Sports injuries

Risk Management

Process of measuring or assessing risk and then developing strategies to manage risk

How can coaching improve risk management?

Provide discipline and understanding of rules

Acute injury

Injuries that occur quickly and for which pain and loss of function are immediate.

Acute injury examples

Bone breaking, muscle tears, sprain, strain

Chronic injury

Injuries that linger and affect performance over the longer term

Chronic injury examples

Stress fractures, growth pains, joint damage, shin splints

Thermoregulation

The maintenance of body temperature and the heat exchange that occurs between the body and the environment

Core temperature ideal range

36.5 - 37.5 degrees

Homeostasis

Maintenance of ideal body temp

Hypothermia

A thermal risk associated with exercising in cold environmental conditions. It occurs when body temp falls below 35 degrees Celsius. Performance will be impaired as blood flow to working muscles will also be reduced in an attempt to maintain homeostasis.

Hyperthermia

Caused by exposure to hot and humid conditions. It is prevented by avoiding those conditions.

Avoiding hyperthermia

Resting in shade, use of ice vests, hydration, light and loose clothing, acclimatise.

Overtraining

Insufficient recovery time between bouts of physical activity, excessive training, inappropriate increases.

Physiological symptoms of overtraining

Feelings of fatigue, chronic muscle soreness, decreased or increased morning resting HR, increased HR during submaximal exercise, earlier onset of fatigue, decreased performance.

Psychological symptoms of overtraining

Decreased concentration span, decreased motivation, increased irritation and anger, increased fear, anxiety, depression, stress, loss of belief

Miscellaneous symptoms of overtraining

More frequent illness, loss of appetite, insomnia, lack of enjoyment, increase in overuse injuries

Direct injuries

When the body contacts an external object such as a person, object or the ground

Direct injury example

Finger dislocation from hitting a ball

Indirect injury

caused by forces inside the body, such as excessive strain on the muscles

Indirect injury example

When you strain your hamstring whilst sprinting

Overuse injury

When specific body regions are used over periods of time, particularly when the movements are repetitive and low-impact.

Overuse injury example

Shin splints from running on concrete daily

Soft tissue injury

An injury to any tissue except bone and teeth

Soft tissue injury example

Muscular tear

Hard tissue injury

Injuries to bone and teeth

Hard tissue injury example

A broken rib from a hard tackle

Skin abrasion

When the surface layer of the skin is broken. They usually cause pain and shallow bleeding as a result of scraping

Skin abrasion example

Graze after falling down in netball

Laceration

Where there is damage to the skin and to the underlying tissue

Laceration example

A boxer's eyelid is split open from a punch

Blister

Where the outer layer of skin separates due to friction, which causes a pocket of fluid or blood to form.

Blister example

Shoes rubbing on the heel of the foot causing a pocket of fluid to form under the skin

Calluses

Build-up of dead skin

Calluses example

Hard skin on feet

Fracture (Hard tissue)

Injured bone caused by indirect trauma such as falling on an outstretched hand

Dislocation/sublaxation (Hard tissue)

Injured joint through excessive movement of the joint

Shin splints

Caused by mild muscle inflammation over time. It is possibly caused by factors such as poor posture, excessive training during a growth spurt, muscle fatigue in lower limbs.

Osteitis Pubis

Gradual onset of groin pain with an increasing level of discomfort. It may be caused by high running loads, frequent change of direction, kicking action, muscle imbalances.

Patellar tendonitis

Patellar tendon is inflamed and tender which may be due to running, jumping, high-impact activities, or a growth spurt

Tennis or golfer's elbow

Recurring pain on the outside of the upper forearm just below the bend of the elbow. It may be caused by technique, equipment or a sudden increase in training/activity

Sprain

The injury of a ligament

Strain

An injury to the muscles and/or tendons of the body

Symptoms of a muscular strain

Pain, particularly at the end of the range of movement, swelling or instability.

Grade 1 Muscular tear

Mild pain, tear of a small number of fibres, pain on stretch but no less strength, mild but not severe pain.

Grade 2 muscular tear

Damage to a number of muscle fibres, reduction in strength, pain on stretch of the muscle.

Grade 3 muscular tear

Complete tear of a muscle, you can feel the muscle tear within the muscle, severe pain and limited movement.

Contusion

When an athlete collides with an external object, causing local muscular damage. E.g a collision between players causing a corked thigh

Contusion example

Collision between players causing a corked thigh

Inflammatory response to soft tissue injuries

The body initiates the response to defend against infection, minimise blood loss, dispose of dead tissue and promote renewal processes.

Acute inflammatory phase

Body sending blood to area, area becomes red, swollen and warm, pain, takes 48-72 hours.

Proliferation or healing inflammatory phase

Fibre blasts moving to tissue, scarring thickens and rebuilds, takes 48hrs to 6 weeks.

Remodeling inflammatory phase

Ligament or tendon gradually comes down to old size, increased strength. It takes up to 3 months and sometimes longer.

Complete fracture

The bone shapes into two or more parts

Incomplete fracture

The bone is cracked, but not snapped into two or more parts

Simple hard tissue injury

Cleanly broken without breaking through skin

Complex or compound fracture

Bone breaking through the skin

Two important procedures for hard tissue injuries

Immobilisation, splinting

Tooth dislocation procedure

Place the tooth back into place and splint it to the adjacent tooth using foil, or place in milk or saliva.

RICERS

Rest, ice, compression, elevation, referral, stretch.

SALTAPS

Stop, ask, look, touch, active movement, passive movement, stand up

DRSABCD

Danger, response, Send for help, airways, breathing, CPR, defib

COWS

Is used for the response: Can you hear me?, Open your eyes, What's your name, squeeze my hand

Why is RICERS used?

Minimise blood around an acute soft tissue injury to reduce recovery time, control internal bleeding.

NOHARM

No heat, no alcohol for 24 hrs, running or exercise of injury, massage

Internal violence

an injury caused by forces within the body

External violence

contact with an external object

Types of internal violence

acute, chronic and overuse injuries

DOMS

(Delayed Onset Muscle Soreness) is muscle pain and stiffness that develops after exercise, usually becoming noticeable on the second or third day after activity

Cause of DOMS

An inappropriate level of exercise that your body is not used to.

What can reduce DOMS

Appropriate increases, appropriate rest, warm up

Expected recovery time for hard and soft tissue injuries

Soft tissue around 6 weeks, Hard tissue upper limb 6 weeks, Hard tissue lower limbs 10-12 weeks.

Ultrasound

Accelerates the normal resolution of the inflammatory process by attracting more mast cells to the injured area. It involves high-frequency sound waves that heat and vibrate tissue.

TENS Therapy

Sends electrical pulses through the skin to start your body's own pain killers. The electrical pulses can release endorphins and other substances to stop pain signals in the brain.

Hydrotherapy

Simply using water in rehab process, it reduces pain and muscle spasms and decreases joint stress. It increases strength and ROM, improves balance and coordination and increases feelings of achievement in acute stages.

Hyperbaric therapy

Using a pressurised room, the athlete breathes a high concentration of oxygen to saturate tissues which, improves circulation

Massage

Flow to the area which removes metabolic byproducts and brings nutrients to the area it also assists in returning the muscles to pre-exercise lengths

Interferential therapy

It is widely used by physiotherapists and it uses electrical currents through suction caps to reduce swelling, stimulate circulation, relieve pain, and stimulate muscles. (Does not produce heat)