(by Dr. Alomar-Jimenez)
The summer months has been exciting time for table tennis. Multiple competitions across the globe including US Open, WTT Contenders, Central and Caribbean American Games, Youth Pan-American Championships, among others, have been completed.
I had the honor to collaborate as a Team Physician in the Central American and Caribbean Games (El Salvador) and the Youth Pan-American Championships (Charleston, USA).
Ankle and Foot Injuries
Ankle and foot injuries are responsible for approximately 7.69% – 9.21% of table tennis injuries. These injuries can be mild, moderate or severe. I would like to discuss some of these injuries that occurred in recent table tennis tournaments.
Ankle Sprain
Lateral ankle sprain is the most common form and typically affects the anterior talo-fibular ligament (ATFL). It occurs due to excessive ankle inversion. Ankle pain, swelling and pain with weight-bearing are common presenting symptoms. Ankle sprains are classified as Grade 1, 2 and 3, depending on pathology, ligaments affected and findings on physical exam stress testing.
Typical mechanism of injury for ankle sprain.
Treatment
– Rest, Ice, Compression and Elevation.
– Patient may need radiographic imaging.
Return to Play
– Depends on the severity of the injury.
– Full range of motion, strength and pain free are indicators that the athlete may return to play.
Injury Prevention
– Bracing, Taping and Neuromuscular training has been shown to reduce re-injury.
Turf Toe
This injury refers to “Big Toe” sprain, first metatarsophalangeal (MTP) joint sprain. The injury is caused by forced dorsiflexion (hyperextension) of the first MTP joint. Risk factors include pes planus, decreased ankle range of motion and decreased first MTP range of motion. Pain and impaired range of motion of the “Big Toe” is the most common presentation.
Typical foot position when turf toe injury occurs.
Treatment and Return to Play
– Evaluate for Joint Instability and Alignment.
– X-rays and MRI may be needed in severe injuries.
– Freeze Spray can be used in game for return to play, if the athlete is able to tolerate.
– Immobilization with taping may be necessary.
Injury Prevention
– Early restoration of range of motion has been shown to be beneficial in recovery when the athlete is able to tolerate.
Subungual Hematoma
Occurs when direct trauma or repetitive pressure from footwear leads to bleeding under the toenails. The nail appears black and purple. The nail may ultimately loosen from the nail bed.
Subungual Hematoma
Treatment
– May require Nail perforation to release collection of blood.
– If the procedure is to be made, is strongly encouraged to be performed in an ambulatory clinic by a physician.
Injury Prevention
– Correct fitting footwear
– Appropriate lacing techniques
References
Analysing Of the Types of Injuries Observed In Table Tennis Players According To the Some Variables Leyla, A.Ebadi, M.Gunay, 2018
