Sports physio/WHS

3 sports assessment

on field (5min), sideline (10min) and clinical

checking on field

spinal damage (if unconcious or injury above shoudler), ABCD, pain, numbness, weakness, heaviness, paradoxical respiration, deformity

to play safetly after injury

must have diagnosis - with evidence (mechanism, felt etc)

subjective on field

closed questions, what happened, feeling, symptom changes, do they feel they can continue

if unsure if they can play

physical assessment: strength, stretch, palpation, stress test, movement etc

side- line assessment - 10 mins

brief but thorough, in change rooms. deeper subjective, feeling and symptoms, function loss, check structures and physical assessment.

sport specific assessment

done before RTP

functional assessment at a satisfactory level

How many days does it take to diagnose

2-3 days due to hyperalgesia (a lot of false positive) lots of swelling causing pain

three common medical causes for athletes symptoms

asthma, hypoglycaemia and concussion

Exercise hypoglycemia can result in

seizures, unconsciousness, lifetime threatening - can be seen as weakness, dizziness and confusion

assessment tool for concussion

SCAT6 for both on field and sideline

Red flags SCAT6

Neck pain or tenderness • Seizure or convulsion • Double vision • Loss of consciousness • Weakness or tingling/burning in more than 1 arm or in the legs • Deteriorating conscious state • Vomiting • Severe or increasing headache • Increasingly restless, agitated or combative • GCS <15 • Visible deformity of the skull

The cognitive assessment (SCAT6)

can only be done in a non-distracting environment not on side lines

An athlete can score within normal limits on the SCAT6 and still have a concussion.

Yes

key sports physio roles

1. Ensuring ultimately the team performs optimally on competition day

2. Ensure the health and safety of the athlete/team (on and off the field)

3. Minimise risk to athlete  

three crucial phases

predeparture (screen players, environment and prep equipment), travel, and competition

Common illness when travelling

URTI, Diahrea

5 Recovery principles

1. Overload

2. Specificity

3. Individuality

4. Recovery

5. Reversibility

Adaptation to training is accelerated

when residual fatigue is reduced as soon as possible after training

Antidoping rule violations include:

• Using a prohibited substance

• Possessing a prohibited substance

• Interfering with the Testing Process

• Not providing whereabouts information

• Encouraging or assisting others to dope

• Covering up doping activities

• Any type of complicity regarding doping activity

• Disqualification

• means the athlete’s results in a particular Competition or Event are invalidated, with all resulting Consequences including forfeiture of any medals, points and prizes;

Ineligibility means

• the athlete or other person is barred on account of an anti-doping rule violation for a specified period of time from participating in any Competition or other activity or funding 

• Provisional Suspension

• the Athlete or other Person is barred temporarily from participating in any Competition or activity prior to the final decision at a hearing ;

• Financial Consequences means

• financial sanction imposed for an anti-doping rule violation or to recover costs associated with an anti-doping rule violation; and

• Public Disclosure or Public Reporting means

• the dissemination or distribution of information to the general public or Persons beyond those Persons entitled to earlier notification. 

What is fatigue

failure to complete a task that was once achievable or failure to maintain required force

overuse, overtraining vs burnout

overuse - biomechanical, burnout - psych, overtraining - immune system

4 times of fatigue

metabolic, neural, psych, environment

metabolic fatigue

acute - >1 hour or chronic - several sessions in one day

depleted energy stores (diet and hydration)

unable to keep up with usual demands

neurological fatigue

short high intensity

long low intensity

white (phasic) get tired more easily

psychological fatigue

Financial, social, competition

could be seen as loss of self confidence, self esteem

Environment/travel fatigue

change of climate, change in time zones, heat and humidity may all cause increased fatigue

4 rest and recovery categories

local, general, normal, pathological

local recovery

local soft tissue recovery

general recovery

physiological recovery

normal recovery

normal post-exercise recovery for general population

pathological recovery

recovery post exercise for people with co-morbidities

tendon recovery

up to 30hrs tendons are degrading

when does synthesis override degradation in tendons

over 30 hours

72 hours post exercise tendons

22% hyper vasculation

cold water immersion

10-15 celcius (10-15 mins) best results

reducing DOMS and reduces CK

but reduced muscle mass and strength

Stretching and recovery

doesnt prevent DOMS

good whenused with massage

foam rolling

warm up activity - or use as needed

recovery with diet and sleep

carbs within 2 hours

sleep is very effective - most supproted

beetroot juice, blackcurrant, cherry juice, caffine, BCAAs

No evidence for Vit C and E

In comp prohibited etc

Ibprofen - not prohibited

panadol - not prohibited

insulin - prohibited

ventolin - conditional

anti-fungal - not prohibited

chlorhexine - not prohibited

prednisole - prohibited

diazapam - not prohibited

benzadrex - prohibited

Components of SCAT6

Immediate or On-field Assessment (for sideline use)

• Red Flags: Signs requiring immediate medical attention (e.g., neck pain, seizure, deteriorating consciousness).

• Observable Signs: Balance issues, disorientation, blank stare, slow responses.

• Memory Assessment (Maddocks Questions): Simple recall questions to assess orientation (e.g., “What venue are we at?”).

• Glasgow Coma Scale (GCS)

CNS fatigue

CNS - related to diet due to low blood sugar (glucose) seen in events greater than 90 mins

Co-ordination and motivation reduced

PNS fatigue

reduced localised force

ACL

18-24 females

change of direction

pop

reduced stability

effussion - intraarticular

lochmans

gentle movement asap

Shoulder dislocation

Impact from posterior

Traumatic

screening for if this has happened

Deformity and pain

Axillary nerve damage

Ambulance

dehydration

dizzy, light headed

fatigue

vomiting

thirst

headache

(kidneys effected)

DRSABCD - stop the game

All work places must (workers comp insurance)

• Take out an insurance policy with a licensed insurer to cover it for workers compensation claims made by its workers; or

• apply to the WorkCover Tasmania Board (the Board) for a permit to self-insure against workers compensation claims made by its workers. This means the employer will manage and be liable for workers compensation claims made by its workers, as opposed to purchasing a policy of workers compensation insurance from a licensed insurer

A worker with industrial deafness

which occurred after 16^th August 1995, and has more than 5% binaural hearing impairment is also entitled.

“Disease” .

is any ailment, disorder, defect, or morbid condition, whether of sudden or gradual development

People who are not workers

• people employed on a casual basis for a purpose other than the employer’s trade or business.

• outworkers

• people employed as domestic servants with a private family, who have done less than 48 hours employment

• crew members of a fishing boat who are paid wholly or mainly on the basis of a share of the profits or gross earnings of the boat.

• people taking part in approved programs of work for unemployment payment (work-for-the-dole schemes)

• people employed on ships covered by the Commonwealth Seafarers Rehabilitation and Compensation Act 1992.

3 key principles for injury management

• all parties, including the injured worker, should:

  •  view recovery and return to work as the prime goals following a work-related injury.

  • have a shared commitment to these goals; and

  •  work together through co-operation, collaboration and consultation to achieve these goals.

Key people involved

Return to work co-ordinator, injury mangement co-ordinator, primary medical practitioner, workplace rehab provider, insurer,

Provides support and assistance to injured workers at their workplace

Return to work co-ordinator

Co-ordinates and oversees the entire injury management process for serious workplace injuries

Injury management co-ordinator

Provides more specific services related to rehabilitation

workplace rehab provider

medical certificate

Medical practitioners are advised not to certify total incapacity for more than 28 days, unless there are valid reasons. If, however the medical practitioner thinks the worker is unlikely to be able to return to their pre-injury hours or duties for a specified period, or ever they must specify this and the reasons for it on the medical certificate

Where a worker suffers a significant injury (more than five working days of either partial or total incapacity for work),

the insurer/employer must appoint an injury management co-ordinator whose job it is to ensure a plan for co-ordinating and managing the worker’s treatment, rehabilitation and return to work is created.

There are two types of plans for managing a significant workplace injury

return to work plans and injury management plans. The type of plan used depends on the time a worker is (or is likely to be) incapacitated for work.

A return-to-work plan

is a simple plan for managing a worker’s injury or condition. It details the agreed actions, goals and assistance required to support the worker to remain at work or return to their pre-injury employment.

An injury management plan

is a more comprehensive plan than a return-to-work plan. It provides details on treatment and rehabilitation as well as strategies to help the injured worker return to work.

The following parties must be consulted in preparing a return to work plan or injury management plan:

• the worker

• the employer

• the primary treating medical practitioner

• the insurer

• the injury management coordinator

• the workplace rehabilitation provider (if there is one).

The employer must keep the injured worker’s job available for them to return for

12 months, unless:

• there is medical evidence that it is highly unlikely the worker will be able to do their pre-injury job, or

• their pre-injury job is no longer required.

TASCAT

If there is any dispute over the expenses paid, the worker, employer or insurer can refer the matter to the Tasmanian Civil & Administrative Tribunal (TASCAT) to resolve

Ergonomics (Derived from the Greek)

is the natural laws of work (Ergon= Work; Nomos = natural laws)

ergonmics represented by

• Increased injury rates, accident rates

• Poor productivity, inefficiencies in operator output

• Fatigue

• Worker dissatisfaction, due to low morale and apathy

• High error rates, due to user difficulties

ergnomic 4 principles

capacity versus demand, fitting the person to the job, fitting the job to the person, system view on a person

capacity vs demand

capacity exceeds demands = safe.

demands exceeds capacity = unsafe.

fitting the person to the job

• Training

• Job selection based on

• anthropometrics

• personality types

• experience

fitting the job to the person

change the work station, task, redesign to reduce hazards

systems view on a problem

This approach focuses on cyclical rather than linear cause and effect, and cautions that reacting to a problem may contribute to development of unintended consequences

3 systems of ergonomics

human, machine, environment

examples of human, machine, environment

strength - postural demands - thermal,

endurance- rest periods - illumination

gender - speed - chemical

age - vibration - radiation

social - cognitive - physical system