Sports Medicine Flashcards
What are the two classifications for a sports injury?
Direct and Indirect. Classifying a sports injury can be either one of these but never both
What is a direct injury?
A direct injury is an injury sustained at the site of external force
What are 3 examples of direct injuries?
Hit by a ball, blisters and black eye from being punched
What is an indirect injury?
An indirect injury is an injury sustained from an internal force
What is an internal force?
Internal forces are often generated by muscles, but includes forces transferred from the outside
What does it mean by forces transferred from the outside?
This is when a force may be applied to a certain part of the body, but the force gets transferred to another part of the body and injures that part. I.e. falling on your hand but injuring your shoulder
What are sprains and strains classified as?
Indirect injuries as external forces do not cause tears in ligaments or muscles
What are 3 examples of indirect injuries?
Dislocated shoulder after falling on arm, rolling ankle which causes a sprain, pulled hamstring
What are the two types of sports injuries that can occur after direct or indirect injuries?
Soft or hard tissue injuries
What are soft tissue injuries?
Occurs to soft tissue in the body, which is basically everything except bone and teeth. I.e. Muscles, ligaments, tendons, skins etc.
What are hard tissue injuries?
Hard tissue injuries are injuries to the bone or teeth, i.e. injuries of the skeleton. These include breaks and dislocations.
How is an injury classified?
Requires the two classifications;
Whether it is a direct or indirect injury
Whether it is a soft or hard tissue injury
What are overuse injuries?
Overuse injuries are caused by repetitive action and are a separate classification as they are not an acute injury but a long term injury. They are similar to indirect injuries as they are caused by internal forces. It develops over time due to athletes not allowing enough time between performance for body parts to recover.
Excessive magnitude or volume of load
Insufficient recovery between bouts of load
Why is classifying the type of injury important?
It will determine how the injury is treated
What does DRSABCD stand for?
Danger, Response, Send For Help, Airway, Breathing, CPR, Defib
What is TOTAPS? What does it stand for?
The TOTAPS method (Talk, Observe, Touch, Active movement, Passive Movement, Skills Test) is an effective way to assess the nature and extent of an injury to a player and make a decision as to whether or not the athlete who is injured can resume playing.
What does the talk part of TOTAPS involve?
Talk: The athlete should be asked a range of questions to establish what happened and how they were feeling. Potential questions include: Where is the pain? Did you hear anything? What happened to cause it? Is this the first time this has happened?
What does the observe part of TOTAPS involve?
Observe: The injured site must be carefully inspected identify any signs of swelling and deformity. It can help to compare the injured site to the other side of the body. (E.g., compare one ankle to the other, to assess an ankle injury). Signs of deformity or swelling are an indication of either soft or hard tissue damage, which means further assessment and treatment from a professional is required.
What does the Touch part of TOTAPS involve?
Touch: If observation fails to yield results the next step involves feeling around the injured site to identify any deformity or swelling. Gentle pressure should be applied from the outside of the injury before slowly working in.
What does the touch part of TOTAPS involve?
Touch: If observation fails to yield results the next step involves feeling around the injured site to identify any deformity or swelling. Gentle pressure should be applied from the outside of the injury before slowly working in.
What does the active movement part of TOTAPS involve?
Active Movement: The athlete will need to test movement around the injured site by performing actions such as flexion, extension and rotation to determine whether the mobility of the joint has been affected. If there is no pain whilst the athlete is performing the movement by themselves then they need to complete an isometric contraction before the athlete can move ahead to the last step. If the assessor feels that the athlete does not have a full range of movement, they should progress to the next stage.
What does the passive movement part of TOTAPS involvee?
Passive Movement: If full range of movement is not evident, the assessor or sports trainer needs to physically move the joint to test the range of motion and identify any instability and painful areas. The athlete must be watched to see if they exhibit signs of discomfort.
What does the skills test part of TOTAPS involve?
Skills Test: The final stage requires the athlete to complete sport specific movements that mimic those which are performed during the game. For example, walking, jogging, side stepping, changing direction and jumping. If the athlete can complete these and the assessor is satisfied, then they can return to play. During this test the assessor must watch the athlete for any signs of discomfort or favour towards one side. At this stage, strapping may be used to reinforce the injured site.
What are examples of soft tissue injuriees?
Tears (ligament sprains, muscular strains)
Skin abrasion or blister
How are soft tissue injuries treated/controlled?
R - Rest
I - Ice
C - Compression
E - Elevation
R - Referral
What is a strain?
A strain is a tear that occurs in a muscle and can often be referred to as a pulled muscle. They are normally caused by internal forces, poor technique or overtraining
What are the three grades to a strain?
Grade 1 - Small tear to muscle
Grade 2 - Larger tear with around 50% or more torn
Grade 3 - Complete tear, and surgery is needed to join the muscle together
What is a sprain?
A sprain is a tear that occurs to a ligament (joining bone to bone around joints). They are caused by external forces being transferred through body often to the other side of a joint. Always caused by a joint being bent in a direction it’s not meant to move
What are the three ways of grading a sprain?
Grade 1 - stretching; small tears
Grade 2 - Larger, but incomplete tear
Grade 3 - Complete tear
What is a contusion?
A contusion is when capillaries are ruptured, thus causing internal bleeding. It is commonly referred too a a bruise and is normally caused by externa forces.
Causes damage to surface of skin and deeper tissues as well, depending on the impact of the blow
What is a skin abrasion?
A skin abrasion is a scraping or wearing away of skin and isn’t usually deep. Can be referred to as a graze
What is the treatment for skin abrasions?
Clean wound
Wash with disinfectant
Cover it with non-stick dressing
If it is a serious abrasion, the management of blood loss is the priority
What is a laceration?
A laceration is a deep cut or tear to the skin, typically from contact with a sharp device.
What is the treatment for a skin laceration?
Manage Bleeding
Apply pressure to the area
Medical attention may be required depending on severity
What is a blister?
A blister is caused by friction or burning that leads to a build up of serum in the skin. Athletes often get blisters on their feet due to the friction from their shoes
How are blisters treated?
Cover blister with a padding
Remove the object causing friction/burning
Don’t pop the blister but allow it to heal
What is the inflammatory response?
It is the bodies natural reaction to injury and infection. It involves vasodilation (widening blood vessels) which allow for more blood to the area and fluid to exit the vessels into surrounding tissue, which ultimately increased white blood cells entering the area to clean up and fight infection
What are thee three phases of the inflammatory response?
Phase 1 - Acute inflammation
Phase 2 - Repair inflammation
Phase 3 - Remodelling inflammation
What is part of Phase 1 of the inflammatory response?
In this scenario, inflammation is fast and painful, and during this phase it involves the vasodilation of blood vessels (expanding) and the transfer of fluid into surrounding tissue. This normally causes additional damage to the area. New blood vessels begin to be developed in this phase, and this phase lasts 2-3 days. RICER is important
What is part of Phase 2 of the inflammatory response?
During this phase, the body begins to fix the damaged or injured site, white blood sells clean up the injury and new body tissue begins to form, and this phase typically results in scar tissue. This phase lasts from 3 days up to 6 weeks
What is part of Phase 3 of thee inflammatory reesponse?
In this phase, the body continues to rebuild/repair the injured area, and new functional body tissue and scar tissue is developed and strengthened further. During this phase, it is important to balance exercise and rest because too much exercise will ruin thee process, but not enough exercise will result in weak scar tissue. This phase of the inflammatory response can last many months.
What is scar tissue?
Scar tissue is a collection of cells and collagen that covers the site of the injury.
What does the Rest part of RICER mean? Why is it important?
Stop playing the sport or doing the exercise, and rest the injured area (i.e. prevent movement). This will ensure that there won’t be further damage to the injured area
What does the Ice part of RICER mean? Why is it important?
It refers to the idea that ice should be applied as soon as possible to the area which has been affected in the form of ice packs or a bag of ice. In this case, ice should be applied over the first 48hrs. Ice has to be consistently applied to the area with short breaks. It will help reduce the pain, decrease inflammation and speed up recovery. This is because ice causes vasoconstriction (narrowing of arteries) to reduce inflammation, and when taken off will allow for vasodilation, which allows for the inflammatory response to occur
What does the compression part of RICER mean? Why is it important?
Compress the area. This is because compression helps to reduce or control the inflammatory response and stabilises the joint if injured. It also helps force fluid away from the area, thus reducing inflammation at the area. Involves application of a compression bandage or garment around the injured area
It essentially increases blood flow to the area, enabling the quicker removal of liquids –> faster recovery
What does the elevation part of RICER mean? Why is it important?
Means to elevate the injury. Elevation involves elevating the injured soft tissue above the heart. This is because gravity can assist in removal of fluid from inflammation and allows for the blood to come back to the heart, thus reducing or controlling the inflammatory response
What does the referral part of RICER mean? Why is it important?
It means that an athlete has to be referred to a health or medical professional. This is because it allows for proper diagnosis and rehab to be applied if required. It will also thus improve recovery and prevent future injury to the site. It is important to control the inflammatory response because if left alone, the inflammatory response will cause further damage to thee area.
What are the three different types of hard tissue injuries? I.e. Fractures
Fractures
Dislocations
Loss of teeth
What is a fracture?
Essentially a broken bone
What are the three classifications of a fracture?
Closed Fracture
Open Fracture
Complicated Fracture
What are features of a closed fracture?
Remains inside body and doesn’t pierce skin
Common fractures
Known as simple fractures
What are features of an open fracture?
A break that pierces the skin so that bone can be seen
Known as compound fractures
What are complicated fractures?
Where the bone causes further damage to major nerves, organs or blood vessels
Are complicated because they can be life threatening and require attention
What are the three types of fractures?
Complete fractures breaks clean through the bone, so that there are two parts
Comminuted Fracture - Results in breaks to more than two parts of the bone
Incomplete fracture/greenstick - does not break the whole way through the bone
What are five signs of fracturees
Pain
Redness
Loss of function
Deformity
Hearing or feeling a break/grating of bone
What are four ways of managing fractures?
Immobilise area
Reduce pain
Prevent further injury
Reduce bleeding and shock
What is a dislocation?
A dislocation (or luxation) is when there is an abnormal separation in a joint between two bones. A dislocated joint results in damage to the surrounding soft tissue including strains to ligaments and muscles. A dislocation is caused by excessive force and is either a direct or indirect injury
What are 5 signs of dislocations?
Pain at joint
Swelling around the joint
Deformity
Tenderness
Inability to move joint
What management strategy should be used to assess and determine the nature of a hard tissue injury?
TOTAPS
What is the management strategy for dislocations? (5)
DRSABCD
Reassure athlete
Immobilise using splint (if possible)
Ice and Elevation
Seeking immediate medical assistance
What are the three typical assessment of injury procedures required after an injury occurs in order?
DRSABCD (crisis management)
STOP ( On Field assessment)
TOTAPS (complete assessment)
What does STOP stand for?
S - Stop the athlete from further participating (game is stopped only if necessary)
T -Talk to the athlete determine what happened, how it happened? Where it hurts? etc.
O- Observe - while talking to the athlete you observe the area and the athlete. From this fast on-field assessment the assessor
determines if the athlete can continue or if they need to be taken off for further assessment.
P - Prevent - any further injury, which comes by taking the player off for further assessment if required.
What are the the three medical conditions that affect children and young athletes that we study?
Asthma, diabetes (normally type 1), epilepsy
What are the different conditions that affect children and young athletes that we study? (5)
Asthma, diabetes (normally type 1), epilepsy, overuse injuries (stress fractures), and thermoregulation problems
What is asthma?
Asthma is a mdical condition that affeects the airways. In this scenario, there is inflammation of the airways which lead to contraction of thee bronchioles, thus limiting the air flow both into and out of the lungs. Asthma attacks are normally triggered by something
What are the various possible triggers for asthma? (4)
Dust, pollen, pollution, exercise
What are the implications of asthma for the ways children and young people engage in sport?
Asthma can be induced by exercise, and is more likely to be triggered in longer duration physical activity than short and intense bursts of activity.
Having asthma should not stop them from participating in sport, but there are actions that should be in place to manage this medical condition (normally an Asthma Management Plan)
How is asthma manageed?
Should have an Asthma management plan for the person supervising the physical activity for their knowledge and use if necessary. People should have a Ventolin puffer with them in case an asthma attack occurs. Exercise induced asthma can possibly be prevented through a proper warm up and cool down
What are the two typs of diabetes?
Type One Diabetes
Type Two Diabetes - Diabetes caused by lifestyle often brought on through physical inactivity and poor diet
What is Type One Diabetes?
Known as insulin dependent and early onset diabetes and is caused by an autoimmune disorder, where the body no longer products insulin, which leads to a build up of glucose in the blood, it is more prevalent in children and young children
What are the implications of diabetes for the ways children and young people engage in sport?
Because diabetes relates to the glucose levels in blood, it affects sports engagement because glucose is an important energy source for ATP production during sport participation. As an athlete pariticpates in sport, muscle cells are opened for glucose transport without need for insulin, this results in a decrease in blood glucose, and if it’s too low it can lead to hypoglycaemia, and if they’re too high it can cause hyperglycaemia , and thus those with diabetes have to monitor blood glucose level during sports
How is diabetes managed?
Managed through insulin injections and access to sugary foods. Children and young athletes who have diabetes should participate in regular physical activity as it helps manage both types of diabetes and can prevent hyperglycemia. Should have access to food and sugary drinks during physical activity to prevent hypoglecemia
What are symptoms of hypoglycemic and hyperglycemic episodes?
Both cause rapid heart rate, sweating, shaking, anxiety, dizziness and thirst all apply to both, thus it is hard to tell what kind of episode they are having, and is thus managed by providing sugary foods or drinks, and then testing to see if insulin injections are required
What is epilepsy?
Refers to the disruption of normal brain activity that results in seizures due to nerve cells misfiring and creating sudden uncontrollable bursts of electrical activity in the brain, this means that people can become confused, uncontrolled or lose consciousness during seizures
What are the implications of epilepsy on the ways children and young people engage in sport?
It shouldn’t stop children and young athletes from participating in sports, as long as they ensure that others are present when they participate in sports to help them if a seizure occurs
How is epilepsy managed?
Epilepsy can be managed through medications such as anti-epileptic drugs (AED) or by supervision of someone who is prone to epilepsy
What are over use injuries caused by? (5)
Poor recovery
High stress loads
Poor technique
Poor muscular strength or imbalance
Ill fitted protective equpiment
What are common overuse injuries in children and young athletes? (3)
Shin Splints
Stress fractures
Tendonitis
Why are younger athletes more prone to overuse injuries?
Because their bodies are growing and developing , and thus require longer recovery periods and nutritional requirements. And thus, if they get small injuries such as muscle tears, it leaves the injured area weak and vulnerable and as further stress is placed on the area, reinjury occurs
What are the implications of overuse injuries on the ways young people engage in sport?
This means that athletes are encouraged to engage in a wider variety of sports and not to specialise in a sport at a young age, as it allows for development and ensures growth is holistic and balanced. And because of this, there must be appropriate rest periods after training and performance to avoid injuries
How should overuse injuries be managed?
Management of these injuries should be supervised by qualified health professionals. Athlete’s then need to stop the movement that has caused the injury, and to give the injured area a break
What is thermoregulation?
Refers to the maintenance of a stable core body temperature.
Why is thermoregulation important?
Because every athlete needs to maintain a safe body temperature to avoid conditions such as hyperthermia and hypothermia
How much faster will a child’s body overheat compared to an adult?
3-5 times because thermoregulation is not as well developed as it is for adults. This may be because they have underdeveloped sweat glands, which means they sweat less and are more affected by their surrounding environments. They also have a small body mass to surface area ratio, which means large surface area (skin) compared to body mass (weight), and are thus more vulnerable to their surrounding environment than adults
What considerations should be made regarding thermoregulation for children and young people engaged in sport
Need to have body temp monitored closely in sports performed in heat or in cold
Wear appropriate clothing
Time of day the sport is played
Availability of shade
Access to fluid
What is hyperthermia?
Refers to any heat induced condition such as heat exhaustion and heatstroke
What is the management of hyperthermia?
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
How do you treay heatstroke?
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
How is hypothermia managed?
DRSABCD
Lie person down in a warm dry place
Avoid wind, rain, sleet, cold and wet grounds
Remove wet clothing
Warm athlete with blanket, head cover and warm drinks
Ensure 000 has been called
Does resistance training slow the growth of children and young athletes?
No. In fact, resistance training is more likely to have a positive effect on children’s and young athlete’s growth, as long as resistance training is done with proper supervision and appropriate guidelines
What are the implications of resistance training for 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 it provides many health and performance benefits
What are the benefits of resistance training?
Increase in muscular size, strength, power, speed, and it also increases bone strength and helps prevent injury
What are the guidelines for children doing resistance training?
Children should be mature enough to follo direction and appreciate risks and benefits of resistance training (typically 6 yo), 1 RM should be avoided, technique should be taught and mastered before increasing resistance
What is the difference between adult and aged athletes?
Although aged athletes are still adults, the aged are usually associated with the elderly, whilst adult athletes are those who are no longer young athletes (typically 21+)
What does the dot point about adult and ageed athletes require you to understand?
The different types of medical conditions listed and how they impact sports availability for adult and aged athletes. This includes a range of heart conditions, bone density and fractures
What are heart conditions? Plus 5 examples
They are broad terms used to refer to a number of health issues relating to the heart including;
High Blood Pressure
Survivors of heart attacks
Cardiovascular disease
Heart valve disease
Angina
What are six recommendations by the American College of Sports medicine for adult and aged athletes with heart conditions to follow?
Contact GP for approval
Include 5-7 min warm up and cool down
Never exercise to the point of chest pain / angina
Exercise around 5 times a week for 30+ mins at moderate intensity for benefits
Don’t exercise outdoors if too cold, hot or humid
Stop exercise if there is dizziness, nausea, unusual shortness of breath etc. during exercise.
Can adults and aged athletees with heart conditions participate in sports that require a high intensity?
No they shouldn’t. They are instead advised to participate in sports and physical activities that can be done using low intensities
What are some examples of sports which can be done using low intensities? (4)
Golf, Cycling, Tennis, Dancing
What are 6 different factors which may predispose someone to poor bone density and fractures?
Genetics
Female
Early menopause
Small Size
Inadequate diet
Poor physical activity levels
What are some key nutrients required for good bone health? (5)
Calcium
Vitamin D
Phosphorous
Sodium
Protein
What sorts of sports should people with poor bone density avoid? + examples
Contact sports or sports that involve powerful changes in direction that place large stress on bones such as: martial arts, football, rugby league and ice hockey
What five sports are good for those with bone density issues?
Cycling
Tennis (?)
Swimming
Walking
Golf
Could weight bearing exercise such as walking and running have a positive impact on bone density? If so, give reasons.
Yes they could. This is because the weight going through the bones cause a physiological adaptation which is increased bone strength through increased bone density. This is because like muscles, bones can adapt to the stress placed on them, as long as the stress is performed with proper supervision and correct technique
What is flexibility?
Refers to the range of motion across joints or entire body?
What is poor flexibility and lack of joint mobility caused by?
Decrease in sport and exercise participation
How do those with poor flexibility increase flexibility?
Through slowly increasing range of motion at each joint through regular exercise
Are adult and aged athletes with poor flexibility and joint mobility limited in their choice of sport?
Not limited, but should begin at low level and then increase their activity, also probably should prevent sports which require good flexibility
Which 3 sports require good flexibility?
Gymnastics
Dance
Martial Arts
Which 3 sports require good joint mobility?
Kicking
Bowling
Hitting
What do female athletes need to worry about which may affect performance?
Menstruation
What are the effects of menstruation on the female?
Affects the female haemoglobin and iron levels resulting in:
Decreased oxygen carrying capacity
Intensity Levels
Motivation
Why do many female athletes have eating disorders?
Because society places great value on external value, especially in relation to a woman, and a female athlete in the media is thus expected to be beautiful, thus leading many women to do anything to be able to be beautiful
What are common eating disorders?
Bulimia, anorexia,
What are the effects of eating disorders?
Decrease in energy and nutrient intake which negatively affects health and sports performance. Can also cause iron deficiency
