Injury
- Created by: felixshears
- Created on: 18-04-19 14:43
Acute + Chronic Injuries
Acute injuries:
- a sudden injury associated with a traumatic event
- e.g. netballer spraining ankle or footballer breaking fibula
Chronic injuries:
- those which develop over time due to repeated continued stress on the body
- associated with overuse
- e.g. shin splints in long distance runners
Acute Hard Tissue Injuries
Hard tissue injury involves damage to the bone, joint + cartilage
Fracture:
- partial or complete break in the bone
- in closed fractures skin remains unbroken + in compound fractures bone breaks through skin
- signs of fracture - deformity, swelling + discolouration
- symptoms of fracture - pain + inability to move injured area
Dislocation:
- occurs from a direct force (collision or object) or an indirect force (a fall) pushing the joint past its extreme range of motion
- subluxation (partial dislocation) causes damage to ligaments + increases the likelihood of recurrent dislocations which can compromise an athlete's career
- sign of dislocation - deformity, swilling + discolouration
- symptoms of a dislocation - may feel a 'pop', severe pain + loss of movement
Acute Soft Tissue Injuries
Soft tissue injury involves damage to the skin, muscle, tendons or ligaments
Contusions + haematoma - a contusion is a bruise from localised congealed bleeding from ruptured blood vessels + severe can be haematoma which involves internal bleeding from minor bruises under skin to deep tissue bleeding shown by swelling, discolouration + pain
Sprains - overstretch or tear in ligament that connects bone to bone caused by sudden twist, impact or fall forcing joint past extreme range of motion shown by swelling, bruising + inability to bear weight
Strains - overstretch or tear in muscle or tendon that connects bone to bone + common in dynamic lunging movement with serious sprain resulting in a rupture (complete tear) + shown by swelling/discolouration, bruising + pain on movement
Abrasion - superficial damage to skin caused by scraping against a surface caused by falling, slipping or clothing rubbing on body with worst needing stitches
Blister - seperation of layers of skin where pocket of fluid formed, caused by friction + can be painful but preventable with correct footwear, equipment + training load
Concussion - traumatic brain injury resulting in a disturbance of brain function causing swelling + possible disruption to electrical processes in brain shown by loss of consciousness, disorientation, vomiting + headaches
Chronic Injuries
Stress fractures:
- hard tissue injury
- tiny crack in the surface of a bone caused by overuse
- common with distance running events, tennis + cricket as repetitive stress of the foot on the ground cause trauma
- overtraining can cause this + usually stops with rest
Shin splints:
- soft tissue injury
- chronic pain due to inflammation of muscles + stress on tendon attachments to the surface of the tibia
- common with distance runners, dancers + football players
- caused by being overweight, wearing inadequate footwear or poor leg biomechanics
Tendinosis:
- soft tissue injury
- the deterioration of a tendon in response to chronic overuse + repetitive stran
- tendons are tough fibrous connective tissues designed to transmit force
- e.g. achilles tendonisis
- shown by limited movement/stiffness, burning, stinging + aching
Risk Factors
Intrinsic risk factors (from inside body):
- previous injury
- posture + alignment issues
- age
- nutrition
- poor preparation
- inadequate fitness levels
- inappropriate flexibility level
Extrinsic risk factors (from outside body):
- poor technique + training
- incorrect equipment + clothing
- inappropriate intensity, duration or frequency of activity
- warm-up + cool-down effectiveness
Warm-up
Warm-ups used for:
- raising body temperature - rise of 2-3 degrees increases enzyme activity, diffusion gradients + metabolic activity, improving efficiency of muscular contraction
- preparing the body physiologically - the elasticity of tendons + ligaments improves, antagonistic co-ordination improves
- preparing body physiologically - mentally performers are ready for task ahead
- minimising the risk of injury - e.g. performer less likely to suffer strains + sprains
Key features:
- lasts 20-45 minutes
- gradually increases intensity
- three stages - pulse raising, stretching + mobility + sport-specific drills
- stretching + mobility should be dynamic in sport-specific patterns
- static stretches should be avoided
Cool Down
Used for:
- maintaining heart rate - to maintain blood flow + metabolic activity, flushing muscle tissue with oxygenated blood
- aiding removal of lactic acid - enhancing future performances, delaying fatigue + injuries
- aiding the healing process
Key features:
- lasts 20-30 minutes
- gradually decreasing in intensity
- has several stages:
- moderate intensity - to maintain HR, aid venous return + remove waste
- stretching - reduce muscle tension + lower temperature
Warm-up + Cool Down Debate
Static stretches historically large part of warm up but research suggests:
- has no effect on injury prevention
- may reduce peak force produced by Achilles tendon by 8%
- deteriorates atagonistic co-ordination, hampering explosive movements
- reduces eccentric strength by 9%, decreasing the ability to change directions at speed
- reduces muscles' ability to consume O2 by 50%
Aa a result, static stretches should be avoided as part of a warm up unless advised by physio
Injury prevetion researchers believe dynamic stretching such as high knee skips + walking lunges should be used as part of a warm-up instead
Historically, an active cool down was thought to benefit all athletes but after low-intensity activity such as jogging, a passive recovery can be more beneficial
Little evidence to suggest an active-cool down can prevent or limit DOMS
Assessment Using SALTAPS
SALTAPS - protocol for the assessment of a sporting injury
Stop - stop the game + observe the injury
Ask - ask the questions of the player/participant: how did the injury happen? + where does it hurt?
Look - at the injury site, check for swelling, bruising, deformity + discolouration
Touch - at the injury site, check for swelling, deformity, bumps or heat
Active movement - ask for active movements from the participant
Passive movement - assesor moves the injured limb/body part
Strength testing - ask the player to stand, lift + put pressure on injured area, asking if they can continue
Acute Injury Management Using PRICE
PRICE - protocol for treatment of of acute injuries
First two or three days after injury
Protect - protect your injury from further damage e.g. using support or splint
Rest - rest your injury for first two or three day e.g. use crutches + reintroduce movement gradually to prevent loss of muscle strength
Ice - ice the painful area with a cold compress e.g. ice or frozen peas wrapped in towel which will reduce swelling + bruising + should be done for 15-20 minutes every 2-3 hours
Compress - compress injured area with an elastic bandage or elasticated tubular bandage to limit swelling + movemement
Elevate - Rest injury above level of heart to keep it supported
Six Rs to Recognise Concussion
Six Rs - protocol for recognition of concussion
Recognise - learn the signs + symptoms of concussion to help identify when an athlete may have a suspected concussion
Remove - any athlete who has suspected concussion must be removed from play immediately
Refer - once removed, the athlete should be immediately referred to a qualified healthcare professional who is trained in evaluating + treating concussion
Rest - athletes must rest from exercise until symptom-free + not be left alone for the first 24 hours following injury
Recover - athletes must be fully recovered + symptom free from the concussion before returning to play with adults taking a minimum 1 week and under-18s a minimum of weeks before seeking approval from healthcare professional
Return - in order for safe return the athlete must be symptom free + cleared by healthcare professional before completing 'Graduated Return To Play' protocol
Rehabilitation
Rehabilitation - the process of restoring full function after an injury has occured
Stages of rehabilitation:
- early stage - gentle exercise encouraging damaged tissue to heal
- mid stage - progressive loading of connective tissues + bones to develop strength
- late stage - functional exercises + drills to ensure body is ready to return to training
Treatment of Simple Fractures
Medical attention ASAP
PRICE
Immobilisation (plaster cast, sling + crutches)
Anti-inflammatory + pain medication e.g. Non-steroid anti-inflammatory drugs (NSAIDS)
Severe fractures may require surgery to realign bones or fix pins + wires
Physiotherapy may be needed
Treatment of Stress Fractures
Medical ttention required for diagnosis + advice
PRICE
Rest for two weeks, avoid activity for 8 weeks
Immobilisation may be needed
Gently return to exercise
Strengthening exercises for surrounding connective tissue
Treatment of Dislocation
Medical attention ASAP
Immobilisation + no attempt to reposition bones unless a medical professional
PRICE
Anti-inflammatory + pain medication
Severe dislocations may require surgery to realign bones + pin them into original position
Physiotherapy will strengthen surrounding connective tissue + improve mobility
Treatment of Sprain
Medical attention may be required in severe cases
PRICE
Immobilisation or support using strapping, brace + crutches
Anti-inflammatory + pain medication
Exercise to strengthen surrounding connective tissue + improve mobility + balance
Severe sprains may need reconstructive surgery
Heat therapy - applying heat to an area before trainng for a therapeutic effect e.g. increasing blood flow
Contract therapy - use of alternate cold + heat for therapeutic effect e.g. increasing blood flow
Treatment of Torn Cartilage
Medical attention
PRICE
Support using strapping e.g. knee brace
Anti-inflammatory + pain medication
Physiotherapy to strengthen surrounding connective tissue + restore ROM
Hydrotherapy to maintain fitness without bearing weight
Arthroscopy - a minimally invasive procedure to examine + repair damage within a joint to reshape + resurface a torn cartilage
Treatment of Exercise Induced Muscle Damage
In most cases, medical attention not required + symptoms should improve within 5 days
Cold therapy such as ice packs + ice baths post-exercise
Massage + stretching techniques
Anti-inflammatory + pain medication
Medical attention may be required if heavy swelling or dark urine
Heat therapy + contrast therapy for pain relief
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