An elite Muay Thai fighter came with a swollen and painful thumb after hurting his thumb when he accidentally hit the side the head of his opponent during a professional bout. Treated it aggressively with RICE therapy, electrotherapy and rehabilitation exercises and he returned to fight again in 2 weeks duration. He had a protective taping for the fight and managed well.
Photos taken from a karatedo athlete who twisted his knee during competition. Note that the aspirate always consist of blood. He also complains of his knee 'giving-way' and locking.
A wushu ex-elite athlete came with complaints of pain and weakness in his left shoulder after landing awkwardly with his arm hyperextended during training yesterday. He could only lift (abduction) his left arm with much difficulty above the level of his shoulder. He would feel more pain as he lifts his arm further.
Upon examination, I found that he had difficulty rotating his arm outwards (External Rotation) and lifting sideways (abduction).There was tenderness of the insertion of the teres minor muscle. He also has a lesser shoulder muscle bulk on his left and some multidirectional instability. 
He was advised to continue RICE treatment for another 2 days and prescribed isometric exercises. He was also given simple exercises for the painfree range of motion while starting early proprioceptive exercises using the wall and ball. However, he was advised not to abduct his arm above the level of his shoulder initially.
He would be reviewed in 1 week to reassess his progress. An elite athlete would undergo an ultrasound scan to determine the extent of muscle strain. Clinically, he was having a Grade II strain.
This sub-elite athlete suffered from an old punching injury to his 3rd metacarpal phalangeal joint a year ago during competition. The initial swelling and pain had subsided with treatment but he still has movement restriction. He should be able to continue training with taping but he will need an X-ray to find out the extent of damage. If the X-ray is normal, physiotherapy with finger exercises would help him regain full range of motion. 
This sub-elite athlete suffered from an Index finger injury 6 months ago. His proximal interphalangeal (PIP) joint is still swollen although the pain has mostly subsided. He wanted to fight in another competition and was advised to tape his PIP joint. He should also obtain an X-ray of the PIP joint to rule out more serious injury.
A video of the wrist of a martial arts exponent who had a fall on his right hand 2 years ago during competition. He sustained an injury to his wrist causing him to have pain during punching. He also had painful full flexion of his wrist and resisted extension.
I have demonstrated the dorsal movement of the ulna with a fixed radius in the video. Although he would maintain some form of wrist stability with taping, he should be seen by a Hand surgeon to correct the instability.
Interesting links:
Radioulnar Joint Instability
Here's a video of a female martial arts exponent who dislocated her left thumb 2 years ago after receiving a kick during competition. I did a test to evaluate the hypermobility of her joint. She is also having some hypermobility of her right thumb but it was less mobile.
Interesting Links:
Dislocation of the Thumb MP Joint
James (not his real name) is a 22 yrs old martial arts sub-elite athlete who sustained a kick to his right eye 6 months ago. He sustained injury to his right cornea laceration due to the contact lens. Although he was seen by an Ophthalmologist and treated for several weeks, he still has blurred vision in his right eye. The corneal injury is visualised as a white patch on the cornea (corneal opacification). It is best seen under slit lamp after fluorescein eye stain. In full thickness corneal laceration, aqueous humour may leak out or there may be bleeding (hyphema) there may be distortion of the shape of the eyeball.
Since he wanted to continue to fight, he has been asked to obtain further treatment with Phototherapeutic keratectomy (PTK) or Corneal Transplant. Failure to do so, he may not be able to clear his Preparticipation examination with 'one good eye'.
Interesting links:
Corneal Laceration
Corneal Abrasion
Corneoscleral Laceration
Sports Pre-participation Examination
Every time I am asked to assist in medical coverage of a martial event, I would ask for the assistance of hospital teams to ensure that the whole mechanism for emergency care is activated. During the 8th AKF, the organisers had the commitment of the Negeri Sembilan Health Department to ensure that the medical services offered during the 3 day competition was adequate and did not endanger the participants' lives.
The most important factors responsible for keeping the injury risks low were:-
1. The high standards of referreeing
2. The high fitness and skill levels of participants
3. Adequate rehydration in between bouts
Despite having a team for each 'tatami', we were busy with minor lacerations, bruises, contusions, muscle strains and mild joint sprains. We only had one participant who injured her neck, was immobilised using the hard cervical collar and long spinal board and transferred safely to the hospital. Two participants had mild concussion and were sent to hospital for further evaluation and observation for 24 hours. We only had to stitch up a bad laceration on an official who had fallen before the second day's competition. The Atomated External Defibrillator (AED) was available on stand-by in the event of patient collapse due to cardiac arrhythmias.
This is definitely a competition involving the whole team of referrees (rules and regulations), officials (traffic), doctors and paramedics, ambulance driver, registar-on-call and surgeon-on-call (immediate hospital care).
We still need qualified volunteers to provide a safer medical coverage during such sports events. You may contact me at draston@gmail.com. 
An exciting world class karatedo competition called the 8th AKF Senior Championships will be held on the 24th - 26th August 2007 at the Nilai Indoor Stadium* (near Nilai International College).
On the first day, Malaysia won 2 gold medals, 1 silver and 2 bronzes. There will be 3 fights simultaneously from 9am to 6pm. My medical team will be in the middle of the three competition mats. We have to observe in 3 smaller teams to ensure that we see the way the athletes fight so that we can gauge the severity of injury even before we examine the athlete.
For the sparring (kumite) competition, each bout lasts for 3 minutes between the Red (Aka) and Blue (Ao) athlete. If there is a draw, there will be another minute of competition with sudden death score. The skills performance (kata) competition will be a show of finesse of the various skills perfected by the athlete.
*Getting there: (A map of the destination is not available)
Take the KL-Seremban Highway (North-South Highway), exit Nilai (Exit 215). After the toll gate go straight and hit a T-junction, turn right go straight until you reach a roundabout. Take the 3 o'clock turn and go straight to pass through an empty area, housing area and you will see the huge red colour building on your right i.e Nilai Indoor Stadium.
Important links you need to know:
Competition Schedule
WKF Rules & Regulations
.jpg)
.jpg)
A martial arts elite athlete came with pain in his right thigh after doing rapid high kicks during filming of a movie. He added that his hamstring was extremely tight and he could not execute a high kick. He already went for treatment by an acupunturist who did some acupunture and massage to release the spasm. He told me he had forgotten to do RICE treatment. It was only after 1 week that he came in to see me.
I examined him and found that he still had mild spasm of his semitendinosus muscle (one of the 3 hamstrings) and tenderness at the myofascial junction. He was able to fully flex and extend(a good sign) but had pain with resisted flexion. I gave him some muscle relaxants and NSAIDS for another 5 days as he had some bruising from the massage. He was told to undergo hydrotherapy (aqua-joggin) and focus on core stability rehabilitation. Since it was only a mild muscle strain I would expect him to recover fully within 2 weeks. However, he would need to be careful if he was to do the high-speed high kicks.
Posts
All Comments
