Classifying Sports Injuries

Classifying Sports Injuries

• Sports injuries are classified as direct/indirect, soft/hard tissue, or overuse injuries.
• Direct injuries result from an external force at the point of impact.
• Common direct injuries include bruises from direct contact.
• Indirect injuries stem from internal forces, frequently muscle-generated, or forces transferred from the outside.
• Sprains and strains are classified as indirect injuries.
• Soft tissue injuries affect muscles, ligaments, tendons, skin, and organs.
• A sprained ankle is an example of a soft tissue injury.
• Hard tissue injuries concern bones and teeth.
• A dislocated shoulder from a tackle in rugby is an example of a hard tissue injury.
• Overuse injuries result from repetitive actions and develop over time.
• An example of an overuse injury is tendonitis.

Soft Tissue Injuries

• Soft tissue injuries only affect tissue besides bone and teeth.
• All stimulate an inflammatory response.
• These injuries include tears, sprains, contusions, skin abrasions, lacerations, and blisters.
• Ligaments are strong, rigid tissues which connect bone to bone and assist with stabilization.
• Tendons connects muscle to bone.

Types of Soft Tissue Injuries: Sprains

• A sprain is a ligament that is torn or stretched.
• Sprains cause pain, swelling, and instability.
• Ligaments are stabilizing tissues; ligament injury means joint instability.
• Rehabilitation, and possibly surgery, may be necessary for sprains.
• Sprains heal slowly due to poor blood flow.
• Sprains are graded 1-3 based on severity.
• Grade 1 sprain is a stretch or slight tear.
• Grade 2 is a deeper tear of the ligament.
• Grade 3 is a complete rupture without any connecting tissue.

Types of Soft Tissue Injuries: Strains

• A strain is a tendon that is stretched or torn.
• Strains can cause considerable pain, bleeding, and discoloration.
• Strains are graded 1-3 based on severity.
• Grade 1 strain is stretched or pulled.
• Grade 2 is a partial tear.
• Grade 3 is a complete tear.

Types of Soft Tissue Injuries: Contusions and Haematoma

• Contusions result from direct impacts.
• Contusions have a varying degree of intensity, but are always superficial.
• Blood rushes to and pools in the impacted area.
• Haematomas are deep bruises that can cause bone bruising.
• Blood clots in connective tissue membranes can cause internal bleeding.
• Haematoma clots need to be broken down to avoid hardness and lumpiness.

Types of Soft Tissue Injuries: Skin Abrasions and Lacerations

• Skin abrasions are grazes.
• Abrasions are painful, cause shallow bleeding, and may contain dirt.
• Gentle cleaning or sterilization is needed to prevent infection.
• Lacerations are cuts or wounds where flesh tears.
• Lacerations are common on the mouth, scalp, lips, and tongue.
• Treatment involves cleansing, allowing to dry, and covering with sterile gauze.
• Seek medical attention for lacerations over 1cm.
• Mouth lacerations require inspection and antiseptic rinse.

Types of Soft Tissue Injuries: Blisters

• Blisters are fluid collections under the epidermal layer
• Blisters are caused by friction.
• The fluid inside can be clear or bloody.
• New or old, overused equipment can cause blisters.
• Treatment involves resting the blister for 24 hours and antiseptic application.

Inflammatory Response and Management (RICER)

• The inflammatory response is a self-healing process that lasts 3-4 days in three phases.
• Phase 1 (inflammatory) involves pain, redness, swelling, loss of mobility, increased blood flow, new blood vessel creation, and blood pooling.
• Phase 2 (repair) lasts 3 days to 6 weeks and includes debris elimination.
• Phase 2 also involves new fiber and scar tissue production.
• Phase 3 (remodeling) lasts 6 weeks to months.
• Phase 3 involves increasing scar tissue and strength/flexibility.
• RICER (Rest, Ice, Compression, Elevation, Referral) is used to manage soft tissue injuries.
• RICER ensures correct healing in the shortest time.
• Rest involves stopping movement.
• Ice should be applied for 10 minutes immediately after the event.
• Cold sprays provide an alternative for icing.
• Compression with a bandage prevents blood flow.
• Elevate the injury above the heart to prevent swelling.
• Seek a professional medical opinion from a doctor or specialist.

Immediate Treatment of Skin Injuries

• Soft tissue injuries should be cleaned ASAP with soap and warm water.
• Minor injuries get antiseptic cream, and major injuries require specialist referral.

Hard Tissue Injuries

• Hard tissue injuries affect the skeletal system.
• Fractures have two classifications: simple (closed) fractures and compound (open) fractures.
• Simple fractures are breaks where the bone stays under the skin.
• Compound fractures are breaks where the bone breaks through the skin.
• Greenstick fractures are incomplete, possibly zigzag-pattern breaks.
• Oblique fractures involve a broken and offset bone.
• Comminuted fractures involve the bone broken into multiple pieces.
• Depressed fractures involve the bone pushed in, such as a cheekbone.
• Signs of fracture include hearing/feeling a break or grating, pain, redness, loss of function, deformity, and bone protruding from skin.
• Fracture management immobilizes the area, reduces pain, prevents further damage/bleeding, and reduces shock.
• Management is achieved through DRSABCD and bleeding control.

Dislocations

• Dislocations are an abnormal separations between two bones caused by excessive force.
• These cause pain, deformity, swelling, and loss of function.
• Signs include joint pain/swelling/bruising, deformity, tenderness, and immobility.
• Treat dislocated fingers with splint immobilization and DRSABCD.
• Do not move the joint or attempt to reposition the bone.
• Check circulation and apply ice.
• Seek immediate medical attention.

Injury Assessment: DRSABCD and TOTAPS

• DRSABCD is the first step in assessing any injury.
• Assess for danger, bystanders, and casualty response.
• ABCD is applied if no response is received.
• TOTAPS is used if the athlete can respond.
• TOTAPS = Talk, Observe, Touch, Active Movement, Passive Movement, Skills Test.
• TOTAPS determines field return and can be stopped at any stage.
• Talk to the player to determine what happened and the nature of the injury.
• Observe the injury for swelling or deformity, comparing both sides of the body.
• Touch the injury gently to feel for deformity or swelling.
• Try to pinpoint areas of pain.
• Active movement is when the injured person performs joint movements like flexion, extension, and rotation.
• Assess the athletes ability to perform without pain before proceeding.
• Passive movement occurs when the first aider manually moves the body part to determine the athletes pain-free movement range. .

Skill Test

• The injured athlete is asked to perform skills relating to performance of that sport.
• Success here means field return.
• Apply ice to the injury to promote healing.

Sports Medicine for Specific Athletes: Children and Young Adults

• Sports medicine must consider the demands of specific athletes.
• Medical conditions like asthma and diabetes must be considered in children.
• Asthma involves constricted airways.
• Triggered asthma causes thickened walls and flooded airways that limit airflow.
• Asthma triggers include pollution, dust, exercise, and pollen.
• Children with asthma needs proper warm-ups, more likely to occur in log duration activities and to be prepared.
• Asthma management includes a plan, Ventolin, supervision, and inhaler use.
• Diabetes involves type 1 and type 2.
• Exercise opens up muscle cells for glucose transport without insulin for diabetics.
• Type 1 diabetes means the pancreas doesn’t create insulin.
• This is an autoimmune disorder that requires insulin injections.
• Type 2 diabetes involves insulin resistance.
• More common in Australia, your body needs high amounts of insulin to break down glucose so eventually the high levels do not decrease fully.
• In type 2 diabetes, physical activity lowers blood glucose, and insulin should not be taken around physical activity.
• Hypoglycemia produces rapid heart rate, sweating, shaking, anxiety, dizziness, and unconsciousness.
• Hypoglycemia is managed with sugary foods i.e. jelly beans.
• Hyperglycemia causes thirst, vomiting, weak rapid pulse, and rapid breathing.
• Epilepsy stems from misfiring neurons causing loss of control and sezuires.
• Do not prevent an epileptic child from participating in sport (just focus on triggers).
• Triggers need to be avoided and others must be present when the athlete performs.
• Safe selections of sports include those besides water sports, bike and horse riding which can be very dangerous.
• Management of epilepsy involves supervision and trained first aid.
• Many medications exist.

Overuse Injuries and Thermoregulation in Young Athletes

• Overuse injuries are common in growing and can result in shin splits, stress fractures and tendonitis.
• Causes of these injuries include poor recovery, technique and muscular strength.
• Variety in balanced sports, rest, and recovery is important to injury avoidance.
• Managing overuse injuries involves rest and professional oversight.
• Thermoregulation refers to constant core body temperature.
• Children have less developed sweat glands and a greater surface area.
• Children are more affected by environmental temperature.
• Children overheat faster than adults.
• During exercise, provide more drink breaks, keep to cooler times of day, and wear sun-protective clothing.

Management for Hypotermia and Hypertermia

• Management of thermoregulation is done through first aid for heat stroke or exhaustion.
• First aid means, slow cooling for heatstroke and exhaustion and warming/blankets up for hypothermia.
• Do not apply hot packs in cases of hypothermia.
• The management of heat exhaustion includes lying the person down, removing clothing and sponging with cold water.
• Heat stroke involves the same, but applying cold packs as well and ensuring emergency services has been called.
• Hypothermia involves DRSABCD, getting the athlete dry and warm and covering them in a blanket.

Considerations for Physical Training (Resistance and Bone)

• Resistance training does not stunt growth
• Consider athlete age and training intensity
• Focus on proper technique and supervision.
• Use a whole body approach.
• Aged adults face factors like: blood pressure, angina, cardiovascular disease and a history of heart failure.
• Approval from a General Practioner should be sought before exercising.
• The ACSM recommends 5-7 minute warm-ups as well as exercising with another person.
• Stop the workout if breath, nausea, dizziness or chest related pain develops.
• Lower moderate levels of intensity for 30 minutes 5 times a week.
• Bone and fractures can be minimized by fractures.
• Poor density with a small size, inadequate diet and lack of activity and predisposes to poor density.
• Good bone health is achieved by; Vitamin D, Phosophorus, protein and calcium.
• Contact and high intensity fracture is not recommended.

Flexibility and Females

• Joint mobility occurs with use and movement.
• Increased slowly is desired.
• Female athletes should consider the "female triad" and are pressured to look a certain way. – Menstruation makes female to lose iron, needs to be replaced.
• To mitigate iron deficiencies eat meat and green vegetables and try to maintain body form.
• Hemoglobin impacts sports due to: decreased and fatigue performance.
• Density is associated with estrogen levels and the intake of D vitamins.
• Pregnancy impacts weight levels.
• Baby needs blood and temperature regulation and may lose performance due to the shift in energy.

Injury Prevention: Planning and Protective Equipment

• Maintaining fitness levels and avoiding diabetes is important for pregnancy.
• Physical preparation, which means checking for health risks must be prioritized.
• Questionnaires are completed by the potential athlete to determine health conditions.
• Medical history is investigated by the trainers and healthcare staff.
• Skill development is essential in preventing injury, so effective training is essential!
• Physical fitness is essential for well being and appropriate levels is beneficial.
• Cooling after a work-out is also essential.
• Appropriate stretching is useful.
• Cool downs and warm-ups can present injury.
• A redistribution of blood-flow is key.
• Sports policy assists with rules on the ground that provide safety and well being.
• Umpire should always enforce.
• Clubs should prioritise player safety.

Modified Rules

• The rules are implemented to accomodate children who need assistance as well ensure enjoyment and lower temperatures.
• Matching equalizes levels of competition to avoid imbalances.
• Maturity and development is the greatest primary consideration.
• Protection is important (helmets etc...) to promote comfortable with the gear to use for leg-pad and elbow injuries etc.

Safe Play

• Facilities and equipment must be maintained and inspected regularly
• Athletes must be aware of environment.
• An appropriate hydration must be considered.
• The core of the body helps to regulates temperature by conducting heat production and the balance to allow working muscles to disperse.
• Athletes may want to employ fluid dispersal.
• Environmental awareness is important.

Fluid Depletion

• Dehydration can be avoided on humidity and winds with appropriate fluids.
• The levels are also affected by exercise.
• Approximately 57% is made out of water, making loss and important factor.
• Symptoms are first detected by feeling thirsty.
• Intake can be checked with pre and post weight check, or the color with urination.
• Be sure to conduct water breaks during workout schedule.
• Suggesting fluid for longer than one hour needs water based and electrolyzed if not try to maintain carbonation.
• Restore all to normalize the hydration level and urine and replenish properly.

Athletic Performance

• Adaptation helps perform and develops tolerane.
• Perform by acclimitizing and using training in new events.
• Taping reduced and causes comfort for athletes with a need sense of motion.
• Can also allow comfort as well.
• Use for short periods as well.
• Proper tape: Anchor, Apply well, overlap, avoid creases and lock after.

Injury Isolation

• Taping is to assist healing and recover areas with focus on protection, support and strenghening.
• Focus of types of sports: football , soocer, hockey and knee ankles.
• Stabilize and protect the ankle during activity with application of tape.

Rehab

• Taping is required so that full actions can be completed throughout the body's injury.
• It should be connected back to the body. All should be checked with progressive mobility
• Strecthing in pain should be minimized
• Isometrics can be a first level treatment with low weights and some range for improvement.
• Skills are also improved to lower the risk.

Return to Performance

• Performance after the injured returns is for the fitness component and sport.
• The process should be communicated and checked by the physiotherapist.
• Monitor the new procedures and progress with rest compress elevated for long periods.
• Strenghting can be done with simple workouts but no bounce in the performance.
• Games are simple with no pressure for less training.
• Improve and slowly increase intensity.
• Amateur trainers are the decision makers of the level.
• Professional training should make sure the player is free from return.
• Tests involve skills and performance.
• Coaches have an ethical consideration to push to participate.
• PainKillers is a dangerous and sensitive part of the ethical nature.