Nature of Injury in sports Flashcards
how many sports injuries occur each year in GB?
20 million
which site is most susceptible for sports injuries?
lower leg, upper limb and head/neck
what are traumatic sports injuries?
-fractures and dislocations
-major muscle ligament tendon injuries
-head and spinal injuries
-chest and abdominal injuries
what are the classifications of bony injuries?
-transverse
-oblique
-spiral
-comminuted
-avulsion (piece of bone attached to tendon or ligament is torn away)
what are the clinical features of bony injury?
-pain
-tenderness
-localised bruising
-swelling
-deformity
-restriction of movement
what is the management for bony injuries
-anatomical functional realignment
-may need reduction
-plaster cast or surgical stabilisation
what is acute compartment syndrome?
-occurs in a fracture where there is a resultant soft tissue damage as well
secondary swelling in a muscle compartment with non distensible fascial sheath
severe pain on movement and numbness
treated by fasciotomy
what sites are at risk of growth plate fractures?
wrist, elbow, distal femur, tibia, fibula
which sites are susceptible to damage of articular cartilage?
talus, femoral condyles, patella and humerus
what is a dislocation?
trauma produces complete dissociation of the articulating surfaces
what is subluxation?
some contact of articulating surfaces remains
what are treatments to dislocation or subluxation?
-reduction
-muscle relaxants
-protect to allow soft tissue to heal
-early protected mobilisation
-rebuild muscle strength
what are grade 1 ligament injuries?
fibres stretched but normal range on stressing
what are grade 2 ligament injuries?
more fibres involved, laxity on stressing but definite end point
what are grade 3 injuries to ligaments?
complete tear, excessive laxity and no end point may be pain free as nerve fibres torn
what is the management for grade 1 and 2 ligament injuries?
-promote tissue healing
-prevent joint stiffness
-protect against further damage
-strengthen muscle to provide additional joint stability
-protection may allow earlier return to sport
what is the treatment for a grade 3 ligament injury?
conservative, medial collateral of knee or lateral collateral of ankle
surgical (direct repair or reconstruction)
when are tears and strains common?
-when demands exceed muscles capacity
-most common if it crosses 2 joints
-commonly hamstring, quadriceps and gastrocnemius
-common during sudden acceleration/deceleration
what is grade 1 classification of a muscle injury?
few fibres, localised pain and no loss of strength
grade 2 muscle injury?
significant no of fibres, swelling, pain on contraction, reduced strength and limitation of movement
grade 3 muscle injury?
complete tear, most common at musculotendinous junctions
how does quadriceps rupture?
direct impact against contracted muscle or sign vigorous contraction
what is myositis ossificans?
occurs when haematoma calcifies
most common in severe contusions
suspected if resolution is slow
diagnosed on x ray after 14 days
slow recovery
what do normal tendons consist of?
tight parallel bundles of collagen fibres
what is involved in injuries to the tendons?
generally occur at point of least blood supply
rupture may be complete or partial and usually occurs without warning
achilles and supraspinatus are most common
what are bursas?
small fluid filled sacs usually situated between a tendon and a bone
role is to reduce friction
present in hips, knees, feet, shoulders and elbows
what are the complications associated with bone injuries?
-infection
-acute compartment syndrome
-DVT/pulmonary embolism
-delayed union/non union
-malunion
what is delayed union?
prolonged healing of a fracture
what is a non union?
failure of a fracture to heal
what is malunion?
-fractured bone does not heal properly
-may be due to bone being twisted, shorter or bent
-bones improperly aligned when immobilised, cast too early, not seeking medical attention after break
-common and painful
what are the 5 R’s of ortho?
-resusciate
-reduce
-radiograph
-restrict
-rehabilitate
who are more susceptible to chronic overuse injury?
females
what does the pill reduce?
-risk of tendon damage and ACL rupture
what can impact sports injuries?
-menstrual cycle
-pill
-menopause
-diabetes
what is bursitis?
fluid filled sac around joints, stops structures from getting irritated from skin movement. can get infected and usually presents in people who work on their knees
how is s a soft tissue injury managed?
POLICE
protection
optimal loading
ice
compression
elevation
what happens if patients rest too much?
risk of loss of bone density and strength
what is the treatment for tendon rupture?
-brace and crutches
-ice reduce swelling
-compression strapping to reduce swelling
-elevation needed
what is the treatment for fracture?
-advanced trauma life support
-stop bleeding
-reduce bone and put it in splint
-X-RAY/CT
-fix bone
-rehabilities
how do we manage chronic injury?
remove the cause
introduce preventative measures
extend rehabilitation
what is tendonosis?
chronic changes that develop due to multiple tendonitis, increased type 3 collagen, separation of collagen fibres over expression of VEGF, tendons feel hard and thick can look dull and brown rather than white
what is the treatment for tendonosis?
-remove cause
-improve health and nutrition
-introduce preventative measures
-discuss extended rehab
what are tendons made up of?
collagen (mainly type I) and elastin embedded in proteoglycan water matrix
how is an ACL injury managed?
Protection – you may be offered a knee brace.
Optimal Loading – you may be given crutches to reduce the amount of weight put on the injured joint. This can help control pain and swelling.
Ice – the regular application of ice packs can reduce pain and swelling.
Compression – you may be given an elastic compression bandage to reduce swelling.
Elevation – this will help reduce swelling. Try to keep your knee above the height of your hip.
ACL reconstruction
how is an Achilles ligament injury managed?
