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BOUNCING BACK.

Injuries are inevitable in the life of every sportsman but the rate of recovery for each differs and depends upon timely medical intervention and thorough rehabilitation

WHICH sports enthusiast hasn't mourned the exit of a star player from the field or court? A minor tackle, a wrong movement of the foot or a slight rotation of the wrist can render a player out of action. While sports injuries are inevitable, the fact is that each time an injury or illness forces a player to stop, the question of how long it will take for recovery hangs in the air. There really is no straightforward answer to this: the fact is that the time taken for each person to heal varies. So while Schumacher ruled Formula One for years, a neck injury now prevents him for burning the rubber again. But then there is Lance Armstrong who continues to defeat his cancer and has emerged a winner at seven consecutive Raid De France. Besides resolve, timely medical assistance and thorough rehabilitation are crucial for recovery. Here we tell you about three players who fought bleak prophecies, and share lessons from them about speedy treatment and lasting recovery.

CECH'S HEAD INJURY

Any injury to the head is considered serious since it holds the all- essential brain. From mild headaches to paralysis of the limb, slurring of speech, memory loss, concussions and other psychological disorders, the outcomes of a head injury are several and varied.

This is why when a player's knee hit Chelsea's goalkeeper Petr Cech on the head during a league match in 2006, everybody was appalled. Cech had a depressed skull fracture and doctors said that it nearly cost him his life.

Returning to the field was termed risky.

Immediate surgery was performed on Cech's head. A depressed skull fracture causes dents in the skull bone. If the depth of a depression is at least equal to the thickness of the surrounding skull bone, surgery is often required to elevate the bony pieces and to inspect the brain for evidence of injury.

Two holes were made in Cech's skull by the surgeon to lift the major piece of bone back into place. As a result of the injury, he suffered intense headaches for months.

" The skull's density is just a few millimeters which is why the broken piece of bone should be lifted back as soon as possible. If it is delayed there can be permanent damage to the brain's functions depending on which area is affected," says Dr Prateek Gupta, consultant sports surgeon, Sir Gangaram Hospita. Post- operation, the skull requires protection more than rehabilitation. " The physiotherapy would only consist of exercises to relieve stiffness and increase the range of motion," says Dr Amit Kumar, consultant physiotherapist and member of Medical Sub- Committee and health services, Commonwealth Games 2010.. Cech was not just lucky to survive, he also recovered beyond all expectations.

He returned to the field in January 2007, wearing a rugby- styled headguard since he has a weaker than normal bone structure in his skull being a triplet.

Although Chelsea lost Eeech's comeback match, he was awarded the FA Premier League Player of the Month award for the first time in his career in recognition of the eight successive league clean sheets he had kept. Cech also kept a clean sheet for Chelsea in the 2007 FA Cup final against Manchester United, clear evidence of the fact that he carries a cool head on his shoulders.

EDUARDO'S LEG BREAK

FOOTBALL fans still remember the gut- wrenching leg break Arsenal player Eduardo da Silva suffered on February 23 last year during a premier league clash.

The injury was so graphic that the game broadcaster decided not to show replays of the incident.

Eduardo was immediately taken to the hospital where he underwent surgery. Most thought the player would never be able to kick the ball again, but Eduardo proved all doomsday prophecies wrong by making a comeback in less than 10 months. This is nothing short of a miracle! The player has also surprised the medical team with his determination and the speed of recovery.

However, the outcome would have been entirely different if medical attention had been delayed. Eduardo had suffered a broken left fibula- the calf bone originating from the ankle- and an open dislocation of his ankle.

This is a serious injury and the chances of infection are high because of the sizeable wound that has been exposed to the dirt from the playing field. Quick attention is key to recovery. " The surgery should be performed within 2 hours of the dislocation.

Since in this case, the bone is out of the joint, it's like fish without water. There is no blood supply, cartilage starts getting rough and abnormal. After eight hours, there is loss of cartilage and it raises the risk of osteoarthritis," says Dr Gupta.

An ankle injury causes muscle atrophy, which means decrease in muscle mass of that area, and results in the inability of the patient to perform certain tasks.

" After removal of the cast, we start with passive joint mobilisation to reduce pain and stiffness and increase elasticity to improve the range of motion. Elevation while lying down, icing and compression are given to reduce swelling for 2- 3 weeks," says Dr Kumar.

Later, exercises to strengthen the injured body part with help of thera bands and balance boards are done before progressing to weight bearing and standing exercises like heel walking, toe standing and gait correction. Since the nerves are damaged, the body also loses its ability to sense movement within joints and joint position. " Exercises are done to increase awareness of body for the damaged ankle's joint and its position.

This way brain relearns how to balance and make the body move," says Dr Kumar. After four months' time, the gentle game practices can be started.

However, sportspersons tend to recover fast because of their overall fitness and good muscle mass.

Eduardo's recovery was so good that when he started playing in the FA Cup this year, he started scoring in the 21st minute and converted a penalty in the second half.

The footballer seems to be putting his best foot forward.

THE LIMP IN TIGER'S GAIT

Tiger Woods has singlehandedly brought a new level of competence to golf. Physically, mentally and technically too he is miles ahead of other golf professionals. Woods is known for his intense level of cardiovascular training and core strengthening, and his athletic physique is apparent.

He has inspired a new philosophy of total body training among a group not previously known for doing squats and crunches or hitting the exercise bike.

But during his last year US Open victory, Woods was often seen clutching his left knee. It wasn't until after the win that the true nature of his injury was revealed. A torn ligament in the left knee was imminent, caused by the huge rotational movement of his body while swinging the club. During the back swing, the left knee ( for a righthander) is forced into external rotation of the shin bone and stress is put on the knee. Many wondered whether it would be possible for the top golfer to return to his pre- injury form. With thorough rehabilitation, however, Woods has prolonged his career.. The procedure for the cartilage tear is grafting of a tendon taken from somewhere else on the patient's knee and the graft is then held in place with screws. Fastening the graft in this manner allows new blood vessels to grow and for healing to occur. " After the surgery, it is possible to bear partial weight on the surgically treated leg by using crutches for the three weeks. In addition, a continuous passive motion device is applied. It very slowly moves the knee, thereby decreasing the risk of stiffness and loss of motion," says Dr Prateek Mandal, consultant sports medicine, Moolchand Medcity.

Core fitness is essential to train the muscles that support the pelvis and spine, in particular the abdominal and hip muscles, which are essential for the golfer's frame. Early in the rehab process, straight plane movements are emphasised, meaning the body moves in one direction. Once the muscles are strong enough and the ligament is mature that it can begin to be subjected to rotational movements.

That Woods gave the best time and attention to rehabilitation was evident when he made a comeback by winning his sixth Arnold Palmer Invitational in March this year. The positive recovery of these three sportspersons underscores the fact that having a general fitness and good muscle mass helps you a lot in case of injury. What's more important is the resolve to hit the field again with a winner's attitude.

manu. moudgil @ mailtoday. in

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Publication:Mail Today (New Delhi, India)
Date:Oct 20, 2009
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