Module 5: soft tissue response

Question 1

what are the forces/load that can act on an athlete’s tissues during sport?

Answer 1

1) compression
2) tension
3) shearing

Question 2

what are the anatomical properties of soft tissue?

Answer 2

• muscle
• fat
• fibrous tissue
• blood vessels

Question 3

what is soft tissue?

Answer 3

non-bony tissue

Question 4

what are the components of blood?

Answer 4

• liquid fraction: plasma (water) = 55%
• forms elements: blood cells = 45% (RBC), WBC (leukocytes) = immune response, platelets (thrombocytes) = clotting factor

Question 5

describe the vascular events of a body in shock

Answer 5

• There will be initial immediate vasoconstriction (first 5-10 mins)
• Histamine causes vasodilation and increased vascular permeability (increase permeability of the tissue, allowing fluid to leak out of vessel to space around it). Happens after 5-10 mins
  o WBC and macrophages ingest and dispose unwanted substances
  o Platelets help seal off the area (clots)

Question 6

what are the signs/symptoms of shock?

Answer 6

• pulse: rapid/weak
• skin: cool/clammy
• breathing: rapid/slow
• sweating: profusely
• pupils: dilated
• BP: steady falling
• unconsciousness
• nausea

Question 7

what is the management of an athlete in shock?

Answer 7

• comfort athlete
• cover w/warm blanket
• elevate feet/get more blood flow to heart
• monitor vitals continuously

Question 8

what is necrosis?

Answer 8

when deprived of O2 results in cell death

AKA no blood goes to part of tissue and bone which makes them die

Question 9

the primary injury is a result of what?

Answer 9

• bleeding

- damaged tissue

Question 10

what causes the secondary injury?

Answer 10

• excessive swelling

Question 11

what are the 3 phases of healing?

Answer 11

1) acute inflammatory phase
2) repair phase
3) remodeling phase

Question 12

what happens in phase 1 of healing (acute inflammatory phase)?

Answer 12

o Initial Immediate vasocontraction (first 5-10 mins)- blood vessels gets smaller
o Histamine causes vasodilation an increased vascular permeability (after 5-10 mins)- AKA more fluid leaks from vessel to space around it (fluid will run through blood and lymphatic system?)
 WBC (neutrophils)/macrophages dispose unwanted substance
 Platelets help clot

(lasts 0-6 days, up to 2 weeks)

Question 13

what happens in phase 2 of healing? (repair phase)

Answer 13

(AKA proliferation phase) (last 3-21 days, but begins within 12 hours of the injury and may continue up to 6 weeks)
o Begins once all necrotic debris is cleared from injury site
o Dense capillary network will form
o Fibroblasts proliferate damaged area and makes collagen
o Collagen forms a loose mesh network of connective tissue at the injury site
 Vascular and fragile
o AKA laying down dense capillaries and collagen onto an injured site.. disorganized and fragile, but very vascular

Question 14

what happens in phase 3 of healing? (remodelling phase)

Answer 14

o Begins once fibroblasts disappear
o Scar tissue collagen begin to align with direction of stress and the cross-link formation becomes more organized
o Scar tissue is avascular and inelastic and may be present up to one year

Question 15

what is the pain-spasm cycle?

Answer 15

pain leads to muscular hyperactivity (spasm), which causes terrible pain

Question 16

what is a muscle spasm?

Answer 16

an involuntary contraction of short duration caused by a reflex action that can be biochemically derived or initiated by a mechanical blow to a nerve or muscle

Question 17

what are some ways to interrupt the pain-spasm cycle?

Answer 17

• icing

- stretching

Question 18

what are adhesions?

Answer 18

a band of scar tissue that joins two internal body surfaces that are not usually combined

Question 19

what is atrophy?

Answer 19

decrease in size of a body part, cell, organ, or other tissue

Question 20

explain some features of the cognitive appraisal model?

Answer 20

• the injury will happen, and the healing process will be different for each individual
• the model is influenced by personal factors and situational factors

Question 21

what is R.I.C.E.S?

Answer 21

• rest
• ice
• compression
• elevation
• support

Question 22

what are the attributes of cryotherapy?

Answer 22

• constrict capillaries and reduce blood flow
• increase blood clotting and decrease haemorrhaging
• decrease pain and muscle spasm
• increase tissue stiffness
• decrease biochemical activity (AKA reduce overall inflammation)

Question 23

outline the return to activity (RTA) guidlines

Answer 23

• do not return the same say as injury
• rest until asymptomatic
• light aerobic exercise
• sport specific exercise
• non-contact training
• full contact training after medical clearance
• return to competition
• *ALL steps are 24 hours apart. At any time athlete has symptoms of concussion, athlete must go back to step 1

Question 24

at what phase of healing is it acceptable to apply tape to an injured limb for return to activity?

Answer 24

only at the remodelling phase

Question 25

what are the properties of collagen fibres?

Answer 25

ligament = wavier
muscle-tendon = smaller waves

Question 26

what are the properties of tensile sterngth?

Answer 26

ligament = not as strong, more elastic
muscle-tendon = stronger, more tense less elastic

Question 27

what the properties of vascularity?

Answer 27

ligament = none
muscle-tendon = none

Question 28

what is vasodilation?

Answer 28

blood vessels widening

Question 29

what is vasoconstriction?

Answer 29

blood vessels constricting/getting smaller

Question 30

what is hypertrophy?

Answer 30

an increase and growth of muscle cells

Question 31

what is necrosis?

Answer 31

damaged tissues due to a lack of O2 or dead tissue

Question 32

what is the role of RBC (erythrocytes)?

Answer 32

carry O2

Question 33

what is the role of WBC (leukocytes)?

Answer 33

fight off infections

Question 34

what is the role of platelets?

Answer 34

clotting

Question 35

what is the role of plasma (liquid fraction)?

Answer 35

makes up fluid portion