Sports Injuries Flashcards
What are the 4 major types of injuries?
- Minor
- Moderate
- Major
- Catastrophic
What does it mean to have a minor injury?
You can go back in less than 1 week.
What does it mean to have a moderate injury?
You can go back in 7-14 days.
What does it mean to have a major injury?
You can’t go back for more than 14 days.
What is a catastrophic injury and where is it commonly seen?
A permanent injury, usually to the spine, neck, or head.
What does STIM stand for?
Soft tissue injury management
What are soft tissues?
Muscles, skin, organs, cartilage, tendons, ligaments, bursa, brain
How do injuries to soft tissues usually happen?
Direct blow, twisting, or stretching of the tissue.
How does the body react to a soft tissue injury?
It produces an inflammation in the injured area.
What are the signs of inflammation?
SHARP
- swelling
- heat
- altered function
- redness
- pain
How should you view pain?
As a warning sign of soft tissue injury, and the need for rest from activity. Possibly referral to a medical professional.
What are the 3 stages of STIM?
- Acute
- Sub-Acute
- Advanced
How long does acute STIM last?
3-4 days
What is the desired with acute STIM?
Decrease swelling, and thus pain.
How can swelling be decreased in an acute STIM?
PIER
- pressure
- ice
- elevation
- rest
What does SHARP stand for?
- Swelling
- Heat
- Altered Function
- Redness
- Pain
What does PIER stand for?
- Pressure
- Ice
- Elevation
- Rest
What does pressure do for injuries?
- Decrease bleeding due to vasoconstriction
- Decrease space available for swelling
What does ice do for injuries?
- Cause vasoconstriction=less blood flow=less swelling=less pain
- Causes decrease in metabolism, so less oxygen is needed
- Decreases pain due to numbing nerve fibres
- Decreases muscle spasms
What does elevation do for injuries?
Reduces blood flow due to gravity
What does rest due for injuries?
Keeps heart rate slow and regular, which decreased blood flow and swelling.
What is a sports injury?
Anything that occurs to a tissue as a result of playing a sport or physical activity.
How long for sub-acute STIM?
4 days until range of motion is normal
What is the goal for sub-acute STIM? How can this be achieved?
Increase range of motion and get rid of swelling. This can be done with heat, cold/heat, and stretching.
What does heat do for sub-acute STIM?
Increases blood flow so white blood cells can remove waste/dead cells.
What does the cold/heat combination do for sub-acute STIM, and how do you do it?
It causes the pumping of blood vessels helping to get rid of dead cells.
- Heat-1 minute
- Cold-3 minutes
When would you use advanced STIM?
When the range of motion is normal and swelling is gone.
What is the goal for advanced STIM?
Increase strength to pre-injury level using resistive exercise.
When can you play again after a soft tissue injury?
When there is no pain, full range of motion, , and full strength.
What are the classifications of sports injuries?
- Tissue type
- Body region
- Specific injury
- Degree
Bruises
AT-contusion, haematoma
SS-discolouration, swelling, tenderness
ET-blunt blow to soft tissue
Rx-PIER
Scrapes
AT-abrasion
ET-injury to the skin due to friction against a hard surface,
skin is removed
Rx-clean with peroxide, alcohol, or saline;
ointment;gauze;dress
-need to prevent infection
Cuts
AT-lacerations
ET-a sharp blow to soft tissue, which cuts the skin, or
even what’s underneath it
Rx-pressure & elevation with a clean dressing to stop
bleeding and prevent infection. May need to close
wound, so stitches or steri-strips. Cover. Keep clean,
and rest so you don’t reopen it.
Blisters
AT-vesicualtions
ET-large amounts of friction on an area of the skin. The
body creates a pad of water to alleviate the pressure.
Rx-open from the bottom-up to prevent infection. If not
opening, build a wall (donut) around it to remove
pressure and friction. Change equipment if necessary
Strains: definition and etiology
Stretch, tear, or rip in muscle or tendon.
ET-repetitive micro stretches, leading to tissue
breakdown
-single, violent contraction or over stretch
Signs/symptoms of a 1st degree strain
Possible haematoma, local pain increased by muscle tension, minor loss of strength, some swelling
Signs/symptoms of a 2nd degree strain
Similar to 1st degree but to a greater degree.
Signs/symptoms of a 3rd degree strain (rupture)
Loss of muscle function, palpable defect in muscle, pain, noise (pop) at time of rupture
How do you treat a strain?
1st/2nd-PIER and STIM
3rd-surgery
Sprains: definition and etiology
Stretch, tear, or rip in ligament. Can be violent or chronic.
ET-traumatic joint movement that results in stretching or tearing of the tissues stabilizing the joint.
1st Degree Sprain
SS-pain, minimal loss of function, mild point tenderness,
little to no swelling
Dx-place a mild stress in the same direction as aetiology,
which will cause discomfort
Rx-PIER
2nd Degree Sprain
SS-pain, moderate loss of function, swelling, slight to moderate joint disability
Dx-place a mild stress in the same direction of cause. Will
cause discomfort and some joint instability.
Rx-PIER and follow trough protocol through advanced
stage. May need external aid (brace)
3rd Degree Sprain
SS-severe pain, major loss of function, marked instability,
tenderness, swelling, may have spontaneous partial
dislocation
Dx-place mild stress test in direction of cause. Will show
joint instability
Rx-surgery
What is a dislocation?
A dislocation occurs primarily from forces causing the joint to go past its normal anatomical limit.
Where do dislocations happen?
Within movable joints (especially fingers and shoulder)
Dislocations
AT-luxations (complete) and subluxations (partial)
ET-severe blow to the joint, usually occurs in the same
direction as force of impact
SS-deformity, point tenderness, swelling, loss of use, pain
on attempted use
Dx-look for deformities and palpate the area. Movement
will cause severe pain. X-rays are needed to see if
stabilizing structures have pulled away portions of the
bone
Rx-may set itself or needs to be set immediately by a
profesional
-PIER
-strengthen
Where do separations occur?
Between the bones of a non-movable joint (especially in shoulder)
Signs/symptoms of a 1st degree separation
Little pain or disability, no deformity, point tenderness
Signs/symptoms of a 2nd degree separation
Subluxation of bones, therefore visual deformity, pain, swelling, point tenderness, inability to abduct. Ligaments severely stretched.
Signs/symptoms of a 3rd degree separation
Luxation of bones, therefore gross deformity, loss of ability, severe pain, disability.
Separation: etiology and treatment
ET-usually direct blow to the relatively unprotected clavicle, or the transmittal of force through other bones
Rx- a) application of cold and pressure
b) stabilization of joint using a sling
c) referral to professional practitioner
How are fractures named?
For the line of break
Fractures
SS-swelling and deformity, limited range of movement,
point tenderness, indirect tenderness, grating
AT-closed/simple (when it does not break skin)
-open/compound (when it breaks the skin
Rx- immobilize in the position you find it in using a splint, contact professional practitioner immediately (who will use x-rays for Dx and Rx)
Why do we tape?
To stabilize the joint (stability) and support ligaments
What are the first 3 steps of taping?
1) Find ET
2) History of person - allergies, previous injury, chronic injury
3) Prepare skin-shave/prewrap with adhesive spray
avoid prewrap
How are joints assessed?
The HOPE principle
What does HOPE stand for?
History
Observation
Palpation
Examination
What does history discover? (HOPE)
Etiology, previous injuries, position of joint when hurt
What does observation look for? (HOPE)
Swelling, discolouration, deformity, favouring the injury/limping, symmetry
What does palpation find? (HOPE)
Point tenderness
What are the different modes of assessment for examination? (HOPE)
Active
Passive
Resistive
Active examination of of joint assessments
Get patient to move joint through its ROM.
Passive examination of of joint assessments
Patient needs to be relaxed. Trainer moves joint through its normal ROM and checks for non-contractile damage to ligaments, bursar, menisci.
Resistive examination of of joint assessments
Apply resistance to movement. Tests strength and therefore muscle/tendon damage.
What is shock?
Sudden decrease in circulatory blood volume
OR
Sudden increase in vascular bed capacity (vasodilation)-too much blood in certain areas and not enough in others.
What do you need to remember regarding shock?
- Etiology
- Recognition of signs and symptoms
- Treatment (how to manage shock)
- Prevention (better to prevent shock than treat)
What are the signs/symptoms of shock?
Decreased:
- Blood pressure
- Breathing
- Pulse
- Consciousness
How do you manage shock?
- Remove cause
- Increase venous return
- Maintain normal body temperature
- Re-assure
How do you increase venous return?
If the face is pale, raise the tail … if the face is red, raise the head.
How do you maintain normal body temperature?
Do not add heat. If heat is being lost, add a blanket.
How do you re-assure the victim?
Don’t let them see the injury, loosen restrictive clothing, give fluids if they are fully alert.
What are concussions?
Transient impairment of neurological function.
How are concussions characterized?
By degrees-1st, 2nd, 3rd
Concussion etiology
- Direct blow to head
- Hard landing on feet or tailbone
- Forceful movement or rotation of head with respect to rest of body (whiplash)
- Blow to jaw
- Direct blow to chest
How do you asses for a concussion while laying down?
- Check level of consciousness (talk to them)
- Re-assure them, do not move them, etiology
- Stabilize head, rule pout spinal injury
- Check mental confusion (where, who , what, etc)
- Ask for headache or tinitis
How do you asses for a concussion while sitting up?
- Check vision (near and far)
- Check memory (remember word and ask again later)
- Check hand-eye coordination
- Check mental confusion (100-7-7)
How do you asses for a concussion while standing?
Check balance (eyes open and closed)
What are things to watch for if there is no formal concussion assessment?
Vacant stare, delayed verbal or motor responses, confusion or inability to focus, disorientation, slurred/incoherent speech, incoordination, emotions out of proportion, memory deficits
When can you go back to play after a grade 1 concussion?
15 minutes asymptomatic
When can you go back to play after multiple grade 1 concussions?
1 week asymptomatic
When can you go back to play after a grade 2 concussion?
1 week asymptomatic
When can you go back to play after multiple grade 2 concussions?
2 weeks asymptomatic
When can you go back to play after a grade 3 concussion? (brief loss of consciousness)
1 week
When can you go back to play after a grade 3 concussion? (prolonged loss of consciousness)
2 weeks
When can you go back to play after multiple grade 3 concussions?
1 month or longer
