Injury prevention and rehabilitation

Question 1

What is an acute injury?

Answer 1

It occurs suddenly during exercise or competition, for example, a sprained ankle or torn ligament.
Pain is felt straight away and is often severe.

Question 2

What are the symptoms of an acute injury?

Answer 2

Sudden, severe pain.
Swelling around the injured site.
Not being able to bear weight.
Restricted movement.
Extreme leg or arm weakness.
A protruding bone or a joint that is visibly out of place.

Question 3

What is a chronic injury?

Answer 3

It occurs after playing sport or doing exercise for a long time.
This type of injury develops slowly and can last a long time.
It is often ignored by performers, which makes the injury worse, causing more problems.

Question 4

What are the symptoms of a chronic injury?

Answer 4

Pain when you compete or exercise.
A dull ache when you rest.
Swelling.

Question 5

What is a fracture?

Answer 5

A break or crack in the bone, it can fracture in different ways:
A simple or closed fracture is a clean break to a bone that does not penetrate the skin or damage any surrounding tissue.
A compound or open fracture is when the soft tissue or skin has been damaged. This is more serious as there is a higher risk of infection.

Question 6

What is a dislocation?

Answer 6

It happens when the ends of bones are forced out of position.
It occurs at joints and is very painful.
Often occur with a fall or contact with another player.

Question 7

What is a strain?

Answer 7

Often called ‘pulled’ or ‘torn’ muscle, a strain occurs when the muscle fibres are stretched too far and tear.
Regularly occur from contact with other players and where the performer continually accelerates and decelerates suddenly.
If the intensity of training is too high and the overuse of specific muscle groups.

Question 8

What is a sprain?

Answer 8

Sprains occur to ligaments when they are stretched too far.
Ligaments are strong bands of tissue around joints that join bone to bone.
When playing sport where there is lots of twisting and turning, and excessive force is applied to a joint, a sprain can occur.

Question 9

What are tendons?

Answer 9

They connect muscle to bone and are strong bands of soft tissue.
When muscles contract they help to move the bones and joints.

Question 10

What is Achilles tendonitis?

Answer 10

Tendonitis causes pain and inflammation of the tendon.
The Achilles tendon is located at the back of the ankle and is the largest tendon in the body.
It connects the gastrocnemius to the heel bone and is used for walking, running and jumping, so when you do a lot of regular activity it can be prone to tendonitis.

Question 11

What are stress fractures?

Answer 11

They are most common in the weight-bearing bones of the legs, often when there is an increase in the amount of exercise or intensity of activity rises too quickly.
They happen when the muscles become fatigued and so are no longer able to absorb the added shock of exercise.
The fatigued muscle eventually transfers the stress overload to the bone and the result is a tiny crack called a stress fracture. The area becomes tender and swollen.

Question 12

What is tennis elbow?

Answer 12

It occurs in the muscles attached to the elbow that are used to straighten the wrists.
The muscles and tendons become inflamed and tiny tears occur on the outside of the elbow. The area becomes very sore and tender.
Any activity that places repeated stress on the elbow through overuse of the muscles and tendons of the forearm can cause tennis elbow.

Question 13

How can screening prevent injury?

Answer 13

It can be used to identify those at risk of complications from exercise, prepare performers for their sport, enhance performance and reduce injury.
It can be used to detect a problem early before any symptoms occur.
Screening can also save lives, for example may young elite performers have CRY (cardio risk in the young) heart screening.

Question 14

How can screening prevent injury in professional sport?

Answer 14

It involves assessing muscle imbalances, core strength, range of joint movements, postural alignment and mobility.
If any problems are detected, a conditioner can select a specific training programme for improvement thus reducing the chance of a potential injury while at the same time enhancing performance.

Question 15

What are the disadvantages of screening?

Answer 15

Some screening tests are not 100% accurate and may miss a problem (false negative) or can either identify a problem that doesn’t exist (false positive).
It can also increase anxiety when an athlete finds out they have a health problem or are more susceptible to injury.

Question 16

How does protective equipment prevent injury?

Answer 16

The correct equipment reduces injury in sport.
This equipment needs to fit correctly and follow NGB regulations.
Shin and ankle pads.
Scrum cap, gum shield, body armour.

Question 17

How is active stretching used in injury prevention?

Answer 17

Active stretching occurs when a stretched position is held by contraction of an agonist muscle.
E.g. lifting your leg up and holding it in position. The tension in the hip flexors caused by holding the leg up in the air helps to relax the antagonist muscles being stretched.

Question 18

How is passive, static and ballistic stretching used to prevent injury?

Answer 18

Passive stretching occurs with the help of an external force, such as another part of your body, a partner or a wall.
Static stretching is when the muscle is held in a stationary position for 30 seconds or more.
Ballistic stretching involves performing a stretch with swinging or bouncing movements to push a body part even further and should be performed by an individual who is extremely flexible.

Question 19

What is taping?

Answer 19

Taping a weak joint can help with support and stability to reduce the risk of injury.
Taping can also be used on muscle. Kinesiology tape is used on muscles because it is more elastic than the tape used on joints.
It is applied directly to the skin to provide controlled support, as it expands as the muscle contracts.

Question 20

What is bracing?

Answer 20

It is much more substantial than taping and often involves hinged supports.
It is used to give extra stability to muscles and joints that are weak or have been previously injured.

Question 21

What is proprioception?

Answer 21

A subconscious process using a system of receptor nerves located in the muscles, joints and tendons.
For smooth, co-ordinated movements, the brain needs to have an accurate knowledge of arm and leg position and how fast these parts are moving.
Proprioceptors deliver vital information, but following injury, it is impaired.

Question 22

How is proprioceptive training used in injury rehabilitation?

Answer 22

It uses hopping, jumping and balance exercises to restore lost proprioception and teach the body to control the position of an injured joint subconsciously.

Question 23

What is an example of proprioceptive training?

Answer 23

A balance board is unpredictable and wobbles, so standing on one with an injured ankle strengthens the joint and at the same time re-educates the body to quickly react to the wobbly movements without thinking about it.

Question 24

How is strength training used in injury rehabilitation?

Answer 24

Strength training uses a resistance of some kind, for example weight machines or free weights, body weight or the use of thera-bands.
It prepares the body for exercise, reducing the risk of injury.

Question 25

How are free weights used?

Answer 25

Free weights such as dumb bells and kettlebells have to be controlled as they are lifted.
By not relying on a machine, the muscles have to stabilise the weight as well as lift it.

Question 26

How are machine weights used?

Answer 26

The machine has a lot of control so in the early stages of an injury the focus can be on just improving strength, starting with low weights and gradually building this up.

Question 27

How is body weight used?

Answer 27

Using the body as the resistance often involves core body exercises such as the plank.
Improving core strength helps balance and posture and reduces any imbalances that could lead to injury.

Question 28

How are therabands used?

Answer 28

Therabands are made of latex and can have different strengths.
Light resistance bands are used for rehabilitation and as the injury improves, bands with greater resistance are used.

Question 29

How do hyperbaric chambers rehabilitate injury?

Answer 29

It reduces recovery time for an injury.
The chamber is pressurised so there is 100% pure oxygen, meaning more is breathed in and can be diffused to the injured area.
The excess oxygen dissolves into the blood plasma where it can reduce swelling and pressure at the injured area.
It also stimulates both white blood cell activity.

Question 30

How is cryotherapy used to rehabilitate injury?

Answer 30

It is the use of cold temperatures to treat injuries.
For common sporting injuries such as muscle strains, treatment is simply Rest Ice Compression Elevation.
This has an analgesic effect and can limit pain and swelling by decreasing blood flow to the injured area.

Question 31

What is whole body cryotherapy?

Answer 31

It involves the use of cryogenic chambers to reduce pain and inflammation.
The chamber is cooled by liquid nitrogen to a temperature below -100 degrees and the patient remains in the chamber protected with socks, gloves and a swimming costume for up to 3 minutes.
The freezing gas surrounds the body so that the blood from the arms and legs flows towards the core to keep the body warm and protect vital organs.
On leaving the chamber, the blood returns back to the arms and legs full of oxygen which helps heal injured cells.

Question 32

How is hydrotherapy used in injury rehabilitation?

Answer 32

It takes place in warm water and is used to increase blood circulation, relieve pain and relax muscles.
Typically, hydrotherapy pools are heated to 35-37 degrees Celsius.
The buoyancy of the water helps to support the body weight so that there is less load on joints, allowing for more exercise than is permitted on land.
Exercising against resistance of the water helps to strengthen the injured area. The faster the more resistance.

Question 33

How are compression garments used to recover from exercise?

Answer 33

They improve blood circulation and prevent medical problems such as deep vein thrombosis (DVT).
They generally help blood lactate removal and reduce both inflammation and DOMS.

Question 34

How do massages aid recovery from exercise?

Answer 34

It can prevent or relieve soft tissue injuries (tendons, ligaments, muscles, nerves and blood vessels).
It increases blood flow to soft tissue, so more oxygen and nutrients can pass through to help repair and damage.
Removal of lactic acid.
Stretching of soft tissue to relieve tension and pressure.
Breakdown of scar tissue which, if not removed, can lead to mobility problems in muscles, tendons and ligaments.

Question 35

How do foam rollers aid recovery from exercise?

Answer 35

They can release tension and tightness in a muscle, as well as between the muscles and the fascia.
Fascia is a layer of fibrous connective tissue which surrounds a muscle or group of muscles.
They can be used to prevent injury and improve mobility.

Question 36

How is cold therapy used to aid recovery from exercise?

Answer 36

It is useful after intense exercise where it can be target any minor aches and pains.
Cooling the surface of the skin using ice gives pain relief and causes vasoconstriction of the blood vessels, which decreases blood flow and reduces any bleeding or swelling.
A decrease in swelling (oedema) enables the muscle to have more movement.
Ice can also reduce muscle spasm by decreasing motor activity, as the speed of the nerve impulses slows down in cold conditions, and metabolic rate.

Question 37

How do ice baths aid recovery from exercise?

Answer 37

After a gruelling training session, sports performers get into an ice baths for 5-10 minutes.
The cold water causes the blood vessels to vasoconstrict and therefore reduces blood flow to the area.
On leaving the bath, the legs fill up with new blood (vasodilation) that invigorates the muscles with oxygen to help the cells function better.
The blood leaving the legs takes away with it the lactic acid that built up.

Question 38

How does sleep aid in recovery from exercise?

Answer 38

Deep sleep is important for muscle recovery, the deepest part is the third stage of non-REM sleep.
Brain waves are at their slowest and blood flow is directed away from the brain towards the muscles to restore energy and to repair the damage done to muscle cells.
If sleep is too short, the time for repair is cut short, most athletes need a minimum of 8-9 hours.

Question 39

How is nutrition used to aid recovery from exercise?

Answer 39

During exercise, muscle glycogen stores decrease, so they need to be replenished when exercise is finished.
Research shows that replenishing glycogen stores during the first 20 minute window after exercise can enhance performance the next day.

Question 40

How can a warm up help injury prevention?

Answer 40

It increases the elasticity of the muscle tissue.
This happens because a warm-up will increase the body’s muscle temperature.
Heart rate and respiratory rate also increase, which increases blood flow and therefore the delivery of oxygen and nutrients to the working muscle.
This prepares the muscles, tendons and joints for strenuous activity.

Question 41

What is the first stage of a warm up?

Answer 41

To perform some cardiovascular exercise, e.g. jogging, which gently increases your heart rate,
This will increase cardiac output and breathing rate and more blood is directed through the vascular shunt to the working muscles.
Together these will all increase the amount of oxygen being delivered to the muscles.

Question 42

What are the second and third stages of the warm up?

Answer 42

Second: The performance of stretching/flexibility exercises, especially with those joints and muscles that will be most active during the training session.
Third: Should involves the movement patterns that are to be carried out, for example, practicing shooting it basketball or netball, or dribbling in hockey or football.