Knowledge
Medical Insight: Polodoc
Dr.med. Andreas Krüger is a Swiss board orthopaedic and trauma surgeon in Zurich, who specialises in knee and shoulder surgery. Andi is a second generation of tournament doctors for equine sports, known as Polodoc since 2013 and affiliated with Polo Park Zurich
Double Impact, Triple Trouble Restarting riding and playing polo after a minor injury can be fateful when the initial injury is underestimated, and diagnostics tools are used too late. In professional sport teams, mostly maximal diagnostics are used on the injury day or within 24 hours to fully assess all dimensions of morphological damages. The precise identification of potential failure points can be crucial for the sport and can prevent on-going impairment and delayed recovery, to full function or secondary chronic disability.
Injury Mechanism
Relatively minor medical injuries like a tendinitis or partial rupture of the insertion of the adductors (riding muscle) can majorly limit your polo performance when the stable A-frame is at risk and movements out of the middle of the saddle are painful. Not
being able to hold that powerhouse in a stable position can lead to non-stoppable imbalance with an increased risk of leaving the horse unintentionally. With that increased risk, the chance of injuring the upper extremity while landing is immensly increased.
Diagnostics
Most polo clubs have some kind of medical staff, which provides basic medical care for tournaments or club events when a fall occurs. Due to the fact this basic care is trained for treating life-threating emergencies, initial minor injuries can be under-estimated or stay undiagnosed. In some cases a medical therapist like the physiotherapist or chiropractor recommends diagnostics after an unsatisfactory or delayed result due to conservative treatment. Initial body checks
Initial X-ray of the pelvis does not show a dislocated fracture of the bone.
46
Polo Times, October 2020
by the general practitioner or family doctor who is unaware of critical polo injuries can mean that the impact of these relatively small injuries can be under-estimated. Secondary assessments of bone and soft tissue after a physical examination need more and more cumbersome referral to a radiological department when ultrasound or x-ray diagnostics are outsourced. In case of dissonance of clinical symptoms and basic radiological results, early cross-sectional diagnostics can be key for correct evaluation and interpretation of the underlying injury.
Case Study
In this case, the initial injury was an adductor injury on the left leg with a partial tear of the insertion. This is a very painful injury to the most important muscle for the polo player when stability in the saddle is needed. Initial diagnostics were done with conventional X-ray where no relevant injury of the bone was stated by the radiologist. Secondary cross-sectional imaging with MRI was recommended but refused by the player. While recreational riding a secondary fall happened with a hard impact to the ground and landing in the ‘superman position’ with impact to the left shoulder and side of the
Partial-tear of the supraspinatus tendon
www.polotimes.co.uk
