11, 2006 |
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 What is the most important concept in Sport Medicine? Without a doubt the most important thing is prevention. It is always advantageous to prevent an injury than to deal with the injured athlete after the event has occurred. Unfortunately, Sport Medicine is no different than most medicine in that we are much more geared to dealing with illness and injury than we are with preventing it. I can recall very little time in medical school spent on the prevention of disease.
It now seems that in the 90's that we are becoming more interested in prevention. We are all familiar with the concept of trying to prevent heart attacks by living a healthy lifestyle with proper nutrition and exercise. We now realize that as individuals rather than getting sick or injured, but there may be things we can do to avoid these problems. We constantly hear about controlling escalating health care costs. It is always much cheaper to prevent injury or illness than it is to treat it. Now, how does this apply to sports.
Recently my friend Dr. David Janda was in town to speak at our annual Sports Medicine meeting. Dr. Janda is the director of The Institute for Preventative Sport Medicine. He does extensive research on ways to prevent sports injuries. Once he has proven methods he is diligent to get the public to comply. His most important contribution so far is the use of break away bases in baseball. He has shown that there is a huge reduction in injury in leagues that use break away bases as compared to ones that use the traditional nailed in bases. An independent analysis by the Centers for Disease Control projected that break away bases would prevent 1.7 million injuries in recreational baseball with an estimated savings in health care of $2 billion per year. Although he has convinced many leagues to change to break away bases it is a crime that any one at all still uses break away bases. We are even worse in Canada where the use of these bags is even less.
Closer to home, Dr. Tom Pashby has almost single handedly been responsible for the virtual elimination of eye injuries in minor hockey with advent of the face mask. Even Don Cherry would have a hard time criticizing Dr. Pashby for saving so many eyes in players. In Canada CSA approved helmets and facemasks are mandatory in all minor hockey, thanks again to all the hard work of Dr. Pashby.
Sometimes it is rule changes in sport that lead to the prevention of injuries. A study in the United States in the 1970's showed that cross-body blocking was a major cause of knee injuries. When they eliminated that kind of blocking the injuries went substantially down. We have all heard of athletes becoming quadriplegic in sports. Rule changes to not permit spear tackling with the head in rugby and football have helped to greatly reduce these catastrophic injuries. We are very hopeful that trying to eliminate the checking from behind will have the same effect in hockey players.
Do not think that the pro leagues are not concerned with the rate of growth of injuries within the sport. It does not help a sport when more and more players especially the stars are off for extended periods of time or even have their careers ended by injury. Although, through better techniques we are able to treat injuries much better than even several years ago, we can not keep up to the rate of growth of injuries both in the profressional and amateur ranks.
Dr. Pashby and Dr. Janda are truly inspirational. We must follow their lead to make the practice of prevention the rule not the exception. Although we are taught and it is easier to treat athletes ""reactively"" when they already injured, it is far better to be ""proactive"" and prevent injury. Whether you are a sport medicine specialist, a coach, a parent, an educator, or a player, let us all collectively emphasize the development of preventative techniques that would lead to a reduction of injuries.
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