FQ1: How are sports injuries classified and managed? Flashcards
Ways to classify sports injuries
- direct + indirect
Direct
- caused by external forces to the body
- injury occurs at the site of the force
- can result in fractures, dislocations, sprains + bruises
E.g. cricketer catching ball + getting a dislocated finger
Indirect
- can be caused by internal or external forces + usually results in an injury occurring at site away from initial force
- can occur as a result of poor prep or excessive movmt
- can occur because of undue strain on muscles, tendons or ligaments + can cause irritation + possible structure damage
- can occur as athlete’s working at max effort + muscle fatiguing as they try to perform to their best - intrinsic force within body puts pressure on muscle
E.g. cyclist falls, puts out his hand + dislocates shoulder (impact at hand, but injury comes from shoulder)
Ways to classify sports injuries
- soft + hard tissue
Soft
- occur to soft tissue in body including: muscles, tendons, ligaments, joint tissue, fatty tissue, organs
- acute = occurring suddenly, chronic = prolonged
- Types: bruises (haematoma), sprains (ligaments), strains (tendons), lacerations (skin), tendonitis (tendons)
E.g. achilles tendonitis, sprained ankle
Hard
- injuries to bones or teeth including: breaks, dislocations
- less frequent in sport but often more serious
E.g. dislocated shoulder from poor tackle in rugby league
Ways to classify sports injuries
- overuse
- caused by excessive use over a long period of time (commonly called Repetitive Strain Injuries (RSI))
- repeated stress without enough time b/w performance to recover
- brought on by repetitive low impact exercise (jogging or swimming) → begins small + develops into larger injury as athlete has not allowed enough time to repair/recover before it is re-injured
- causes include: poor training techniques, high intensity too soon, poor surfaces, inappropriate equipment + physical characteristics (flat feet etc.)
- injuries characterised by pain + inflammation
- common overuse injuries: shin splints, tendonitis, stress fractures
Soft tissue injuries
- tears, sprains, contusions
Tear
- disruption of the fibres of muscles or tendon
- occur when muscle/tendon is overstretched or contracted too quickly
- causes = internal forces, poor technique or overtraining
- can range from microscopic to full rupture of all connecting soft tissue to a bone or muscle (surgery)
E.g. pulled hamstring while running
Sprains
- stretch or tear of ligament fibres, muscles or tendons that support a joint
- often caused by an external force
- occur when joint capsule + its surrounding ligaments are stretching beyond natural ROM = torn ligament fibres
E.g. rolled ankle in netball or ACL rupture in the knee
Contusions
- a bruise (bleeding into any soft tissue structure)
- normally caused by external force upon soft tissue resulting in capillaries bursting (direct impact)
- also caused through internal forces being imbalanced
E.g. cricket ball hitting a player’s leg
MANAGEMENT = RICER
Soft tissue injuries
- skin abrasions, lacerations, blisters
Skin abrasions
- outer layer of skin is removed, usually a scraping action
- common in any sport, especially those where athlete may frequently fall or be tackled
E.g. grazed knee from a slide tackle in soccer
Lacerations
- deep cut or tear which penetrates skin + will usually require stitches
- often result of contact with sharp device, or head clash or contact with other sport-specific equipment
E.g. ice hockey player gets hit with a stick cutting skin open
Blisters
- caused by friction or burning that leads to a buildup of fluid in skin (pocket of fluid under skin)
- often on feet due to friction from shoes or equipments such as a tennis racquet
Soft tissue injuries
- skin abrasions, lacerations, blisters (MANAGEMENT)
Skin abrasions - Clean wound (gentle cleansing) - Wash with disinfectant (sterilisation) - Cover with non-stick dressing - More serious: manage blood loss Lacerations - Manage bleeding - Apply pressure to area - Medication attention + stitches or surgery (dependant on severity) - Self managed: clean wound, apply non-stick dressing with pressure Blisters - Cover with padding (band aid) - Remove object causing friction - Do not pop - rest
Soft tissue injuries
- inflammatory response
- initial stage of repair involving first 48-72 hrs after injury as body increases blood flow to injured site
Phase 1: inflammatory stage = just after injury has taken place
→ blood flow increases to area - redness, heat, swelling, pain, loss of function
Phase 2: repair stage (3 days - 6 wks)
→ Eliminate debris
→ Form new fibres (repair)
→ Produce scar tissue
Phase 3: remodelling stage (6 wks - mths)
→ development of scar tissues: tissue needs to strengthen in direction force is applied, dependant on amount of exercise + rehab routine, aim to regain full function
→ balance of exercise + rest important
LEARN TO:
manage soft tissue injuries:
- RICER (Rest, Ice, Compression, Elevation, Referral)
Rest → first 2-3 days (48-72 hours)
- immediate cessation of activity
- place in comfortable position with injury elevated + supported
- WHY: prevent further damage by minimising mvmt = ensure inflammatory response is not stimulated again, →
reduces bleeding in area (less blood flow around body)
Ice
- carried out by placing a bag of crushed ice in a wet towel on injury
- can be secured with clear plastic wrap wound around it
- administered 20 mins at a time → repeated every hr for next 24-48 hrs to ensure swelling is minimium
- WHY: reduce pain + swelling by cooling area → discouraging blood flow to area, vasoconstriction around area reducing inflammation then when taken off vessels dilate (vasodilation) increasing fresh blood flow = waste removal + nutrients to be delivered for repair, recovery
Compression
- application of a compression bandage or garment around injured area (over, above + below site)
- administered periodically for next 24-48 hrs
- WHY: ensure bleeding is reduced + therefore
swelling = minimum, reduce/control IR, pressure helps force fluid away = reducing inflammation, stabilises joint
Elevation → for the first 72 hrs
- administered immediately when athlete is rested once injury has been sustained
- raise injured area above level of heart by placing support (e.g. pillow) under injury
WHY: reduces volume + pressure of blood flow to injury, gravity assisting in removal of fluid/waste products from site = reducing/controlling IR, efficient recovery, reduces bleeding, swelling + pain
Referral → asap following injury
- seeing/appointment with a health/medical professional e.g. doctor, specialist, physio
- WHY: can be difficult to determine extent + nature thus allows athlete to ascertain full nature + extent of injury, allows for accurate/proper diagnosis e.g. grade 1 sprain + initiates an effective rehab program, improve recovery + prevent future injury to site
LEARN TO:
manage soft tissue injuries:
- immediate treatment of skin injuries
- Immediate response aims to: → Prevent further damage + reoccurrence → Reduce swelling → Restore flexibility → Minimise/erase pain → Reduce risk of infection - Abrasions/lacerations: Stop bleeding + clean wound where possible, apply non-stick sterile dressing, seek stitches if necessary - Blister: cover with appropriate material, pressure, elevation, rest, stop bleeding → reduce risk of infection
Hard tissue injuries
- fractures
- break in the bone
- signs + symptoms: pain, deformity, irregular alignment, hearing/feeling break of grating bone, local tenderness
- identified by a loss of function of mobility, intense pain, deformity + swelling
- Classification:
→ Simple/closed fracture: breaks inside body + does not pierce skin
→ Compound/open fracture: breaks + protrudes through/pierces skin
→ Complicated fracture: causes further damage to major nerves, organs or blood vessels - Types:
→ Complete: breaks clean through bone so that there are two parts
→ Comminuted: more than two parts to bone; smashing or multiple fractures
→ Incomplete (greenstick): doesn’t break whole way through bone (still in one piece but has a break in it)
Hard tissue injuries
- dislocation
- displacement of bone or joint from joint structure; abnormal separation in a joint b/w 2 bones
- caused by excessive force (direct or indirect)
- results in damage to surround soft tissues including: sprains to ligaments, strains to muscles
- signs + symptoms: loss of movmt, swelling + tenderness, pain at site, deformity
Manage hard tissue injuries
- assessment for medical attention
- immobilisation
- both require medical intervention
- Main aims: immobilise area, reduce pain, prevent further damage, reduce bleeding + shock
Fractures - DRSABCD
- To manage:
→ immobilise injured limb or area, eg using a sling
→ if pierced skin = essential to reduce + control any external bleeding, using pressure, provided it does not cause further pain or injury
→ monitor for shock
→ taken to medical facility for treatment by a doctor e.g. X-ray + plaster cast or splint if required
Dislocations - DRSABCD
- To manage:
→ do not move joint - check for circulation past joint
→ joint should be supported in a comfortable position + if possible a sling should be applied
→ not attempt to relocate joint - only done by a medical professional after an X-ray has been taken
→ applying ice may help to reduce swelling + pain
Assessment of injuries
- TOTAPS (Talk, Observe, Touch, Active + Passive movement, Skills test)
- if it is determined at any point throughout steps that athlete cannot continue to play: assessment is stopped, athlete is removed from play + further medical assessment + treatment is required
Talk - talk to athlete to gather as much info about injury as possible
- injured athlete asked to describe what happened + to describe nature of injury including symptoms eg. pain
- ask questions e.g. where does it hurt? how painful is it out of 10?
Observe - observe injury site + overall response of athlete to see if there are any signs of obvious deformity or swelling
- compare both limbs on either sides of the body to determine abnormalities e.g. swelling, blood
Touch - gently feel area for any sign of deformity, heat + swelling → only if there is no great risk of further injury
- ask permission + compare with other site
- apply pressure to determine if it hurts (look at face for indication of pain)
Active movement - if there is still no pain ask athlete to perform a range of movements such as flexion, extension + rotation
- athlete moves injured body site + observe extent of pain
- look to see if athlete has full ROM around injured site
- Pain = should not continue + be removed from field, No pain = continue to next step
Passive movement - assessor physically mobilises joint using a range of movements aimed at identifying painful areas + any instability in the joint
- moves injured part through its expected ROM + determines how much pain-free movement is possible
- Pain + lack of mobility = assessment stop (first aid applied), No pain + full ROM = continue to next step
Skills test - athlete performs a range of skills necessary for participation in game e.g. sidestep
- progress from basic low intensity/force movmts to faster more powerful/forceful activities
- if able to perform to satisfaction of assessor, then athlete can return to game
Assessment of Injuries
DRSABCD
- no response = would continue through rest of DRSABCD procedure
- response = would not continue with rest of DRSABCD, + would move on to STOP assessment
STOP
- on field assessment done to quickly assess injury + determine if further assessment is required or if athlete can continue to play
- Stop: athlete is stopped from further participating (game is only stopped if necessary)
- Talk: talk to athlete. What happened? How did it happen? Where does it hurt?
- Observe: athlete (distressed, lying awkwardly)/injury sit (deformity, swelling, discolouration)/ROM (restricted, pain)
- Prevent further injury: take player off for further assessment if required (transport may be required)
