3 - Sports Medicine Flashcards
What are the two major categories of athletic injury types?
Acute - macrotrauma seen in contact sports
Overuse - microtrauma seen in non-contact sports
What is the definition of athletic exposure in sports med?
One athlete participation in once practice or game in which there is a possibility of injury
What is the definition of a reportable injury?
Any injury that occurs during a scheduled practice or game that requires medical attention and restricts the athlete from finishing the practice or game or prevents them from future participation
Where are the most common/severe sports injuries seen?
Spring Football
Wrestling
Female Gymnastics
Female Soccer
What sport has the highest percent of severe injuries?
Female gymnastics - highest percent of reportable injuries too
What sports have the highest amount of catastrophic injuries and fatalities
Ice hockey
Gymnastics
Football
List some banned substances in sports
DHEA - fountain of youth, anti-aging/obesity via increased serum androgen levels
Androstendione - increases testosterone
Creatine - increases phosphocreatine
Beta-Hydroxy or Beta-methylbutyrate - supplement that is a metabolite of leucine and increases muscle mass and rate of recovery after strenuous exercise.
List some restricted drugs in sports.
HGH - increases type II fast twitch fibers and decreases body fat
Diuretics
Beta Blockers (reduced anxiety and reduce tremors), pt with required beta blockers must get physicians proof
What is the most dramatic difference in body part injured/prevalence between men and women?
Knee - women have a 5x higher chance
Plus, most female contact sports are non-contact, which makes the difference even more impressive
Describe the female athlete triad
Amennorhea, Eating Disorder, Osteoporosis
Describe the course of treatment for athletic menstrual irregularities.
If3 yrs since last menarche, then start low dose oral contraceptives
Osteoporosis increases in female athletes is likely due to ?
Anemia leading to loss of bone mass
List the guidelines for pregnant exercise.
Maternal HR should not exceed 140bpm Maternal Temp should not exceed 38c Strenuous activities should not exceed 15 mins Avoid valsalva maneuver Remember to increase caloric intake
Describe little league shoulder
stress reaction to proximal humeral epiphysis (microfracture and widening)
leads to labral tears
Describe pediatric elbow as it is seen in sports.
Little league elbow
excessive acceleration/deceleration
may progress to avulsion
Describe madelung deformity.
Shortened or Deformed distal radius
Gymnasts or weightlifter children can have problems with weight bearing at wrist and have dorsal impactoin of RCJ (due to excessive dorsiflexion under load)
What is the major cause of juvenile LBP in sports
Spondylolysis - nondisplaced pedicle fractures?
Seen with repetitive hyperextension - usually at L5 level– seen in diving, volleyball, soccer, dance, skating, gymnastics
Describe pediatric hip in sports
Snapping hip - causd by tight iliopsoas, bursitis, and/or inflammation
Painful snapping with external rotation
Describe osgood schlatters disease
Partial avulsion of tibial tuberosity seen in adolescents involved with frequent running/jumping sports/activities
What would your differential be if a pediatric patient (athlete) prestents with posterior heel pain?
Sever’s Apophysitis
Achilles Tendonitis
Plantar Fasciitis
or Osteochondritis of the talus.
What is Sever’s disease?
Apophysitis at the achilles insertion on the calcaneus seen in juvenile athletes
Where do most muscle strains occur?
At the musculotendinous jct.
Define concussion
An alteration of cerebral function caused by a direct or indirect (rotational) force transmitted to the head resulting in one or more of the following acute signs.
Describe post concussion syndrome
Continued neurotransmitter dysfunction causing headache, slowed reflexes, impaired memory, and concentration, depression, and excessive sleep
What is second impact syndrome?
An athlete who has sustained an initial head injury and returns to play while still symptomatic and sustains a second head injury.
Loss of cerebral autoregulation
Cerebral vascular congestion
Increased intracranial pressure
Brain Herniation
List the levels of concussion grading
1 - No loss of consciousness, less than 30 mins amnesia
2 - Loss of consciousness for fewer than 5 minutes, more than 30 mins of amnesia
3 - Loss of consciousness for more than 5 mins, Amnesia more than 24 hours
List the recovery criteria based on the cantu grading system.
1 - Athlete may return to play if asymtomatic for one week (same day can be considered if completely asymptomatic)
2 - Athlete may return to play if asymptomatic for one week
3 - Athlete may not return to play for at least one month. If asymptomatic for one full week, may return to play
What is heat exhaustion?
Due to loss of electrolytes and fluid from body, muscle cramps, nausea, and vomiting
Fever over 102, body unable to cool itself.
May need IV fluids if initial conservative treatment doest’t work.
What is heat stroke?
Most severe form of heat illness, occurs when body’s heat regulation system is overwhelmed
Life threatening
Fever over 104, Warm DRY skin
Confusion, lethargy, stupor, seizures, coma, death
