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Wrestling Injuries and Illnesses- the Role of a Sports Medicine Physician

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Wrestling Injuries and Illnesses- the Role of a Sports Medicine Physician WRESTLING INJURIES AND ILLNESSES- THE ROLE OF A SPORTS MEDICINE PHYSICIAN Wrestling injures and illnesses are unique due to the frequency, and intensity of competition, and the close contact of the athletes with surfaces and with other wrestlers. In order to compete, wrestlers require a high degree of fitness and mental preparedness, along with a skill set of strength, flexibility, and specific wrestling skills. Weight classifications are established causing the athlete to maintain the required weight range during the entire season in order to compete. Monitoring this appropriate weight is a unique aspect to the sport, and can be challenging for these athletes. Wrestlers are chosen to compete according to their weight classes. Nutritional advice and ongoing consultation must be provided to the athlete throughout the season. A balanced diet is emphasized with calorie intake for maintaining weight and requirements during competition. This will prevent dramatic weight variances and excessive weight loss in order to “make weight.” Dramatic changes in weight and short interval weight loss can cause increase fatigue, loss of power and strength, dehydration, and increase the risk of injury and result in a decrease of performance. The athlete’s ideal competition weight is established by minimum weight certification programs. During the first two weeks of the season, each wrestler must weigh in. The athlete’s minimum weight is not established as the athlete’s best weight, but rather as no less than 7% of his/her initial weigh-in. The use of anthropometry or skinfold determination of body fat should also be used. Most authorities place the minimal weight at 5% to 8% of body fat. The most common injuries in wrestling are abrasions, contusions, lacerations to the face, tongue and lips, and repetitive blows to the ears and cauliflower ear. Cauliflower ear infections are caused by severe bruising to the ear. Wearing headgear is the mainstay to prevent these injuries. A Sports Medicine Physician is required to evaluate and acutely drain the ear hematoma and apply a pressure wrap to prevent a disfiguring injury. Skin infections with epidemics of a deadly skin infection, MRSA, is occurring in schools across the country. Showering daily can minimize the risk of skin infections. On site showering facilities must be available, and the athlete should not delay cleaning and wearing clean clothing at each practice and competition. The school must take a proactive approach to sanitizing mats with antiseptic solution after each practice and event. All skin infections require prompt Sports Medicine Physician evaluation and treatment. The wrestler may continue to engage in practice and conditioning, however, direct skin contact with other team members or competitors should be avoided until the infection is completely resolved. Other skin infections include Tinea Gladiatorum or “ringworm” (a fungal infection), Herpes Gladiatorum (a viral infection), and Impetigo (a bacterial infection). In the spring of 2011, a New York State Senator, Lee Zeldin, drafted a legislation that would mandate all the schools holding wrestling tournaments to have working showers and that the mats would be disinfected after every practice or competition. The bill will be introduced to the Assembly this year. Most of the time lost, surgery, and additional treatment are mainly caused by orthopedic injuries to the knees, shoulders, elbows such as fractures and dislocations. The most commonly injured areas are the knee (19%), shoulder (12%) and the ankle (9%). Knee injuries include MCL and LCL ligament sprains. The supportive knee ligaments are injured from excessive twisting force during take downs or during grabbing the ankle and forcing the wrestler to the mat. Lateral meniscus injuries to the knee are more common in wrestlers compared to other sports. Strengthening and flexibility programs can assist the athlete in preventing such injuries. The most common knee injury in wrestling is prepatellar bursitis. Prepatella bursitis or inflammation of the knee and bursa sac occurs as the wrestler is thrown or pushed on to the mat. Protective knee pads can cushion the force and impact. The mainstay of treatment includes rest, ice, compression wrap and NSAIDs medications such as Advil, Motrin or Aleve. Recurrent injury to the knee is common, with a 57% chance of reinjury to the affected knee. The incidence of injury in wrestling is relatively high in comparison with other sports. The focus on proper conditioning, appropriate weight maintenance, nutritional programs and early treatment of illnesses and injuries is important during the season. Preventing dermatological illnesses by having onsite showering, having an athletic trainer and a Sports Medicine Physician to acutely access the athlete is critical in order for the athlete to continue to compete. The primary approach in wrestling is illness and injury prevention. This is a team approach with the participants, parents, coaches, trainers, and the Sports Medicine Team Physician. This requires adherence to infection prevention protocols, early intervention and treatment. The school should be providing high quality equipment, including mats, uniforms, headgear and protective pads. Wrestlers need proper coaching and supervision stressing techniques and discipline to prevent injury. Officials are also part of the prevention team. Wrestling is physically demanding and they require well-organized, structured conditioning and strengthening programs during the season. The goal is to enhance the athlete’s performance as the season progresses, and to comprehensively support the athlete during the entire season. .
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