Megan Thomas

Sports & physio columnist

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Physio's guide to the top 5 injuries from the Rio Olympics

Watching athletes suffer insane injuries at the Olympics may not be your favourite past-time, unless of course you're TropicNow columnist and physio Megan Thomas.

With any competitive event there are bound to be injuries and the 2016 Rio Olympics was no disappointment.

"No disappointment?" you ask? That’s correct: sports physio’s love injuries and it may not be for the reason you think.

We love to analyse what actually happened, which bone or structure was hurt, the mechanism of how it happened, how long the recovery would be, and the big question: is it career ending?

Of course we are also well aware of what emotions are associated with these injuries.

Loving to watch, slow down, analyse and talk about these injuries does not mean we are being insensitive to the athlete whose dreams have just been shattered.

The injury, the devastation and the pain has already occurred - we are just then moving on with this athlete's next stage and that is getting their injury diagnosed.

So what were the top five injuries from Rio from this point of view?

1. Andranik Karapetyan

The Armenian weightlifter crashed out of the Olympics in agony as his left elbow gave way during a second attempt to lift 195kg (429lbs).

Some news headlines said his elbow "snapped" but this isn't correct. His elbow actually dislocated – a very cool thing for a sports physio to see.

Firstly, this is not a common injury, especially one where it is recorded from many angles in such good quality film.

The elbow is actually a very stable joint as it has large bony stabilising features, unlike that of its neighboring shoulder or Glenohumeral joint (GHJ).

Secondly, it requires very large forces to dislocate it and hence we know it is going to be a huge force to produce such a dramatic result.

In the pictures we all saw from Rio we got to see the exact weight, angle and direction of the force – what more could an biomechanical analysis want?

2. Samir Ait Said

Once again the commentator's got it wrong by constantly saying Samir's leg snapped as he tried to complete his vault during team preliminaries.

To listen to the commentator with physiotherapist knowledge of what has just happened was rather comical as it was said that his knee was in trouble.

In fact, his knee was OK. It is the fact that his left lower limb now has two ‘knees’ that is his problem.

While a broken tibia and fibula is not that uncommon, this mechanism is. It often happens in contact sports where there is a direct impact to the shin area, usually from another player's foot or body.

Gymnastics or athletics participants have been known to ‘snap’ their tibia and fibula due to having a tibial stress fracture and then landing heavily on that foot one too many times and finally breaking at this stress fracture point.

This gymnast actually landed on his shin from a height at speed, from a double pike vault to be precise and thus it could be the result from either mechanism – forceful direct impact to the shin and clean break or impact to a stress fracture point and easily snapped.

It was a point of high discussion amongst physiotherapist’s following Rio, and only Samir Ait Said and possibly those closest to his pre-Games lead up will truly know the answer.

3. Kim Mickle

The Australian javelin thrower dislocated her right shoulder during a qualifying throw.

This was when most sports physiotherapists literally tired to jump off their lounges and into the television screens to help Kim by relocating her shoulder.

What happens is that the ball at the top of the humerus (arm bone) pops out the front of the shoulder joint, and the sooner that ball is back in place the better the prognosis for that athlete, not to mention the immediate pain relief.

No Physio will ever forget the look on the person’s face as they relocate that athlete’s shoulder.

Kim’s shoulder was reportedly out for three hours at Rio, a duration that definitely makes a physiotherapist cringe and wonder if only someone had been able to act immediately would her shoulder have still been out that long.

4. Abbey D’Agostino

Abbey and Nikki Hamblin became famous in Rio for their display of sportsmanship in the women’s 5000m, but for sports physiotherapists it was all about viewing every angle possible to determine the extent of Abbey's knee injury.

The commentators first stated this was an ankle injury, when those of us with medical knowledge could clearly see the knee buckle and give way.

But as she tried to continue around the track, it meant that not only did we have one image to analyse when the damage occurred but a second when the knee gave way as she tried to continue around the track.

At this point she actually held her knee and in replay we saw her mouth the words "I think it's broken". This coupled with the giving way is a huge indicator to a physiotherapist that the ACL is the structure likely to be affected.

In slow motion replay we got to watch the huge medial forces grow through the knee and we then knew the “unhappy triad” was competing for the overall naming rights to D’Agostino’s injury.

A point to also mention on this injury is that most athletes will rate this as 10/10 pain for at least the first 30 seconds after the rupture occurs, but Abbey was already up by this point and trying to help Nikki to her feet.

Next time your bored Google a "footballer rupturing their ACL" and watch how they not only lie there screaming for a good few minutes holding their knee, they are stretchered off the field to the sanctuary of a green whistle.

That's a stark contrast to the way Abbey got up, ran, fell again, got up again and finished the race. Now that’s impressive: you go girl!

5. Annemiek Van Vleuten

The Dutch cyclist flew over her handle bars in the Olympic road race, landing on her head and making us all grimace at home.

The slow-mo feature was again in use by sports physios around the world to see where she went wrong and lost control and how she flew through the air, impacted the ground, twisted and finished in an awful side flexed/compressed position.

The brain and neck were obvious points of concern from viewing this footage and the possibility of extreme brain damage and even death was high up there as she lay motionless in the ditch.

Luckily (if you could this injury 'lucky') she escaped with three fractured vertebrae and a concussion.

Coming first in a cycling road race comes with huge risk-taking and it's only those that take the risks that are out there in the first place.

This was one risk too many for Annemiek but oh boy did it gives us some awesome sports injury footage!