SPORTS MEDICINE

Sports medicine is a broad specialty which involves treating sports- related injuries in sportsmen and others who occasionally involve in sporting activities. It is a multi- specialty which integrates the services of an orthopaedic surgeon, physiotherapist, physical trainer, sports nutritionist, and psychiatrist.

Injuries peculiar to sports may be sprains and strains, chronic overuse injuries, muscle ruptures, ligament injuries etc. Each sport is associated with specific patterns of injuries. Knee ligament injuries are very common in footballers, tennis elbow in tennis players, golfer’s elbow in golfers, shoulder and back injuries is fast bowlers, shoulder, wrist and finger injuries in spinners and so on. This is not to say that these injuries are exclusive to these sports; tennis elbow, today, is rather more common in housewives!!

The orthopaedic surgeon is involved in the treatment of these injuries. The initial treatment for all these injuries includes elevating and resting the injured part, applying ice packs to reduce the bleeding into the tissues, splinting the injured part, applying compression and administering an anti- inflammatory analgesic. Clinical examination and investigations are then carried out to assess the nature and severity of the injury.

Most ligament and muscle sprains and strains settle down with adequate rest and splinting for a period of three to six weeks. This is followed by a period of rehabilitation to train the body as a whole and the injured part in particular to a level of fitness requisite on the playing field.

This requires the services of a physical trainer and a physiotherapist. Absolute lay off from sports during this period is essential to ensure complete recovery. Most instances of chronic injuries and recurrences can be traced to inadequate rest during the critical initial phase and to inadequate rehabilitation before taking to the field.

Chronic overuse injuries such as tennis elbow, golfer’s elbow and others can be traced to repeated stressing of a particular group of muscles due to an action peculiar to that sport. These injuries can be treated with adequate rest and splinting to relieve stress from the injured part. A local infiltration of a cortisone and local anaesthetic may help in the acute phase. But the most important part of the treatment involves modification or complete cessation of the action which aggravates the injury. This involves the services of a coach and physical trainer.

Ligament injuries inside joints are most common in the knee joint and less so in the shoulder and ankle joints. These include meniscus tears, cruciate ligament ruptures etc. Treatment involves meniscus repairs, excision of torn bits of menisci, augmentation or reconstruction of cruciate ligaments etc.

Arthroscopy has revolutionized the treatment of joint injuries and pathologies. It is a minimally invasive, endoscopic procedure that is most commonly performed in the knee joint. It provides the surgeon with an accurate diagnosis and adds to or modifies the diagnosis made after clinical examination and investigations. As the morbidity of the procedure is low, the time to recovery is minimal and the patient can be discharged the same day.

Arthroscopy is performed for removal of loose bodies, repair of peripheral tears of menisci, excision of torn bits of menisci, reconstruction of anterior cruciate ligament, synovectomy, abrasion chondroplasty, debridement of the knee joint in degenerative arthritis etc.

Dr. Nandkumar Sundaram is a renowned arthroscopy surgeon who has performed more than 3000 arthroscopic surgeries of the knee. He has rekindled interest in arthroscopic debridement of the knee joint for degenerative arthritis. Arthroscopic debridement provides good pain relief in early and moderate osteoarthritis of the knee and postpones the need for total knee replacement by 3 to 10 years. Even patients with severe osteoarthritis, who are not fit to undergo a major surgery such as total knee replacement, may obtain symptomatic pain relief of variable duration with arthroscopic debridement.

Dr. Nandkumar Sundaram is a trained and experienced sports medicine specialist. He has treated many a sportsperson of eminence and others who indulge in sports for leisure. The common problems encountered in the sports clinic are low back pain, hamstrings pull, ankle sprain, knee ligament injuries, rotator cuff injuries in the shoulder, tennis elbow and golfer’s elbow etc. Our sports clinic is well equipped to treat all these injuries and all these sportspersons have been returned to active sports and are representing the national teams in their respective fields.

Dr. Nandkumar Sundaram has performed more than 500 anterior cruciate ligament reconstructions of the knee. He has pioneered the concept of brace-free rehabilitation after anterior cruciate ligament reconstruction in our country, which has been proved to restore full range of movements without compromising the stability in any way.

Dr. Nandkumar Sundaram has performed more than 300 shoulder reconstructions for recurrent dislocations of the shoulder. He has consistently achieved the dual aim of a completely stable joint and a full range of movements through a very cosmetic scar. Many of his patients have returned to active contact sports such as basketball and volleyball at a highly competitive level.