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A stretching or tearing of the ligament occurs when joints are moved beyond their normal range of motion and the collagen fibers within the ligament are pulled apart. Joint "sprains" most frequently occur at the knee (medially), the ankle (laterally), and the acromioclavicular joint of the shoulder (shoulder separation).

Ligament injuries are graded by physicians:

Grade 1 (mild): Ligament is stretched but still intact. Bleeding is minimal, some mild pain and swelling with no instability.

Grade 2 (moderate): Involves a partial rupture of the ligament. Moderate bleeding, pain and swelling. Inability to walk on the limb.

Grade 3 (severe): Complete tear of the ligament. Extensive bleeding, severe pain and swelling. The athlete is usually unable to bear weight on the limb. Potential feeling of complete dislocation (even though that may not have happened).

More tips at the Province Sports Academy.

Signs and symptoms include varying degrees of pain. Athletes will often report a "popping" or "snapping" sound at the time of the injury. Immediate discoloration and swelling is often indicative of a more severe ligament sprain.

If the athlete is unwilling to move the area, a fracture should be suspected. The shoe (in the case of an ankle) or other equipment/clothing should not be removed as this may cause further damage.

Follow the PRICE principle. PROTECT the area from further injury (wrap). REST the area to promote healing. ICE the area to reduce inflammation. After 72 hours, use both hot and cold treatment to encourage bad blood away from the area. COMPRESSION helps with inflammation. For a knee or ankle ligament injury, ELEVATE the area to promote circulation towards the heart.

With a severe sprain, attention by a physician is necessary. All athletes should be referred to a therapist for a comprehensive rehabilitation program consisting of strength and flexibility exercises, as well as soccer-specific return to activity drills.

After receiving medical clearance, wraps, taping and/or bracing is always a good idea to protect the injured area.

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Photo: Reuters

In the muscle-tendon unit, the area where the muscle joins the tendon is often the weakest link in the chain. Consequently, this is often the location where acute ruptures or complete tearing of the tendon occurs. The tendon, however, can also completely tear away from its bony attachment. A rupture of the Achilles tendon is a common injury for soccer players.

Achilles tendon ruptures often occur when quick, explosive actions are involved - like when a player cuts to get away from an opponent or chases after the ball. Micro tears of the tendon from prolonged tendonitis can also be a contributing factor.

Signs and symptoms include a loss of muscle function and pain (you won’t be able to push off to run using your calf muscle). Athletes will usually report hearing a “snap” or a “pop,” or say it felt like they were kicked in the back of the leg. Swelling and deformity may occur, as the affected muscle will bunch up in a contracted state.

On-site management includes following the PRICE principle. PROTECT the area from further injury (by bracing). REST and ICE the injured area often. COMPRESSION is NOT recommended. ELEVATE to increase circulation towards the heart. An immediate trip to the hospital is mandatory because in most cases, surgical reattachment of the muscle is necessary.

More tips at the Province Sports Academy.

After physician approval, see a physiotherapist for modalities, range of motion, and strengthening exercises.

The athlete should prepare for a lengthy spell on the sidelines as the recovery process takes a minimum of four months. Only after an exercise rehabilitation program and a doctor’s OK can the player return to activity.

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Photo: Getty Images

A series of proposals aimed at reducing the number of serious injuries in ski racing was unveiled earlier this week by Alpine Canada after the conclusion of a two-day Safety Summit held in Calgary.

The summit brought together leading doctors, scientists, coaches, athletes, equipment specialists and other experts from the ski community.

Following a series of presentations, discussions and workshops, Alpine Canada Alpin (ACA) president Max Gartner announced a series of measures aimed at improving safety in domestic ski racing, as well as a strategy to work with the International Ski Federation (FIS) to call for improvements at the World Cup level.

"We have taken a big step forward," said Gartner. "By focusing on the risk factors related to injuries we were able to determine where we are at from a scientific point of view and examine what changes can be made, both now and over the longer term, to reduce injuries.

"Safety is a multi-faceted issue that has to be addressed at a number of levels. At the domestic level, we need to communicate these changes and recommendations to our stakeholders. At the elite level, we will put together a proposal to present to FIS."

Gartner said a detailed document will be put together outlining key initiatives and recommendations agreed at the two-day summit, alongside a strategy for rolling out those plans at the domestic and international levels.

Highlights of the proposals and recommendations agreed at the summit include:

- Consistent snow preparation: Avoiding the use of water injection when building courses for domestic ski racing

- Quality course setting: Ski courses in Canada to be set according to conditions, with a focus on reducing speed

- Jump progression: Specific jump training to be introduced for young Canadian skiers, to improve their skill level

- Suits: ACA to lobby for different ski suit materials to be used at the elite/World Cup level to increase padding and slow down ski racers

- Helmets: Alpine Canada Alpin to conduct safety testing of helmets used by national team athletes

- Mouth guards and back braces: Their use will be strongly recommended at all levels of ski racing

- Nationwide tracking system for athletes to be introduced to monitor physical testing, injuries suffered by Canadian skiers of all ages

- Team selection criteria: Young Canadian skiers to be encouraged to race technical events (slalom, for example) before they focus on downhill racing, which will not commence until age 18. There's a bigger injury risk factor with downhill racing due to increased speed.

- Examine use of sleeves and other devices to reduce the risk of knee injuries

- Improve the management of skiers

"It was really good to have representatives of the provincial ski organizations here to be part of this process," said Gartner.

"We've made some progress, particularly with how we approach speed events - going from skill development at the lower level to increasing the age at which skiers are eligible to race in downhill to 18. We also want to make sure we create consistent snow conditions, preferably without the use of water injection. The general aim in course setting will be to reduce speed."

At the World Cup level, ski, boot and binding setup has been found to be a significant risk factor for injuries. FIS is working on rule changes and equipment modification in those areas, but they are not expected to be introduced some time after the 2011-12 season.

"The big thing we are waiting for is equipment changes," said Gartner. "We have to be patient because it takes a little more time to implement these things at the international level."

ACA also plans to lobby FIS to change the fabric used in the suits worn by elite skiers. More padding and a reduced emphasis on making the suits as aerodynamic as possible could help to reduce injuries, said Gartner.

Ten national ski team members, including North Vancouver’s Manuel Osbourne-Paradis, Whistler’s Ashleigh McIvor and Chilliwack’s Kelly VanderBeek all suffered serious long-term injuries over the past two seasons.

VanderBeek was the main athlete representative at the Safety Summit. The 28-year-old said she is optimistic that the proposals put forward at the meeting will make a difference.

"I have come to realize that there's no silver bullet when it comes to safety," said VanderBeek, who has developed an athlete survey to gain feedback from skiers who suffer injuries. "But I'm very hopeful looking forward."

Physiotherapist Chris Napier (of SportMedBC) was a member of the Canadian Core Medical team working with the Canadian Ski Cross squad at the 2010 Winter Olympic Games. He’s worked directly with some of the national team skiers who are recovering from injury. While complete injury prevention is difficult, Napier told SportMedBC.com making the sport less dangerous is a possibility.

“It’s such a physical sport and the body takes a beating, but there are many factors that can be addressed and that could lead to fewer injuries.   

“Athlete conditioning, strength training, course safety, equipment, along with snow and weather conditions all play big roles. Fatigue levels also affect the athletes. The racing, travel and time change can catch up with them during the ski season.

"But focusing on these issues will help these athletes out in the long run." 

The two-day Ski Racing Safety Summit was the first of its kind held in Canada.

- with files from Alpine Canada and the Canadian Press

Photo: Canadian Press

When a player rises for a header – unfortunately more often than not – their elbows also rise, striking the opponent in the face. That’s just one of the ways a soccer player can suffer a dental injury.

A tooth may chip, be knocked loose or get completely knocked out. A blow to the upper or lower jaw is the usual mechanism by which the teeth can be damaged. A fractured tooth could expose the nerve, rendering the tooth very sensitive to cold, and thereby requiring the athlete to keep his/her mouth closed.

Signs and symptoms include cracking, splitting or chipping of the tooth, along with pain and sensitivity.

When managing the injury onsite, stop the bleeding by having the athlete sit with their head forward, allowing the blood to drain from the mouth. Apply pressure with sterile gauze to any areas of the mouth that may be affected.

More tips at the Province Sports Academy.

The injured area should be protected from the air by wrapping it in wet gauze. A small amount of calcium hydroxide can be applied to the exposed area to reduce the pain.

If a tooth has been completely knocked out, immediately replace the tooth back into the socket, provided that the tooth is clean and replacement is easily accomplished. Do not attempt to wipe the tooth clean as this may destroy an important membrane surrounding the tooth and it will delay treatment. Rinse the tooth with only water or saline solution. If it’s not possible to replace the tooth, have the athlete carefully hold it under their tongue (very carefully as the athlete may inadvertently swallow the tooth) or wrap it in a saline-soaked gauze pad. Alternatively, the tooth can be placed in a container of saline solution or milk.

A trip to the dentist is mandatory, with an immediate visit required if the tooth is completely knocked out. There’s only a small window of time to save an injured tooth.

Possible prevention of a dental injury includes the use of a mouthguard.

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Photo: Associated Press