R041 – Reducing the risk of sports injuries

1. R041 – Reducing the risk of sports injuries Learning Outcomes • LO1 - Understand different factors which influence the risk of injury • LO2 - Understand how appropriate warm up and cool down routines can help to prevent injury • LO3 - Understand how to respond to injuries within a sporting context • LO4 - Understand how to respond to common medical conditions

2. Responding to injuries There are two types of injury associated to sport. Acute injuries occur as a result of an incident during an event, training or match. i.e. a bad tackle in football leading to knee ligament damage. Chronic injuries occur over a period of time. These are associated with repetitive/ continuous use or otherwise know as over use injuries. i.e. tennis elbow

3. Responding to injuries Injuries are also classified as either hard tissue or soft tissue. Soft tissue injuries are the most common in sport and include sprains and strains of muscles, tendons and ligaments. Hard tissue refers to damage involving bone, joints or cartilage.

4. Soft tissue injuries Soft tissue injuries are common in sport. Contusion:A contusion (bruise) is an area of the body where blood vessels have been damaged under the skin/tissues. These are often caused by a fall or direct impact from a player. The damaged tissue can lead to a haematoma. This is where the bleeding from the ruptured blood vessels fill the local area.

5. Soft tissue injuries Abrasions (Grazes and Cuts):This is damage to the skin caused by scraping against a playing surface. Open wounds can carry an infection risk and if cuts are deep, medical attention may be required to apply stitches. Blisters:After friction, layers of skin can become separated and form a pocket of fluid between them. This is often due to poorly fitting footwear. Think. Pair. Share – How can blisters be prevented?

6. Soft tissue injuries Sprain: This soft tissue injury can occur when the ligaments at a specific joint get stretched/wrenched or torn. Sprains are particularly common in basketball players due to the game involving a lot of jumping and landing throughout. • Strain: This is an overstretched or torn muscle or tendon. • Games players can often suffer this type of injury due to the nature of the sport and can be classified as a grade 1 – 3 depending on severity.

7. Fractures Signs and symptoms of acute injuries are sudden and often unpreventable. Common examples are fractured metatarsals and anterior cruciate ligament (ACL) damage. Bone fractures are a hard tissue injury were a break or crack in the bone occurs due to excessive force from a collision/object or poor landing. Think. Pair. Share – What are the common bones broken in sport and how do they occur?

8. Fractures There are a number of typical fractures that can occur. 1. Simple (closed) fracture The surrounding skin is unbroken. However, injury to internal tissue may cause swelling. 2. Compound (open) fracture The skin is broken and the bone may protrude through increasing the risk of infection.

9. Concussion Concussion:Concussion is trauma or injury to the brain. It is caused by a direct blow to the head resulting in a disruption to brain functioning. If an athlete is concussed, they may show the following signs/symptoms: • become unconscious. • feel sick, dizzy or drowsy. • get confused, stare & suffer memory loss.

10. Overuse Injuries Overuse injuries are also called chronic injuries. It is caused by the overuse of a particular part of the body. Although symptoms are milder than acute injuries, these develop slowly and can last a long period of time affecting daily life. 

11. Overuse Injuries Tendonitis is the chronic overuse of tendons in the body. Both golfers elbow and tennis elbow affects the tendons that attach muscles to the elbow joint. These become inflamed, sore and painful. Treatment depends on the length and severity of the symptoms. Many patients improve without surgery. Rest and oral medications may help reduce the swelling and pain.

12. Overuse Injuries Shin Splints:Repeated overuse of the tibialis anterior can result in tenderness and inflammation around the shin area. Excess weight, inadequate footwear and poor technique can lead to shin splints which is a common injury for runners, dancers and footballers. • Treatment includes: • Rest • Ice the shin to ease pain and swelling • Take anti-inflammatory painkillers

13. Injuries Cramp:A cramp is a sudden involuntary muscle contraction (over shortening) While it is generally temporary and non-damaging, they can cause significant pain, and a paralysis-like immobility of the affected muscle.

14. Injuries relating to children Severs disease:This is inflammation of a growth plate. The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children.

15. Injuries relating to children Osgood Schlatter’s disease:This is a form of knee pain found in growing children. The pain is over a bump of bone in the front of the knee and mostly subsides once the individual has stopped growing.

16. Responding to Injuries/Medical Conditions The assessment procedure for sports injuries can be remembered with the ‘SALTAPS’ rule. This is the procedure when considered the extent of sports-related injuries and whether a player can continue. S is for See and stop play if a player goes down. A is for Ask the player what happened and how they feel. Check facial expressions and posture (position either standing or lying down)

17. Responding to Injuries/Medical Conditions L is for Look at injured limbs for obvious signs of injury: bleeding, bruising, swelling, deformity. Take the player off if there are significant signs of injury. T is for Touch the injured site if the player will let you. Gently palpate to find source of pain. If you are unsure, don’t touch or move the limb until a qualified person can assess the player.

18. Responding to Injuries/Medical Conditions A is for Active movement: Can the player move the limb, with or without pain? If unable to move – take the player off. P is for Passive movement: If A applies, move the limb/joint to full extent and note reaction. S for Strength testing: This last step should be performed when the medical personnel assessing the injured player feels that they can now continue playing then the final strength testing assessment should be conducted. 

19. Responding to Injuries/Medical Conditions Accurate assessment and correct diagnosis of sports injuries are paramount for the health of players. In an ideal situation, a medically trained individual should be in attendance in every sports training session and matches. Treatment for all soft tissue injuries is RICE

20. Responding to Injuries Stretching – Using appropriate stretches will test the range of motion and determine whether the performer can return to the activity. Massage – A sports massage is an ideal way to treat injuries and a preventative method too. This therapy can increase the health of muscle and connective tissue, range of movement, tone, symmetry, balance of muscle and the quality of an athlete’s posture.

21. Responding to Injuries TapingTaping a weak joint can support the injured area of the body and reduce the risk of injury. Muscles can also be taped applying directly to the skin or joint area. Bandaging is a more substantial application to support a weakened or previously injured area of the body. Think. Pair. Share – When might a performer apply taping or bandaging and would they be likely to carry on playing?

22. Responding to Injuries If the injury is more severe it may need to be immobilised and further treatment applied by trained medical personnel. Splints – A device used to support and stop an injured body part from moving, protecting it from any further damage. Sling – A device used to support and stop an injured body part from moving, protecting it from any further damage.

23. Responding to Injuries Hot and cold treatments – Research has shown that use of heating and cooling methods can treat injuries and pains as well as boost recovery rates. The selection of which therapy to use depends on severity and nature of the injury.

24. Responding to Injuries Freeze spray – This will reduce the swelling of a muscle. Ideal for treatment of sprains, strains, minor sports injuries, muscle and joint pain. Heat pack - There are many forms of heat treatment including heat packs, towels, heat rubs and water immersion. Heat therapy should be used on overuse injuries and late stages of recovery from an acute injury.

25. Responding to Injuries Emergency procedures: Emergency first aid should only be administered by trained individuals, this include basic CPR and placing a performer in the recovery position. More severe injuries such as a fracture, dislocation or head injuries should be dealt with by the emergency services. i.e. call 999

26. Responding to Injuries Emergency Action Plans (EAP): This is a document which outlines the procedures for response to a emergency during a sporting activity. It broadly covers three areas of need: 2. Emergency communication – details are provided with relevant contact numbers for the emergency services and any on-site/specialist provision. 1. Emergency personnel – details are provided as to who the key personnel on-site are (first responder, first aider, coach) to contact in an emergency (if they are not present) and where/how to contact them.

27. Responding to Injuries 3. Emergency equipment – details of where first aid kits and other relevant materials may be for use in an emergency.

28. Retrieval Practice

29. Exam Question Application 1. SALTAPS is used for on-field assessment of a sport injury. (a) Fill in each of the missing words below to complete the acronym. (3) (b) Give an example of how you would apply each of the following elements of SALTAPS: Active .............................................................................................. Strength ..........................................................................................

30. Exam Question Application 2. Explain the difference between an acute injury and a chronic injury. (2) ........................................................................................................................................................................................................................................................................................................................ 3. Describe how you would treat a soft tissue injury. (4) .............................................................................................................................................................................................................................................................................................................................. ..............................................................................................................................................................................................................................................................................................................................

31. Exam Question Application 4. An emergency is any sudden life threatening injury or illness that requires immediate medical attention. Preparation is the key to responding to unexpected emergencies in sport. Describe the three main components of an emergency action plan. (3) ........................................................................................................................................................................................................................................................................................................................ ........................................................................................................................................................................................................................................................................................................................

32. Exam Question Application 5. Circle your chosen option to indicate which of the following is true or false. (5) • An acute injury results in immediate pain (b) Shin splints are an example of an acute injury (c) An abrasion is an example of an overuse injury (d) Golfer’s elbow occurs as a result of wearing incorrect footwear (e) Acute injuries occur over a long period of time 6. Outline the features of two injuries that are related to children. ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. (4)

33. Exam Question Application • Marks Scheme: • 1. (a) • Ask • Touch • Passive • (b) Active – seeing if the area can be moved (e.g. for a knee injury, can they flex the joint?) • Strength – is the area strong enough to be used (e.g. for an ankle injury, can they stand up and put weight on the joint?)

34. Exam Question Application Marks Scheme: 2. Acute injuries: Happen as a result of a sudden trauma to the body (e.g. tackle, being hit by a ball). Result in immediate pain, and usually swelling with a loss of function. Chronic injuries (also known as overuse injuries): Are a result of continuous stress on an area (e.g. Achilles tendonitis, shin splints or tennis elbow). These injuries tend to come on gradually over a period of time. 3. How would you treat injury (You would use RICE): R – rest the injury I – ice the injury’s site C – compress the injury’s site E – elevate the injury’s site above the heart

35. Exam Question Application Marks Scheme: 4. Emergency personnel; Emergency communication; Emergency equipment; • Emergency personnel – details are provided as to who the key personnel on-site are (first responder, first aider, coach) to contact in an emergency (if they are not present) and where/how to contact them. • Emergency communication – details are provided with relevant contact numbers for the emergency services and any on-site/specialist provision. • Emergency equipment – details of where first aid kits and other relevant materials may be for use in an emergency

36. Exam Question Application Marks Scheme: 5. (a) True (b) False(c) False (d) False (e) False 6. Sever’s(disease) Affects / pain in heel/s (when walking) During a ‘growth spurt’ or bones growing quicker/different rates than muscles. The (Achilles) tendon at the back of the heel pulls at the heel bone. Osgood Schlatter’s (disease) Affects / pain / swelling in upper part of the shin / knee Most commonly occurs in teenagers (who play sport) or during a 'growth spurt' or bones growing quicker/different rates than muscles.