Doc MacLean
Time to face up: Contact sports can do serious damage
WITH the autumn rugby internationals starting last week it is full on for the medical support staff. Watching the rugby reminds those of us who work in sport that it is a traumatic contact sport with injury inevitable. The speed and strength of the modern rugby player contribute to the risk and pattern of injury though excellent medical care and changes to the rules contribute to making rugby as safe as it can be, especially at international level. Contact sports, like rugby, have a well-recognised pattern of injury with facial injury not uncommon, just ask Wales hooker Ken Owens following a collision with Scotland No 8 Ryan Wilson.
Facial injuries are potentially lifethreatening if the airway is involved or the player has an associated head or spinal injury. Facial fractures result in swelling, bruising, deformity and the player may complain of pain, numbness or blurred vision. Fractures to the lower jaw or mandible will usually result in the player being unable to open and close his mouth comfortably. Cheekbone fractures occur with direct trauma from contact with an opponent or another object such as a goalpost.
Involvement of the eye socket should always be suspected in cheekbone fractures and can result in a permanent loss of vision. All significant facial injuries including the eye need immediate medical attention so if in doubt – refer for medical assessment.
The face is one of the most vulnerable areas of the body to suffer a contact injury and probably the least protected. Sports related facial injuries account for around 10 per cent of all facial injuries seen in A&E and around 10-15 per cent of sports injuries involve the face – mostly in young males.
The pattern of injury varies with the sport involved with football, rugby, boxing and skiing the most common. Surprisingly facial injuries in American football and ice hockey are now less common due to mandatory facial protection, including mouthguards. It will be interesting to see if the incidence of facial injury changes in boxing with the removal of the headguard.
As with all sporting injuries, prevention is the ideal. Administrators can modify the rules to punish reckless challenges. We can try to minimise the risk of injury from equipment by removing all unnecessary objects, applying padding to goalposts, ensuring equipment is functioning properly and that children taking part in sport have adequate adult supervision. Protective equipment reduces the incidence of injury. Good pitchside medical care and a careful assessment before returning to the field will protect our players and their future health. ■ To contact the Hampden Sports Clinic call 0141 616 6161 or visit www.hampdensports clinic.com