Behind the Bench

Don Winsor
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Fracture factor, tender tendons

To experience absolute pain from participating in sport one needs to visit one of the areas above. Both of these injury types are extreme when it comes to pain.

The agony of defeat is a minor inconvenience compared with the popping sound of a tendon exploding. A tendon rupture is a separation of a tendon from the bone or muscle, or a complete tear in the tendon itself. Bone and muscle separations are the most common tendon injuries.

Tendon ruptures are usually caused by, and the result of, sudden violent contractions. They occur in sprinters, hockey players, soccer players, and athletes in other sports where sudden bursts of speed are required. When an athlete ruptures his/her tendon, you generally can hear a pop. The pain is so severe that the athlete writhes in pain and holds the affected muscle in a contracted position.

A good safeguard is to routinely stretch the Achilles tendon. To do this, stand about three to four feet from a wall, lean forward so that you are at an angle, with your heels raised. Gently push your heels toward the ground. If a tendon rupture occurs, or is suspected, consult physician immediately. In the meantime apply RICE.

A complete fracture is a break in a bone that separates the ends. Complete fractures are usually the most painful of all athletic injuries. The jagged ends of the separated bones contain a rich supply of nerves and when they rub against each other, or any other tissues, they cause extreme pain. The pain and swelling can continue for weeks or months.

Complete fractures require expert medical treatment. The sharp edges of a broken bone can cut a nerve and leave you paralyzed, can sever a blood vessel and cause you to bleed, and cut through the skin and open a door of entry for germs.

While some complete fractures of the small bones of the hands and feet heal by themselves, those of large bones of the arm and legs often do not and should be checked immediately by an orthopedist. He will line up the bones properly so that they can heal without complications. This often requires taping, splinting, casting, or traction. Complete fractures can take one to six months to heal, depending on the extent of the fracture, the treatment, and the absence of complications.

“When an athlete ruptures his/her tendon, you generally can hear a pop. The pain is so severe that the athlete writhes in pain and holds the affected muscle in a contracted position.”

The final fracture is the troublesome stress fracture. These are slight cracks in the surface of the bone. The most common areas are the bones of the feet, legs, and hands. Sometime, if you see me around, just ask me about a particular stress fracture in the instep on my left foot. How can you tell that you have a stress fracture? Use the finger test. A stress fracture usually hurts when you press on it with your finger, both from above and below, while a tendon or ligament usually hurts only on pressure from one side.

X-rays usually are not sensitive enough to pick up small cracks in bones. It is not until two or three weeks later, when a callus - a layer of bone material - forms over the crack that an x-ray diagnosis of a stress fracture can be made. By this time, if you rested the fracture, the pain should have abated.

A sports medicine physician usually will not apply a cast to the injured area. Stress fractures heal by themselves in most cases. The immobilization caused by the cast makes the muscle smaller and weaker.

Another item of concern, when dealing with bones, is that of the bruise. Sometimes the impact of a sudden force to a bone, such as occurs when you step on a foreign object or bang your leg, can cause a bone bruise, which is a bleeding under the outside covering of the bone. Although they may be painful, they usually heal within a few days and don’t require any treatment or layoff from exercise. However, if you have a pain in your bone and it becomes worse with exercise, see your doctor! Next week, to clue up this short series, we’ll take a quick look at other injuries; knee, ankle, hip, and head.


Organizations: NHL

Geographic location: Toronto

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