Lecture 2 Introduction to Sports Injuries Flashcards
Mechanisms of Injury may be
Primary or Secondary
Primary injuries occur as a …
direct result of stress of sport.
Primary injuries can result from
athlete or equipment.
Examples: Sprains/strains/fractures
Secondary injuries occur as a
a indirect result of stress imposed by sport
Secondary injuries can be result of
environment, existing health conditions, hereditary…
Examples: Heat exhaustion, altitude sickness, sickle cell anemia
The several common Musculoskeletal Injuries
Sprains Strains Tendinopathies Bursitis Contusions Fractures
Sprains are injuries to ____ structures
passive
sprains are Injuries to
ligaments
sprains results from
overstress of the ligament fibers or their
bony attachment point
Strains are injuries to
____ structures
active
Strains are injuries to
Muscles
Strains Result from
excessive forceful contraction or stretch, or
stretching while contracting (eccentric contraction).
Tendonitis:
Inflammation stage of tendinopathy.
Tendonosis:
Chronic tendonitis
Tendinopathies usually include ____ mechanisms
overuse
Tendinopathies are
Inflammation or degenerative changes in tendons
-Usually secondary to repeated micro-traumas or
circulatory disturbances in the tendon
Bursitis:
Inflammation of a bursal sac
Leads to pain and substantial swelling. If not left to
resolve can become degenerative to bursa
Bursa’s may be___ or _____
contused or chronically irritated
Contusions may be____ or____
superficial or deep
Contusions:
Crushing injuries to soft tissues with a blood supply.
Common in muscle tissue, and result in an intra-
muscular hematoma formation.
Closed fracture (simple):
Does not break skin
Open fracture (compound):
Bone breaks surface of skin
There are 3 stages of the healing process
Inflammation
- Proliferation
- Maturation
Acute Inflammation Stage
Inflammation:
The inflammation stage is the reaction of tissue to
acute trauma the result in damage at the cellular level.
What happens in the acute inflam stage
Vasoconstriction and platelet rxn to reduce blood loss
-Growth factors released by platelets attract reparative
cells to the site of injury.
-Clot formation triggers other cellular cascades that
promote vasodilation and blood vessel permeability.
-Migration of neutrophils/macrophages to cleanse damaged
tissue via phagocytosis.
The inflammation stage is
necessary but may be
managed to our benefit.
Inflammation usually lasts
~24-72 hours
Repair of tissue does not start until
inflammation stage
is ending.
Signs of inflammation
S – Swelling H – Heat A – Altered Function R – Redness P – Pain
Management
P - Pressure
E - Elevate
I - Ice
R - Rest
Proliferation stage:
Proliferation begins near the end of inflammation, and
typically extends as long as 6 weeks.
What happens in the proliferation stage
Development of new blood vessels (angiogenesis)
-fibrous tissue formations (fibroplasia)
-Generation of new epithelial tissue (if necessary),
and/or scar tissue in other tissue types.
-Immature collagen/granulation tissue laid down.
Primary Healing (ends touching)
Secondary Healing
Immature collagen laid down during proliferation will _______
However…
mature (next phase of healing) depending on the tissue
type and the stress placed on it.
Tissue is very vulnerable during proliferation, and the
end functional ability of the tissue will depend on the
proliferation stage.
Maturation stage:
starts towards the end of proliferation,
and extends until the tissue reaches full
function/strength
Varies greatly from tissue to tissue, often longer that
1 year!
what happens in maturation stage?
-Type I and III collagen replace immature collagen within
scar tissue to increase strength of repair.
-Elastin is incorporated (ongoing) with healing.
-Collagen fibers align with stresses
Maturation stage starts at the end of _____
and extends until the tissue ______
proliferation … reaches full function.
The end of maturation will include return to sport
activities and full use of injured structure.
-The lead up to this should
be extensively planned
and follow a sounds understanding of timeline and
tissue expectation.
General ligament and tendon healing
Immature collagen/granular tissue deposition :
70 % of pre-injury strength regained:
Full function restoration:
3-6 Days
6 - 8 weeks
Up to 1 year
General Muscle healing:
Degeneration/replacement of myofibrillar proteins =
50% of strength regained =
Full return to sport strength =
1-7 days
Varies based on stg 1/2/3
Varies
General Bone Healing : Hematoma formation = Soft callous formation = Hard callous formation = up to 12 weeks) Return to sport remodeling =
~48 hours
7-14 days
4-6 weeks (longer for primary long bones
up to 12 weeks) Greatest risk for re-injury
As tolerated
Risk factors can be either_____ or_____
Intrinsic or Extrinsic
Intrinsic risk factors relate to ______
Extrinsic risk factors relate to _________
the athlete/individual
sport/surface/environment
Some general themes of intrinsic risk factors include:
Age
- Gender
- psychological state
- medical conditions
Some age related risk factors:
- Legg-Calve-Perthes Disease
- Scoliosis
- Growth plate injuries
- Osgood Schlatter Disease
Some gender related risk factors:
Most injuries affect men and women relatively equally, however: -Concussions -Knee injuries -The female athlete triad
The Female Athlete Triad:
Energy imbalance (with or without disordered eating) can
lead to loss of body weight:
-Lower estrogen/hormone production causing
dysmenorrhea (menstrual dysfunction)
-Premature bone loss causing osteoporosis and
increased incident of fractures (result of low calories
and decreased estrogen.
some medical conditions-related risk factors
Diabetes
- Asthma
- Heart Conditions
- Previous MSK injuries
- Leg length discrepancies
- Marfan Syndrome
- Absence of organs…*!
