OPTION 3 - Sports Medicine Flashcards
WAYS TO CLASSIFY SPORT INJURIES
- direct and indirect
- soft and hard tissue
- overuse
DIRECT AND INDIRECT INJURIES
Direct injuries = result of an external force impacting on a person.
- e.g. This could be two players colliding with each other in a soccer tackle, or an external object coming in contact with a person, such as a hockey stick hitting a person in the shins. Either way, the impact of the external force results in an injury.
Indirect Injuries = result of internal forces within the body, and can be the result of poor technique, lack of fitness or poor warm up, ballistic or excessive movements.
- Examples include a rolled ankle during a netball game, a back injury due to poor lifting technique or a torn hamstring in a sprinter.
SOFT AND HARD TISSUE INJURIES
Soft tissue injury = damage to muscles, tendons, ligaments, cartilage, skin, blood vessels, organs and nerves.
- may be acute (occurring suddenly, such as a sprain) or chronic (prolonged).
- Acute soft tissue injuries include sprains, strains, dislocation, subluxation, torn cartilage, contusions and abrasions.
Hard tissue injury = one that relates to the bones or teeth.
- Bones are the core component of the skeletal system. If they are injured, this will impact on the support and protection of the body.
OVERUSE INJURY
occurs as a direct result of a repeated force on body parts, including bones, tendons and muscle
- Common overuse injuries include shin splints (an irritation to the anterior portion of the tibia), stress fractures, tendonitis (irritation of tendons eg the Achilles tendon) and tennis elbow.
- The constant pressure can be due to poor technique that, over time, leads to an overuse injury (for example, a shoulder injury due to poor pitching technique in softball).
SOFT TISSUE INJURIES
- tears, sprains, contusions
- skin abrasions, lacerations, blisters
- inflammatory response
TEARS, SPRAINS, CONTUSIONS
occur when tissue is excessively stretched or severed.
- Tears can be classified as sprains or strains. Strains occur when muscle of tendon (connects muscle to bone) is stretched or torn.
arise from the stretching or tearing of a ligament (connects bone to bone).
- They severity is measured using grades from 1 – 3 (1 least severe, 3 most severe).
- Sprains can be classified according to the severity of ligament damage. A Grade I sprain is when there are some stretched fibres in the ligament, but generally the joint still has a normal range of motion, with some pain
(bruise) are caused by a sudden blow to the body. Contusions interupt blood flow to the surrounding tissues.
SKIN ABRASION, LASCERATION, BLISTER
occurs when the surface layers of the skin (epidermis) have been broken.
- They can occur in games such as netball or tennis where a player may fall on a dry, hard surface.
a wound where the flesh has incurred an irregular tear.
- Care must be taken to prevent infection and pressure must be applied to prevent further bleeding.
- occurs when the outer layers of the skin separate due to excessive friction, and cause a pocket of fluid (sometimes blood, if the vessels is damaged) to form.
INFLAMMATORY RESPONSE
When the body’s soft tissues are injured, they respond with a physiological reaction known as the inflammatory response
- The main functions of the inflammatory response are to protect the injured tissue from further damage, remove dead cells that have been injured, and enable the tissue to regrow through the production of new blood cells and tissue
- involves vasodilation (widening of blood vessels) allowing more blood to the area and more fluid to exit the vessels into the surrounding tissue
Phase 1: Inflammatory stage
• Pain, redness and swellinng around injured area
• Damage to cells and surrounding tissues
• Increased blood flow to area
• Formation of blood cells to promote healing
Phase 2: Repair and regenerative stage (3 days – 6 weeks)
• Elimination of debris
• Formation of new fibres
• Producion of scar tissue
Phase 3: Remodelling stage (6 weeks – many months)
• Increased production of scar tissue
• Replacement tissue that needs to strengthen and develop
• Type of remodelling varies depending on severity of injury and rest period taken by athlete
MANAGE SOFT TISSUE INJURIES
- rest
- ice
- compression
- elevation
- referral
HARD TISSUE INJURIES
Any injury to a bone or tooth is known as a hard tissue injury. These injuries are more painful and serious than soft tissue injuries, and require more specialised treatment. Fractures are the most common form of hard tissue injury.
- fractures
- dislocations
HARD TISSUE - FRACTURE
A break to any part of a bone is known as a fracture. The type of fracture will depend on the severity of the break to the bone. There are many types of fracture:
Closed Fracture = remains inside the body and does not pierce the skin. These are the most common broken bones that occur. They are also known as simple fractures.
Open Fracture = a break that does pierce the skin so that bone can be seen. These are also known as compound fractures, because there is more than one (1) issue that needs to be addressed (i.e. bleeding, open wound etc).
Complicated fractures = where the bone causes further damage to major nerves, organs or blood vessels. These are complicated because they can be life threatening and require immediate medical attention.
HARD TISSUE - DISLOCATION
A dislocation occurs when bones are displaced from a joint.
- In a dislocation, the bone comes out of the joint and remains out until it is physically reinserted. The bone should only be put back in place by a qualified practioner, as more damage can occur if the placement is incorrect.
Causes
Excessive force can move bones out of their joint sockets. Shoulder and finger joints are more susceptible to dislocations, as the surrounding ligaments are less supportive.
Signs and symptoms
Deformity and swelling, pain and swelling, loss of function, limited movement.
Management of a dislocation
- Follow the DRABCD procedure.
- Secure with a splint to immobolise the injury
- Ice, elevation and support using a bandage
- Do not attempt to put the joint back in place. (This must be done by a sports specialist, as there is a risk of nerve damage if the bone is not put back correctly.)
- Seek medical help.
ASSESSMENT OF INJURIES
Minor and severe injuries can occur in a wide range of sporting situations. When faced with an injured person, it is important that DRABCD procedures, followed by TOTAPS providing a comprehensive assessment of injury.
- TOTAPS: talk, observe, touch, active movement, passive movement, skill test
TOTAPS
- Talk – find out what happened. Provides information about nature of injury
- Observe – look at injury for signs of swelling or deformity. Compare to other side of body
- Touch – gently feel injury for signs of deformity and pinpoint area of pain
- Active movement – ask player to perform range of joint movements (e.g. flexion)
- Passive movement – assessor mobilises joint using range of movements to identify pain
- Skills test – perform skill required during the game
CHILDREN AND YOUNG ATHLETES
- medical conditions
- overuse injuries
- thermoregulation
- appropriateness of resistance training
YOUNG ATHLETE - MEDICAL CONDITIONS
Asthma:
a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.
Triggers = pollen, cold weather, exercise, bushfire/smoke
Implications = can be induced by exercise, usually of a long duration as oppose to short bursts of intensity e.g. during a marathon run. Asthmatic attack is usually proportional to intensity of exercise.
Management
- Gradual warm up and lesisurely cool down
- Steady exercise intensity
- Use required medication prior to exercise
- Consume adequate amounts of water
Diabetes:
Diabetes is a chronic disease marked by high levels of glucose in the blood. It occurs when the pancreas stops producing insulin, produces too little insulin, or the body’s insulin becomes ineffective.
- Type 1: diabetes is most common in children and young people, and occurs when the body is unable to produce insulin – requiring multiple daily insulin injections or wear an insulin pump.
- Type 2: do produce insulin, but the body cannot use it effectively, resulting in elevated blood sugar levels that impact on the normal functioning of the body. As obesity levels among children and young people have increased, the incidence of type 2 diabetes has also increased significantly.
Implications
- Relates to the glucose levels in the blood, affecting sports engagement because glucose is an important source for ATP production.
- As children participate in sport, their muscle cells open for glucose transport without the need for insulin, resulting in decreased glucose levels, which can become an issue for diabetics.
- if levels are too low, hypoglycaemia occurs, if they are too high, hyperglycaemia occurs – with both having the ability to result in loss of consciousness or death.
Management
- Balance insulin with food and activity levels
- Rest breaks for food
- Carbohydrates before activity to replenish glycogen levels
- Monitor 24 hours after physical activity
e.g. For a child or young athlete, diabetes can have a significant impact on participation in sport. If the sugar levels of a person with diabetes are not maintained during exercise, they may have a hypoglycaemic episode, or a hyperglycaemic episode. Either of these can lead to loss of consciousness.
Epilepsy:
a group of medical condition relating to disruption of normal brain activity that results in seizures. A seizure is when the brains nerve cells misfire and generate sudden, uncontrolled burst of electrical activity in the brain – can be subtle with only momentary loss of consciousness or sudden loss of bodily response.
Implications
- many medications that can reduce the chance of occurrence
- should not limit sport choice for children and young athletes, but type and possible triggers should be considered as sports are selected.
Management
- medication should be administered
If a child or young athlete has a seizure, the following steps should be taken:
• Do not try and restrain the person.
• Let the seizure occur, but move any objects away that may cause more harm.
• Once the seizure has finished, place the person in the lateral position (on their side).
• Loosen any tight clothing and reassure the person that everything will be fine.
• If the seizure lasts longer than 5 minutes, call an ambulance.
YOUNG ATHLETES - OVERUSE INJURIES
Overuse injuries result from repetitive movements placing repetitive stress upon the body parts involved, such as: bones, muscles, tendons and ligaments. Overuse injuries can be caused by:
- poor recovery
- high stress loads
- poor technique
- poor muscular strength or imbalance
- ill-fitted protective equipment
Common overuse injuries
- shin splints
- stress fracture
- Tendonitis
YOUNG ATHLETES - THERMOREGULATION
refers to maintenance of a stable internal temperature independent of the temperature of the environment.
Children do not have developed ability to loe heat through evaporation because sweat glands release fluid much more slowly. They acclimatise to heat much slower, which increases their risk o hot and humid days. This increases their risk of dehydration. Children also have increased risk of developing hypothermia from exposure to cold compared to adults.
How conditions associated with thermoregulation are managed
Thermoregulation issues such as hyperthermia, or hypothermia need to be managed swiftly and properly. Hyperthermia refers to any heat-induced condition such as heat exhaustion and heatstroke. The management of heat exhaustion is:
• lie the person in a cool place with circulating air
• remove unnecessary clothing
• sponge with cool water
• give cool water to drink
• seek medical aid
Heatstroke is an emergency situation and is managed by: • DRSABCD • lie the person in a cool place with circulating air • remove unnecessary clothing • apply cold packs or ice • cover with a wet sheet • ensure 000 has been called • give water
Hypothermia is a cold-induced condition and is managed by:
• DRSABCD
• lie the person in a warm dry place
• avoid wind, rain, sleet, cold, and wet grounds
• remove wet clothing
• warm the athlete with a blanket, head cover and warm drinks
• ensure 000 has been called
YOUNG ATHLETES - APPROPRIATENESS OF RESISTANCE TRAINING
Strength traiing for children should involve low resistance with high repetitions through the full range of motion. It is an integral part of young athlete’s program as it increases stability throughout the body and improves skill and fitness.
Implications of resistance training for the ways young people engage in sport
Resistance training is appropriate for children and young athletes when proper supervision is provided and guidelines are followed, and provides many health and performance benefits. The American College of Sports Medicine states:
While regular participation in a strength training program can enhance the performance of young athletes and reduce their risk of sports-related injuries, boys and girls of all abilities can benefit from strength training.[1]
• Age of athlete
• Intensity of training
• Technique
• Supervision
• Whole body focus – ensure the whole body is trained to make sure muscles stay balanced
Management
Resistance training should be managed by well trained professionals when being used for children and young athletes. Anyone conducting resistance training with children and young athletes should follow appropriate guidelines. If injury occurs, proper first aid and follow up treatment should be sought.
• Professional to supervise program and training
• Injury treatment
• Adequate rest periods – a minimum of 48 hrs rest between session, every 6-8 weeks 1 week of rest, every 6 months, 1 month of rest
ADULT AND AGED ATHLETES
- heart conditions
- fractures/bone density
- flexibility and joint mobility
AGED ATHLETES - HEART CONDITIONS
Heart conditions is a broad term used to refer to a number health issues including:
- high blood pressure
- Cardio vascular disease
- Angina
- survivors of heart attacks
- heart valve disease (e.g. leaky valve) etc
Management
Prescribed exercise for those with these conditions is beneficial as it reduces blood pressure. However, for benefits to occur, a low fat and low salt diet should be consumed. A medical professional should provide testing and clearance to patients before persuing exercise.
AGED ATHLETES - FRACTURES AND BONE DENSITY
Osteoporosis is a common condition occurring in the elderly and increases risk of bone fracture. Exercise should be at low risk of falls and fractures occurring.
Physical activity increases bone mass and strength. Inactivity causes calcium discharge from bones, making them weaker. High resistance must be avoided and developed gradually. Activities include: endurance (e.g. walking, swimming), low impact (e.g. aerobics), low range strength.
AGED ATHLETES - FLEXIBILITY AND JOINT MOBILITY
Exercise increases flexibility and mobility in older people. Arthritis, aching joints and tight muscles improve from programs which focus on safe stretching and increasing range of motion in joints. Programs should also increase balance and stability to reduce risk of falls.
FEMALE ATHLETES
- eating disorders
- iron deficiency
- bone density
- pregnancy
