Nutrition in Combat Sports

17 Wushu (Chinese Martial Arts) 317
extremity with the wrist dorsiflexed. Bone scan or CT scan may be needed to diagnose
or delineate the fracture if it is not seen on radiographs. The most frequent significant
fractures that cause residual problems are fractures of the scaphoid, lunate,
and hamate. A vascular insult may affect bony healing or cause avascular changes
(Kienbock disease of the lunate). Surgery may be required depending on the location
of the fracture and the orientation of the vascular supply.
Treatment of metacarpal fractures depends on the location and amount of angulation
and rotation of the fracture and whether there is extension into the joint.
Some fractures can be treated with casting after reduction while others require
surgery. Splinting is recommended until further assessment by a hand surgeon.
17.12 Hip and Thigh Conditions
A wide variety of hip injuries and conditions are present in Wushu participants,
where the demands of the sport frequently outpace the tolerance of the joint and its
supporting structures. Some athletes have an anatomic predisposition to hip joint
laxity, such as a dysplastic development of the hip, which allows great mobility but
tends to make the hip joint unstable. Hip and thigh injuries in Wushu athletes are
much like those encountered in dancers and gymnasts.
An athlete with snapping hip syndrome feels a popping sensation, clicking, or
possibly a shifting in the joint, which may be palpable or audible and may or may
not be painful. Often this click can be reproduced volitionally. Most frequently
snapping of the hip is caused by the iliopsoas passing over the iliopectinal eminence
or the iliotibial or gluteus maximus tendon passing over the greater trochanter,
but acetabular labrum tears also can be a cause. The diagnosis is clinical
and imaging studies seldom are necessary, although this phenomenon has been
documented with ultrasound.
Femoral-acetabular impingement syndrome causes anterior hip and inguinal
pain that is exacerbated by hip flexion, adduction, and internal rotation. Excessive
stress on the hip joint or abnormal contact between the femur and the acetabulum
causes inflammation of the anterior capsule and labral complex. The impingement
test (pain elicited by 90 degrees of flexion, adduction, and rotation of the hip) is
almost always diagnostic. Athletes with hypermobile hips and an anatomic mismatch
between the femoral head and the acetabulum may be predisposed to this
condition, and it is believed to contribute to the development of labral tears and
osteoarthritis.
Labral injuries can be caused by an acute injury or progressive attritional
changes; they may represent a continuum, with impingement leading to progressive
joint narrowing and degenerative arthritis. Symptoms overlap those of snapping hip
syndrome and impingement. Athletes with hip dysplasia, altered femoral head contour,
or abnormal femoral head–neck configuration are predisposed to labral tears.
Although standard radiographs can identify bony abnormalities, MRI/arthrogram
with contrast is the “gold standard” for identifying labral tears.