B.3.1 Causes of Injury

Adapted from class notes.

Injury

• Injury is a reduction/loss of bodily function or structure

• Trauma relates to the sensation of pain, discomfort, or loss of function

Risk of Injury

• Risk assessment deals with how likely an injury is to happen and how severe that injury would be

• Magnitude of Risk = likelihood times severity

  • High magnitude if risk is high likelihood, or if risk is high severity

Likelihood and Severity of Risk

• Likelihood:

  • 5 - Almost certain, more likely to occur than not, almsot expected

  • 4 - Likely, there is a possibility

  • 3 - Possible, this has happened before, reasonable chance

  • 2 - Unlikely, not likely but it could happen

  • 1 - Rare, only in exceptional circumstances

• Serverity:

  • 5 - Extreme, death or major permanent injury

  • 4 - Major, long-term incapacity or disability, requires medical treatment

  • 3 - Moderate, significant injury requiring medical treatment

  • 2 - First air or minor treatments, minor

  • 1 - Negligible, doesn’t even need first aid

Classification of Risk

• When severity and likelihood are both high, the risk is very high. Totaling greater than or equal to 9

• High risk if total is greater than or equal to 7

• Medium if risk total is greater than or equal to 5 (or if 2 and 2)

• Low risk if less than or equal to 4

• Zero risk does nto exist, even in rare or negligible injuries

Internal Risk Factors

• Risk factors associated to the person or physical activity

• Age:

  • Higher risk at higher ages

  • During adolescence, bones/muscles grow at different rates, resulting in higher possibility of strains

  • Children are less likely to break bones due to increased boen flexibility and lower energy impacts (slow/low mass)

  • Large growth rate during adolescence (peaks at 12 for girls, 14 boys) meaning an increased height/weight among higher age groups

• Training:

  • More training could be an increase in muscular strain, as in the case with weight training

  • It could mean more collisions, as in the case for sportslike football and rugby

• Previous Injury:

  • Reduced strength as a result of previous injury

  • Reduced sense of body movement and position

  • Reduced range of motion

• Sex Differences:

  • Less information available for female sports injuries due to relative newness

  • Higher rate of injury in male than female (110 vs 88 out of 1000)

  • Hormonal differences (especially fluctuating hormones) leads to different injuries and different treatment requirements

  • Females more impacts by concussions

  • Females are more likely to have knee/ligament issues whereas males are more likely to have most other types of injury

• Pregnancy causes large changes in the body

• Congenital factors (present at birth):

  • Can be structural differences affecting bones, joints, ligaments, or muscles, such as hypermobility

  • Bone density, muscle strength, collagen, healing

  • Neurological conditions

• Psychological:

  • Can increase risk of injury due to fatigue from loss of sleep or other lack of motivation

Pregnancy

• During Pregnancy:

  • No evidence that regular physical activity causes injury at higher rates

  • Impact sports must be avoided

  • Increase in body weight can cause joint pain. Mitigation can include exercising in water

  • Ligaments loosen to allow for expansion of uterus and pelvis. Can cause extra stress to joints in high velocity exercise/jumping, changing direction

• Postpartum:

  • Each person is different. Some can return quickly and report improvement, others not so

  • Some evidence to support that VO2 max can return to pre-pregnancy level shortly after delivery

  • Pelvic floor muscles shoudl be this primary focus of strength training at first

  • Very limited info on this category

External Risk Factors

• Risk factors associated outside the individual, such as the environment or location

• Protective Equipment:

  • Padding reduces injury from impact (football, taekwando, etc)

  • Braces reduce injury from bending wrong way (like twisted ankle)

  • Wrist guards when falls are common (like snowboarding)

  • Mountain biking - Includes high velocity and quick turns, falls are common. Neck braces are encouraged. Abrasions (scratches) and contusion (impact damage, like a bruise)

  • Ice hockey high risk with many preventative measures. One study shows mouthguards decreases risk of concussions

• Position:

  • The role in sport you play

  • Rugby forwards experience a higher rate of shoulder injury and increases in rates as matches go on

  • Pitchers and catchers have high rates of shoulder injuries because they throw more frequently than other members

• Playing Surface:

  • Higher risk of injury on artificial turf

• Equipment:

  • For example, the setting of seat/handlebars on a bicycle can result in improved muscular range

Musculoskeletal Injuries

• An injury to muscle, bone, ligament, or tendon

• Laceration/Shearing:

  • A cut through skin or in some cases muscle

  • Can also include abrasions (scratches), which include friction

• Contusion/Compression:

  • Often from contact sports

  • Bleeding (haematoma) causing bruises either superficially or deep

  • Can also cause broken bones

  • Concussion (caused by a blow to the head)

• Strain:

  • Excessive stretching of a muscle resulting in reduced or lost muscle function

Acute vs Chronic Injuries

• Acute:

  • Occurring suddenly

  • Laceratious, contusions, compressions

• Chronic:

  • (Overuse) - Occurring gradually

  • Unlikely with a single exercise

    • Example: Tennis albow, skin splits, tendonitis

Common Sports Injuries

• According to Ritzer et al. (2021) analyzing ROI (Reporting Information Online)

  • Vast majority of high school injuries are acute (93%)

  • Most (acute 49% and chronic 66%) are lower limb (leg)

  • Head/neck/face was about 25% of acute, but 1% of chronic

  • Upper limbs about 20% for each

  • Body/trunk was 5% acute, 13% chronic

• Ligament sprains most common acute (32%); concussions (21%); muscle strain (125); contusions (12%)

• Muscle strain and tendonitis most commonc hronic (23% each)