Doc MacLean

Time to face up: Con­tact sports can do se­ri­ous dam­age

Evening Times - - SPORT - In­jury clinic

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

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