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Preventing Athletic Injuries

Preventing Athletic Injuries. Tony Milian, ATC, LAT Manager, Sports Medicine [U18] Sports Medicine Cooper City Optimist Lecture February 16th, 2010. Parents’, Coaches’, Trainers’, Physicians’ Everybody’s Goals. Make the game as safe as possible for the players

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Preventing Athletic Injuries

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  1. Preventing Athletic Injuries • Tony Milian, ATC, LAT • Manager, Sports Medicine • [U18] Sports Medicine • Cooper City Optimist Lecture • February 16th, 2010

  2. Parents’, Coaches’, Trainers’, Physicians’Everybody’s Goals • Make the game as safe as possible for the players • Protect the athlete from further injury • Accurate evaluation • Early recognition and treatment • Definitive injury care • Return to play

  3. Prevention • Representative Areas For Today: • Head Injury • Heat Injury • Supplement Injury • Lightning Injury • Stretching Dynamic / Static

  4. Head Injury: Concussion • Definition - Immediate and transient impairment of neurologic function due to traumatic injury to the head • May or may not involve loss of consciousness (LOC)

  5. Early Signs of Concussion • Impaired attention • Slurred, incoherent speech • Disorientation • Impaired Coordination • Emotional reaction out of proportion • Memory deficits • Any loss of consciousness

  6. Late Signs of Concussion • Persistent headache • Dizziness • Poor Attention • Memory Dysfunction • Nausea or Vomiting • Irritability • Photophobia

  7. AAN Concussion Grading Scale • Grade I • Abnormal symptoms resolve in less than 15 minutes • Grade II • Abnormal symptoms resolve in greater than 15 minutes • Grade III • A: Brief LOC (seconds) • B: Prolonged LOC (minutes)

  8. Assessment • Cervical Spine (LOC) • Facial Expression • Pupil size and reactivity • Upper and Lower extremity • Orientation • Immediate Memory • Delayed Recall

  9. AAN Concussion Management • Grade I (<15 minutes, no LOC) • Remove from contest • Immediate exam and at 5 minute intervals • Out for Remainder of Game

  10. AAN Concussion Management • Grade II (>15 minutes, no LOC) • Remove from contest; no return • Immediate exam and at 5 minute intervals • Re-exam the next day • MD exam and clearance after 1 asymptomatic week

  11. AAN Concussion Management • Grade III (Any LOC) • EMS transport to nearest ER • MD evaluation and +/- brain imaging • Possible Admit

  12. AAN Concussion Management • Grade III - Return to play • Brief LOC : 1 week • Prolonged LOC : 2 weeks • 2nd Injury: 1 month • Abnormal Brain Scan : season terminated

  13. Heat Injury • When “walk it off” is not the right thing to say • What three types exist • What are the risk factors • Prevention strategies • Treatment strategies • Heat cramps • Heat exhaustion • Heat stroke

  14. Heat Related Injury • Heat production increases 15X with exercise • Two mechanisms to dissipate head • Radiation (65%) – Clothing • Evaporation (30%) – Humidity

  15. Heat Related Injury • Heat Cramps • Painful muscle spasms that most commonly occur in the calf and abdomen but can occur anywhere. • Treatment involves drinking water, mild stretching and ice massage of the affected area.

  16. Heat Related Injury • Heat Exhaustion • Headache • Dizziness • Weakness • Fatigue • Muscle cramps • Vomiting • Excessive thirst dry tongue and mouth • In-coordination, mental dullness, • Elevated body temperature & reduced sweating. Looks Like a Viral Illness

  17. Heat Related Injury • Heat Exhaustion • Treatment • Rest • Remove from hot environment • Fluid replacement over several hours • Likely requiring IV fluid • Ice packs to neck, groin, armpits

  18. Heat Related Injury • Heat Stroke • Sudden collapse usually with a loss of consciousness • Flushed, hot skin; Rapid, strong pulse • Sweating is often absent • Body has lost the ability to cool itself • Treatment - Immediate call to 911 and • Cool the body • Strip all the clothing off the athlete • Sponge with cool water, and fan with a towel • Ice water immersion is controversial • No alcohol sponge baths

  19. Heat Related Injury • Prevention Strategies • Education • Hydration • Prior to activity (1/2 liter starting 2 hours prior to activity) • Every 15-20 minutes during activity • If Child = 5oz • If Adolescent = 9oz • Rest • More frequently during hot and humid days • Schedule adjustment • Equipment removal

  20. Heat Related Injury • Hydration • Sports Beverages Recommended • Carbohydrate (glucose and sucrose) • Sodium • Potassium

  21. Heat Related Injury • WARNING!!!

  22. Heat Illness • Heat illness may be hard to detect • Fluids before / during / after • EMS activation • Treatment on scene • Prevention is key

  23. Supplement Illness • Caffeine • Steroids • GNC • Amphetamines • Red Bull

  24. Caffeine Content Standard 4 ounce cup = 50 mg caffeine 8 oz Red Bull 16 oz Rockstar 16 oz Arizona 8 oz Cocaine Energy Drink OR 2 oz Extreme Energy

  25. Lightning Injury • Florida ranks as # 1 in the US for lightning related injury and death • One out of every 9 lightning strikes end in a fatality • Common misconceptions

  26. Lightning Illness

  27. Lightning • Lightning strikes up to 25 miles away • Be Proactive! • Plan Ahead • Monitor the weather • Postpone the activity • Get to a safe place

  28. Lightning • Use the 30/30 rule… • If time between lightning and thunder is LESS than 30 seconds…get to a safe place!!! • WAIT 30 seconds after hearing last thunder before leaving safe location • Retreat to an enclosed building • Vehicle with closed window adequate • OK to touch victim • AVOID… • Dugout • Picnic pavilion • Rain shelter

  29. Lightning • Move victim ONLY if necessary, with particular attention to any possible brain or spinal cord injury • Examine for burns, broken bones, cuts, loss of hearing or eyesight • Emergency Plan Activation • Activate your plan • Notify EMS • AED if available • Log roll • Initiate effective CPR

  30. Some Emergencies on the field Obviously need 911 • Dislocations • Open Fractures • Gross Deformities • LOC

  31. Injury Prevention • 3.5 million injuries each year • Most common are strains and sprains • Prevention • Dynamic warm up • Static stretching • Proper biomechanical training 33

  32. Stretching • Stretching: the act of performing a particular exercise to improve joint range of motion. European College of Sports Sciences 2006. • Static Stretching: when a body part is taken to a point of mild discomfort and held for an amount of time. • Dynamic Stretching/Movements: movements that maximize active range of motion and elevate core body temperature. • Journal of Strength and Conditioning 2005 34

  33. Static vs. Dynamic • Does static stretching prior to activity achieve the goals of injury prevention and performance enhancement? • NO • Research has shown that static stretching can be detrimental to performance and does not lead to a decrease in injury 35

  34. Static vs. Dynamic • Study from the Journal of Strength and Conditioning, 2008 • 24 Division I wrestlers were randomly assigned to complete a 4 week Dynamic or Static warm up routine prior to their preseason practices • 11 performed the static warm up • 13 performed the dynamic warm up • They were tested on med ball underhand throw, 300 yard shuttle, pull ups, push ups, sit ups, broad jump, 600 m run, sit to stand reach, trunk extension, quad and hamstring peak torque tests. 36

  35. Static vs. Dynamic • Results Dynamic Group • Increase in quadriceps peak torque by 11% • Increase in broad jump by 4% • Increase in underhand med ball throw by 4% • Increase in sit ups by 11% • Increase in push ups by 3% • Static group posted no improvements to tests performed. 37

  36. Static vs. Dynamic • Study from the Journal of Strength and Conditioning, 2006 • United States military academy took 30 cadets to do a study on static vs. dynamic warm up routines to see which one would better prepare their cadets for power and agility activities • Tested on the 5 step jump to determine functional leg power • Medicine ball throw was chosen to measure total body power • T-drill was chosen to measure agility 38

  37. Static vs. Dynamic • For 3 days one group of cadets performed static stretches for 10 minutes prior to data collection • Other group performed dynamic stretches for 10 minutes • All routines were done at 6AM each day • There was a 2 minute period between finishing the warm up and beginning the performance test 39

  38. Static vs. Dynamic • Results • T –drill static warm up = 9.69 sec vs. dynamic’s 9.56 sec • Medicine ball throw = 9.34 meters with static vs. 9.79 meters with dynamic • 5 step jump = 9.78 meters with static vs. 10.06 meters with dynamic • For task requiring power and agility, the results suggest that dynamic warm up will offer performance benefits not found with static warm ups. 40

  39. Times have changed! 41

  40. Thank YouTony Milian, ATC, LATManager, [U18] Sports Center954-538-5501amilian@mhs.netwww.u18sportsmedicine.com

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