Musculoskeletal Injuries and Illnesses
Classification of Injuries
Injuries can be classified into three types:
Acute
Chronic
Overuse
Acute Injuries
An acute injury occurs quickly, with immediate pain and loss of function.
Classified as:
Direct (external force)
Indirect (internal force)
Direct Injuries
Result from an external force.
Causes:
Collision with another person
Direct blow from an implement (e.g., hockey stick, cricket ball)
Examples:
Minor and major damages as a result of a direct injury
Indirect Injuries
Usually caused by a sudden change in direction or intensity.
Most common examples: sprained ligaments and strained muscles.
Acute Injuries: Soft Tissue
Soft tissue injuries are the most common in sports, involving damage to skin, muscles, tendons, and ligaments.
A tear occurs when connective tissue is excessively stretched or ruptured.
Types of tears:
Strain: muscle or tendon (e.g., strained hamstring)
Sprain: ligament (e.g., sprained ankle)
Contusion (or bruise): caused by bleeding into the soft tissue.
Acute Injuries: Soft and Hard Tissue
Strains and sprains are classified by the number of fibers torn, indicating the severity of the injury.
Acute Injuries: Hard Tissue
Hard tissue injuries involve bones.
The most common injury to bones is a fracture, which is a break in the bone.
Closed fracture: bone doesn't break through the skin
Open (compound) fracture: bone breaks through the skin
Causes of fractures:
Direct trauma (e.g., a blow)
Indirect trauma (e.g., falling on an outstretched hand).
Signs and symptoms of a fracture:
Pain, swelling, bruising, tenderness, difficulty moving, or deformity.
Dislocations:
Occur at a joint, involving displacement of bones.
Damage both hard tissue (bone) and surrounding connective tissue.
Chronic Injuries
Chronic injuries often start as acute injuries and recur due to re-injury, prolonged weakness, or insufficient rehabilitation.
Example: Recurring hamstring strains in AFL players.
Overuse Injuries
Caused by excessive and repeated use of the same muscle, bone, or joint.
Diagnosed by inflammation and pain.
Tend to be prolonged and take a long time to recover (e.g., shin splints, stress fractures).
Causes:
Internal: muscle imbalance, anatomical problems (e.g., poor posture).
External: training errors, incorrect technique, uneven surfaces, or hard running tracks.
Illnesses Associated with the Musculoskeletal System
Many illnesses and conditions affect the muscular and skeletal systems, impacting an individual's ability to engage in physical activity.
Statistics: In 2011–12, 6.1 million Australians (28% of the population) had a musculoskeletal condition.
The most common musculoskeletal conditions in Australia include:
Arthritis
Osteoporosis
Back pain and problems.
Arthritis
Characterized by inflammation of the joints, causing pain and stiffness.
Estimated to affect 3.5 million Australians (15.5%).
Over half (58.9%) suffer from osteoarthritis.
11.5% with rheumatoid arthritis.
More common in females than males, especially after age 45.
Can restrict daily activities such as walking, preparing food, and hygiene.
The three most common forms are:
Juvenile Arthritis
Osteoarthritis
Rheumatoid Arthritis
Juvenile Arthritis
Occurs in children under 16 years of age.
Affects less than 1% of Australian children.
Can be unpredictable, with symptom-free moments alternating with severe swelling and tenderness.
The cause is currently unknown.
Osteoarthritis
A degenerative condition resulting from overuse or 'wear and tear' of a joint.
Mostly affects weight-bearing joints (hip, knee, ankle) but can also affect hands and spine.
Cartilage wears away, causing bones to rub together, creating pain, swelling, and restricted range of motion.
Risk factors include increasing age, physical inactivity, being overweight, joint trauma, and repetitive stress.
Rheumatoid Arthritis
A chronic disease resulting from an autoimmune response.
The immune system attacks the tissues lining the joints, causing pain, swelling, stiffness, progressive and irreversible damage, and deformity.
The most severe form of arthritis, generally affecting smaller joints (hands and feet).
Management strategies for Arthritis
Physical activity should consider the individual’s condition and limitations.
Lower-impact exercises are often more comfortable.
Recommendations:
Flexibility exercises (e.g., stretches) to maintain or improve mobility.
Muscle strengthening (e.g., resistance training with weights) to support joints and connective tissue.
Aerobic activities (e.g., walking, swimming) to improve heart and lung health.
Osteoporosis
A musculoskeletal condition characterized by the thinning and weakening of bone, making it fragile.
Occurs when bone loses minerals (especially calcium) faster than the body can replace them.
Impairs bone density and increases the risk of fracture.
More common in women than men and has a higher incidence in people over 55 (AIHW).
Often called the 'silent disease' with little to no symptoms until a fracture occurs.
Largely preventable.
Risk factors include sedentary behavior, lack of exercise, poor calcium intake, and vitamin D deficiencies.
Regular physical activity (particularly weight-bearing activities) helps maintain or improve bone density and strengthen muscles.
Stronger bones and muscles improve posture and balance, reducing the likelihood of falls and fractures.
Back Pain
Can affect the bones, joints, tissues, and nerves of the back.
Caused by soft tissue injury, displacement of intervertebral discs, postural stress, nerve irritations (e.g., sciatica), and structural problems.
Often stems from overuse, injury, weakness, degeneration, or postural misalignment.
Can be acute, but often becomes chronic.
Risk factors include sedentary behavior, physical inactivity, being overweight or obese, type of occupation (lifting, bending, twisting), poor posture, and stress.
Back Pain Treatment
Exercises to strengthen back and core muscles for correct posture and support.
Maintaining a healthy weight to reduce strain on the back.
Staying active.
Physiological Strategies to Prevent Musculoskeletal Injuries
Correlation between certain sports characteristics and increased injury risk.
High-risk characteristics include:
High levels of physical contact
High impact activity
Heavy physical demands
High training volume (e.g., swimming, gymnastics with 6-9 sessions/week)
Long seasons with no breaks.
Preventative actions include:
Performing pre-participation screening.
Developing physical fitness appropriate to the activity.
Developing correct skills and techniques.
Completion of adequate warm-up, stretching, and cool-down procedures.
Pre-participation screening
Should be undertaken by all individuals before starting or increasing physical activity.
Can take the form of questionnaires and/or physical examinations.
Questionnaires commonly ask about medical history, current conditions, allergies, family histories, and previous injuries.
Physical examinations provide data on height, weight, and blood pressure.
Physical preparation of athletes
Training should ensure athletes achieve appropriate fitness levels specific to the sport.
Athletes and coaches must correctly apply the principles of training:
Specificity
Appropriate progressive overload
Intensity
Frequency
Adequate recovery between training sessions is vital to benefit from the session and prevent injury.
Fitness testing in the pre-season to identify strengths and weaknesses.
Overtraining refers to a physical condition characterised in its most severe form by decreased athletic performance, increased fatigue, persistent muscle soreness, mood disturbances, and a feeling of being ‘burnt-out’ or ‘stale’.
Warm-up
Prepares the body for physical activity.
Physiological effects:
Increases heart rate and respiratory rate.
Increases blood flow to muscles, increasing muscle temperature.
Increases enzyme activity within muscle cells due to increased muscle temperature.
Includes a general phase followed by a sport-specific phase.
The general phase includes low-impact aerobic activities and stretching.
The sport-specific phase includes activities related to the muscles, joints, and body parts to be used in the activity. These activity-related movements should be dynamic movements and could involve activities such as:
Run-throughs
High knee-lift running
Horizontal ladder stepping
Skill drills that replicate the specific movement patterns performed during the sport or activity; for example, kicking a football.
Cool-down
Assists the body to recover from exercise via a low-intensity version of the activity.
Followed by static and proprioceptive neuromuscular facilitation (PNF) stretching of major muscles.
Aims:
Prevent venous pooling.
Ensure waste products (e.g., lactic acid) are broken down and removed.
Reduce the potential for muscle soreness.
Allow the body to return to its resting physiological state.
Physical Aids to Support the Musculoskeletal System
Safety Equipment:
Designed to reduce the risk of injury, especially the effect of impact and collisions.
Important aspects:
Worn during training and games
Fits correctly
Specific and appropriate for the sport, size, and age of the athlete
Regularly checked and maintained.
Correct Footwear
Many sports require different types of footwear depending on the demands and surface.
Specialized footwear can include running shoes, spikes, and football boots.
A good running shoe can help prevent injuries such as shin splints, overpronation, underpronation, and Achilles tendon problems.
Taping
Preventative taping (or strapping) and bandaging of joints before playing or training can reduce the chance of injury and the severity of a ligament injury or strain.
Used to restrict potentially harmful movements while allowing desired movement.
Potential harms can include irritation of the skin and reduced circulation if too tight.
Tape does lose elasticity over time.
Can be applied by the athlete or medical professionals.
Kinesiology Taping
Thinner and more elastic than traditional rigid strapping tape.
Less restrictive, allowing muscle support without compromising range of motion.
Not completely wrapped around the injured joint or muscle but applied over or on the periphery.
Benefits include pain relief, greater range of motion, and longer wear.
Braces
Play a similar role to taping in injury prevention.
Athlete can put on the brace themselves rather than relying on a professional.
Protective Equipment in Sport
Sport: Soccer.
Protective Equipment List:
Shin Guards:
Why: Protect the shins.
Injury Prevention: Prevents bruises, fractures, and contusions on the shin from kicks and collisions.
How: Absorbs impact and distributes force.
Compulsory.
Mouth Guard:
Why: Protect teeth and jaw.
Injury Prevention: Prevents dental injuries, concussions, and jaw fractures from collisions.
How: Cushions impact to the face.
Optional.
Headgear (Soccer-Specific):
Why: Reduce risk of head injuries, especially in young players.
Injury Prevention: Reduces risk of concussion and head lacerations during headers and collisions.
How: Provides a protective layer to absorb impact.
Optional.
Gloves (Goalkeepers):
Why: Protect hands and improve grip.
Injury Prevention: Prevents finger sprains, dislocations, and fractures. Enhances grip for catching the ball.
How: Padded for shock absorption and grip enhancement.
Compulsory for Goal Keepers.
Ankle Braces:
Why: Provide additional support to the ankle joint.
Injury Prevention: Reduces the risk of ankle sprains, particularly for players with a history of ankle injuries.
How: Stabilizes the ankle, limiting excessive movement.
Optional.