KAAP 305 midterm

performance enhancement umbrella

• exercise physiology

• biomechanics

• sports physchology

• sports nutrition

• strength and conditioning

• coaching

• personal fitness trainers

injury care management umbrella

• athletic training

• practice of medicine

• sports physical therapy

• sports massage therapy

• sports dentistry

• osteopathic medicine

• orthotists/ prosthetists

• sports chiropractic

• sports podiatry

• paramedics/ emergency medicine

• occupational therapy

what are CATs trained in?

prevention, assessment, treatment, rehabilitation

5 domains of athletic training

1. prevention and wellness protection

2. immediate care and emergency care

3. clinical evaluation & diagnosis

4. treatment and rehabilitation

5. organization & professional health and well being

athletic trainers vs physical therapists

ATs are trained to deal with injuries specifically in sport while PTs have a broader background in treating patients of all ages with wide variety of physical problems

what is the first step in injury prevention process

pre-participation screening: can include medical history, physical examination, or other screenings

medical history

completed before the examination to identify past existing medical conditions

physical examination

should include assessment of height, weight, body composition, blood pressure, pulse rate, vision, skin, dental, etc

orthopedic screening

part of physical examination or separate part; range of motion measures

strength and conditioning

ATs, strength coaches, head coaches all work closely to review conditioning programs, and amend programs for injured athletes

what is the most common student-athlete cause of death

cardiac issues

warm up

prepares the body for physical activity, stimulates increase in cardiorespiratory system, musculoskeletal system core temp, muscle temp/ elasticity

dynamic warm up

Fifa 11+; should include activities for all major muscle groups immediately after warm up

cool down goals

• return to homeostasis

• speeds lactate removal

• decreases soreness

• reduce muscle damage

• neuromuscular function

• stiffness and ROM

• injury reduction

• CV and immune system response

lactic acid

not the cause of fatigue!- because your muscle becomes more acidic

foam rolling

doesn’t reduce injuries

flexibility

move joints through full ROM by stretching, dependent on bony structures, fat, skin, muscles and tendons, ligaments/ capsule, neural tissue tightness

stretching

doesn’t really do that much to prevent injury, but can improve performance; warmup DOES reduce injury

hyperthermia

heat rash, heat cramps, heat syncope, hyponatremia

muscle cramps

aka “heat cramps”, most mild heat illness, sudden or progressive onset, involuntary painful contractions during or after exercise

what are the causes of heat cramps

combination if dehydration, electrolyte imbalances, altered neuromuscular control, fatigue

heat syncope

(fainting) aka “ortheostatic dizziness”, occurs in unfit or heat unacclimated people who stand for a long time in the heat, typically in the first 5 days of unaccustomed heat exposure

caused of heat syncope

dehydration, venous pooling of blood in periphery, reduced cardiac filling, low blood pressure→ cerebral ischemia

heat exhaustion

the inability to effectively exercise in the heat, occurs secondary to CV insufficiency, hypotension, energy depletion, central fatigue

common heat exhaustion symptoms

dizziness, headache, nausea, dark urine, and heavy sweating

heat exhaustion core temp

high but less than 105 degrees

exertional heat stroke

most severe heat illness, neuropsychiatric impairment, working muscles and environmental heat load overwhelm thermoregulatory system and goes into failure (low blood oxygen)

symptoms of heat stroke

***core body temp over 105 degrees, dizziness, severe headache, nausea, confusion, no new sweating*, CNS dysfunction

heat illness prevention

begin well hydrated, fluid and electrolyte replacement, gradual acclimatization, identify susceptible individuals, weight records, appropriate uniforms, monitor heat index (temp + humidity)

Kory Stringer

offensive lineman for the minnesota vikings, died of heat stroke

Drake Geiger

16 year old football player collapsed just 10 mins into practice and died of a heat stroke

hyponatremia

reduction in blood sodium levels, excess of total body water in comparison to body sodium content (rehydrating vigorously with water, sweating too much and being replaced with water

hypothermia

frost nip, frostbite, prevention comes from apparel (waterproof, windproof, and allows for sweat to evaporate)

cold related injuries

results of exposure to cold environments during physical activity/ occupational pursuits, low air/water temperatures

mild hypothermia temperature

core temp 95-98.6 degrees

moderate hypothermias temperature

core body temp of 90-94 degrees

severe hypothermia temperature

core body temp below 90 degrees

frostbite

the actual freezing of body tissues

frostnip

precursor to frostbite, generally doesn’t cause permanent damage

Chilblain/ Pernio

extended exposure to cold AND wet conditions, typically measured in hours to days, hands and feet most commonly affected 

lightning injuries 

odds of being hit by lightning in a persons lifetime is 1 in 13,500, golf, running, baseball, football soccer, dont stand under trees!

mechanical injury

harmful disturbance in function or structure (external force or internal damage), response dependent on tissue properties

compression loading on bone

forces applied from both ends down onto bone, crunch 

tension loading

forces applied pulling away from both ends

tension stress injuries 

muscle strains, ligament sprains, avulsions fractures (tendon pulled off bone)

shear loading on bone

forces from both sides onto the middle of the bone

torsion loading on bone

twisting motion in opposite directions from both ends 

torsion stress injuries

spiral fracture of long bones, ligament sprains (ACL)

bending loading on bone

extremely strong, bending inward from forces on both ends, 3 point and 4 point

traumatic injury

direct blow

overuse injury

repetitive dynamic use over time (injury cause is complex)

muscle strain

stretch, tear, or rip in the muscle or adjacent tissue such as facia or tendons

MOI muscle strains 

abnormal muscle contraction, impaired reciprocal coordination of the agonist and antagonist muscle 

Grade 1 muscle strain

slight stretch (<20% of muscle fibers torn)

Grade 2 muscle strain

partial tear (20-70% of muscle fibers torn)

grade 3 muscle strain

complete tear (>70% of muscle fibers torn)

ligament sprain

an injury to a ligament which results when a joint is forced beyond its normal anatomical limits, (grading 1-3 like strains)

overexertion muscle problems

delayed onset muscle soreness (DOMS), 1-2 days post exercise

acute muscle soreness

acute onset muscle soreness, ischemia (lack of O2 in the blood)

contusions

“bruise”, sudden traumatic blow to the body resulting in soft tissue compressed against bone, blood leaks into soft tissue- forms hematoma/ecchymosis

myosistis ossificans

traumatic, severe blow or repeated blows, irritated tissue produces calcified formations

hematoma

(bruise with swelling), a localized mass of blood and lymphatic confined within a space or tissue 

tendonitis/tendinosis/ tendonopathy 

injury (acute or chronic) to a tendon, one of the most common overuse injuries (tendonitis = inflammation, tendinosis=degenerative, tendinopathy=broad term)

tendonitis

acutely inflamed swollen tendon that doesn’t have microscopic tendon damage

tendinosis

degenerative changes, chronically damaged tendon with disorganized fibers and a hard, thickened, scarred and rubbery appearance

tendinopathy rehab approach

lots of strength training!!

joint dislocations

bone out of joint congruity, requires manual force/surgery to fix

subluxation

joint is partially out, immediately reduced

osteoarthritis

degeneration of articular cartilage, not as simple as wear and tear, includes an inflammatory process as well with synovial and chronic bone inflammation

Goldilocks principle

strength training at just the right amount to prevent osteoarthritis, but also not too much to injur yourself

does running cause knee osteoarthritis?

no, prior injury increases risk 

bursitis 

repetitive stress or acute trauma to the protective bursa between tendons and bones 

open/compound fracture

requires open wound/break in the skin

greenstick fracture

incomplete break that have not completely ossified, more common in children

comminuted fracture

three or more fragments at the fracture site, cause by hard blow or awkward position, hard to heal 

spiral fracture

s-shaped separation

avulsion fracture

the tendon or ligament pulls of a piece of the bone, common in adolescence

blowout fracture

traumatic deformity of the orbital floor or medial wall, most common orbital fracture

longitudinal fracture

bone splits down the middle along the length

stress fractures

remodeling can not keep up with the loading, common in hip, tibia, foot, lumbar spine

bone stress injury

“stress fracture”, inability of normal bone to withstand repetitive loading leading to localized bone weakness and pain

types of evaluation

1. pre-participation

2. on the field

3. off the field 

4. progress evaluation

clinical diagnosis

identifies pathology, signs and symptoms, clinical findings

diagnosis

one disease from another, often includes other testing (MRI, blood work), functional impairment 

differential diagnosis

method for diagnosis, how you rule out other things it can be, not how you rule something in

prognosis

predict future, what is the recovery going to look like?

syndrome

signs and symptoms correlated, usually indicate specific pathology/disease

etiology

cause of the injury or disease

mechanism of injury (MOI)

how did the injury happen?, used synonymously with etiology

pathology

structural/functional change resulting from injury

pathophysiology

physiological process associated with the disease or injury

symptom

perceptible change in a patients body or its function, not measurable, subjective

sign

obvious indicator for a specific condition, objective, measurable

sagittal plane

separates left and right, flexion and extension

frontal plane

separates front and back, abduction/adduction

transverse plane

separates top and bottom, spinal rotation

HOPS approach

history, observation, palpation, special tests

acute pain

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage 

chronic primary pain

disability or emotional distress and not better accounted for by another diagnosis of chronic pain