LM

Sports Medicine Exam 2 Review (Chapter 6-11)

CHAPTER 6: Legal Concerns

  • Purchasing Equipment

    • Buy only from reparable manufacturers.

    • Purchase safest equipment resources allow.

    • Ensure correct assembly of equipment.

    • FOLLOW DIRECTIONS for usage and maintenance.

    • Maintain equipment periodically.

    • Exercise caution when modifying existing equipment.

    • DO NOT USE DEFECTIVE EQUIPMENT to avoid injuries.

  • Types of Equipment

    • Off-the-shelf equipment:

    • Pre-made and packaged products, including ankle braces and neoprene sleeves.

    • Custom protective equipment:

    • Tailored to meet specific individual needs.

    • Material for Protection:

    • Use polycarbonate for lenses, face shields, and protective goggles for maximal protection.

  • Sports with High Injury Incidence

    • Boxing and wrestling:

    • These sports have the highest incidence of ear injuries.

  • Purpose of a Sports Bra

    • Designed to minimize excessive vertical and horizontal movements of the breasts during activities like running and jumping.

    • Heavier-duty versions provide increased support during sports.

Football Helmet Fitting

  • Measure the athlete's head and read all manufacturer instructions prior to fitting.

  • Fit Requirements:

    • Should fit snugly around all parts of the athlete's head.

    • Must cover the base of the skull, avoiding neck coverage.

    • Should NOT obscure eyes; maintain two fingers above the bridge of the nose.

    • Ensure ear holes match the athlete's ears.

    • Helmet must not shift when manual pressure is applied or recoil on impact - No soft spots should exist in the helmet.

    • Chin Straps:

    • Should be equal distance from helmet center.

    • Cheek Pads:

    • Should fit snugly against the face and be filled with air.

    • Face Masks:

    • Must fit securely to the helmet, three fingers away from the nose.

  • NOCSAE:

    • The National Operating Committee on Standards for Athletic Equipment is responsible for regulating equipment.

    • Equipment should be recertified annually by the manufacturer.

Mouth Guards

  • Prevention of Dental Injuries:

    • Majority of dental injuries are preventable with a correctly fitted mouthpiece.

  • Protection:

    • Absorbs impacts to the jaw, potentially preventing concussions.

    • DO NOT CUT the mouthpiece.

    • Always keep the strap on the mouth guard to avoid choking hazards.

Neck Protection

  • Equipment like cowboy collars and neck rolls serve as reminders for athletes to be cautious rather than preventing injuries.

Shoulder Pad Fitting

  • Initial Steps:

    • Measure shoulder width (tip to tip in the back).

    • Inside pad should align with shoulder tips.

    • The pads cover the deltoid and allow movement.

  • Neck Opening:

    • Should allow the athlete to raise arms overhead without sliding pads.

  • Straps:

    • Must fit snugly without cutting off circulation.

Footwear

  • Orthotics:

    • Devices used to correct existing biomechanical problems in the foot.

  • Heel Cup:

    • A device to compress fat pads and provide cushioning to relieve plantar fasciitis symptoms.

  • Footwear Characteristics:

    • Strong heel counter, flexibility in the forefoot, high heel for tight Achilles tendons, and good construction is essential.

    • Must fit comfortably from heel to the longest toe, as well as from the heel to bend.

Ankle Taping vs. Bracing

  • Taping:

    • Best applied directly to the skin.

    • Tape with pre-wrap is effective for approximately fifteen minutes.

  • Brace:

    • Requires tightening during activity for effectiveness; however, it does not prevent injury.

  • Knee Bracing:

    • Used similarly to neck bracing, it reminds athletes to be cautious but does not prevent injuries.

    • Protective Knee Brace:

    • Provides stability and reminds caution (e.g., device protecting MCL in football linemen).

    • Rehabilitative Knee Brace:

    • Used following surgical repair of the knee.

CHAPTER 7: Emergency Procedures

  • Emergency Plan:

    • Must be established for every sport.

    • 911 Call Protocol:

    • Identify who will make the call: adult, calm, capable of giving directions, must meet paramedics upon arrival.

  • AED (Automated External Defibrillator):

    • Used to evaluate cardiac rhythm and deliver an electrical charge to the heart.

    • Must know the location of AEDs and have them present at all games.

    • Operators must remain calm and follow instructions.

  • Principles of Assessment:

    • Observe body position; the athlete must not remain motionless.

  • Primary Survey (ABCs):

    • A = Airway (ensure if needed, open with jaw thrust).

    • B = Breathing.

    • C = Circulation.

  • Secondary Survey:

    • Note any severe bleeding or signs of shock.

    • Apply direct pressure, elevate the bleeding area, or use pressure points to control external bleeding.

  • Injury Assessment On-The-Field Decisions:

    • Seriousness of injury.

    • Type of first aid to be administered.

    • Need for a doctor or ambulance.

    • Type of transportation needed.

Additional Injury Treatment

  • PRICE Principle:

    • Protection, Rest, Ice, Compression, Elevation - serves to manage acute injuries and minimize pain and swelling.

  • Manual Conveyance:

    • Assistance given to an athlete able to walk.

  • Pressure Points:

    • Locations on the body utilized to control external bleeding.

    • While splinting fractures, ensure to splint both above and below the fracture site and maintain the limb in its original aligned position.

  • Unconscious Athlete Protocol:

    • Always assume life-threatening injuries are present.

    • Head and neck are always involved in such cases.

    • Blows to the head, solar plexus trauma, or shock can induce unconsciousness.

    • Keep the helmet ON and cut face mask away (use trainers' angel, anvil pruner, fm extractor, or screwdriver) to ensure the neck or head are not moved.

    • Continually monitor life support functions, including BPM and pulse rate.

  • Determining Unconsciousness:

    • The simplest method is to ask the athlete a question.

    • Perform secondary survey only once the athlete is stable.

Body Positions

  • Supine Position:

    • ON BACK

    • If the athlete is not breathing, establish ABCs.

    • If breathing, do nothing until the athlete awakes and becomes responsive.

  • Prone Position:

    • FACE DOWN/ON STOMACH

    • If not breathing, execute a log roll and establish ABCs.

    • If breathing, do nothing until the athlete awakens and becomes responsive, followed by log rolling and establishing ABCs.

Shock

  • Shock Definition:

    • Can occur with any sport injury, most common with fractures, significant bleeding, or internal injuries, due to diminished blood levels in the circulatory system.

  • Symptoms of Shock:

    • Moist, pale, clammy skin.

    • Cold body temperature (maintaining body heat is crucial).

    • Disinterest and lethargy.

    • Weak, rapid pulse and low blood pressure.

    • Increased, shallow respiratory rate.

    • Thirst, restlessness, excitement, irritability, and loss of bowel or urinary control.

  • Types of Shock:

    • Hypovolemic: Due to blood loss.

    • Respiratory: Insufficient oxygen provided by the lungs.

    • Neurogenic: Vascular (blood vessel) dilation resulting in inadequate blood supply (6 liters insufficient).

    • Psychogenic: Fainting (syncope), temporary dilation of blood vessels resulting in insufficient brain oxygen supply.

    • Cardiogenic: Heart fails to pump enough blood to meet the body's demands.

    • Septic: Results from severe bacterial infection and toxins.

    • Anaphylactic: Caused by severe allergic reactions.

    • Metabolic: Resulting from severe illnesses such as diabetes.

Shock Management

  • Maintaining Body Heat:

    • Use a blanket.

    • If possible, elevate feet 8-12 inches off the ground.

Vital Signs

  • Understanding Vital Signs:

    • Familiarity with normal values is necessary for accurate assessments.

    • Pulse Rate:

    • Healthy adult range from 60-80 beats per minute at rest.

    • Respirations:

    • Healthy range from 12-15 breaths per minute.

    • Blood Pressure:

    • Systolic: pressure caused by heart pumping.

    • Diastolic: residual pressure between heartbeats.

    • Normal blood pressure ranges:

    • Males 15-20 yrs: 100-140/60-90 mmHg.

    • Females 15-20 yrs: 90-120/50-80 mmHg.

    • Children's blood pressure varies by age, sex, and height.

    • Temperature:

    • Normal range is 98.6°F.

    • Pupils:

    • Important for evaluating nervous system changes.

CHAPTER 9: Psychological Concerns with Student Athletes

  • Overtraining:

    • Resulting from prolonged stress leading to staleness or burnout.

    • Overreaching:

    • Temporary state of overtraining.

  • Stress:

    • Positive and negative forces causing disruptions in the body's equilibrium.

  • Anxiety:

    • Feelings of uncertainty or apprehension.

    • Burnout:

    • Related to physical and emotional exhaustion; often caused by excessive stress.

    • Sports Psychologist:

    • A specialist who can aid athletes in coping strategy development.

  • Athletes characterized as “risk-takers” often exhibit injury-prone tendencies.

Causes of Burnout

  • Training too hard for too long without sufficient rest, both mental and physical.

  • Poor nutrition or inadequate calorie intake.

    • Dietary Advice:

    • "EAT TO COMPETE" is essential for athletes.

  • Elevated anxiety, especially during losing seasons, can induce stress and detriment to athletes' confidence and motivation levels.

Signs and Symptoms of Burnout/Staleness

  • Decline in performance.

  • Chronic fatigue.

  • Loss of appetite and associated weight loss.

  • Apathy and lack of interest in activities.

  • Indigestion.

  • Sleep disturbances.

  • Elevated blood pressure and pulse rate.

Physiological Response to Stress

  • GAS Theory (General Adaptation Syndrome):

    • Represents the body's response to stress in three stages.

    • Alarm Stage:

    • Immediate response to stress (e.g., pop quiz), induces fight or flight responses, muscle responsiveness, acute hearing, and pupil dilation.

    • Resistance Stage:

    • The body attempts to deal with the stress by adapting and recovering; beneficial training adaptations may occur here.

    • Comes with the risk of overtraining that leads to exhaustion.

    • Exhaustion Stage:

    • Results from overtraining leading to chronic stress and depletion of the body's adaptive resources.

    • The body can no longer adapt to training demands.

Psychological Aspects of Injury and Mental Health

  • Phases of Coping:

    • Denial:

    • An athlete may seek second opinions and reject the initial diagnosis.

    • Anger:

    • Questions arise regarding the cause of the injury.

    • Bargaining:

    • Attempting to negotiate reduced stress regarding the injury or its cause.

    • Depression:

    • Intese reality of what occurred sets in, leading to deep sadness, emotional numbness, apathy, and isolation can occur.

    • Acceptance:

    • Coming to terms with the new reality, not necessarily “okay” but has stoped resisting.

    • Establishing new goals can help in reorienting one's life post-injury and allow to make peace with the injury.

Aspects of Rehabilitation

  • Building Rapport:

    • Athletic trainers must establish trust with their athletes.

  • Cooperation is essential; both athlete and trainer must commit to rehabilitation.

  • Educating the athlete throughout the rehabilitation process fosters understanding and commitment.

  • Regaining Competitive Confidence:

    • Trainers should aid athletes in recovering their competitive spirit before returning to the sport.

  • Goal Setting:

    • Goal setting is essential for an athlete to establish motivation for rehabilitation, as well as reducing stress associated with rehabilitation for the athlete.

    • Goals should be specific, challenging, realistic, and cover short, medium, and long-term objectives.

    • Positive language aids in motivation.

  • Decision-Making in Return:

    • Most difficult in the rehabilitation process.

    • Difficult determination regarding when athletes are ready to return to sports, balancing physical and mental readiness.

  • Phases of Reaction:

    • Reaction to the injury.

    • Reaction to the rehabilitation process.

    • Reaction to the return to sporting activities.

CHAPTER 10: Environmental Concerns

  • Heat Stress:

    • Results from direct and prolonged exposure to heat and humidity, and illnesses stemming from this are preventable.

Body Temperature Regulation

  • Metabolic Heat Production:

    • Produces heat naturally as a result of metabolic processes.

  • Conductive Heat Exchange:

    • Heat loss or gain occurs through direct contact with surfaces.

  • Radiant Heat Exchange:

    • Heat shifts occur without direct contact (e.g., sunlight, radiators).

  • Convective Heat Exchange:

    • Involves heat loss or gain through air or water mediums (e.g., wind, water).

  • Evaporative Heat Loss:

    • Loss of heat when liquid evaporates (sweat); efficacy declines at 65% humidity, ceases at 75%.

Heat Illnesses

  • Non-Sequential Occurrences:

    • Heat cramps: caused by electrolyte deficits (calcium, magnesium, sodium).

      • Athletes physically active throughout a game are susceptible.

    • Heat exhaustion: results from inadequate hydration; symptoms include profuse sweating, flushed skin, mild fever, rapid pulse, dizziness.

      • Athletes with higher body weights (big fatties) are particularly prone to heat exhaustion.

    • Heat stroke: arises suddenly and is a medical emergency.

      • Symptoms include elevated core temperature, unconsciousness, hot/red skin, and almost a complete absence of sweating - which indicates that the body has reached 107 degress and has lost its ability to lose heat.

      • Must lower body temperature within 45 minutes for survival.

      • Big fatties are prone

Prevention of Heat Illnesses

  • Gradual Acclimation:

    • Extended practice over 5-6 days achieving 80% acclimation.

  • Weight Charts:

    • Reflects water loss; guideline: for each pound lost, replace with 20 oz of fluid.

  • Identification of Susceptible Athletes:

    • Freshmen and transfers are at higher risk.

  • Uniform Considerations:

    • Wear breathable clothing, avoiding long sleeves; cotton is recommended for heat mitigation.

Cold Disorders

  • Frost Nip:

    • Occurs due to exposure to cold temperatures and wind.

  • Frost Bite:

    • Can be superficial (reversible) or deep (irreversible leading to tissue necrosis, blackened skin).