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Out of Harm’s Way: Sport Injuries

Out of Harm’s Way: Sport Injuries. Chapter 8. Outline:. Biomechanical principles of injury Injury treatment and rehabilitation Pain: nature’s warning system Soft tissues injuries Dislocations Fractures Concussions Overuse injuries Injury prevention. Biomechanical Principles of Injury.

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Out of Harm’s Way: Sport Injuries

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  1. Out of Harm’s Way: Sport Injuries Chapter 8 Sport Books Publisher

  2. Outline: • Biomechanical principles of injury • Injury treatment and rehabilitation • Pain: nature’s warning system • Soft tissues injuries • Dislocations • Fractures • Concussions • Overuse injuries • Injury prevention Sport Books Publisher

  3. Biomechanical Principles of Injury Sport Books Publisher

  4. Epithelial Muscle Connective Nervous Tissue Types Each type of tissue possesses unique mechanical characteristics Sport Books Publisher

  5. Loading • To best understand the biomechanical characteristics of tissue we examine its behaviour under physical load • Under load a tissue experiences deformation • Deformation can be visualized through deformation curve Sport Books Publisher

  6. High Ultimate Failure C Elastic Limit B Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  7. High Ultimate Failure C Elastic Limit B Elasticity: capacity of a tissue to return to its original shape after removal of load Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  8. High Ultimate Failure C Elastic Limit B Plastic region begins Tissue no longer posesses elastic properties Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  9. Permanent tissue deformation (does not return to original shape) Resulting in micro-failure or injury (e.g. sprains) High Ultimate Failure C Elastic Limit B Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  10. High Ultimate Failure C Elastic Limit Macro- or completes failure (e.g. torn ligament) Tissue becomes completely unresponsive to loads B Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  11. Area = strength of the material High Ultimate Failure C Elastic Limit B Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  12. Slope = stiffness (or resistance to deformation) of the material High Ultimate Failure C Elastic Limit B Load Plastic Region Elastic Region Low A Small Large Deformation Sport Books Publisher

  13. Tissues Response to Training Loads • Training load =/ elastic limit • Micro-failure  making of new tissue • Positive training effect • Training load > elastic limit • Permanent failure • Injury Sport Books Publisher

  14. TENSION COMPRESSION BENDING SHEAR TORSION Forces Acting on Tissue Sport Books Publisher

  15. Injury treatment and rehabilitation Sport Books Publisher

  16. Treatment • Received by patient from a health care professional • Promotes healing • Improves quality of injured tissue • Allows quicker return to activity • Rehabilitation • Therapist’s restoration of injured tissue +patient's participation • Individualized for each athlete Sport Books Publisher

  17. Healing Phases Sport Books Publisher

  18. Inflammatory Response Phase 2 – 4 days Inflammatory Response Phase hrs – 6 wks Inflammatory Response Phase 3 wks - yrs Sport Books Publisher

  19. Inflammation begins at the time of injury Signs Redness Swelling Pain Increased temperature Loss of function Protect Rest Cryotherapy Decreases swelling, bleeding, pain and spasms Compression Decreases swelling Elevation Decreases swelling Inflammatory Response Phase Sport Books Publisher

  20. Repair and scar formation Granulation tissue fills the gap Collagen fibres are deposited by fibroblasts Signs seen in the phase1 subside Rehab-specific exercises Restore range of motion and strength Manual massage therapy and ultrasound Help break down scar Protective taping and bracing Fibroplastic Repair Phase Sport Books Publisher

  21. Maturation-Remodeling Phase • Remodeling or realigning of the scar tissue • More aggressive stretching and strengthening • To organize the scar tissue along the lines of tensile stress • Include sport-specific skills and activities Sport Books Publisher

  22. Pain: nature’s warning system Sport Books Publisher

  23. Pain Nature’s way of telling us something is wrong One of the best indicator of when it is best to resume play Sport Books Publisher

  24. Masking with medications Continued participation Pushing injured tissue closer to yield-level point Addiction Gastrointestinal complications Problem with Ignoring Pain Pain Sport Books Publisher

  25. Soft tissues injuries Sport Books Publisher

  26. Contusions Sport Books Publisher

  27. Bruise • Compressing force crushes tissue • E.g. “charleyhorse” – quadriceps • Discoloration and swelling • Myositis ossification – abnormal bone formation in a severe contusion • Life-threatening if the tissue involved is a vital organ • P-R-I-C-E Sport Books Publisher

  28. Strains and Sprains Sport Books Publisher

  29. STRAIN Tendon or muscle tissue is stretched or torn SPRAIN Ligament or the joint capsule is stretched pr torn Sport Books Publisher

  30. Grades of sprains and strains • GRADE 1 • Slightly stretched or torn; few muscle fibres • GRADE 2 • Moderately stretched or torn, more muscle fibres • GRADE3 • Complete rupture • Surgery required • E.g. ACL tear Sport Books Publisher

  31. Quadriceps Adductors Hip flexors Hamstrings Rotator cuffs Common Strains Sport Books Publisher

  32. Hamstring Strains • Most frequently strained muscles • Mechanism: • Rapid contraction in a lengthened position • E.g. sprinting and running • Due to strength imbalance • Hamstring strength >>> quadriceps strength Emphasize hamstrings and quadriceps equally Sport Books Publisher

  33. Ankle Sprains • During running, walking, dancing or stepping off a curb • Most common = lateral ankle sprain • Inversion • Common reoccurrence • Decreased proprioception • Symptoms • Rapid swelling • Point tenderness • Rehabilitation • Decreases reoccurrence • Incorporation of balance exercises Sport Books Publisher

  34. Dislocations Sport Books Publisher

  35. Great enough forces push the joint beyond its normal anatomical limits • Joint surfaces come apart • Subluxation • When supporting structures (e.g. ligaments) are stretched or torn enough • Bony surfaces partially separate • Most common = fingers • Can become chronic Sport Books Publisher

  36. Dislocation of the Shoulder Sport Books Publisher

  37. Most mobile  most unstable joint • Categories of dislocation: • Partial (subluxation) • Complete • Most common • Head of humerus slips anteriorly • Falling backwards on extended arm • Symptoms • Swelling, numbness, pain, weakness, bruising • Capsule and/or rotator cuff tears • Brachial plexus injury • Require medical treatment to relocate head of humerus back to glenoid fossa Sport Books Publisher

  38. Fractures Sport Books Publisher

  39. Simple fracture • Stays within the surrounding soft tissue • Compound fracture • Protrudes from the skin • Stress fracture • Results from repeated low magnitude loads • Avulsion fracture • Involves tendon or ligament pulling small chip of bone Sport Books Publisher

  40. Concussions Sport Books Publisher

  41. Injury to the brain • Mechanism: • Violent shaking or jarring action of the head • Brain bounces against the inside of the skull • Symptoms • Confusion • Temporary loss of normal brain function • REST No such thing as “minor concussion and “shaking off” Sport Books Publisher

  42. Overuse injuries Sport Books Publisher

  43. Due to • Repeated and accumulated microtrauma • Non-sufficient recovery • Results from • Poor technique • Poor equipment • Too much training • Type of training Sport Books Publisher

  44. Tendonitis Sport Books Publisher

  45. Age (loss in elasticity) Excessive , repetitive motion Improper technique Tendonitis • Inflammation of tendon as a result of a small tear in the tendon • Symptoms • Pain (aggravated by movement) • Tenderness • Stiffness near joint Sport Books Publisher

  46. Tennis Elbow • Lateral epicondylitis • Affect forearm extensors • Attach to lateral epicondyle • Extend wrist and fingers • Contributing factors • Excessive forearm pronation and wrist flexion • Gripping racquet too tightly • Improper size3 grip • Excessive string tension • Excessive racquet weight • Topspins • Hitting ball off-centre Sport Books Publisher

  47. Gofer’s and Little League Elbow • Medial epicondylitis • Affects tendons of forearm flexors • Attach to medial epicondyle • Flex wrist and fingers • May result in collateral ligament and ulnar nerve injury • May affect medial humeral growth plate in young children (little league elbow) Sport Books Publisher

  48. Jumper’s Knee • Patellar tendonitis • Affects infrapatellar ligament • Caused by: • Repetitive eccentric knee actions • Eccentric load during jump preparation >>> body weight Sport Books Publisher

  49. Bursitis Sport Books Publisher

  50. Inflammation of the bursae • Tiny fluid-filled sacs • Lubricate and cushion pressure points between bone and tendons • Results from overuse and stress • Age is also a factor • Most common • Shoulder, elbow and hip • Inflammation and pain aggravated by movement and direct pressure Sport Books Publisher

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