Injury presentation Flashcards
what is a MOI?
mechanism of injury - how the injury happened?
what are the two sources of MOI
trauma and overuse
what is acute onset of an injury?
sudden onset
what is insidious onset of an injury?
gradual and often of an unknown origin
what is the resulting injury given the following MOI: lateral force to the knee causing dorsiflexion and internal rotation of the tibia while foot is planted - tibia and fibula splay apart
high ankle sprain (anterior inferior talofibular ligament and posterior talofibular ligament which are both lateral)\ to become ruptured)
signs
something you see
symptoms
something athlete feels/descrievs
what is important for a trainer to have regarding pain management
reassurance
what psychological symptoms accompany pain?
fear, denial, sadness, catasrophizing, regret, shock
howc an we help psychologically post injury>?
LISTENING, reassuring with a plan supporting concerns expressed, know when to refer, educated on injury/prevention/next steps, make sure they have support, make sure their RTP is mindful and sequential, keep them apart of the team even when they are injured
what are some different types of skin wounds?
laceration, abrasions, punctures, contusions, blisters
what is a laceration?
clear cut
can go through various levels of skin
how are lacerations managed?
- control bleeding
- clean wound
- steri-strips
how do we control bleeding?
- PPE (ie gloves)
- Pressure - use non-sterile loose gauze, add extra layers as needed (don’t remove previous later), stretch gauze bandage
3.elevation - above heart to decrease blood flow to area
how do we clean a wound?
soap and water, cinder suds (foam soap) applied directly to the wound to lift dirt and debree
what are some considerations when applying steri-steri strips
dry area around laceration, adhesive spray via Q tip (do not spray directly on skin) and do not introduce spray into wound, pill skin together with steri steri strips
When do we send for stiches?
sooner the better - can only be effective within 24 hours if injury
send if
unable to stop bleeding
wound is to the face
wound is across a joint
what is the RTP protocol for minor cuts and abraisions?
clean, non-stick gauze and cover roll to dry skin
how do we treat punctures?
LEAVE IT IN (to prevent further bleeding), pad around it with gauze rolls, send for medical attention
what is a contusion
bleeding under skin from blunt trauma that leads to various levels of tissue drainage
how to manage deep contuision?
no deep tissue massage, effleurage and lympth drainage (light contact like this will give releif and help get rid of muscle spasms and reflex inhibition), protective padding,
pulse setting ultrasound in clinic (not continous) - this helps in inflammatory pahse by bringing circulation to the area,
unterferential current (IFC)
what is a blister?
fluid-filled bubble caused by friction
how do we prevent blisters
skin lube over areas of friction
how do we treat blisters>
if broken, clean well
second skin - this will provvide a buffer to absorb the friction, and coverroll
with cuts, lacerations, abraisions, etc (skin wounds) when do you seek medical attention?
when you are unable to control bleeding
when wound is dirty and can’t clean it
wound is deep/puncture is deep
object is still impaled
changes in sensation around injury site -says that nerve has been affected
wound is from animal/human bit
wound is from rusty object
how does cartilage and meniscus heal?
limited capacity to heal, they need little/no direct blood supply
how does a ligament heal
repair phase: collagen/connective tissue fibers are layed down randomly
scar is formed
takes months byt eventually collagen fibers align in response to joint stress/strain
how do skeletal muscle heal?
regernation of new myofibers in the muscle is minimal (focus is on healing injured ones)
generally follows process of random collagen aligment and developing strength in response to stress/steain
how do nerves heal?
regeneration (takes long time, heals abour 3-4mm a day)
PNC nerves regenerate better than CNS nerves
hemostatis
process that stops bleeding (ie blood clot)
inflammation
vascular and cellular response for tissue healing
repair and regeneration
formation of granulation tissues (new connective tissue)
remodeling
strengthening tissues along lines of tension
what are the stages of wound healing?
- inflammation (4-6 days) - this brings circulation to the area to prevent healing, when it is prolonged it can lead to chronic conditions
- proliferation/repair and regeneration (4-24 days)
- Remodeling - regeneration of the matrix of collagen fibers (21 days - 2 years)
what are some S&S (signs and symptoms) of inflammation?
redness, swelling, heat, pain, loss of function
(RH PLS)
what is happening during the inflammatory response
vasodilation of blood vessels, white blood cells (neutrophils and macrophages) fight infection, break down and clean up damaged tissue to start the healing process
there is decrease collagen synthesis and an increased number of inflammatory cells
what is happening during repair and regeneration (proliferation)
collagen is laid down in a disorganized matrix, revascularization brings O2 and nutrients, edges of wound draw closer
what happens during remodeling?
Wolff’s law - collagen reorganizes itself along lines of stress and tissues increase in tensile strength
what are the 5 stages of bone healing?
hematoma formation
cellular proliferation (cells grow and divide)
Callus formation (soft callus - not strong and very re breakable)
Ossification (hard callus)
Remodeling
what are the aims of treatment for the inflammatory phase (days 1-5)
reduce inflammation, reduce pain, reduce swelling, reduce activity, protect athlete, educate athlete
what are the aims of treatment during the demolition phase (day 3-15)
reduce SP
Increase ROM, Flex, Strength, Proprioception, and CVF
reduce residual swelling via lymphatic drainage and IFC
Reduce residual pain
Increase ROM
Increase flexibility
Increase strength via controlled isometric contraction
Increase proprioception
Prevent 2nd complications
Increase cardiovascular fitness
Educate athelete
What are the aims of the healing phase (day 10 - 8 weeks)
increase circulation ROM flexibility Strength CV Proprioception and decreased pain/muscle spasm
what are the longterm goals of treatment
preventing scar adhesions
ensure full ROM, strength at lesion site, maintaining/+ overall flexibility, psychological readiness, optimal biomechanics, correct training habits,main/+ proprioception, protect injury site, educate
what are the guidelines for RTP?
full ROM, 80% strength, able to perform demands of sport, psychological readiness
when do we use heat?
healing phase and beyond, relaxation, promote flexibility
when do we not use heat
INFLAMMATION PHASE
what is tissue’s response to heat?
increase in circulation, inflammation, metabolism, edema/swelling and decreased pain and spasm
what are some examples of moist heat application?
hydrocollator packs, hot wet towel wrapped with a dry towel
can an ultrasound be used for heat in a pulsed setting?
NO! ultrasounds can be used as a source of heat but only in a continuous setting
what is the difference between an infrared and a traditional sauna
infrared saunas heat your skin/body directly
traditional heats the air around you
when do we not use heat as a form of treatment?
inflamed tissues/immediately post-injury, bleeding disorders, blood clots, impaired sensation, metal implants, infection, open wounds,
what is the tissue response to cold?
decrease inflammatory response, edema and swelling, pain, circulation, hematoma formation, muscle spasm, tissue metabolism, enzymatic activity, extensibility
what are some contraindications to cryotherapy
urticaria (hives/rash from cold), clotting disorders, over superficial nerves, altered skin sensation, complex regional pain syndrome, and raynauds phenomenon
when do we use massage?
tight muscles (this will increase ability to extend and decrease pain)
injured muscles (inflammatory phase only effleurage and lymph drainage to decrease pain and swelling and in the healing phase deeper forms of message to increase circulation and promote healing)
to increase circulation
when do we not massage?
during acute inflammation (just effleurage and drainage), contusions (just effleurage and drainage)
acute spasms around another injury
over open wounds or skin reactions
when patient feels altered sensation
possible blood clots
bleeding disorders
over varicose veins (swollen and twisted veins_, Deep vein thrombosis (deep burning calf pain), cancer,
bleeding disorders, diabetes
what are the 4 main principles of massage therapy
General - specific - general (this warms up the body)
Superficial (pressure)- deep - superficial
Proximal - distal -proximal (proximal = begin closer to the centre, this helps move oxygenated blood toward extremities and push deoxygenated blood back to heart) - this allows you to work with circulation
Peripheral - central -peripheral (injury = central)
what are the 3 most important things to do before applying treatment?
- clear contraindications
- expose area being treated
- Ask permission before you do anything
what is urticaria
hives/rash from cold
what is raynauds phenomenon
decreased blood flow to dingers/toes due to vasospasms in the area
what is the acronym for cold treatment?
Cold
Burn
Ache
Numb (stop here)
what massage technique enhances drainage and stimulates lymphatics
terminus technique
when is petrissage massage used?
both before play and after play (it can be a general tissue warmup and help circulation, relieve knots/muscle spams, and imporve muscular function)
when is stripping massage used?
after play
what is stripping massage?
weight and pressure towardsd heart
when is pressure point massage used?
after play
what is pressure point massage?
pushing for about 15 seconds to elonagage muscle or release knot
what is petrissage?
spreading muscle belly across its fibers, hands pushinf and pulling to create friction and seperate msucle fibers
