Transcript Unit 3_pathology of sports injuryx

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Think about the “coolest” injury you have
ever seen. What was it and why did you
think it was “cool” or interesting?
Physical injury or wound that is produced
by an external or internal force
 Mechanical injury- when a force applied
to any part of the body results in harmful
disturbance in function and/or structure
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Tension
› Force that pulls or stretches a tissue
 Pulls tissue apart
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Compression
› External loads applied towards one another on
opposite surfaces in opposite directions
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Shearing
› Equal but not directly opposite loads are
applied to opposing surfaces forcing those
surfaces to move in parallel directions relative to
one another
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Bending
› When two force pairs act at opposite ends
of a structure
› When an already bowed structure is axially
loaded
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Torsion
› Twisting in opposite directions from the
opposite ends of a structure cause shear
stress over the entire cross section of that
structure
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Acute- sudden traumatic onset of injury
› Example: ankle sprain
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Overuse- gradually develops due to
repetitive forces
› Example: stress fracture
Blister- fluid filled wound due to rubbing
and/or friction
 Abrasion- top layer of skin is rubbed
away

› “Strawberry” or “carpet burn”
Incision- smooth edged cut
 Laceration- jagged edged cut
 Puncture- object penetrates body
 Contusion- bruise
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Strain- a stretch, tear, or rip in the muscle
or its tendon
 Grades
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› Grade 1- some muscle fibers have been
stretched or actually torn.
 Some tenderness and pain with active motion
 Movement painful
 Full ROM
› Grade 2- a number of muscle fibers have
been torn
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Active contraction of muscle extremely painful
Depression or divot present
Some discoloration due to capillary bleeding
ROM decreased
› Grade 3- complete rupture of a muscle
 Significant impairment or loss of movement
 Pain is intense but diminishes after rupture
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Muscle cramps- painful, involuntary muscle
contractions
› Due to fluid and electrolyte loss
Muscle guarding- involuntary muscle
contractions in response to pain from a
musculoskeletal injury
 Muscle soreness- pain caused by
overexertion in exercise

› DOMS = delayed onset muscle soreness
 Occurs 24-48 hours after rest
 May occur to small tears in muscle fibers or
disruption in connective tissue
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Tendon- attaches muscle to bone
› Example – Achilles tendon, patellar tendon
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Tendinitis- inflammation of the tendon
› Key is REST to heal
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Ligaments- connective tissue that
connects bone to bone
› Helps provide stability to the joint
› Example: Anterior Cruciate ligament (ACL)
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Ligament Sprain grades
› Grade 1- stretching and separation the
ligament fibers
 Minimal instability
 Mild to moderate pain
 Swelling and joint stiffness
› Grade 2- some tearing and separation of the
ligament fibers
 Moderate instability
 Moderate to severe pain
 Swelling and joint stiffness
› Grade 3- total tearing of the ligament
 Initial severe pain that subsides
 Swelling may be great
 Joint become stiff
 Typically results in surgery
Dislocation- a bone is forced out of
alignment and stays out until surgically or
manually replaced or reduced
 Subluxation- a bone is forced out of
alignment but goes back into place
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https://www.youtube.com/watch?v=91L
a-IZAXME
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Functions:
› Body support
› Organ protection
› Movement
› Calcium storage
› Formation of blood
cells
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Classification:
› Flat
 Skull, ribs, scapula
› Irregular
 Vertebrae and skull
› Short
 Wrist and ankle bones
› Long
 Humerus, ulna, femur,
tibia, fibula,
phalanges
Injuries caused by tension, compression,
bending, twisting, shearing
 Periositis- inflammation of the periosteum
(lining on the bone)
 Fractures
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› Open- bone protrudes through skin
› Closed- fracture does not penetrate
superficial tissue
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Greenstick-incomplete breaks in bones that
have not completely ossified
Comminuted- three or more fragments at
the fracture site
Linear- bone splits along its length
Transverse- straight line, more or less at right
angle to bone shaft
Oblique- one end of the bone receives
sudden torsion or twisting while the other
end is fixed or stabilized
Spiral- “S-shaped” separation

http://northcarolina.247sports.com/Bolt/
Graphic-video-Olympic-gymnast-breaksleg-on-vault-46624459
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Causes:
› Overload caused by muscular contraction
› Altered stress distribution in the bone
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accompanying muscle fatigue
A change in the ground reaction force
Overtraining
Starting initial training too quickly
Changing habits or environment
What kind of changes in your habits and
environment may lead to a stress fracture?
Also, what kind of sports have a lot of stress
fractures? Why?
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Signs and symptoms:
› Swelling
› Focal tenderness
› Pain
 Occurs with rest and at night
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Common sites- tibia, fibula, metatarsal
shaft, calcaneus, femur
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Healing process is a continuum
› Phases overlap
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3 phases:
› Inflammatory
› Fibroblastic/proliferation phase
› Maturation/remodeling phase
Begins right after injury occurs
 Characterized by:
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› Redness
› swelling,
› Tenderness
› Pain
› loss of function
› increase temperature
Injury to cell
Chemical mediators liberated (histamine, leukotrienes, cytokines)
Vascular reaction (vasoconstrictionvasodilationexudate creates statsis)
Platelets and leukocytes adhere to vascular wall
Phagocytosis
Clot formation
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https://www.youtube.com/watch?v=su
CKm97yvyk
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Realignment or remodeling of the
collagen fibers that make up scar tissue
according to the tensile force to which
scar tissue is subjected
In small groups, discuss the psychological
and social effects an injury may have on
an athlete?
Write your ideas down on the post its you
have and we will put them up on the
chart.
EVERY RESPONDS DIFFERENTLY TO INJURYno two people will react the same
 Factors that may effect athletes reaction to
injury:
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› Severity of injury
› Length of recovery
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Reactive phases:
› Reaction to injury
› Reaction to rehab
› Reaction to return
Length of rehab
Reaction to
injury
Reaction to rehab
Reaction to return
Short (<4 wks)
Shock
Relief
Impatience
Optimism
Eagerness
Anticipation
Long (>4 wks)
Fear
Anger
Loss of vigor
Irrational thoughts
Alienation
Acknowledgment
Chronic
(recurring)
Anger
Frustration
Dependence or
independence
Apprehension
Confident or
skeptical
Termination
(career-ending)
Isolation
Grief
process
Loss of athletic
identity
Closure and
renewal
Athletes may have difficulty socially
following injury
 May feel alienated if they are unable to
participate
 May feel a lack of support from coaches
and teammates
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Depression or grief
 Anxiety
 Anger, agitiation, or aggression
 Denial
 Sleep Disturbance
 Psychosocial isolation
 Substance abuse
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What can you do as an Athletic Trainer to
help your athletes? How can you help?
Be a good listener
 Find out what the problem is
 Be aware of body language
 Project a caring image
 Explain the injury to the patient
 Manage the stress of the injury
 Help the Athlete return to competition
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You have a senior football athlete who
recently tore his ACL during preseason of
football. The college scouts were supposed
to be coming to watch him this coming
week. He has been distant and his
teammates approached you saying he
has been keeping to himself or been
getting angry with them. What do you do
as his Athletic Trainer?