Wednesday, 18 January 2017

If a tree falls in the forest...

Nothing wrong with those fingers Dennis
I have often said in this forum and in others, that injuries to the hand are often neglected by patients, especially it seems, in an athletic population. For that I think we have only ourselves as therapists to blame. In spite of best intentions, these injuries are regarded as less important and less crucial. The only real way to change this perception is through researching the impact and incidence of hand injuries within a sporting population. 

For many years, Dr John Orchard has been compiling injury reports in elite cricket. On the back of these papers, a great deal of good work has been done to address hamstring, groin and back injuries at all levels of cricket, with particular attention to fast bowlers and the development of appropriate workloads. 

In a recent publication, Dr Orchard revisits injury incidence within an elite cricket population, and updates the injury definitions. The article is well constructed, discussing at length the most common injuries and whether rule changes might make a difference. What stood out for me having been alerted to the article via Twitter by Alex Kontouris, the Australian cricket team physio, was that in spite of ranking third for incidence and fourth for most affected body part over a ten year period, wrist and hand fractures were not discussed at all.(1) 

Does "!" make him soft?
To be fair, the article was written to address the rise in hamstring injuries in connection with the rise in Twenty20 cricket becoming a the most popular cricket format. I also accept Alex's comment that most fractures occur in situations which cannot be controlled in the manner that a soft tissue injury can be. Yet if a maintained incidence rate at an elite level is not commented on, if those injuries aren't considered worth commenting on at an elite level then the perception of laypersons become that the injuries aren't worth taking seriously even though those of us who treat elite athletes know that isn't the case. 

Getting amateur sports persons to take wrist, hand and finger injuries seriously before they become chronic is an issue I face every day in my clinic. I need someone to show me how to make Dr. Orchards' research have an impact in my clinic for the everyday athlete. Any takers? 

Look after those fingers,

Hamish

Refs:    (1)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167453/

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