HSC PDHPE: Option 3 Sports Medicine

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97 Terms

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Sports Medicine

Prevention, assessment, treatment and rehabilitation of injuries sustained in athletic events

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SIQ: How are sports injuries classified and managed?

Ways to classify Sports Injuries

Soft Tissue Injuries

Hard Tissue Injuries

Assessment of Injuries

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SDP: Ways to classify Sports Injuries

Direct and Indirect

Soft and Hard Tissue

Overuse

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Direct Injuries

External force is applied to the body causing injury. Example, cricket batsman developing a contusion on the shoulder by being struck on the arm by the ball

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Indirect Injuries

Caused by an internal force in the body. Example, soccer player straining ankle

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Soft Tissue Injuries

Occur in muscles, tendons, ligaments as well as the skin. Example, Sprinter strains their hamstring in push-off

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Hard Tissue Injuries

Injuries to bones and teeth. Example, boxer breaks teeth in match

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Overuse Injuries

Caused by repetitive stress or strain on the body. Occur over time. Example, Tennis player develops tendinitis in elbow from too many backhands

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SDP: Soft Tissue Injuries

Tears, sprains contusions

Skin abraisions, lacerations, blisters

Inflammatory response

(SLT: Management)

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Tear

Damage to a muscle or tendon caused by over-stretching of the muscle fibres, causing some or all of these fibres to tear

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Strain

Aka tear, when muscle fibres/tendons fail to cope with demands placed on them

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Sprain

Damage to ligament (holds muscle to bone)

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Contusion

Caused by a collision with another person or object; causes local muscle damage and bleeding

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Abrasion

Occurs when surface layers of skin have been broken

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Laceration

Causes damage to skin and underlying tissue

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Blister

Outer layers of skin are separated due to excessive friction- causes pocket of fluid

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Inflammatory Response

A natural response immediately following tissue damage. Blood rushes to the site, causing redness and swelling (Oedema), heat and reduced function. Often excessive and slows the healing process, without RICER, collagen replaces the damaged tissue, and scar tissue produced which is bulky and limits future movement and strength.

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Management of Soft Tissue Injuries

RICER - Rest, Ice, Compression, Elevation, Referral - Used in the first 48-72 hours after an injury

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SDP: Hard Tissue Injuries

Fractures and Dislocations (SLT: Management)

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Fracture

Crack, chip or break in the bone. Common in young children as their bones are still growing and can bend easier. All fractures require DRSABCD and RICER if soft tissue is injured

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Simple fracture

Bone is broken but does not pierce skin.

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Compound fracture

Bone is broken and breaks surface of skin.

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Complicated fracture

Bone is broken and causes internal damage.

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Management of fracture

- Control bleeding

-Identify type of fracture

-Immobilise with broad bandages

-Ensure bandages do not cut of circulation

-Call medical assistance

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Tooth Injury management

-Locate tooth

-Rinse in person's saliva/milk

-Reinsert tooth holding the crown of the tooth, or --Store in milk until reaching a dentist

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Dislocation

-Bone has been removed from its joint structure.

-Symptoms include pain, swelling, limited movement, deformity, bruising

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Subluxation

A dislocation that immediately realigns itself, 'popping in and out' a joint

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Management of dislocation

-Support in comfortable position

-Do not attempt to relocate

-Sling dislocation

-Apply RICER to reduce swelling if possible

-Seek medical advice

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Management of Hard Tissue Injuries

Immobilise the joint using a bandage and splint/sling to prevent further movement that could cause injury.

Medical attention

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SDP: Assessment of Injuries

TOTAPS - Talk, Observe, Touch, Active Movement, Passive Movement, Skills Test

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SIQ: How does sports medicine address the demands of specific athletes?

Children and young athletes

Adult and aged athletes

Female Athletes

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SDP: Children and Young Athletes (MORT)

Medical Conditions (Asthma, Diabetes, Epilepsy)

Overuse Injuries

Thermoregulation

Resistance Training

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Medical conditions (children/young athletes)

- Asthma

- Diabetes

- Epilepsy

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Asthma (children/young athletes)

- chronic inflammatory condition of the airways in which the bronchioles contract and restrict oxygen intake

- shouldn't be an excuse for participation

- coughing and wheezing (signs)

- exercise is beneficial (swimming is best)

- measures: first aid action plan warm up/cool down, steady intensity, medication, adequate water

4x4x4

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Diabetes (children/young athletes)

- Body does not produce or properly use insulin

- Don't stop playing sport

- Exercises assists in managing condition

- Diet = well balanced (complex carbs significant amount)

- Ensure their are plenty of breaks for eating and monitoring blood levels

-Hypoglycaemia- worse than hyperglycaemia

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Epilepsy (children/young athletes)

- Disruption to brain function, causing a brief alteration to the level of consciousness and resulting in seizures or fits

- Shouldn't stop participation in sport/ activity

- Get assessed by doctor before enrolling

- Seizures occur on a daily or weekly basis, collision and water sports should be avoided

- Players, parents or supervisors should be present and know what to do if a seizure occurs

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Overuse injuries (children/young athletes)

- Repeated use of body e.g. stress fractures (skin splints)

- Common causes - high training volume, intensity and frequency, inadequate warm ups, poor technique

- Have days of non-training and monitor volume and intensity (to avoid)

-Allow recovery time

-Use different muscles

-Cross training

-Warm up and cool down

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Thermoregulation (children/young athletes)

- Balancing of heat loss with heat gain is managed through this

- Children are at risk from environmental stress (less ability to loose heat through evaporation)

- Children's acclimatisation to heat is slower (increase possibility for dehydration)

- Higher chance of developing hyperthermia from exposure to cold

-No exercise in 34 degrees+

-Provide adequate rest breaks

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Appropriateness of resistance training (children/young athletes)

- Strength training is an integral part of overall program to improve skill and fitness

- Low resistance, high reps though full range of movement

- Strength specialisation is avoided - may lead to imbalance between muscle groups and contribute to injury

-Must be supervised

Must not start until after puberty- can stunt growth

tailored to individual

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SDP: Adults and Aged Athletes (HFF)

-Heart Conditions

-Fractures/bone density

-Flexibility/joint mobility

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Heart Conditions (Adults and Aged Athletes)

CV system becomes less efficient and its ability to pump blood is reduced

Recommendations:

Lower intensity exercise

Always warm up and cool down

Allow plenty of rest/recovery time

Discourage holding breath in activities

Alternate workout days

Low-medium intensity

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Fractures/Bone Density (Adults and Aged Athletes)

Bones become brittle with age and changes in Oestrogen in women.

Avoid high impact/contact sports.

Weight bearing activities should be encouraged.

Osteoporosis: extreme bone frailty- people with this should seek medical advice before starting exercise regime

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Flexibility/Joint Mobility (Adults and Aged Athletes)

Ligaments, Tendons and Muscles lose elasticity as people get older.

Sedentary lifestyle causes cartilage to shrink and stiffen

Exercise increases fast twitch muscle fibres, which improves reaction time so falls are less likely

They should focus on flexibility.

Activities (Pilates, Yoga) are recommended.

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SDP: Female athletes (PEIB)

Eating disorders

Iron deficiency

Bone density

Pregnancy

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Eating disorders (female athletes)

- Low body fat and idealised body shape and size are expected. E.g. gymnastics, dance.

- Twice the risk of developing eating disorders, which may result from, Peer influence, Social expectation

- Implications: Trainers and coaches can - Be better educated to detect signs of eating disorders, monitor diet, Engage parents in training schedule and diets

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Health risks of eating disorders

Loss of energy, weak bones, abnormal heart beat, dehydration, starvarvation

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Iron deficiency (female athletes)

- Causes anaemia (low haemoglobin) which reduces number of red blood cells limiting oxygen

- Reasons:

Females consume less red meat

Menstruation

Intense training (endurance events)

- Implications:

Supplementation not necessary for all athletes however iron levels need to be monitored

High iron levels can cause liver disease, diabetes and heart problems

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Bone density (female athletes)

- Quality of calcium in bones

- Low calcium in bones = fractures and structural weakening

- Regulated by parathyroid gland - controls the level of calcium stored and what is released

- Following menopause women loose calcium faster

- Well balance diet with adequate calcium (milk, cheese)

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Pregnancy (female athletes)

- Exercise in the cool of the day

- Consume adequate water - avoid thermal stress which can affect foetal development

- Sustained moderate exercise has considerable benefits;

Maintain fitness and general wellbeing

Weight control

Improve muscle tone

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SIQ: What role do preventative actions play in enhancing the well-being of the athlete?

Physical preparation

Sports policy and the sports environment

Environmental considerations

Taping and Bandaging

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SDP: Physical preparation (PSPW)

Pre-screening

Skill and technique

Physical fitness

Warm up, stretching, cool down

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Pre-screening

-Preventative measure to perform prior determining athletes fitness and medical history

-Provides starting point for exercise

-Consider age, gender, health, previous experience

-Risk factors for those: overweight, diabetes, pregnancy, high blood pressure

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Skill and technique

-Lack skill/poor technique restrict opportunities

-Lead to increase risk of injury

-Responsibility on coaches to ensure competent basic skill and self protection

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Physical fitness

- Enhances wellbeing which ensures level of physical fitness is attained

- Has a range of elements and quantity required depends on the sport e.g. more cardio than strength

- Major contributing factor to injury

- Ensures energy supplies are adequate and body systems are able to meet the demands

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Warm up

- Prevent injury

- Geared to the demands of the sport

- Time taken varies - endurance sports have a longer warm up

- Causes redistribution in blood flow

- Increase the ability of the muscle to stretch without tearing

- Reflexes improve

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Stretching (static, PNF)

- 4 to 5 times a week

- Stretched passed the range required

- Static - gradually stretched beyond normal range (Hold 30 secs)

- PNF - performed with a partner. Isometric contraction (push against) then relax

- Must be specific to the sport

- Greater demand = more stretching

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Cool down

- Recovery

- Body temp, circulation and respiratory rates return to pre-exercise state

- Maintain the stretch in muscle groups

- Disperse lactic acid

- Prevent blood pooling

- Involves; stretching, performing callisthenics and gross motor activities (light jog, swim)

- Not intense and short

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SDP: Sports policy and the sports environment

- Rules of sports environment

- Modified rules for children

- Matching of opponents (growth and development, skills level)

- Use of protective equipment

- Safe grounds, equipment and facilities

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Rules of sports environment

Set guidelines for safe conduct of sport. Sticking to rules is essential to prevent injury

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Modified rules for children

Many sports have been modified to meet specific needs of children. Modification applies to equipment, field size, time, rules

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Matching of opponents (growth and development, skills level)

Most junior competition run on ages decision however maturity level can differ and size and strength. Considerations should be given to size, age, gender, strength, psychological development and skill level

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Use of protective equipment

Equipment must protect desired areas, allow movement, be comfortable EG mouth guards, helmets, gloves and padding

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Safe grounds, equipment and facilities

Clubs must provide safe fields, equipment and facilities that suit players, crowds. Fencing of area to keep unwanted visitors out etc

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SDP: Environmental considerations

- Temperature regulation (convection, radiation, conduction, evaporation)

- Climatic conditions (temp, humidity. wind, rain, altitude, pollution)

- Guidelines for fluid intake

- Acclimatisation

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SDP: Temperature Regulation (CRCE)

Convection, radiation, conduction, evaporation

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Convection

The process of air moving across the skin's surface

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Radiation

The transfer of heat to and from the atmosphere (e.g. the skin surface will warm the air surrounding the body, causing the net effect of heat loss from the body)

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Evaporation

The loss of heat from the body via sweating. The airflow over the fluid on the surface of the skin causes accelerated heat loss from the body into the surrounding air.

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Conduction

The transfer of heat to and from the skin via direct contact with an object (eg ice pack)

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SDP: Climatic conditions

Temperature

Humidity

Wind

Rain

Altitude

Pollution

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SLT: Analyse effect of temp on sport participation

Low ambient temp increase the risk of lowering athletes core temp --> hypothermia

Need effective warm up, clothing, acclimatise appropriately.

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SLT: Analyse effect of Humidity on sport participation

Put athlete at risk of dehydration, and hyperthermia. Cause fatigue, dizziness and lack of coordination. Inhibits ability to cool down using evaporation.

Increase fluid intake, clothing, regular rest breaks, shade.

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SLT: Analyse effect of altitude on sport participation

Air is thinner higher up you go, less O2 for the lungs to extract and use for muscle performance.

Spend a number of weeks training at high altitude prior to competition to acclimatise adequately.

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SLT: Analyse effect of rain on sport participation

In warm weather, may help the body to disperse heat and lower temperature. In cold weather, increase heat loss from body increasing the risk of hypothermia. Slippery playing surface --> injury, collisions, falls, loss of control on equipment.

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SLT: Analyse effect of pollution on sport participation

Decrease efficiency (ability to) breathe, reducing the body's ability to oxygenate blood. Symptoms: wheezing, coughing, watery eyes and feeling of restriction.

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Guidelines for fluid intake

During sport: 200-300mL every 15-20mins of exercise in warm weather. An adult male athletes exercising in warm weather should drink approx 3 L of water per day to maintain hydration.

Weigh yourself before and after, weight loss = amount of water you should drink.

Be careful not to over hydrate (hyponatraemia: low blood sodium levels)

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Acclimatisation

The process of preparing the athlete's body for optimal performance in the climatic conditions that will be experienced during the event. Achieve this by training in these conditions in the months/weeks leading up to the event, allowing the body to adapt to function at its peak.

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SDP: Taping and Bandaging

Preventative Taping

Taping for Isolation of injury

Bandaging for immediate treatment of injury

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Taping

Supports joint structure or muscles and gives player confidence in mobility

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Preventative taping

Usually used in proffessional sports that put a lot of strain on joints, eg AFL

Taping occurs to prevent injury- gives confidence

can cause reliance on tape and restrict motion

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Isolation of Injury

Gives support during condition whist in rehabilitation, and return to play

Prevents further injury, eg taping fingers, but does not prevent injury as a whole

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Bandaging for immediate injury

Compression bandages used in Ricer and Immobilisation bandaging used in HT Injuries

Reduces severity

minimises inflammatory response and provides support

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SIQ: How is injury rehabilitation managed?

Rehabilitation procedures

Return to Play

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SDP: Rehabilitation procedures

To regain physical fitness to a pre-injury level. Includes

Progressive mobilisation

Graduated exercise

Training

Use of heat and cold

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Progressive Mobilisation

As soon as the acute swelling phase is over and pain is reduced, athlete should attempt to slowly move injury

This can be done actively or passively

TO reduce build up of scar tissue, which will restrict future movement

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Stretching (Graduated Exercise)

Start with static stretch to begin to improve flexibiity around the joint, before progressing to PNFwhich will help speed up the recovery process

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Conditioning (Graduated Exercise)

Start with calisthenics and isometric contractions

progressively overload

Strengthens joint to initiate a return to maximum strength

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Total Body FItness (Graduated Exercise)

Important to maintain other ares of fitness both skill and health related

Involves cross-traing that does not compromise rehabilitation

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Training

Should progressively increase demands onon injured tissue

AIm is to achieve pre-injury fitness levels and skill

Athletes sould be pain free before returning to play

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Use of heat and cold

RICER should be used immediately, with ice to reduce inflammatory response. After first 72 hours, heat should be used to alleviate pain and increase blood flow, which will get rid of any damaged cells and decrease scar tissue

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SDP: Return to play

Involves specific physical, psychological and ethical considerations. Should prioritise player's welfare

- Indicators of readiness for return to play

- Monitoring progress

- Psychological readiness

- Specific warm-up procedures

- return to play policies and procedures

- Ethical considerations

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Indicators of readiness

If rehabilitated correctly, injury should have normal function

This means pain free and having full range of motion

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Monitor progress

Progress should be monitored through tests, which should be compared to pre-season fitness.

These tests should be sport specific and place demand on injured joint similar to the demand placed on it by the sport

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Psychologocal Readiness

Athletes can lose confidence due to being away from competition

Supporting damaged tissue can improve confidence via taping

Athlete should play lower-grade games or be on reserve until confidence is restored or they could be a danger to themselves and others

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Specific Warm Up

Developed to achieve full recovery and minimise further re-injury

Should target injured muscles and joints

should develop from static to PNF and dynamic

promotes flexibility at joint

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Return to play policy and procedures

Should prioritise player welfare

Dictate when player can return to play

E.g Concussion guidelines say player can return under any circumstances, even if they pass the SCAT test

All medical examinations should be done by a doctor independent of the game's bias

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Ethical Considerations

Athletes have lots of pressure to participate, and often want to return before recovered

This can cause further injury, which may be life-threatening

Therefore athlete must be pain free and have full motion

Painkillers are unethical, and should not be used to cheat the pain-free rule, as it subdues the nerves

Coaches and organisations should not pressure their athlete to return when injured.