Kitesurfing common injuries

 

KITESURFING & WINDSURFING INJURIES by Andrew Bellamy

Please note that the comments in this blog come from many years of clinical experience and practice, combined with details and opinions taken from various sources, including open-source internet articles. Where relevant, links are provided.

Please also note that we cannot comment on individual cases without taking a proper history and conducting a full examination.

SO, HOW DANGEROUS IS IT to go windsurfing and kite surfing? Well, a quick search of the internet will throw up various reports of serious and even occasionally fatal events involving, in particular, kitesurfers.  However, these events are still rare and are no more frequent than other ‘dangerous or extreme sports’.

What sorts of injuries do we, as osteopaths and physiotherapists, see as a result of these now popular sports?

Here in Shoreham-by-Sea there is a particularly active group of surfers that range mainly from mid-teens to mid-fifty’s and who spend as much of their free time on the water as they can. Great fun with lots of adrenaline, wonderful exercise and what a way to get away from the mobile and other distractions!

However, where there is pleasure there is often pain and these sports are no exception. One of my best friends, who is almost messianic when it comes to windsurfing, tells me that he never has any injuries! Except, that is, for the bruised ribs caused by his harness as he came to a sudden stop recently, the neck strain and stiffness and foot and shin pain from doing too much for too long.

This is fairly typical from what I hear at the Adur Osteopathic Clinic and remember that those comments are from an experienced windsurfer!

Our Osteopathic and Physiotherapy Practitioners are frequently asked to help with treating injuries sustained while doing water sports such as windsurfing and kitesurfing.

NOVICES & LEARNERS typically suffer forearm muscle problems from gripping too hard until they learn to relax as well as shin and foot strains for much the same reasons.

Back strains from rigging and up-hauling tend to happen more in the early stages, but no one should be complacent about them as potential risks.

  • As is often the case, prevention is the better path to tread.
  • Take up Pilates to gain core strength and make you fitter before problems start.
  • To ease backache while sailing, try tilting you pelvis back and forth in the quieter moments.
  • Many of these problems can be overcome simply by practice and good coaching in the early days.

What are the common injuries in these sports?

Where I, as a Registered Osteopath and my colleagues come in is when it goes beyond a ‘bit of a strain’ and becomes a proper injury.

Listed below are some of the most common types of injury and where they occur on the body.

TYPE                                                                        TREATMENT

  • Sprains, (26%)                                              Osteo/Physio Treatment
  • Cuts, (21%)                                                   Self Treat/A&E is more serious
  • Bruises, (16%)                                               Self Treat or Osteo/Physio Treatment
  • Fractures, (14%)                                            A&E, but may initially be diagnosed by an Osteopath.

Where on the body do they happen?

  • Lower extremities, (approx. 45%).
  • Upper extremities, (approx. 18%).
  • Head & Neck, (approx. 18%).
  • Trunk, (approx. 16%).

Data kindly from http://physsportsmed.com/issues/2002/05­02/rosenbaum.htm

 

The Knee & Below.

How?

Being thrown from your board, while the foot remains in the strap is the most likely cause. This is especially likely if you are thrown backward and sideways off the board.

Ankles and feet are the most often injured and almost half are severe enough for fractures or ligament damage. 75% of fracture and ligament injuries in the foot are caused by getting caught in the foot straps.

The resulting effects can be long lasting if not dealt with adequately in the early stages. Fractures, of course, need to be properly diagnosed and treated in hospital.

What to look for?

The ‘classic’ fracture injury for these sports is the LISFRANC Fracture-Dislocation and may need surgery.

There will be pain and swelling over the front half of the foot. It may be difficult to put weight on the foot, especially once you get your boot off.

If it hurts to twist the front of the foot inwards and then bend it outwards to the side, you may have this fracture.

Suffice to say that the bone sticking up in the middle of the foot, as seen in this X-ray, is not natural!!

First aid includes R.I.C.E. This stands for Rest, Ice, Compression (strapping/support) & Elevation.

  • So, take the weight off.
  • Lift the leg above heart level and support it, i.e. lie on the sofa or bed.
  • Get a gel ice pack on ASAP, (5-10 minutes initially and don’t apply directly to the skin).
  • Apply strapping or a bandage. (The last element is in my view the least important in some ways. If you get it wrong, you can do more harm than good. It also may be too painful and can obstruct natural swelling – use with care and get some professional advice as soon as possible).

NB. If the foot swells very quickly, (in a few minutes), this suggests bleeding and will result in bruising.

Slow swelling over several hours suggests more of a strain/sprain, but these aren’t hard and fast rules.

If in doubt, go to A&E for advice. X-ray diagnosis is helpful but will miss fractures in as many as 20% of cases that turn up at A&E.

So, even if you get the all clear for any fracture, if there is still significant swelling after 3 to 5 days after the injury and it is difficult to put your weight on the foot, get a further opinion.

The Arm, Elbow & Wrist.

Nowadays generally called Upper Limb Disorders, ‘simple’ arm problems in sport tend to fall into the ‘overuse’ category – gripping too hard or for too long, especially if your hands are too small, (or large), for the boom or grips.

Knocks and blows over the side of the elbow are another common cause.

Strain of the insertions of the tendons into the elbow joint typically present to the osteopath or physiotherapist as Tennis or Golfer’s Elbow, (tennis elbow on the outside, lateral epicondylitis and golfers elbow, medial epicondylitis, inside the elbow).

  • This shows up as sharp tenderness over the bony knobs either side of the elbow.
  • You may have difficulty in gripping, handshaking, opening doors, changing gear and picking things up at stretch.
  • Early morning stiffness and pain is common.
  • Eventually can cause pain and stiffness in the shoulder and neck, especially as you start to compensate.
  • Can take from two months to two years to get better, even with good treatment and if you keep doing the thing that causes it.

Other injuries include dislocations or subluxations, particularly fingers. Injuries where the thumb is forced backwards are variously called Skier’s, Poacher’s or Gamekeeper’s Thumb, (which are all basically the same injury). Dislocation of the shoulders is an important injury to resolve professionally.

Shoulder dislocations are a serious injury and are usually caused by blows from front or back, i.e., landing heavily onto a wave, board or even beach – backward dislocations seem to be more common. Forwards, or anterior, dislocations may occur if the boom is wrenched out of your hands unexpectedly.

A true dislocation must be seen at an A & E Department. The arm will usually be longer than normal, an odd shape at the shoulder, (dropped), and effectively useless! They may reduce the dislocation, or put the shoulder back in, there and then. The procedure is straightforward in uncomplicated cases, but not comfortable!

Your therapist will advise you on the initial treatment, recovery and rehabilitation stages. This is really important as recurrence rates for dislocation are fairly high and if you want to safely carry on with your sports, then strengthening of the rotator cuff muscles of the shoulder, (Subscapularis, Supraspinatus, Infraspinatus and Teres minor), is essential.

  • Rehabilitation with an osteopath or physiotherapist should be started as soon as possible, but overhead movements should be avoided for about six weeks.
  • Rotator cuff muscles should be rehabilitated asap. The use of Resistance Bands is widely recommended, especially for the home exercise phase.

Less serious are subluxations, where the ball is not fully separated from the socket and can easily is treated by experienced osteopaths and physiotherapists. However, the damage to the muscles and tendons can still be significant.

I see lots of people who tell me that they have dislocated joints – most haven’t and most of those telling me are blokey sorts!

Joking apart, while guys all like to brag a little after the event don’t treat things too lightly, as either type can leave you with permanent injuries and limitations.

My left shoulder, subluxed twice during one rugby game at age 17, (because they couldn’t do without me), still gives me jip. I didn’t get it fixed at the time because I knew better, of course!

In those days sports injury care was much less developed, but that has changed. Get it looked at as soon as it happens and you will benefit later.

Some excellent rehabilitation exercises can be found here.

Head & Neck injuries fall essentially two categories; blows to the head and strains and whiplash to the neck.

The first category should not need much explaining. Hit your head hard under any circumstances, see someone in the know!

Any blackouts, unconsciousness, dizziness, double vision, lacerations, contusions or odd behaviour that is at all unusual should be taken seriously and mean a trip to A & E straight away, please.

Neck injuries can be strains from overuse of the shoulder and neck muscles or whiplash from sudden stops or being flung from the board. I suspect that this is rather more likely to be relevant to kitesurfers, but let me know if that’s not your experience.

Injuries in these categories are just the sort of problems that osteopaths and physiotherapists are trained for and I’m proud to say that we have the experience at the Adur Osteopathic Clinic.

This article doesn’t cover all the possible injuries that wind and kitesurfers might suffer, but let me know if I you would like me to cover anything in particular.

Conclusion: Kitesurfing should be considered a high-risk sport.  Most Authorities that have investigated and researched this area have come to the same conclusion.

Some Key Words: Pilates, Lisfranc Fracture-Dislocation, A & E, R.I.C.E, First Aid, Upper limb disorders, Tennis elbow, Golfer’s elbow, Lateral epicondylitis, head & neck injuries, blackouts, whiplash

Many thanks to those websites that images were copied from.

A Prospective Study of Kitesurfing Injuries

Christoph Nickel, MD*, Oliver Zernial, MD, Volker Musahl, MD, Ute Hansen, MD, Thore Zantop, MD|| and Wolf Petersen, MD||,¶

http://ajs.sagepub.com/cgi/content/abstract/32/4/921

 

Source: Adur Osteopathoic Clinic Blog