Transcript File

ALL OTHER INJURIES
AND GENERAL
INJURY
MANAGEMENT
Lesson 3 – REC 1020 Injury
Management I
10 SHOCKING SPORTS INJURIES
ETIOLOGY AND PATHOLOGY OF SPORTS
INJURIES
Etiology – the study of the
cause or origination
Sports injuries are most
commonly caused by:
 Poor training methods
 Structural abnormalities
 Weakness in muscles or muscle
group differences
 Unsafe exercising environments
Achilles Rupture
ETIOLOGY AND PATHOLOGY
Most common cause of injury is poor training
 Example: muscles need 48 hours to recover after an intense
workout
 Incorrect or unsafe form
Everyone’s bone architecture is a little different
 Uneven leg length
 Excessive Pronation (flat feet)
 Cavus feet (over-high arches)
 Bowlegged or knock-knee alignment
OTHER STRUCTURAL CONDITIONS
 Lumbar Lordosis – forward curve in
the lumbar vertebrae
 Patella Alta/Baja – a kneecap that is
higher or lower than usual
 High Q Angle – kneecap displaced to
one side, as with knock knees
 Tight Illiotibial Bands – can lead to
major knee pain
 Muscle Imbalances – if quads are
stronger than hamstrings, hamstrings
are more prone to injury
SPRAINS, STRAINS, FRACTURES
SPRAINS
STRAINS
FRACTURES
Stretching or tearing
of a ligament
(connects bone to
bone) or joint
capsule.
Stretching or tearing of
musculo-tendinous (muscle
and tendon) structure.
External forces act on bones until
integrity is compromised and they
“break”.
Occur when a muscle is
stretched and suddenly
Occur when a joint is contracts as with running
forced beyond
and jumping.
normal range of
motion.
Limited swelling, but pain,
muscle spasm, limited range
Symptoms will be
of motion and muscle
“SHARP” and can be spasms are likely and can
treated with RICE.
be treated with RICE.
Symptoms will be “SHARP”.
(Exception: if an artery is damaged,
the site may be cool and pale –
instead of hot and red). Muscles or
tendons MAY OR MAY NOT be
affected as well. Only an X-Ray will
confirm a fracture. Will not show
soft tissue damage.
RICE will help minimally, but
stabilization and immobilization is
priority. Sometimes surgery needed.
SEVERITY OF SPRAINS AND STRAINS
ANKLE SPRAINS
SEVERITY OF SPRAINS AND STRAINS AND
TREATMENTS
Severity
 GRADE 1- Stretching or minor tearing of muscle or ligament
 GRADE 2 – Partially torn but still intact of muscle or ligament
 GRADE 3 – Complete tear of muscle or ligament
Treatment
 GRADE 1 – RICE
 GRADE 2 – RICE plus additional immobilization of injured area
 GRADE 3 – RICE, complete immobilization and possible surgery
CHRONIC OR OVERUSE INJURIES
 The four stages:
1. Discomfort that disappears during the warm-up
2. Discomfort that may disappear during warm-up but
reappears during the end of the activity
3. Discomfort that gets worse during the activity
4. Pain or discomfort all the time
PALPATION
 Palpate the injured area using pads of fingers and thumb
 Start distal and move proximal
 Compare to uninjured side of the body if possible
 Check for:
 Point tenderness – extreme pain or discomfort in specific points or regions
 Skin or feeling changes – sensation, tingling, numbness
 Crepitus – grating, cracking or popping sound under the skin and joints due
to air in the subcutaneous tissue
 Temperature – hot and red (inflammatory phase) or cold and pale (possible
shock indicated)
 Pulse – one of the vital signs
CAUSES OF CHRONIC OR OVERUSE
INJURIES
 Lack of appropriate muscle strength or endurance
 Poor core stability
 Muscle imbalances
 Inflexibility
 Structural or biomechanical issues
 Training errors
 Faulty technique
 Incorrect equipment
 HIGHLY REPETITIVE, EXTREME IMPACT
 or “TOO MUCH, TOO SOON”
COMMON CHRONIC OR OVERUSE
INJURIES
 Achilles Tendon Rupture
 Muscle Strain
 Achilles Tendonitis
 Olecranon Bursisitis
 Bursitis Knee
 Plantar Fasciitis
 Calf Muscle Tear
 Rotator Cuff Syndrome
 Carpal Tunnel Syndrome
 Shin Splints
 Compartment Syndrome
 Stress Fracture
 Degenerative Disk Disease
 Many more….
 Golfers or Tennis Elbow
 Illiotibial Band Syndrome
 Meniscus Tear
RICE
Rest – from an aggravating
activity that could make the injury
worse
Ice – to reduce swelling and pain
Compression – usually applied
by tensor wrapping toward the
heart
Elevation – during and after
application of ice body part
should be elevated higher than
the level of the heart
INFLAMMATORY PHASE
 During the Inflammatory
Injury Phase (typically 3-5
days), the body will experience
“SHARP” symptoms
 Swelling, Heat, Altered
Function, Redness, Pain
 RICE will help combat some
of these initial symptoms
REST/RESTRICTED ACTIVITY
 Rest the body part that was injured by protecting it from inappropriate
or painful movement
 This may involve use of stabilizing, splinting, slings, crutches or bandaging
 If EMS is activated and on the way, stabilize the injury
 Rest the affected area on a stable surface (chair, desk, table, floor)
and ask the athlete not to bend the joints near or around the injury
 For fractures and dislocations, leave the athlete in the position
found if it is stable. Support the joints above and below an injury by
holding them in place if the athlete is an unstable position.
REST/RESTRICTED ACTIVITY
 If EMS is not available, or transportation of an injured athlete is
necessary, a splint may be used for immobilization.
 Splinting prevents further damage to an injured area by preventing
movement.
 To split, immobilize the joints above and below an injury. For
example, if an athlete has a broken arm, the wrist and the elbow
must be immobilized to prevent further injury to the arm
 Any rigid material can be used to splint. Make sure the splint is well
padded to avoid discomfort
 Tie the rigid material in place above and below the injury, but never
over the injury.
 Monitor circulation below the ties, and loosen if circulation is
impaired
ICE/COLD APPLICATION
 Can reduce swelling, pain, bleeding and muscle spasms
 Apply:
 In 15-20 minute intervals with 60 minutes in between applications
(the temperature of the body should completely return to normal
before applying ice again)
 In 10 minute intervals with 60 minutes in between applications on
the hands, face, neck, groin and outside the knee.
 This is because there is less fat and tissue in these areas so they will
cool down faster, and risk of frostbite is higher
 Ice should be applied for the first 24-72 hours after injury
ICE/COLD APPLICATION
 Can be directly applied to the skin as long as the
time parameters are followed correctly
 If uncomfortable with that, you can place a wet
towel or tensor between the ice and skin
 Wet material conducts much better than dry
material and will assist in cooling down the injury.
Dry material essentially stops the cold from
reaching the injury
ICE/COLD APPLICATION
 Can take many forms
1.
2.
Frozen Water
 Crushed ice is best because it compresses uniformly, does not encourage
air pockets like ice cubes, and conforms easily to the body part it is applied
to
 Snow from outside or ice from an ice resurfacer can be used too
 Place crushed ice or snow in a plastic bag or a wet towel
Ice Cups
 Water is frozen in Styrofoam cups, and then the cup is peeled away at the
top and the ice is continually rubbed on the injured area for 10 minutes
 Not the best for acute injuries or large areas
 Typically used for localized injuries that are close to the surface of skin
(example over the wrist for tendonitis)
ICE/COLD APPLICATION
3.
Frozen Vegetables
 Frozen peas or corn work best
 Very convenient and reusable if refrozen – conforms well to the body
 Make sure the mark the bags so that they are not used for food after
4.
Reusable Gel Cold packs
 Convenient and reusable
 Must be large enough to cover the entire surface of the injury and also pliable
enough to give uniform coverage
5.
Instant Cold packs
 Convenient but expensive because often one time only use
 Should be used with caution as chemicals can escape from package
 Many do not get very cold or do not stay cold for long enough for effective
treatment
ICE/COLD APPLICATION
6.
Spray coolants or cold rubs
 Expensive
 Only work superficially (cool down the skin, not the underlying tissues) so they offer
little benefit in injury treatment
7.
Cold water immersion
 Not the ideal choice as it is difficult to apply in combination with compression and
elevation
 Use if other options are not available (camping or hiking, etc)
ICE/COLD APPLICATION
 The type of ice is not as important as ensuring that R.I.C.E. is followed.
CAUTION
 Use caution when applying ice or cold
 Over the heart, vital organs, eyes, spine or other areas of
altered sensation
 On athletes with diabetes or arthritis
 Do not use ice on athletes who have Lupus, Reynaud’s
disease, or allergies to cold
COMPRESSION
 Early application of compression is the most important treatment in the
management of injuries to the musculoskeletal system
 Gentle compression can be very effective in minimizing swelling
 A tensor bandage works well for applying uniform compression
 Apply:
 As soon as the possible after injury
 In a consistent, firm manner
 In more than one layer – overlapping layers is best
 By starting the wrap from the furthest point away from the heart and moving towards the
heart, over the injury
 During the application of ice by securing the ice pack to the body part with a tensor
bandage (follow ice application timelines)
COMPRESSION
 CAUTION:
 Do not cut off circulation below the compression site. Loosen a wrap if it causes
discoloration below the injury
 A slower color return to tissue in the nails of a wrapped limb (compared to
unwrapped limb), or numbness or tingling below the compression site indiciate
inadequate blood flow
 Instruct the athlete not to wear the tensor or wrap to bed
ELEVATION
 Elevate an injured limb above the level of the heart if the
injury is stable and there is no suspected spinal damage
 Helps return extra fluids from swelling back to the heart
and lymphatic system
 Helps prevent shock from setting in which can be lifethreatening
SO… NOW WHAT?
 Rehabilitation
 Return the body to pre-injury state
 Should be carried out under the guidance of a
physician, physiotherapist or athletic therapist
 These professionals can recommend progressive
exercises and activities to return the injured body
part to its pre-injury state
THERMOTHERAPY
 When an injury is older than 48 hours, local area heat can be applied in
the form of a wheat bag, heat pads, heat cream or hot water bottles.
 Heat causes the blood vessels to dilate, bringing more blood to the area
and stimulating healing of damaged tissues.
 It has a direct soothing effect and helps relieve pain and spasm.
 It can also ease muscle stiffness and make tissues more supple (which
helps when manual therapy is done next)
 Apply for 10-20 minutes at a time, with the same amount of rest
between for 2-3 hours.
 Heat rubs only work superficially and are thus not effective
MANUAL THERAPY
 Massage, stretching, kneading, range of motion exercises are done by an
experienced and trained therapist
 Improves mobility, reduces pain, stimulates healing
 Myofascial Trigger Point Release
 Can be aided at home using foam rollers, lacrosse balls, hand rollers, etc.
ELECTRICAL NERVE STIMULATION
 Transcutaneous Electrical Nerve Stimulation (TENS)
 Stimulate nerves via an electrical current through your skin
 May provide modest, short term pain relief
 Manipulating the pulse width, frequency or intensity achieves different
pain relief results for different people
RETURN TO PLAY
 Criteria includes:
 Written consent from physician
 Complete, uninhibited, pain free range of motion
 Pre-injury strength, flexibility, endurance, speed and
coordination without aggravating the injury
 Athlete confidence both physically and psychologically