Biomechanics of Gait The biomechanics of gait is the study of the body’s mechanics during walking or running, involving the complex interaction of muscles, bones, and joints to achieve forward progression, stability, and energy efficiency. Two main phases of gait : stance (60%) and swing (40%). Heel-strike → foot-flat → mid-stance → heel-off → toe-off → swing.
Biomechanics of Gait – Clinical Relevance Overpronation at sub talar joint → tibial stress fractures, plantar fasciitis. Overs upination at sub talar joint. → lateral ankle sprains. Abnormal stride length → hip & knee overload.
Malalignment Injuries . Definition: Malalignment injuries in sports occur when bones or joints are not in their correct anatomical position, which can be congenital, caused by trauma like a poorly healed fracture, or result from chronic postural issues. Common malalignments : genu valgum genu varum pes planus pes cavus . Femoral anteversion .
Malalignment creates uneven stress on the musculoskeletal system, predisposing athletes to following injuries:
Medial tibial stress syndrome (shin splints) Iliotibial band syndrome
Stress fractures
Plantar fasciitis
Traction apophysitises : (in children and adolescents)
Early-onset arthritis: if a malalignment involves a joint surface
Injury Prevention Strategies Principles Warm-up & stretching. Proper technique. Protective equipment. Load management. Physiotherapy. Playing on safe surfaces. Adequate nutrition and hydration. Giving sufficient time to rest and recovery.
Develop a fitness plan that includes cardiovascular exercise, strength training, and flexibility to decrease your risk of injury. Prepare your body for exercise by increasing blood flow and muscle flexibility, which also improves nerve sensitivity and cardiovascular response. Improve the ability of muscles to perform and increase flexibility, which can reduce the risk of injury.
Focus on strengthening the muscles around joints to improve stability and reduce strain. Drink enough water to prevent dehydration, heat exhaustion, and heatstroke. Follow an appropriate diet that meets functional requirements and supports recovery after exercise.
Injury Prevention Orthopaedic Role Screening for malalignment (clinical + imaging). Corrective measures: orthoses, physiotherapy, surgery if needed. Pre-season musculoskeletal screening.
Rehabilitation Process The rehabilitation process is a structured approach that involves an individual, healthcare professionals, and a treatment plan to restore and enhance physical, mental, and social well-being after an injury, illness, or addiction.
Rehabilitation Process Phases of rehabilitation 1. Acute (control swelling & pain ,protect, rest, ice, compression,elevation . ) 2. Subacute (ROM, strengthening) 3. Remodelling (resistance, proprioception) 4. Return to play
Assistive Devices in Rehab Assistive devices in rehabilitation are tools and technology designed to help individuals with disabilities or injuries regain or improve their independence and function. These devices span various categories, including mobility aids like wheelchairs and walkers, sensory aids such as hearing aids and magnifiers, communication tools like hearing loops and electronic communication boards, and cognitive aids such as reminder devices and software. The goal is to reduce functional limitations, slow functional decline, and enhance a person’s quality of life and participation in daily activities.
Psychological Impact Anxiety D epression F ear of re-injury. Loss of athletic identity. Anger Frustration. Social Isolation.
Anger and Frustration: A common response to being sidelined and unable to perform. Sadness and Depression: Feelings of sadness, hopelessness, and low self-worth can arise from the loss of play and a threat to their athletic identity. Anxiety and Fear: Athletes may feel anxious about their recovery, performance upon return, and the possibility of re-injury.
Social Isolation: The absence from team activities can lead to feelings of loneliness and disconnection from peers and coaches. Loss of Identity: For many athletes, being an athlete is a central part of their identity. An injury can create an identity crisis and feelings of self-doubt. Reduced Confidence: The experience of injury can erode an athlete’s confidence in their body and ability to compete at the same level again.
Mental Health Conditions: Left unaddressed, the emotional toll of an injury can escalate into depression, anxiety disorders, or even substance use and eating disorders. Maladaptive Coping: In response to stress, some athletes may resort to unhelpful coping strategies, such as increased alcohol consumption. Fear of Re-injury: This fear can manifest as a hesitancy to engage fully in rehabilitation and a physical caution during training, which can slow recovery.
Performance Anxiety: Athletes may experience increased nervousness and pressure when returning to competition, fearing they won’t perform as well as before.
Psychological Support Strategies Sports psychologists. Goal setting and motivation. Team inclusion during rehab. Psychological Interventions: Strategies like positive self-talk, goal setting, visualization, and mindfulness can help athletes manage their emotions and build confidence. Integrated Care: Clinicians and physiotherapists can play a crucial role by monitoring the athlete’s emotional state alongside their physical progress and integrating psychological support into rehabilitation programs.
Multidisciplinary Case Example ACL rupture case: - Surgery by orthopaedic surgeon - Rehab by physiotherapist - Nutrition support for healing - Psychological counselling - Strength coach for conditioning
Current Advances in Sports Injury Management Biologics: PRP, stem cells. Computer-assisted gait analysis. Wearable tech for monitoring load. Enhanced recovery protocols.