Injuries and the Healing Process
Download
Report
Transcript Injuries and the Healing Process
Injuries and the Healing Process
Olympic High School Sports
Medicine
Chapter 12,13
Vocabulary Chapter 13
RICE
Muscle
Tendon
DOMS
Myositis
Fasciitis
Ectopic calcification
Creptitation
Synovia
Articulation
Osteochondrosis
Apophysis
Osteoblasts
Osteoclasts
Wolff’s law
Callus
Mechanoreceptors
Muscle guarding
Trigger point
Open fracture
Closed Fracture
Types of Injuries
Strains/Sprains
Grade 1- slight stretch but no deformity,
mild to mod. Pain, localized swelling
Grade 2- some tearing of fibers, mod.
Instability, mod. Severe pain, swelling
Grade 3- total rupture, major instability,
severe pain at first then little or no pain,
swelling is great
Contusion
Bruise, hematoma, ecchymosis
Tendinitis: inflammation of tendon
Overuse injury, pain, swelling, crepitus
Bursitis: inflam. Of bursa
Swelling, pain, increased pressure
Tenosynovitis:same
as tendonitis but
Wound Injuries:blister, abrasion,
inflamed
laceration, skin avulsion, incision, puncture tendon/synovial sheath.
Types of Injuries continued: fractures
Types of Injuries continued
Muscle Cramps/spasm: muscle contraction/tightness due to fatigue
or injury
Myositis Ossificans: calcification of muscle due to excessive
bleeding.
Dislocation: complete displacement of bone with the joint
Subluxation: partial displacement of bone with the joint
Epiphyseal Injuries: growth plate injuries. Salter fractures for
epiphyseal fractures
Nerve Injuries:
– Hypoesthesia: a diminished sense of feeling
– Hyperesthesia: an increased sense of feeling such as pain or touch
– Paraesthesia: numbness, prickling, or tingling, which may occur from a
direct blow or stretch to an area
Kyphosis: round back, forward-thrust head, winged scapulae, flat
chest. Tight pectoral muscles
Lordosis: sway back or hollow back. Tight lower back muscles with
weak abdominal muscles. Lineman or gymnasts most susceptible.
Scoliosis: lateral curvature of the spine
Genu Valgum: knock knee
Genu Varum: bowleg
How do injuries happen?
What are the
possible
injuries that
can happen
in this slide?
Mechanical Forces and Strengths
Compression Force: A
force that with enough energy
crushes tissue. A contusion
occurs if too much force is
applied
Tension Force: a force that
pulls and stretches tissue.
Sprains/strains, avulsions,
ruptures
Shearing Force: a force
that is transverse to fibers.
sprains
Example of injuries
Pain
– Two types of soreness
» Acute-onset muscle soreness - accompanies fatigue, and is
transient muscle pain experienced immediately after
exercise
» Delayed-onset muscle soreness (DOMS) - pain that occurs
24-48 hours following activity that gradually subsides (pain
free 3-4 days later)
Potentially caused by slight microtrauma to muscle or
connective tissue structures
– Prevent soreness through gradual build-up of
intensity
– Treat with static or PNF stretching and ice
application within 48-72 hours of insult
Muscle Stiffness
– Does not produce pain
– Result of extended period of work
– Fluid accumulation in muscles, with slow
reabsorbtion back into bloodstream, resulting in
swollen, shorter, thicker muscles --resistant to
stretching.
– Light activity, motion, massage and passive
mobilization assists in reducing stiffness
Vocabulary
Vasoconstriction
Vasodilation
Regeneration
Phagocytosis
Serum
Synthesis/lysis
Cryokinetics
Modality
Conduction
Convection
Conversion
Inflammatory Response
Occurs first for 3-4 days
Swelling, redness, pain, heat, loss of function.
This occurs to protect the body
Acute Inflammation-
Before inflammation begins intact blood vessels
vasoconstriction up to 10 minutes
Then blood coagulation begins to seal broken
vessels
Then vasodilatation- blood viscosity increases
slowing blood flow and swelling then serum
seepage 15-30 min.
Phagocytosis starts to clean out debris
Internal swelling: 1. Throboplastin is sent 2.
Thromboplastin and calcium is sent. 3. Thrombin
to fibrinogen into final fibrin clot
Inflammatory Response
Repair PhaseFibroplastic(scar formation)
Regeneration
Regrowth of lost cells
Last up to 3 weeks following
injury
Primary healing- heal around
edges
Secondary healing – gaps
heal toward each other
Remodeling
Increase scar tissue first 3
weeks
Last 3 months to a year
Factors that impede
healing
1. Extent of the injury
2. Edema/hemorrhage
3. Poor vascular supply
4. Separation of tissue
5. Muscle spasm
6. Atrophy
7. Infection
8. age
Pain Perception
Pain-
Is described by: burning, sharp, dull, aching, tingling
Deep pain is different than superficial pain
– How
Psychological aspects of Pain
Must treat the whole athlete
Personality differences plays a role in pain perception
Referred Pain-
Visceral pain has a tendency to radiate and give rise to pain that
becomes referred to skin’s surface
COLD AND HEAT
Types of cold:
Ice bag, ice massage, ice boot, cold whirlpool, ice bucket, chemical
spray
Physiological effects of cold
Decrease in local temperature up to 4”
Vasoconstriction of capillaries w/in first 15-20 min., vasodilation 5
min., vasoconstriction 20 min. (Hunting effect)
Decrease local cell metabolism
Decrease blood flow
Decrease nerve velocity
Decrease excitability of muscle
Analgesic effect (numb) which will decrease spasm
Cold and Heat cont.
Types of heat
Conduction-transmission of heat between two objects
Convection-heat produced by a moving mass(gas or liquid)
Conversion-heat by electrical current
Radiation- ultraviolet light
Physiological effects of heat
Increase elasticity of muscles & tendons
Increase blood flow- vasodilation
Decrease spasm
Increase local cell metabolism
Increase excitability of muscle
Increase temp. to 3mm depth
Indications of heat
Post acute phase
Decrease spasm
Decrease pain
Help wound healing
Prior to exercise
Contraindications
Acute injuries
Hyper/hypo sensitive to heat
Circulatory problems
Indications of cold
Acute trauma
Anti-inflammatory
Decrease pain
Decrease spasm
Post exercise
Prior to therapy
Contraindications
Before or during activities
Hyper/hypo sensitive to cold
Circulatory inefficiency
Different Modalities
Heat Therapies
Short-wave diathermy:
High frequency electrical current.
Used for: bursitis, capsulitis, osteoarthritis, spasm, strains
Heat depth= up to 2 inches
Ultrasound:
High frequency sound waves causes molecules to vibrate and warm
Used for: joint contractures, scar tissue, tendonitis, bursitis, skeletal
muscle spasm, and pain
Paraffin bath:
Hot wax used for extremities especially the hand.
Massage Techniques:
Effleurage- stroking, Petrissage- kneading, friction-heat, tapotementpercussion, vibration-rapid shaking
Contrast Baths and other
Modalities
Hot and cold modality
Physiological effects:
Same as heat/cold
Flushing affect. Brings in new material for repair and flushes out
edema
When should you use contrast bath?
– When swelling has subsided (48-72 hours)
Time interval for treatments
4 min. cold then 1 min hot 4 times end in cold= 24 min.
3 min. cold then 2 min hot 4 times end in cold= 23 min
2 min. cold then 3 min hot 4 times end in hot= 20 min
1 min. cold then 4 min hot 4 times end in hot= 20 min
Or 5 min. cold/ 5 min. hot
Treatment times and Temperatures
Ice bag, ice boot, ice whirlpool (55-65
degrees) - 20 min.
Ice massage 5-10 min.
Warm whirlpool (97-102 degrees), moist
heat pack –10 min.
Ultrasound- 5-7 min.
Muscle stim- 10-20 min.