key procedureSports Surgery

Like many of his patients, Dr Alan Cheung is a keen sportsman, having participated in athletics and rugby at college, and in mixed martial arts (Evolve MMA) currently. He also enjoys golf, skiing and cycling. He is a Ringside Doctor for One Championship and pitchside doctor for international events such as the HSBC Sevens and SuperRugby. He is a member of the Faculty of Sports and Exercise Medicine, UK.

Which Athletes Do We Treat? – Everyone is welcome
At International Orthopaedic Clinic (IOC), we see many athletes of all ages and abilities involved in all types of sport. These include the weekend soccer player, the ironman competitor in their 60’s, members of national teams, and martial arts World Champions. Our philosophy is the give you the best possible care to get you back to your desired sport as soon (and as safely) as possible. We also understand that not everyone needs surgery and may recover well with physiotherapy alone.

Sports Specific Physiotherapy
We understand that each athlete is different in terms of their body size, shape and how their body functions. Every sport has unique demands that are placed upon different parts of the body. This is why IOC partners with sports specific physiotherapists who are experts in their own sporting fields. This enables patients to understand their injury and treatment better, as well as having someone who understands their sport at a high level looking after them.

What kinds of injuries are seen and will I need surgery?
All types of musculoskeletal injury are seen at IOC. These range from sprains and partial tears of tendons or ligaments which may managed without surgery, to full tears, broken bones and worn out or dislocated joints which may require surgery. A careful history and examination will be performed, and you will likely need some form of imaging such as an XR and/or MRI of the affected area. In most cases a trial of non-operative management will be trialled involving sports specific physiotherapy, painkillers and bracing. Steroid injections can sometimes be helpful.

COMMON CONDITIONS THAT MAY NOT REQUIRE SURGERY

Runner’s Knee (Patellofemoral Pain Syndrome)
Runner’s Knee or Patellofemoral Pain Syndrome (PFPS) is irritation of the cartilage under the kneecap, resulting in pain at the front of the knee. This typically occurs after long runs, sitting for long periods, or whilst going down hills or stairs. Risk factors include overpronation (excessive rolling of the foot inward), and weak quadriceps or gluteal muscles.

Achilles Tendonitis
The Achilles tendon connects the gastrocnemius muscles (2 large muscles at the back of the calf) to the heel. Repetitive stress may cause inflammation of the tendon (tendonitis). Rapid increases in training intensity and duration, as well as weak tight calf muscles are predisposing factors for achilles tendonitis.

Iliotibial Band Syndrome (ITBS)
The iliotibial band is found on the outside of the thigh, running from the hip to the knee. Running causes the iliotibial band to rub on the outside of the thigh bone at the knee causing pain. Foot overpronation, weak hip and abductor and gluteal muscles can contribute.

Plantar Fasciitis
The plantar fascia is a thick band of tissue in the sole of your foot, which connects your heel to your toes. Small tears in the plantar fascia cause pain along the heel and inside of your foot, particularly in the morning. Runners with excessive pronation or supination (rolling of foot inwards / outwards), abnormal foot arches, and rapid increases in mileage are at risk. Recovery time with complete rest can take 3 months to a year.

Hamstring Injuries
The hamstring muscles are located at the back of the thigh, and help bend the knees. Hamstring pain may occur when the muscles are weak, and overpowered by the stronger quadriceps muscles. The spectrum of hamstring injury includes sprains which may take several days of rest to recover, to a full blown tear which takes months to heal.

Shinsplints
Shinsplints or medial tibial stress syndrome refers to pain along the inner border of your shin bone, where muscles attach. They are common in new runners and indicate too much running too quickly, or the wrong type of shoes.

Stress Fractures
These occur through repetitive strain on the bone and commonly occur in the shinbone, feet and heel. Overtraining is a major risk factor. Underlying conditions such as vitamin D and nutritional deficiency, low bone density, and low calorie intake can also be responsible.

COMMON CONDITIONS THAT MAY REQUIRE SURGERY

For more information on these conditions, please see the SERVICES section of the website.

Meniscal Tear
The menisci are shock absorbing pads that sit between your thigh bone and shin bone. Twisting movements during sports may tear the meniscus and lead to pain, swelling and restriction of knee movement. In this circumstance you may benefit from repair or removal of the torn meniscus.

Anterior Cruciate Ligament Tear (ACL)
The ACL is a rope like structure that prevents the shin bone from sliding out of position during pivoting and sidestepping movements. If you have a torn ACL, and your unstable knee is preventing you from playing sports you enjoy then you may benefit from an ACL reconstruction.

Rotator Cuff Tear
The rotator cuff are a group of muscles that help move and stabilise your shoulder joint. A rotator cuff tear may be extremely painful and stop you from lifting your arm up or behind your back. You may find simple activities like dressing and washing difficult, and playing sports impossible.

Cartilage Injury
Cartilage is the lining of large joints such as the hip, knee and shoulder which allows smooth movement during day to day activities and sports. A fall or injury may injure your cartilage. Cartilage has a poor blood supply and does not heal well. Failure to treat a cartilage injury may lead to osteoarthritis over time. If pain persists despite non-surgical management, you may benefit from a keyhole surgery procedure called microfracture where tiny holes are drilled into the bone to allow cartilage healing to take place.

Achilles tendon tear
The Achilles tendon connects the calf muscles to the heel bone. It is important to allow pushing off motion of the foot (plantarflexion) during walking, running and jumping. An achilles tendon tear can occur spontaneously during sports and can feel a kick to the back of the leg. You will have difficulty walking properly. Your doctor will diagnose the tear through clinical examination and sometimes an ultrasound. You may benefit from repair of the achilles tendon if you play sports involving running and jumping.

FAQ’s About Sports Surgery

How big is the scar?
Most sports surgery operations are through small ‘keyhole’ incisions using a telescope system. Most scars fade away and are not noticeable over time.

Does it hurt?
You will be asleep during the surgery and will receive strong painkillers after the surgery. Most people can stand straightway following a sports surgery to the leg. Some can go home the same day.

How long does it take to recover?
It depends on the type of surgery you have. Wounds take around ten days to heal and there may be swelling around the joint for several weeks. You will start physiotherapy soon after the surgery. Return to sports can take weeks to months depending upon the procedure. Most can return to work after 2-6 weeks, depending upon their occupation.

Feeling Pain from Your Injuries?

Dr Alan Cheung is a Consultant Orthopaedic Surgeon specialising in Sports Injuries such as torn ligaments and tendons, and cartilage injury in the knee, hip and shoulder, Adult Joint Reconstruction including total and partial Knee Replacement and Total Hip Replacement for osteoarthritis, and Robotic Surgery (Makoplasty, Navio and Robodoc systems). He has also received extensive training in trauma (fixing broken bones) and musculoskeletal tumour (bone cancer) surgery.

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