Transcript PAI-2 (new window)

Physical Activity Injuries
Lecture 2
FDSc FISM year 1
Janis Leach
Recap of Lecture 1

Roles of a therapist?

Causes of injury?
Today's lecture
 Classification
 What
of injury
can it tell us and how can it help
us as therapists?
Lecture objectives
At the end of this lecture you should be
able to:
 differentiate types of skin wounds and
fractures
 differentiate between a sprain/strain
 Be aware of grading systems
 Complete an assessment of the hip
Lecture outline

Classifications
 Skin injuries
 Muscle tears
 Joint injuries

Tendon injuries
 Ligament injuries
 Bone injuries
Orientation

Produce a list of different types of
injuries
Classification of Injury

Extrinsic –


due to external violence
Intrinsic

-
due to stress developed within the athlete
Examples?
Classification of Injury
Acute

Ties in with inflammatory phase
Sub-Acute

Proliferation phase ( scar formation )
Chronic

Unresolved
Skin injury

Haematoma,
contusion or bruise is due to a direct
blow, usually with a
blunt instrument
ABRASION

an injury often of the
glancing type, where
the surface of the
skin is broken but
there is no complete
tear throughout the
whole depth
LACERATION

LINEAR WOUNDS
WITH DAMAGE TO
THE FULL
THICKNESS OF
THE SKIN
Puncture wound

where the depth of
the wound is greater
then the length or
breadth
Blisters

injuries to the skin
where one layer is
detached from the
layer beneath.
 The gap between
becomes filled with
with fluid exuded from
the injured cells
Burns

involve damage to
the skin as the result
of heat
INTRINSIC MUSCLE INJURY
STRAIN / TEAR

GRADE 1

GRADE 2

GRADE 3
GRADE 1



Small number of torn fibres
Localised pain
No loss of strength
GRADE 2
Significant number of torn fibres
 Pain and Swelling
 Pain on movement
 Reduced strength
 Reduced ROM

GRADE 3
 Complete
rupture
Extrinsic Muscle Injury
 CONTUSION
accumulation of blood and lymph within
a muscle
 HAEMATOMA
within a space or tissue
Haematoma
Intermuscular
Latin for between
Intramuscular
Latin on the inside
Muscle physiology
Haematoma
Calcification



MYOSITIS OSSIFICANS - deposits of calcium and
eventually bone are laid down in the muscle, usually
as a result of a direct blow
It is usually as a result of impact which causes
damage to the periostium as well as the epymysium.
The bone will grow 2 to 4 weeks after the injury and
become mature bone within 3 to 6 months.
Tendon Injury

Tendonitis - generalised oedema and
inflammation causing pain and loss of
function

Peritendonitis - inflammation of tissues
surrounding the tendon
Tendon Injury
Rupture complete
 Rupture - partial

Grade 1- Ligament Injury

Some stretched
fibres
 No laxity on testing
 Pain
Grade 2 – Ligament Injury

Considerable fibres
torn
 Evidence of laxity
 Pain
 Definite end point
Grade 3 – Ligament Injury

Complete tear
 Excessive joint laxity
 No firm end point
Joint injury
Traumatic synovitis - damage to the
lining of the joint
 Loose bodies - pieces of bone that
interfere with the joint mechanically
(Osteochondritis Dissecans)
 Dislocation - complete disruption of the
joint surface areas
 Subluxation - misalignment of joint
surface but still some overlap

Bone Injury

Sudden injury (Fracture)

Stress fracture
(repetitive forces)

Pathological (Underlying
bone disease i.e. tumor
or cyst
Bone Injury/ Fractures
 Closed
 Open
(compound)
 Avulsion
PATTERNS OF FRACTURE
Transverse (broken straight across)
 Oblique (as above but at an angle)
 Spiral (broken due to twisting motion)
 Comminuted (shattered bone)
 Compression (vertabrae)
 Greenstick (usually found in children)

Bursitis

Subcutaneous
prepatellar bursa
becomes distended
with fluid caused by
irritation
 Housemaids knee
Review
What is the difference between a strain
and a sprain?
 How does an intermuscular and
intramuscular haematoma differ?
 Name four patterns of fracture?
 What is the difference between a
dislocation and a subluxation?

Task

In pairs you are going to assess the
ankle, knee and hip joint on each other.