Transcript 2012-2013-Sports-Conditions-Injuries-and-Prevention-2

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Sleepiness, sleep disturbance,
Poor concentration
Nausea/vomiting
Slurred speech
Personality change
Impaired playing ability
Which 2 sports have the highest
incidence of concussion?
1. Professional horse jumping jockeys
2. Australian footballers
Physio role?
• Remove player from field of play!
• Exclude the presence of serious head injury or
spinal injury
• If athlete’s unconscious assume presence of
head injury and spinal injury and manage
accordingly – hospital...for assessment and
observation...
Bleeding
• Open and closed wounds
– Incised: a cut from a sharp edge
– Laceration: rough tear or crush to the skin
– Abrasion: graze or superficial wound from a
rough surface
– Contusion: bruise or internal bleeding
– Puncture: an object entering the body
– Velocity injury: a puncture wound at
velocity will cause extensive damage, there
may be an entry and exit wound
Physio role:
• From first aid perspective, dress wound to
maintain sterile state and remove to hospital
for treatment if required
• Sports medic on pitch side can stitch wounds
as required
Joint Injuries:
Joint injuries:
• High energy impact
• Damage to:
– Menisci – like cartilage, prevents friction.
– Ligaments
– Joint capsule – contains the synovial fluid.
– Bony structures
• Knee “big three”
– Anterior cruciate ligament (ACL), medial
meniscus, medial collateral ligament (MCL)
– Traumatic knee, shoulder, elbow, wrist,
ankle injuries eg dislocations
What are the Soft Tissues?
• Muscles & Tendons
• Ligaments, Joint Capsules, Bursa
Bursa: Small fluid filled sacs.
Provides cushioning between bones &
tendons.
Helps to reduce friction.
• Cartilage
• Nervous Tissue
Types of soft tissue injuries
• TRAUMATIC:
• Specific cause is identified
• Cause of injury easily identified
• OVERUSE:
• Develop slowly not attributed to one incident
• Specific injuries assoc with a particular sport
Injury Classification
• ACUTE: rapid onset, traumatic event with
a clearly identifiable cause.
• CHRONIC: slow insidious onset,
gradual development of structural
damage.
• SUB-ACUTE: period between acute and
chronic, usually 4-6 weeks post-injury.
Causes of Soft Tissue Injuries
• Intrinsic causes of injury
–factors within the sports person
• Extrinsic causes of injury
–factors outside the sports person
Muscle Injuries
• Muscle strain= tear in muscle fibres beyond its
limit
• Causes: (i) forceful contraction of the muscle
(ii) Overstretching the muscle
Muscle Injuries
• Classification of muscle strains
Grade
Extent of damage
Grade 1 5% or less muscle
Symptoms
Minimal pain
fibres
Grade 2 5% - 99%
Some muscle fibres
still present
Grade 3 Complete rupture
Moderate / severe
pain on contraction
Limited ROM
No contraction
Less pain / no pain
Muscle Injuries
Assessing a Muscle strain:
1. PAIN on movement / resistance
2. PAIN on contraction
3. PAIN on palpation
Muscle most susceptible to injury?
Rectus femoris (quad)
Hamstrings
Gastrocnemius (calf)
Tendon Injuries
• Tendon properties:
– Connects muscle to bone
– Low blood supply
• Tendonitis –inflammation???
• Tendinopathy – Degeneration of tendon
• Healing tendon:
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HEAT (increase blood supply)
DTFM - massage
Strengthen
Stretch
Ligament Injuries
• Ligament Properties:
– Connects bone to bone
Grade 1 –minimal swelling, bruising, pain
Grade 2 – Moderate to severe swelling, bruising,
pain
Grade 3 – A lot of swelling, agony, may or may not
bruise
Management of soft tissue
injuries
• Acute Injury
• PRICE:
– Protect
– Rest
– Ice
– Compression
– Elevation
Icing
• Limits Inflammatory process
• First 48-72 hours
• Methods: - Crushed ice in a towel, frozen veg, Ice
bath, Chemical ice packs (pitch-side), Freeze spray /
cryogel
• Application:
- 10 mins every 2 hours
• Dangers of leaving ice on too long
- Ice burn
- Nerve damage
- Increase in blood flow
The aims of early management
The management of STI in the first 72 hours:
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to reduce pain
to reduce local tissue temperature
to limit and reduce inflammatory fluid
to reduce metabolic demands of the tissues
to protect the damaged tissue from further injury
to protect the newly-formed fibrin bonds from disruption
to promote collagen fibre growth and realignment
to maintain general levels of cardio-respiratory and
musculoskeletal fitness / activity
Management of medical problems
• HYPOTHERMIA
• ‘Hypo’ = Below / under
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‘Thermia’= heat
Condition in which a person’s body temperature is sufficiently
below normal to cause distress and disorder of normal bodily
functions.
– Mental deterioration
– Loss of coordination
– Unconsciousness
– Failure of breathing and circulation
– Death
Hypothermia
• Causes:
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Cold
Wind
Wet clothing
Perspiration
Water immersion
• Stages:
Peripheral (core 37-36)
Moderate (core 34)
Severe (core 32 or lower)
Hypothermia
• Signs / Symptoms:
-Tiredness / exhaustion
- Shivering
- White / purplish appearance
(bluish tinge to lips / fingers)
- Clumsiness / falling/ tumbling
- Weak grip and slowness in muscle contraction
- Cold rigid arms and legs
- Poor concentration, loss of interest, lethargy
- Slurred speech
Hypothermia
• Treatment:
• Removal from cold, wet, windy conditions
(shelter)
• Insulation to prevent further heat loss
• Passive or active re-warming
• Gentle and minimal handling
• Provision of nutritional and fluid support
• Transport to medical facility
Hypothermia
• Hypothermia hits stumbling Lebanese
Gloucester
30th Oct 2000
New Zealand Vs
Lebanon
Rugby League
Group2
Hyperthermia
• Hypertherma = overheating of body
• Hyper = ‘ high’, therma = ‘heat’
• Body can not effectively regulate excess heat /
elevated temperatures
• Temperature > 37.5–39.9 °C
• Causes:
– Exposure to excessive heat
– Exposure to high humidity
– High physical exertion
– Dehydration
Hyperthermia
• Signs and Symptoms
- Hot, dry skin
- Dizziness / Fainting
- Nausea / Vomiting
- Headaches
- Gastrointestinal problems e.g. Diarrhoea
- Multi-organ dysfunction
Treatment:
- Cool / tepid water immersion
- Rehydration
- Sponging head, neck, trunk with cold water
- Sit in shade
Dehydration
• Fluid Loss exceeds Fluid Intake
• Causes:
- Excessive Sweating
- Insufficient fluid intake
- Hot & humid conditions
- High intensity exercise
Dehydration
• Consequences:
– Increase in perceived effort
– Reduced performance
– Impaired reaction times, judgement,
concentration and decision-making
• Electrolyte Drinks
- Sodium (speeds fluid absorption)
- Carbohydrate (provides fuel)
- Small amounts frequently (500-800ml/Hr)
Quick overview of........
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Fractures
Concussion
Bleeding
Joint injuries
Soft tissue injuries
– Muscle injuries
– Tendon and ligament injuries
• Skin damage
• Dehydration
• Hyperthermia (heat stroke) and hypothermia
Questions: