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As a Pediatric Chiropractor, Dr. Todd Donohoe, DC, DICCP has specialized, advanced training and certification in the evaluation, care and management of health and wellness conditions specific to pregnancy, infancy, childhood and adolescence. He is able to provide primary, comprehensive, therapeutic and preventative chiropractic health care for expectant moms, and their children—newborns through adolescents.

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Common Motocross Injuries - Identification, Treatment and Prevention - Part 1

Taylor

The weather is changing, the 100 degree days are gone and the red stickers are legal again!  It's dirt bike season!  Whether you ride the desert, the mountains, the sand or the track, we all have to deal with the same stresses on our bodies.  OK, some may have to deal with more stress than others, but the basics remain the same for everyone.  In this month's column, I will discuss the most common injuries associated with our sport, what they are, how to identify and treat them and better yet how to prevent them.

First, some essential information.  Sprains vs. strains.  A strain is an injury to a muscle.  A sprain is an injury to a ligament (ligaments hold bones to bones and tie our joints together).  Both are graded on a scale of 1-3.  Grade 1 is an excessive stretch.  Grade 2 includes some actual tissue tearing, but only partial.  Grade 3 implies a complete tear of the tissue involved.  Grades 1 and 2 can most often be managed by conservative methods, but grade 3 will usually require a surgical intervention to regain full activity in the affected area.  

According to the literature, the most common injury associated with the sport of motocross is to the knee joint.  It's no wonder when our entire body weight, plus some extra G forces, has to be absorbed by these two joints on every jump, bump and rut.  There are four major ligaments that tie the knee joint together.  The ACL or anterior cruciate ligament is the most commonly injured ligament of the knee.  Much like a tight rope, the ACL can be torn by a sudden contraction of the quadriceps (thigh) muscle when a sudden change in direction occurs, or when an externally applied force is projected directly onto the knee (such as the ground)!  When the ACL tears, the patient reports hearing a "pop" and there is a sense that the knee "went out".  The pain is usually bad enough to end the day's activity.  

The medial collateral ligament MCL is another commonly injured ligament of the knee.  This one will most often occur as a result of blunt force trauma directed at the outer aspect of the knee.  It pushes the knee inward and stretches the inside ligament.  The lateral collateral ligament, LCL, and posterior cruciate ligament, PCL, are also sites for potential injury, though less likely due to the rider's positioning on the bike.  If you feel as though you have received a knee injury, remember this: if the pain is on the same side of the knee that was hit, it will more than likely be a bruise and will heal quickly. However, if the pain is on the opposite side of the knee that was hit, you may have a serious injury and should seek professional treatment.  Chiropractors are well trained in the diagnosis and conservative treatment of grade 1 and 2 ligament sprains.  Grade 3 sprains will require orthopedic evaluation and most likely surgery to repair.

The features that give us our flexibility and extreme range of motion in the shoulder are the same ones that make it vulnerable to injury.  The shoulder joint is a very shallow ball and socket joint, a complex of muscles and ligaments that tie the arm to the rest of the skeleton.  The rotator cuff is a group of four muscles and their tendon attachment points on the shoulder and they are the most common of the shoulder injuries sustained by motocross riders.  These injuries are of the strain variety and occur in grades 1-3 as discussed previously.  Damage to the rotator cuff causes chronic pain, weakness and tenderness.  Treatment consists of soft tissue stretching and strengthening along with evaluation and treatment of the alignment of the shoulder joint

Above the rotator cuff is another area of the shoulder susceptible to injuries associated with riding.  The clavicle (collar bone) and the acromioclavicular or AC joint.  The clavicle is the bone that holds the entire arm to the rest of the skeleton.  It joins the arm through the scapula (shoulder blade) to the breast bone.  The point at which the clavicle and scapula meet is the AC joint and is the weakest point in the chain.  A fall onto the top of the shoulder can sprain the ligaments that tie the clavicle and scapula together.  AC joint separations can be painful and produce a visible bump on the top of the shoulder which is the end of the clavicle which was once attached to the scapula.  Most AC separations can be managed conservatively by a doctor of chiropractic unless significant weakness and muscle damage results in which case, surgery can be necessary.  

Next month I will continue with injuries to the wrist, ribs and spine.  Though professional evaluation and management of most of these injuries is necessary, some simple treatment at home can help to alleviate the less extreme of these injuries and will be covered in part 2 of this article next month.