General Topics
Know the Score on Facial Sports Injuries


Playing catch, shooting hoops, bicycling on a scenic path or just kicking around a soccer ball have more in common than you may think. On the up side, these activities are good exercise and are enjoyed by thousands of Americans. On the down side, they can result in a variety of injuries to the face.

Many injuries are preventable by wearing the proper protective gear, and your attitude toward safety can make a big difference. However, even the most careful person can get hurt. When an accident happens, it's your response that can make the difference between a temporary inconvenience and permanent injury.

When someone gets hurt:

  • Ask “Are you all right?” Determine whether the injured person is breathing and knows who and where they are.
  • Be certain the person can see, hear and maintain balance. Watch for subtle changes in behavior or speech, such as slurring or stuttering. Any abnormal response requires medical attention.
  • Note weakness or loss of movement in the forehead, eyelids, cheeks and mouth.
  • Look at the eyes to make sure they move in the same direction and that both pupils are the same size.
  • If any doubts exist, seek immediate medical attention.
  • When medical attention is required, what can you do?
  • Call for medical assistance (911).
  • Do not move the victim, or remove helmets or protective gear.
  • Do not give food, drink or medication until the extent of the injury has been determined.
  • Remember HIV...be very careful around body fluids. In an emergency protect your hands with plastic bags.
  • Apply pressure to bleeding wounds with a clean cloth or pad, unless the eye or eyelid is affected or a loose bone can be felt in a head injury. In these cases, do not apply pressure but gently cover the wound with a clean cloth.
  • Apply ice or a cold pack to areas that have suffered a blow (such as a bump on the head) to help control swelling and pain.

Facial Fractures:
Sports injuries can cause potentially serious broken bones or fractures of the face.
Common symptoms of facial fractures include:
  • swelling and bruising, such as a black eye
  • pain or numbness in the face, cheeks or lips
  • double or blurred vision
  • nosebleeds
  • changes in teeth structure or ability to close mouth properly
It is important to pay attention to swelling because it may be masking a more serious injury. Applying ice packs and keeping the head elevated may reduce early swelling.
If any of these symptoms occur, be sure to visit the emergency room or the office of a facial plastic surgeon. (such as an otolaryngologist) where x-rays may be taken to determine if there is a fracture.

Upper Face
When you are hit in the upper face (by a ball for example) it can fracture the delicate bones around the sinuses, eye sockets, bridge of the nose or cheek bones. A direct blow to the eye may cause a fracture, as well as blurred or double vision. All eye injuries should be examined by an eye specialist (ophthalmologist).

Lower Face
When your jaw or lower face is injured, it may change the way your teeth fit together. To restore a normal bite, surgeries often can be performed from inside the mouth to prevent visible scarring of the face; and broken jaws often can be repaired without being wired shut for long periods. Your doctor will explain your treatment options and the latest treatment techniques.

Soft Tissue Injuries
Bruises cuts and scrapes often result from high speed or contact sports, such as boxing, football, soccer, ice hockey, bicycling skiing, and snowmobiling. Most can be treated at home, but some require medical attention.
You should get immediate medical care when you have:
  • deep skin cuts
  • obvious deformity or fracture
  • loss of facial movement
  • persistent bleeding
  • change in vision
  • problems breathing and/or swallowing
  • alterations in consciousness or facial movement

Bruises
Also called contusions, bruises result from bleeding underneath the skin. Applying pressure, elevating the bruised area above the heart and using an ice pack for the first 24 to 48 hours minimizes discoloration and swelling. After two days, a heat pack or hot water bottle may help more. Most of the swelling and bruising should disappear in one to two weeks.

Cuts and Scrapes
The external bleeding that results from cuts and scrapes can be stopped by immediately applying pressure with gauze or a clean cloth. When the bleeding is uncontrollable, you should go to the emergency room.
Scrapes should be washed with soap and water to remove any foreign material that could cause infection and discoloration of the skin. Scrapes or abrasions can be treated at home by cleaning with 3% hydrogen peroxide and covering with an antibiotic ointment or cream until the skin is healed. Cuts or lacerations, unless very small, should be examined by a physician. Stitches may be necessary, and deeper cuts may have serious effects. Following stitches, cuts should be kept clean and free of scabs with hydrogen peroxide and antibiotic ointment. Bandages may be needed to protect the area from pressure or irritation from clothes. You may experience numbness around the cut for several months. Healing will continue for 6 to 12 months. Scars that look too obvious after this time should be seen by a facial plastic surgeon.

Nasal Injuries
Perhaps because it protrudes, the nose is one of the most injured areas on the face. Early treatment of a nose injury consists of applying a cold compress and keeping the head higher than the rest of the body. You should seek medical attention in the case of:
  • breathing difficulties
  • deformity of the nose
  • persistent bleeding
  • cuts

Bleeding
Nosebleeds are common and usually short-lived. Often they can be controlled by squeezing the nose with constant pressure for 5 to 10 minutes. If bleeding persists, seek medical attention.
Bleeding also can occur underneath the surface of the nose. An otolaryngologist/facial plastic surgeon will examine the nose to determine if there is a clot or collection of blood beneath the mucus membrane of the septum (a septal hematoma) or any fracture. Hematomas should be drained so the pressure does not cause nose damage or infection.

Fractures
Some otolaryngologists set fractured bones right away before swelling develops, while others prefer to wait until the swelling is gone. These fractures can be repaired under local or general anesthesia, even weeks later.
Ultimately, treatment decisions will be made to restore proper function of the nasal air passages and normal appearance and structural support of the nose. Swelling and bruising of the nose will last for 10 days or more.

Neck Injuries
Whether seemingly minor or severe, all neck injuries should be thoroughly evaluated by an otolaryngologist. Injuries may involve specific structures within the neck, such as the larynx (voice box), esophagus (food passage), or major blood vessels and nerves.

Throat Injuries
The larynx is a complex organ consisting of cartilage, nerves and muscles with a mucous membrane lining all encased in a protective tissue (cartilage) framework.
The cartilages can be fractured or dislocated; either is serious because of the possibility of injuring the airway and obstructing breathing. Hoarseness or difficulty breathing after a blow to the neck, are warning signs of a serious injury and the injured person should receive immediate medical attention.

Prevention
The best way to treat facial sports injuries is to prevent them. To insure a safe athletic environment, the following guidelines are suggested:
  1. Be sure the playing areas are large enough that players will not run into walls or other obstructions.
  2. Cover unremoveable goal posts and other structures with thick, protective padding.
  3. Carefully check equipment to be sure it is functioning properly.
  4. Require protective equipment - such as helmets and padding for football, bicycling and rollerblading; face masks, head and mouth guards for baseball; ear protectors for wrestlers; and eyeglass guards or goggles for racquetball and snowmobiling are just a few.
  5. Prepare athletes with warm-up exercises before engaging in intense team activity.
  6. In the case of sports involving fast-moving vehicles, for example, snowmobiles or dirt bikes - check the path of travel, making sure there are no obstructing fences, wires or other obstacles.
  7. Enlist adequate adult supervision for all children's competitive sports.


What first aid supplies should you have on hand in case of an emergency?
  • sterile cloth or pads
  • scissors
  • ice pack
  • tape
  • sterile bandages
  • cotton tipped swabs
  • hydrogen peroxide
  • nose drops
  • antibiotic ointment
  • eye pads
  • cotton balls
  • butterfly bandages