Excs Phys- Injury prevention and Rehabilitation Flashcards
Distinguish between a sprain and a strain. [total 2 marks]
Sprains
One or more ligaments are stretched, twisted or torn
Strains
When muscle fibres stretch or tear
Name and describe three different types of fracture. [Total 3 marks]
*Stable fracture- Broken ends of bone line up and are barely out of place
*Open / compound fracture- Skin pierced by bone or by a blow that breaks the skin at the time of the fracture
*Transverse fracture- Fracture has a horizontal fracture line
*Oblique fracture- Fracture has an
angled pattern
*Comminuted fracture- Bone shatters into three or more pieces
- Spiral- A winding break
*Hairline- A partial fracture of the bone that is difficult to detect
- Longitudinal- A break that occurs along the length of the bone
Describe the possible causes, symptoms and treatment for a dislocation. [total 3 marks]
Cause
Fall or a blow, sometimes from playing a contact sport
Symptoms
Swollen, painful and visibly out of place / unable to move joint/limb
Treatment
Manipulation to reposition bones, a splint / sling, and rehabilitation
Identify three symptoms of a fracture. [total 3 marks]
- Swelling or bruising
- Deformity
- Pain in the injured area
- Loss of function
- In compound fractures, bone protruding from the skin
Describe an Achilles tendonitis injury and a tennis elbow injury. [total 4 marks]
Tendonitis- Chronic injury
* Overuse injury of Achilles tendon
* Common in runners who suddenly increase intensity or duration of runs / people who are active occasionally
Tennis elbow- Chronic injury
* Inflammation of the tendons of the elbow (epicondylitis)
* Caused by overuse of muscles of the forearm
Elite-level rugby players are at high risk of suffering from musculo-skeletal injuries due to the physical nature of the sport.
Evaluate the use of screening to prevent musculo-skeletal injuries in elite rugby.
[total 8 marks]
AO1 Knowledge of screening to prevent musculo-skeletal injuries
* Screening to prevent musculo-skeletal injuries involves undertaking a series of tests to establish the current musculo-skeletal condition of the athlete/current injury status.
* Screening can be used to assess/identify muscle imbalances / core strength / range of joint movement/mobility / postural alignment / stress fractures.
**
AO2 Application of screening to prevent musculo-skeletal injuries to elite rugby players**
* Screening can identify muscle imbalances such as stronger quadriceps and weaker hamstrings which would increase the risk of the rugby player injuring their hamstring.
* Screening can identify a weakness in core muscles which would decrease stability during contact which increases the likelihood of injury.
* Screening can identify a lack of mobility in the rugby player’s ankles which may place increased pressure on other joints when trying to scrummage/ruck etc.
* Screening can identify hypermobility in a rugby player’s shoulder which may increase the likelihood of dislocation when tackling.
* Screening can identify postural defects which could increase the risk of injury when scrummaging/rucking/mauling.
AO3 Evaluation of the effectiveness of using screening to prevent musculo-skeletal injuries
Positives
* Screening can allow for pre-hab work so injuries are avoided and the rugby player does not miss any training or playing time.
* Based on the results of screening, conditioning programmes can be individualised to target specific weaknesses, decreasing the risk of future injuries.
* Detection of issues can allow for additional interventions such as bracing to limit the chance of injury/surgery to correct chronic issues.
Negatives
* Some screening tests are not 100% accurate and may miss a problem/provide a false negative which could lead to the rugby player picking up a more serious injury.
* Despite screening being commonplace in professional rugby, injuries still occur as some are unavoidable.
* Preventative measures such as taping/bracing/protective equipment may be more effective at preventing injuries than screening.
* Screening can incorrectly identify issues/provide false positives which can lead to a rugby player unnecessarily missing training/games while the issue is investigated which then results in a reduction in fitness levels.
* The identification of potential issues may cause the rugby player anxiety/confidence issues which would increase the likelihood of injury if the player wasn’t fully committed to a tackle.
Accept any other appropriate evaluation of the use of screening to prevent musculo-skeletal injuries in elite rugby.
Describe the different types of stretching that could be safely used with a group. [total 4 marks]
* Active - position held by agonist;
* Passive - position held by another body part OR position held by partner;
* Static - position held with isometric contraction;
* Ballistic - bounce in and out of stretch;
* PNF – position held and isometric contraction.
Safety considerations (sub-max 4 marks)
* Warm-up prior to stretching;
* Make stretch sports specific;
* Begin slowly;
* Hold stretch for (30) seconds;
* Never hold a painful stretch – injury;
* No bouncing / over-stretching;
* Balance / equalise stretches / agonists and antagonists;
Evaluate the use of different types of strength training during injury rehabilitation.
(Total 8 marks
AO1 – Knowledge of strength training methods for injury rehabilitation
* Methods: Free weights, machine weights, body weight, therabands
* Free weights – dumb bells, kettle bells, needs to be controlled whilst lifting, muscles stabilise the weight
* Machine weights – machine has control, set movement patterns, lat pull-down, chest press
* Body weight – develops core strength and balance, such as plank, squatting
* Therabands – elastics that provide resistance, resistance increases as injury improves
AO2 – Application of strength training methods for injury rehabilitation
* All methods are good in injury rehabilitation as it allows the injured performer to strengthen weaker muscles to prevent injuries reoccurring
* Machine weights useful for early stages of injury
* Therabands offer variety in resistance so can also be used in early stage of injury
* Body weight exercises put less stress on the body, as the performer is only required to hold their own body weight, this allows injured muscles more chance of recovery
* Free weights - varying degrees of weight can be used to build up to full strength, can target specific injured muscle groups more easily
* Dumbbells used for a shoulder press to help an athlete recover from a shoulder injury
Accept applied examples of specific strength training methods
AO3 – Evaluation of strength training methods for injury rehabilitation
* Therabands are useful because there are different bands of varying resistance, allowing athletes to choose the correct resistance depending on the stage of their injury, however, they can snap, causing further injury / may provide insufficient resistance to build strength as muscle recovers
* Body weight exercises are useful because they can be low impact, which is beneficial in the early stages of recovery, however, there is less opportunity to overload / build strength to a high degree
* Fixed weight machines are good in the early stages of injury rehabilitation as they provide the athlete with a lot of control which allows them to focus on improving strength, however the range of motion generated by the machines may be limited / focus tends to be on larger muscle groups / movements don’t always mimic sporting actions
* Free weights can be good because the performer can make exercises sports specific / mimic sporting actions that will ensure the correct muscles are strengthened, however, poor form / technique can lead to further injury
Accept any other appropriate evaluation of strength training methods for injury rehabilitation
Describe how using a hyperbaric chamber can aid recovery.
(Total 3 marks)
* Highly pressurised environment containing 100% oxygen/O2(1)
* High concentrations/pressure of oxygen/O2results in larger quantities being inhaled (1)
* Haemoglobin becomes fully saturated with oxygen/O2(1)
* Larger quantities of oxygen/O2reaching the injured area (1)
* Reduces swelling (1)
* Stimulates white blood cell production/Increased activity of white blood cells (1)
* Removes lactic acid (1)
Accept any other appropriate descriptions of how using hyperbaric chambers aid recovery.
Analyse how cryotherapy aids recovery from exercise by causing the body to
redistribute blood flow.
(Total 8 marks)
AO1 – Knowledge of cryotherapy and redistribution of blood
* Cryotherapy is the use of cold temperatures to help an athlete recover from exercise more quickly and effectively
* This can take the form of cryotherapy chambers and ice baths
* Redistribution of blood occurs due to the vascular shunt mechanism
* This process involves the vasodilation and vasoconstriction of blood vessels
**
AO2 – Application of redistribution of blood to cryotherapy after exercise**
* Cold temperatures will cause blood vessels to the extremities to vasoconstrict
* Directing blood to the core
* Redistribution of blood controlled by Medulla / Vasomotor centre
* Via sympathetic / parasympathetic nervous system
* Vasoconstriction caused by the pre-capillary sphincters contracting
* This narrows the internal diameter of the blood vessels
* This is the body’s way of trying to maintain body temperature
* When cryotherapy ends, vasodilation will occur
* Redistributing blood around the body as temperature increases
* Vasodilation caused by the pre-capillary sphincters relaxing
* Widening of the internal diameter of the blood vessels occurs
AO3 – Analysis of how cryotherapy uses redistribution of blood flow to aid recovery from exercise
* Vasoconstriction during cryotherapy means swelling is decreased. A reduction in swelling at this early stage may limit the damage that occurs and allow recovery to be quicker
* Reduction in swelling helps to manage pain allowing the performer to remain mobile
* Vasodilation flushes muscles with blood which may help to begin the process of lactic acid removal / speed up slow component of EPOC
* Oxygenated nutrient rich blood returning to the muscles can help restore myoglobin oxygen stores / provides nutrients to begin the recovery process
* Cryotherapy may limit the impact of delayed muscle soreness meaning the performer is able to return to maximal training sooner
Credit other relevant analysis of the impact of cryotherapy on the redistribution of blood and recovery from exercise.
Elite athletes must develop and maintain extremely high levels of fitness to maximise their chances of winning. Elite athletes may use the results from lactate sampling and the respiratory exchange ratio (RER) to ensure that their training is effective.
How may hyperbaric chambers aid injury rehabilitation?
[total 3 marks]
Reduces pressure at injured area / reduces swelling.(Chamber) delivers oxygen at high pressure.
Answers must be related to hyperbaric chambers, NOT oxygen tents.
Approximately 2.5 more times than normal / 100% pure oxygen.
Haemoglobin / red blood cells fully saturated with oxygen.
‘more oxygen’ too vague.
Accept answers which indicate equivalent of fully saturatde.
Excess oxygen dissolved in plasma.Oxygen reaches parts of body that not normally saturated.Increased white blood cell activity at injury site.Increased blood supply / formation of new blood cells.
Analyse how using a hyperbaric chamber would help rehabilitation from a muscle strain.
Refer to the following in your answer:
* gas exchange at the alveoli and muscles
* transportation of oxygen.
[Total 15 marks]
AO1 Knowledge of a hyperbaric chamber, gas exchange and transportation of oxygen
* Hyperbaric chamber:The chamber delivers oxygen at high pressure.
* Approximately 2.5 more times than normal/100% pure oxygen.
* Muscle strain:The fibres of the muscle are stretched too far/tear.
* Gas exchange:Movement of gases by diffusion. Diffusion is the movement of gases from an area of high partial pressure to low partial pressure.
* Transport of oxygen:Red blood cells contain haemoglobin which transports oxygen around the body.
AO2 Application of a hyperbaric chamber to a muscle strain with reference to gas exchange and transportation of oxygen
* High partial pressure of oxygen in the chamber means that there is a larger diffusion gradient between the air in the alveoli and the blood in the capillary.
* Moreoxygen will diffuse into the blood ensuring that haemoglobin becomes fully saturated with oxygen, forming more oxyhaemoglobin.
* Excess oxygen will also dissolve into the blood plasma.
* As a result, more oxygen will reach the injured muscle than under normal atmospheric conditions.
* Due to the higher diffusion gradient between the blood and muscle cells more oxygen will diffuse into the injured muscle.
* Myoglobin in the injured muscle cells will pull additional oxygen into the muscle.
AO3 Analysis of how the use of a hyperbaric chamber would result in faster rehabilitation from a muscle strain
* (Increased oxygen supply to the injury site) will speed up rehabilitation from a muscle strain.
* (Increased oxygen supply to the injury site) is used by the mitochondria for energy production to power the faster recovery of the muscle fibres.
* (Increased oxygen supply to the injury site) has an anti-inflammatory effect reducing the pressure/swelling in the muscle.
* This may reduce the athlete’s perception of injury allowing more natural movement, thus limiting any additional complications due to a change in movement patterns.
* (Increased oxygen supply to the injury site) stimulates the production of more white blood cells in the muscle.
* These blood cells encourage growth and regeneration of the injured muscle fibres in the muscle.
Screening elite performers is a technique used by coaches for a variety of reasons.
Outline three purposes of screening.
(total 3 marks)
* Can identify past / current injuries / prevent injury (1)
* Can identify muscle imbalances / assess joint mobility / posture weaknesses in the musculoskeletal system (1)
* Can identify performers at risk of complications from exercise e.g. cardiac risk / any other medical condition (1)
* Can identify a suitable rehabilitation programmes (1)
During a training programme to prepare for a marathon, endurance athletes will often supplement their diets to optimise performance.
(a) Explain why a marathon runner may ‘glycogen load’ in the days leading up to a race.
AO1 (sub-max 1 mark)
* Reduce glycogen levels by endurance training / exercise / explanation of tapering down of exercise and tapering up of carbohydrate (1).
* Day before competition complete three minutes of high intensity exercise / high carbohydrate diet to make use of opening of ‘carbo window’ (1).
* Non-depletion protocol / reduce training intensity the week before competition / three days before competition follow high carbohydrate diet / light training (1).
A02 (sub-max 1 mark)
* Used to ‘supercompensate’ for high glycogen demand (1).
* Potential to run out of carbohydrate / hit the wall / reduced performance (1).
* Glyco-loading delays the onset of fatigue / delays hitting the wall (1).
* Depletion of carbohydrate / glycogen would result in an inability to maintain intensity / affects muscle function, etc (1).
Evaluate the appropriateness of a marathon runner using an ice bath as a recovery method during their training programme.
(total 4 marks)
AO1 (sub-max 1 mark)
* Involves sitting in ice cold water for between 5–20 minutes / physiological explanation regarding vasoconstriction to extremities / limbs / vasodilation occurs after leaving the ice bath / flush of oxygen rich blood (1).
**
AO3 (sub-max 3 marks)**
* Long arduous training for a marathon can result in a build-up of lactic acid which can be removed as a result of ice bath use (1).
* Strong belief in the physiological benefits for such athletes / the general theory behind this cold therapy is that the exposure to cold helps to combat the microtrauma (small tears) in muscle fibres and resultant soreness caused by intense or repetitive exercise / reduce swelling (1).
* Fairly easy to incorporate into training routine – simply needs some preparation of large water container and ice, eg wheelie bin (1).
* Not completely proven to aid recovery / some evidence suggests that cold water is effective rather than ice cold (1).
* Other recovery methods may be better / easier / less extreme, eg cool down and massage / cool down and foam rolling, etc (1).
Describe fours ways that a performer may be able to prevent an injury to themselves from occurring.
[total 4 marks]
- Warm up - go through motions of sport - slow, sustained stretches
- Wear appropriate footwear
- Tape or strap vulnerable joints
- Use appropriate safety equipment – e.g mouth guards, helmets, pads
- Drink plenty of fluids before, during and after game
- Avoid exercising in hottest part of day – 11.00 - 15.00
- Maintain fitness in off season
- Cross-train to ensure overall fitness and muscle strength
- Ensure training includes appropriate speed and impact work.
- Gradually increase intensity and duration of training.
- Use good form and technique.
- Cool down after sport with gentle, sustained stretches.
- Allow adequate recovery time between sessions
- Have regular medical check-ups
Apart from warming up, cooling down and wearing suitable clothing, what other precautions can be taken to prevent injury from occurring?
[total 3 marks]
- Correct recovery time/don’t over train/correct application of SPORT principles/principles of training
- Modify techniques
- Taping/elastic support/neoprene support/braces
- Conditioning/strength programme/core strength training
- Correct diet/nutrition/fluid intake/glycogen loading
- Long term athlete development programme
- Ice baths/cryotherapy chambers/hyperbaric chambers
- Massages
Competitive swimmers will often compete in several events and suffer from fatigue due to limited recovery time.
Explain how the use of an ice bath can help to reduce the ‘delayed onset of muscle soreness’ (DOMS).
[total 4 marks]
(Involves sitting in ice cold water for) between 5-20 minutes.
Be careful not to credit DOMS – in the question.
Causes blood vessels to tighten / decreases metabolic activity / vasoconstriction;
Restricting blood flow to the area;
Reduces swelling / tissue breakdown / aids muscle repair;
After leaving the ice bath, area is flooded with new blood / vasodilation;
Fresh oxygen removes lactic acid (when out of the ice bath).
must be linked to previous point
don’t accept ‘waste products’ for lactic acid
Some studies suggest ice baths of limited value.
Name and explain three rehabilitation techniques elite athletes may use to recover from a soft tissue sports injury.
(Total 3 marks)
Ice baths/ice/cold compression
Sit in cold water for short period of time to restrict blood flow, on leaving bath fresh oxygenated blood rushes into the muscles/discussion of vasoconstriction and vasodilation/equiv descriptions of other techniques
Hyperbaric chambers
Sit inside chamber where high pressure oxygen forced into the muscles/forces 100% oxygen into the muscles
Oxygen/hypoxic tents
Sit or sleep inside where high altitude conditions are replicated increasing red blood cells
Massage/Rollers
Involves kneading or rubbing muscles to breakdown scar tissue/improve blood flow/remove lactic acid or equivalent
Elite athletes must develop and maintain extremely high levels of fitness to maximise their chances of winning. Elite athletes may use the results from lactate sampling and the respiratory exchange ratio (RER) to ensure that their training is effective.
How may hyperbaric chambers aid injury rehabilitation?
[total 3 marks]
Reduces pressure at injured area / reduces swelling.
(Chamber) delivers oxygen at high pressure.
Answers must be related to hyperbaric chambers, NOT oxygen tents.
Approximately 2.5 more times than normal / 100% pure oxygen.
Haemoglobin / red blood cells fully saturated with oxygen.
‘more oxygen’ too vague.
Accept answers which indicate equivalent of fully saturatde.
Excess oxygen dissolved in plasma.
Oxygen reaches parts of body that not normally saturated.
Increased white blood cell activity at injury site.
Increased blood supply / formation of new blood cells.
Katarina Johnson-Thompson is a heptathlete competing in multiple events over two days.
Analyse why a lack of sleep between the two days of competition may impair her recovery and performance.
[total 3 marks]
* Lack of non-REM sleep/third stage less blood available to muscles to help recovery, leading to KJT performing below expectations on the second day (1)
* Insufficient sleep can reduce growth hormone production, meaning fatigue caused by the first day’s events takes longer to repair, reducing the standard of performance in the second day’s events (1)
* Lack of sleep can increase the risk of injury due to reduced concentration/lack of time to repair, could lead to KJT having to compete in the second day’s events whilst not fully fit (1)
* Lack of sleep can cause tiredness, which can affect KJT’s concentration/delay her reaction time leading to a slow start in sprinting events (1)
Accept any other appropriate analysis of why a lack of sleep between the two days of competition may impair her recovery and performance.
