Sports med

ways to classify sport injuries

• direct and indirect

• soft and hard tissue

• overuse

Direct injuries

caused by an external force applied to the body and are at the sight of contact.

Examples:

• Impact from catching the basketball causing a sprained or broken finger

• Bruises on shoulder from pushing past opponent

Indirect injuries

result from an intrinsic (internal) force and are away from the site of contact (if any). This can be a result of inadequate warm-up, ballistic movements (explosive), or poor skill execution.

Examples:

• Torn hamstring while running for the ball, improper warm up

• Stress on a knee ligament when landing or changing position while playing basketball

Overuse injuries

result from intense or repeated stress without enough rest for the body to heal. It may be caused through low impact, repetitive exercises. Common cause is poor technique and no rest

Examples:

• Tendonitis such as tennis elbow

• Shin splints: pain along tibia caused from lots of running ——poor technique and no rest

• Stress factor in feet

Soft tissue injury

injuries to any part of the body other than bones or teeth. E.g. sprained ankle, strained hamstring, contusions (bruise) or skin abrasions (graze)

Hard tissue injuries

occur to bone or teeth. E.g. fractured humerus, dislocated hip, tooth falling out

Soft tissue injuries

• tears, sprains, contusions

• skin abrasions, lacerations, blisters

• inflammatory response

Tears

occur when a muscle or tendon is overstretched and torn

Signs and symptoms:

• Pain with movement

• Swelling

• Bruising

Sprains

a tear that occurs to a ligament when the joint is forced beyond normal range of motion resulting in the stretch or tearing of ligaments.

Signs and symptoms:

• Unable to put weight on injured limb

• Swelling

• Bruising

• Pain

2 types of sprain

3 Types of strains:

• Grade 1 tear/strain is a small tear to the muscle.

• Grade 2 tear/strain is a much larger tear around 50% or more torn.

• Grade 3 tear/strain refers to a complete tear, so that surgery is needed to join the muscle back together.

• An example of a strain is a pulled hamstring.

Medial ligament sprain occurs from the stress from the side

Cruciate ligament sprain occurs from stress in a forward direction (e.g. coming down from layup and forward pressure of femur tears ligaments in center of knee)

Contusions (aka brusie)

caused by a sudden blow to the body causing internal bleeding

Signs and symptoms:

• Pain at site

• Swelling

• Bruising

• Difficulty moving

skin abrasion

scraping or wearing away of the skin and usually not very deep

Treatment:

1. Clean wound

2. Wash with disinfectant

3. Cover with non-stick dressing

Laceration

a deep cut or tear to the skin resulting from contact with a sharp device — often resulting after a head clash or contact with sport specific equipment.

Treatment:

1. Manage bleeding

2. Apply pressure to area

3. Depending on the severity of the laceration, medical attention and stitches or surgery may be needed

If bleeding does not stop quickly, ice can be used, and medical treatment is needed

Blister

caused by friction or burning that leads to a build up of serum in the skin. Athletes often get blisters on their feet due to friction from their shoes.

Treatment:

1. Cover it with padding (e.g. bandaid)

2. Remove object causing the friction/burning

3. Allow time to heal and do not pop

Inflammatory response

3 Phases:

1. acute inflammation

2. repair and regenerative phase (scar building)

3. remodelling phase

IR: Phase 1— acute inflammation

• Rapid onset and short acute period (6-8 hrs)

• during this phase involves the vasodilation of blood vessels, and the transfer of fluid into the surrounding tissue

• response causes secondary (additional) damage to the area

• New blood vessels begin to be developed in this phase and the area is swollen, red and painful

• The acute inflammatory phase lasts 48-72 hrs (2-3 days) and it is during this time that RICER is most important

IR: Phase 2— repair and regenerative phase (scar building)

• Generation of repair material and scar formation- needs to be established in an oriented way

• The white blood cells clean up the debris from the injury and new body tissue begins to be formed

• Repair tissue is different, fibres are shorter, inelastic and different texture

• This increases risk of recurrence of rupture

• Collagen replacing damaged tissue, elimination of waste product

  Lasts from 3 days-6 weeks

IR: Phase 3— remodelling phase

• More scar tissue is produced but also new functional body tissue is developed and strengthened

• This tissue can replace scar tissue if proper treatment is sought from health professionals

• During this phase the balance of exercise and rest is important as too much exercise will cause further injury, but not enough exercise will result in too much weak scar tissue

• This phase can last many months. An athlete will not be back to full health until this phase is completed (though they often have already returned to play)

RICER

Rest
Ice
compression
elevation
referral

Rest

• Stop playing the sport or doing the exercise and rest the injured area, keeping it still

• Helps to prevent further damage to the injured are, helps to ensure the inflammatory response is not stimulated again

• To reduce bleeding

Ice

• Ice should be applied as soon as possible (ice pack, ice bag or other forms of cryotherapy)

• Applied over the first 48 hours

  • Many methods e.g. 20 min on 20 min off

• just as long as ice is consistently applied to the area with short breaks benefits will occur

• Helps reduce pain and inflammation, speeds up recovery

• causes vasoconstriction (narrowing of the arteries) around the area reducing inflammation

• then when taken off the vessels dilate (vasodilation) allowing the blood to flow through with a momentary increase in the inflammatory response that allows waste removal and new nutrients to be delivered for repair

Compression

• Involves application of a compression bandage or garment around affected area

• Pressure applied helps force fluid away from area reducing the inflammation at the area

• Helps to reduce or control inflammatory response and stabilises the joint (if injured)

• Helps reduce movement, limiting reinjury, and provide support for injured area

• Decreases bleeding and swelling

Elevation

• Elevation only works if injured soft tissue is above the heart

• Above the heart means gravity can assist in the removal of fluid from inflammation

• Gravity helps to move blood and other fluid back towards the heart reducing ,or controlling, the inflammatory response

• Decreases bleeding and swelling

Referral

• Referral to health or medical profession

• Allows for proper diagnosis and rehabilitation to be applied if needed

• Help improve recovery and prevent future injury to the site

• Often GPs will provide an anti-inflammatory drug to help reduce pain and improve recovery.