Contact team sports such as soccer and rugby, equine sports and skiing have the highest rate of injuries, closely followed by cricket, cycling and fencing. Then come racquet sports, athletics, gymnastics, water sports, mountaineering and the other winter sports, in that order. Surprisingly, the traditional combat sports (judo, boxing, karate) and aerial sports (parachuting, hang gliding, bungee jumping) have a relatively low injury rate, but when an injury does occur it tends to be more serious.
Only about half of all sports related injuries are treated by a qualified professional, and then only because of a pitchside osteopath, chiropractor or physiotherapist (Scottish Med J, 1982; 27: 189 and Sports Medicine and Soft Tissue Trauma, 1989; 1: 4-5). Musculo skeletal inflammatory disorders and soft tissue injuries account for over 80 per cent of sports injuries and their self treatment can lead to chronic injuries, or worse. Sportsmen and sportswomen often treat themselves with NSAIDs (non steroidal anti inflammatory drugs). Deaths from self poisoning through NSAID ingestion are at an epidemic 4,000 plus per annum (G R McLatchie, Essentials of Sports Medicine, Edinburgh: Churchill Livingstone, 1995: 145-147). This amounts to 77.8 per million prescriptions.
Lotions can be effective. Arthrosenex ointment (Brenner, FRG) is a combination of labrador tea oil, rhododendron oil, arnica oil, camphor oil, melissa oil, vitamins A and E, saffron tincture and orange oil (K Langbein, H-P Martin, & H Weiss, Bittere Pillen: Nutzen und Risiken der Arzneimittel-Ein kritischer Ratgeber, Vienna: Verlag Kiepenheuer & Witsch, 1986: 216). In controlled trials, this ointment stopped the injury exuding while simultaneously mobilising natural defence mechanisms.
A linen bag filled with hayseed (Flos graminis), sweet vernal grass seed (Anthozanthum odoratum) and woodruff (Asperula odorata), now available ready filled, makes a superb hot pack for use in bruising and muscle injuries. It retains heat for a long period and can be used several times before it needs replacing or refilling. A hayseed bag is immersed in a small pot of boiling water, and left for about 10 minutes. Then the excess water is squeezed out and the bag is covered in a flannel cloth, which helps retain the heat and makes it bearable on the skin. It should be applied at 42¡C (107.6¡F). These hayseed hot packs have been shown to provide beneficial local heat treatment, which is effective on joints, muscles or tendons, after trauma injuries.
Non pulsed ultrasound therapy has been shown to be more or less ineffective in the relief of pain (Pain, 1995; 63: 85-91). But pulsed ultrasound, which does not have a thermal effect, is effective on acute lesions if it is applied at an early stage (Physiotherapy, 1978; 64: 105).
The most effective massage for soft tissue lesions are effleurage (firm stroking in the direction of venous and lymphatic return), petrissage (a localised kneading action) and deep circular and transverse frictions accurately applied to the lesion. If used before exercise, this will delay the onset of muscle soreness.
In overuse injuries, relief is obtained by transverse friction at a right angle to the tendon. Massage to break down adhesions in muscle, ligaments, tendons and connective tissue is uncomfortable initially, but the pain generally settles after treatment. The part should then be actively mobilised (though not overused), which reduces the risk of new adhesions forming.