SINGAPORE - It happened in a matter of seconds. One minute, Ethan Chong was diving for the ball during his football training, and the next, he was on the ground with a dislocated shoulder. 

He had fallen on his arm in an awkward position, causing his joint to pop out of its socket. He sat on the ground in panic for a few seconds before the joint popped back into place on its own. 

Recounting the injury, Mr Chong, 19, recalled the immediate pain and soreness he felt, as well as his inability to lift his arm after sustaining the injury. Once his training ended, he went to the accident and emergency department to consult a medical professional.

“The doctor said that my shoulder would now be slightly more prone to recurrent dislocations in the future because the tendon holding my shoulder joint and socket together is now damaged and cannot hold them together as well as before,” said Mr Chong.

“Additionally, if dislocations do occur, the tendon would completely tear and my shoulder will be prone to dislocate very easily.”

After his first injury, Mr Chong continued to experience around two to three dislocations a year, further worsening his condition. Eventually, his tendon tore, and he went for surgery to repair his shoulder joint. 

Mr Chong is just one of an increasing number of young people with sports- and recreation-related injuries. The injuries, which range from fractures and dislocations to concussions, are often sustained during sports training or other physical activities. 

In 2020, a paediatric sports injuries study based on data from 2012 to 2017 at the KK Women’s and Children’s Hospital Children’s Emergency found that the most common types of injuries among those aged 13 to 17 were fractures, sprains and contusions, superficial injuries such as cuts and abrasions, neurological injuries, and then dislocations. 

The majority of these injuries are caused by impact to the bones and soft tissue, as well as overstretching or tearing ligaments, muscles or tendons. Concussions, a form of neurological injury, are the result of impact to the head, leading to a temporary loss of brain function. 

Dr Benjamin Soh, registrar of orthopaedic surgery at Khoo Teck Puat Hospital, said: “Other injuries that frequently occur but often do not present to the emergency department include overuse injuries: These develop over time due to repeated stress on a particular part of the body, such as tendinitis or stress fractures.”

He added that while the reason for each injury may vary depending on the sport or activity, the common causes include equipment issues, environmental factors and poor technique or form.

Additionally, a lack of conditioning, when the athlete has insufficient endurance or strength for his desired sport, as well as excessive training, can lead to fatigue and thereafter an increased risk of acute or overuse injuries. 

Dr Han Fucai, head of division and consultant at Ng Teng Fong General Hospital’s Department of Orthopaedic Surgery, said he saw a rise in the number of youth patients with sports-related injuries post-Covid-19, with around 50 such patients per week, a nearly 50 per cent increase from pre-Covid-19 numbers.

“This is probably because teenagers and young adults start to become active after a prolonged period of inactivity and lockdown. Due to inadequate conditioning and the excitement of restarting sports after stopping for a long time, they get injured more often,” he said. 

Dr Han also noted that adolescents involved in competitive sports were subject to the same level of competitiveness that adult athletes were, and that youth tended to have a reduced perception of risk and have “boundless energy”, which could lead to a higher risk of injury.

As in Mr Chong’s case, young people who sustain sports injuries are often at risk of re-injury in the region of their original injury. Furthermore, they could also suffer decreased mobility or strength, as well as chronic pain issues if their injuries are improperly treated or rehabilitated. 

Ms Tan Ee Leng, senior physiotherapist at Alexandra Hospital, said: “Compliance and adequate rehab are crucial in preventing recurrent injuries. If there are frequent or severe sport injuries, this may put the youth at an increased risk of further injuries when older or at risk of degenerative conditions like osteoarthritis (OA). For example, patients with ACL – anterior cruciate ligament – injuries or ACL reconstructions have an increased risk of knee OA.” 

A delay in seeking medical intervention after injury may also lead to the injury worsening. If rehabilitation or treatment plans are not consistently followed, there may be long-term consequences for the patient. 

“For patients who neglect their physiotherapy, they may not be able to hit their expected milestones of recovery in a timely manner. Also, they may continue to experience symptoms such as pain or instability which may become chronic and affect them even after the injuries have healed,” said Ms Tan. 

Mr Hari Thevar, a 24-year-old student who suffered a shoulder labrum tear from boxing, was told he had to go for physiotherapy for a year after undergoing keyhole surgery to treat his injury. Although he managed to do so consistently for the initial four to five months post-surgery, he struggled with finding the time to do so once school had started, and eventually stopped. 

Said Mr Thevar: “I never regained proper range of motion for my shoulder’s external rotation. Sometimes, when someone pulls my arm or when I’m stretching, it’s still super-tight and because of that it does have some pain.”

For those keen on participating in sports, both competitively and recreationally, Dr Soh advises them to engage in proper training and conditioning, such as specific training to slowly improve strength, as well as pacing the training according to the individual’s needs.

Using appropriate equipment and following safety guidelines is also of utmost importance. If one does end up sustaining an injury, one should immediately stop and seek medical attention to prevent further injury. 

“A structured rehabilitation plan post-injury will help to reduce the risk of re-injury. Avoid premature return to strenuous activities before clearance from your medical professionals,” said Dr Soh. “Giving your body adequate rest and recovery time between physical activity sessions can help prevent overuse injuries and improve overall physical performance.”