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Internal Abdominal Injuries: Athletes

Internal Abdominal Injuries: Athletes

Children, teens, and adults participate in organized and recreational sports activities for fun, exercise, and social benefits. Individuals and parents are used to scrapes, bumps, bruises, sprains, and strains. However, internal abdominal injuries from the body colliding with another player or object are less common but dangerous. Abdominal injuries make up less than 4 percent of sports injuries but can be severe when they occur. These injuries are common in sports like wrestling, gymnastics, soccer, basketball, football, skiing, snowboarding, BMX freestyle, motocross, skateboarding, ice/field hockey, and lacrosse. Early symptoms are not always obvious or apparent and can be mild or seem to go in a different direction away from the abdominal region, which is why it is essential to know what to look for.

Internal Abdominal Injuries Athletes

Internal Abdominal Injuries Athletes

There are about 3oo 000 abdominal sports-related injuries. Kids and young athletes risk injuring their abdominal organs because their abdominal wall is thinner and still in development. However, internal abdominal injuries to the stomach, small and large intestine, spleen, liver, and kidneys can and do happen in adults.

Injury Types

Sports-related internal abdominal injuries are considered rare, but studies suggest they are increasing. The most common sites include:

Liver

  • This causes pain in the upper right side of the abdomen.
  • The liver has two lobes.
  • The right lobe is the one that gets injured more often because it is bigger and presses against the ribcage.
  • A torn liver can cause severe bleeding.
  • Shock can develop from the bleeding, causing heart palpitations, rapid breathing, shortness of breath, and a pale, grey, and/or sweaty appearance.

The liver and spleen are the most commonly injured organs in sports. They are filled with blood and can get bruised, or ruptured, and can cause severe bleeding when torn or cut. Bleeding in the abdomen can irritate the diaphragm, which can cause pain in the shoulder. Sometimes shoulder pain is the only symptom making it difficult to diagnose and because bleeding can take time to develop, the symptoms might not present for several hours.

Spleen

  • This causes pain in the upper left side of the abdomen.
  • The spleen filters around 10% of the body’s blood supply every minute.
  • A torn spleen can cause rapid and life-threatening internal bleeding.

Kidneys

  • The kidneys can be injured by a blow/hit to the back or flank that causes bruising or laceration.
  • This injury can cause flank/side pain, blood in the urine, nausea, and/or vomiting.

Abdominals

  • A single organ or multiple organs can be injured.
  • This can be the pancreas, diaphragm, stomach, gallbladder, bladder, or intestines.
  • Bruising discoloration or bruising, particularly around the belly and flanks.
  • This can cause abdominal pain with movement that does not get better that could be accompanied by fever, nausea, or vomiting.

Running into an object, another player, or falling hard can cause bruising, laceration, or create a tear/opening of a bowel wall. Symptoms can be delayed days to weeks after the injury when inflammation or infection develops.

Recognizing Internal Injuries

Signs and symptoms to look for include:

  • Abdominal pain
  • Bruising around the abdominal area.
  • Tenderness over the injured area.
  • Rigid abdomen.
  • Left-arm and shoulder pain.
  • Right-sided abdominal pain and right shoulder pain.
  • Blood in the urine.
  • Cold, sweaty skin.
  • Nausea and vomiting.
  • Rapid heartbeat.
  • Low blood pressure.
  • Loss of consciousness.

Treatment

Chiropractic focuses on whole-body health and can help with abdominal injuries. The nervous and digestive systems are interconnected, meaning that damage could lead to viscerosomatic reflexes even if not directly injured. If internal damage or bleeding has occurred, individuals will be referred to a specialist, surgeon, or another emergency medical professional. If internal damage is ruled out, a chiropractic treatment plan that includes adjustments, massage therapy, manual and mechanical decompression, exercises, stretches, and health coaching will help with tissue injuries and problems that are causing gastrointestinal distress.


Spinal Non-Surgical Decompression


References

Arumugam, Suresh, et al. “Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis.” Journal of emergencies, trauma, and shock vol. 8,4 (2015): 193-8. doi:10.4103/0974-2700.166590

Barrett, Cassie, and Danny Smith. “Recognition and management of abdominal injuries at athletic events.” International journal of sports physical therapy vol. 7,4 (2012): 448-51.

Kucera, K. L., Currie, D. W., Wasserman, E. B., Kerr, Z. Y., Thomas, L. C., Paul, S., & Comstock, R. D. (2019). Incidence of Sport-Related Internal Organ Injuries Due to Direct-Contact Mechanisms Among High School and Collegiate Athletes Across 3 National Surveillance Systems. Journal of athletic training, 54(2), 152–164. doi.org/10.4085/1062-6050-271-17

Slentz, Cris A et al. “Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT.” American journal of physiology. Endocrinology and metabolism vol. 301,5 (2011): E1033-9. doi:10.1152/ajpendo.00291.2011

Viscerosomatic Reflex:  Internal Organ Distress Back Pain

Viscerosomatic Reflex: Internal Organ Distress Back Pain

Low back and mid-back pain could be caused by abdominal or pelvic organ distress/irritation or infection that an individual doesn’t know about. This could be a viscerosomatic reflex. This can be the case when there is no back injury, muscle strain, or sprain that would coincide with back aching and soreness. Identifying the symptoms and diagnosing the underlying cause is the first step in getting ultimate pain relief.

Viscerosomatic Reflex: Distressed Internal Organs Can Cause Back Pain

The Organs

Inflammation and other issues with any internal organs in the central, abdominal, or pelvic region can produce low back pain. These include the following:

  • Heart
  • Lungs
  • Stomach
  • Intestines
  • Liver
  • Gallbladder

Viscerosomatic reflex pain can also be felt in a completely different body part than where the organ is located. This can cause an individual to think something is wrong in that body region when there is not.

Kidneys

  • The kidneys help remove liquid waste from the body.
  • Urine that contains more chemical substances than what can be diluted can cause kidney stones to form and sharp pain in the side and the lower back.
  • Kidney stones can also cause difficulty urinating and blood to show up in the urine.
  • A kidney infection can result in mid-low back pain and fever.

Pancreas

  • The pancreas plays a vital role in digestion and blood sugar regulation.
  • Pancreatitis is inflammation that can cause severe and disabling pain that starts in the upper abdomen and radiates to the low back.

Appendix

Large Intestine

  • Inflammation of the large intestine/colon and/or ulcerative colitis can also cause:
  • Low back pain.
  • Abdominal cramps
  • Rectal pain.

Visceral Pain

Visceral pain is different as it can be harder to pinpoint a source and feels like a dull aching or tightening pressure.‌ The pain originates in the organs of the respiratory system, stomach, or pelvis that is often described as a dull ache but is also described as:

Visceral pain has distinguishing characteristics:

  • The pain originates in the middle of the body but can be felt in other areas.
  • The pain can be scattered, and difficult to locate a definitive source.
  • The affected area or other body regions can become sensitive.
  • It can accompany other symptoms like nausea, vomiting, sweating, or heart palpitations.
  • Psychological symptoms like depression can begin to present.

Chiropractic Care

Chiropractic focuses on healing the musculoskeletal system of aches and pain, muscle stiffness, and/or chronic conditions that complement traditional medical care. Adjustments can correct the body’s alignment and how the body physically functions. A chiropractor will use manual or mechanical decompression techniques to realign the spine. This will release the muscle, tendon, ligament, and nerve tension, bringing pain relief, and improving nervous system function, and viscerosomatic reflex. Treatments include:

Adjustments

  • Will gently realign the joints to decrease pain and increase range of motion.

Soft-tissue therapy

  • Will relax tight muscles, relieve spasms, and release tension in the surrounding connective tissues.

Exercises and stretches

  • Will restore and maintain joint stability and mobility.

Joint bracing and Kinesio taping

  • Will support sprained joints or muscles as the healing process continues.

Integrative medicine expert referrals

  • Experts will guide individuals on diet and nutrition to reduce inflammation and promote healthy eating for overall health.

DRX9000 Low Back Pain, Sciatica, Herniated Disc


References

Bath M, Owens J. Physiology, Viscerosomatic Reflexes. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK559218/

Beal, M C. “Viscerosomatic reflexes: a review.” The Journal of the American Osteopathic Association vol. 85,12 (1985): 786-801.

Lefebvre R, Peterson D, Haas M. Evidence-Based Practice and Chiropractic Care. (www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/) J Evid Based Complementary Altern Med. 2012;18(1):75-79. Accessed 4/25/2022.

Sikandar, Shafaq, and Anthony H Dickenson. “Visceral pain: the ins and outs, the ups and downs.” Current opinion in supportive and palliative care vol. 6,1 (2012): 17-26. doi:10.1097/SPC.0b013e32834f6ec9

Zhou, QiQi, and G Nicholas Verne. “New insights into visceral hypersensitivity–clinical implications in IBS.” Nature reviews. Gastroenterology & hepatology vol. 8,6 (2011): 349-55. doi:10.1038/nrgastro.2011.83