pdh- sports med

direct injury

direct injury

caused by direct force generated from outside the body e.g. abrasion from falling over

indirect injury

caused by an intrinsic force within the body e.g. sprinter tearing a hamstring

soft tissue injury

include damage to muscles, tendons, ligaments, cartilage, skin, blood vessels, organs and nerves e.g. sprain, contusion

hard tissue injury

cause damage to bones and teeth e.g. fracture

overuse injury

result from intense or unreasonable use of joints or body areas e.g. shin splits

ways to classify soft tissue injuries

acute, overuse and chronic injuries

tears

occur when the fibres in ligaments or tendons are stretched beyond their normal range

ligament

connects bone to bone

tendon

connects muscle to bone

sprains

occur from the stretching or tearing of a ligament, which results in pain, swelling and inability to perform joint movements

strains

when a muscle or tendon is stretched or torn

contusion

a bruise where the skin is not broken

three phases of the inflammatory response

inflammatory stage, repair and regenerative stage, remodelling stage

inflammatory stage

begins after injury and lasts for about 2-4 days characterised by pain, redness, loss of mobility and function, increased blood flow to supply nutrients and oxygen

repair and regenerative stage

lasts from 48h-6 weeks, characterised by a reduction in swelling, elimination of debris, production of new cells and scar tissue

remodelling stage

from 6 weeks to many months after injury, characterised by an increased production of scar tissue and laying down of new tissue to increase strength of muscle fibres, need to ensure new fibres and tissues are aligned in the right direction

what does ricer stand for

rest, ice, compression, elevation, referral

what does rest involve

rest injury and avoid movement by placing injury in a comfortable position to reduce bleeding and further injury

use of ice

use crushed ice, ice pack wrapped in a towel for 20 minutes every hour for up to 4 days to reduce pain, blood flow and swelling

compression

Wrap an elastic compression bandage over the injured area periodically for at least 24 hours to decrease bleeding and swelling

elevation

raise injured area above the level of the heart in a supported position when possible during the day and the following 2-3 nights

referral stage

advise injured person to see a doctor or physio to understand nature and extent of the injury

steps to treat skin injuries

Pressure, elevation, rest

treatment of a fracture

immobilise the area using splints or slings

treatment of dislocation

immobilise area- never attempt to relocate

how to treat a tooth injury

rinse tooth in milk or saliva, reinsert tooth into socket or place it in milk and go to dentist

assessment of injury steps

talk, observe, touch, active movement, passive movement, skills test

assessment of injury through talking

Talk to the player to find out what happened and provides nature of the injury

assessment of injury by observing

Look at the injury and see if there are any obvious signs of swelling or deformity, compare both sides of the body

assessment of injury by touch

Gently feel the injury for any sign of deformity or swelling or pinpoint area of pain

active movement assessment of injury

Ask the player to perform a range of joint movements such as flexion, extension and rotation

passive movement assessment of injury

The assessor physically mobilises the joint using a range of movements aimed at identifying painful areas and any instability in the join

assessment of injury by skills test

Player is asked to perform a skill that is required during the game e.g. sidestep and if they can do this, they can return to the game

appropriateness of resistance training for children

is appropriate in a fitness program to increase strength, prevent injury and improve performance

Guidelines that should be followed for resistance training in children

should focus on technique, resistance should be low to avoid damage to growth places, max of 3 sessions per week, should be properly supervised

thermoregulation in children

Children do not develop their sweating mechanism until they get older and take longer to register that they are hot, thirsty or cold and are at higher risk of dehydration and hyperthermia

how to manage thermoregulation in children

games broken into quarters, play in early mornings to avoid heat of the day, wear airy clothing

overuse injuries in children

caused by repeated trauma to a bone that leads to small fractures and is more likely to occur with poor recovery, high stress loads, poor technique, poor strength

how to avoid overuse injuries in children

need to prevent these injuries by avoiding repetitive activities or repeating the same movement continually

how to prevent asthma symptoms in children

use blue inhaler before they warm up, participate in an effective warmup

precautions for diabetes in children

Appropriate food and drink available and diabetes devices to monitor their blood glucose levels and children having something to eat prior to exercise

how to manage a seizure in children

do not restrain movement, place athlete on their side after, allow them to rest and seek medical treatment

what impacts adult and aged athletes participation

heart conditions, fractures/bone density, flexibility/joint mobility

how to manage heart conditions in aged athletes

exercise under supervisions at an appropriate intensity, should have a gradual warm up and cool down, good activities include walking, swimming, cycling

fractures/bone density in aged athletes

bone density increases with age and it is recommended that aged athletes with bone density avoid high impact activities e.g. yoga, swimming

flexibility/joint mobility in aged athletes

should maintain flexibility to avoid injury which can be done by participating in activities that involve gentle movements of the joints and stretching of the muscles such as yoga, pilates

what do female athletes need to consider in participation in sports

eating disorders, iron deficiency, bone density, pregnancy

eating disorders in female athletes

most at risk athletes are in sports that require low body fat and wear tight clothing such as gymnastics, swimming but they can impair performance and have health consequences such as fatigue, weak bones and dehydration

how to reduce the risk of eating disorders in female athletes

focus on performance, avoid regular weight/body mass checks, be educated about early signs of eating disorders and take action

iron deficiency in female athletes

common in women due to loss of iron in menstrual blood and high levels of sport and can have a negative impact on performance

bone density in female athletes

Low bone density is more common in females than males due to hormonal and dietary reasons (lack of calcium) and causes an increased risk of fractures

pregnancy in female athletes

should exercise at a reduced level (30 mins) and at a mild, aerobic level and should be avoided in excessive heat, place a strain on the neck or back, involve in a sudden change in posture, anaerobic activities

What is part of physical preparation

pre screening, skill and technique, physical fitness, warm up, stretching and cool down

pre sceening

Preventative measure that should take place before any training program that aims to detect any existing physical or medical issues that may need to be considered to prevent injury

skill and technique

correct skill and technique need to be taught to ensure the safety of the athletes and reduce the risk of injury

examples of skill and technique

A netball knowing how to catch correctly will minimise the risk of finger injuries, rugby player learning how to tackle correctly will reduce the risk of head, neck or shoulder injuries

physical fitness importance

having a good level of general fitness helps athletes cope with the demands of sport and reduce fatigue related injuries and all sports have specific fitness requirements which need to be developed to enhance safety

importance of warm up, stretching and cool down

physically prepare the body and help the body recover

warm up phases

whole body activity e.g. jogging, easy swimming or cycling, stretching and vigorous sport specific exercises

sports policy and the sports environment considerations

rules of sports and activities, modified rules for children, matching of opponents, use of protective equipment, safe grounds, equipment and facilities

importance of rules

designed to allow for safe participation, it is the players responsibility to obey the rules they are taught by their coach

examples of rules in sports and activities

yellow cards in soccer, no contact in netball, no stick above shoulder in hockey, heat rules

importance of modified rules for children

ensure safety and wellbeing and encourage participation

examples of modified rules for children

softer and lighter equipment, shorter game times or smaller fields, tee ball

importance of matching of opponents

promotes safer participation and is done through age, size and skill level depending on the sport and the demands e.g. contact sport would match by skill and possibly size

use of protective equipment

important to avoid injuries but needs to be relevant, in good condition and fit correctly

what needs to be done to ensure safe grounds, equipment

grounds should be inspected to ensure there are no hazards, goal posts should be padded, there should be adequate lighting and ventilation and equipment should be checked for faults

example of safe grounds, equipment and facilities and rules in netball

must remove jewellery, padded goal posts, court should be free of obstructions, blood rules

considerations for children athletes

Appropriateness of resistance training, thermoregulation, overuse injuries, medical conditions

conduction

When two objects are touching, heat will transfer from the warmer object to the cooler object

how to support temp regulation using convection

fans or breeze, loose clothing in hot weather and warm, wind proof clothing to reduce wind chill

convection

Air moving across the skin's surface will cool down OR heat up the body (depending on the air temperature)

how to support temperature regulation using conduction

ice vests, wet towels in hot weather, wetsuits and spray jackets (for rain) in cold weather

radiation

heat radiates from a warm object to a cooler object that are not touching

how to manage temperature using radiation

move into the shade or indoors, train during cooler times of the day, acclimatisation and wearing light clothing in hot weather and wearing warm clothes in cool weather

evaporation

water on the surface of the skin (sweat) evaporates which takes heat from the body with it

how to manage temperature using evaportation

hydration, acclimatisation and wearing breathable clothing in hot weather and saying dry in cold weather

strategies for temperature regulation

Evaporation, convection, conduction, radiation

climatic conditions

heat/humidity, cold/wind, rain, altitude, pollution

effects of heat

can lead to heat stress, heat exhaustion, heat stroke and impact cognitive function

strategies to manage heat

ice vests, slushies, stay in shade, wearing airy clothing

impact of cold

stiff and less elastic muscles, impact physiological function, chance of hypothermia

strategies to manage cold

wearing suitable clothing and dress in layers

impact of humidity

increases the chance of dehydration, increased body temperatures as it inhibits sweat evaportaion

impact of wind

increases the chance of hypothermia due to wind chill

impact of rain

can help keep the body cool in warm conditions but in cold conditions it can accelerate heat loss and also can cause slippery surfaces and impact visibility

how to manage rainy conditions

wearing a rain jacket, non slip shoes, cancel or postpone event

impact of altitude

there is less oxygen available which means muscles are not getting as much oxygen which can lead to fatigue and lethargy

how to manage altitidue

altitude training and acclimatisation which leads to the body producing more red blood cells

impact of pollution

can trigger asthma and respiratory illnesses which can hinder performance

how to manage pollution

acclimatisation, reducing intensity or cancellation of event

rehabilitation procedures

progressive mobilisation, gradual exercise (stretching, conditioning, total body fitness), training, hot and cold

aims of rehabilitation procedures

restore site so that athlete can return to competition without pain, restore optimal function, prevent recurrence of injury

graduated exercises

stretching, conditioning, total body fitness

how does stretching help rehabilitation

when an injury occurs, muscle fibres seize up and scar tissue builds, stretching helps muscle regain elasticity

progressive mobilisation

involves gradually moving the area, using gentle movements and rotations to reduce the formation of scar tissue and slowly stretches the muscles to allow for greater mobility

how does conditioning assist rehabilitation

involves the restoration of muscle strength through isometric exercises and gradually increasing resistance

how does total body fitness improve rehabilitation

due to missing training sessions, fitness levels decrease but exercise can still be performed to maintain fitness for when the athlete can return to sport

training in rehabilitation

once athletes has improved and fitness is achieved, they can gradually begin participating again, an athlete should not return to competition if they cannot undertake a full training session

use of heat and cold

cold reduces pain and swelling e.g. ice massage and heat should be applied after acute phase to increase blood flow to the area, reducing inflammation, bringing nutrients and speeding up the healing process, can also heat up the muscles and increase their elasticity prior to exercise and joint stiffness