Fractures, Dislocations and Bone Injuries

Inflammatory Response & Healing

• Occurs after soft tissue injury for up to 3 days.
• Activates a self-healing process with phases.

Hard Tissue Injuries

• Involves damage to bones and teeth.
• Fractures are breaks, cracks, or chips in bone from direct trauma, twisting, or repetitive motions.
• Incomplete: Bone snaps into two or more pieces.
• Open: Bone fracture that penetrates the skin.
• Closed: Bone fracture that does not penetrate the skin.

Signs of Fractures

• Pain, swelling, tenderness, potential deformity, and bleeding.

Fracture Management

• DRSABCD (Danger, Response, Send for help, Airways, Breathing, CPR, Defibrillation).
• Control bleeding.
• Treat for shock.
• Immobilize limb with sling, splint, or bandage to restrict movement and prevent further injury.

Dislocation

• Bone displacement from joint structure.
• Often involves fractures and damage to ligaments.

Subluxation

• Bone momentarily pops out and returns.
• Stretches ligaments, causing joint weakness.

Dislocation Management

• Immobilize joint with sling, bandage, and ice.
• Elevate limb.
• Prioritize medical attention for relocation of bones.

Injury Assessment: TOTAPS

• T: Talk: Question the athlete about the injury.
• O: Observe: Look for signs and swelling.
• T: Touch: Gently feel for deformity.
• A: Active Movement: Athlete moves injured part.
• P: Passive Movement: Trainer moves the joint.
• S: Skills Test: Ensure athlete can continue competing.

Sports Medicine for Specific Athletes: Children and Young Athletes

• Specific needs for safe participation in sport and exercise.
• Underdeveloped ability to regulate body temperature.
• Prone to overuse injuries.
• Common medical conditions: asthma, type 1 diabetes, epilepsy.

Medical Conditions: Asthma

• Airway restriction due to triggers like exercise or cold air.
• Exercise-induced asthma occurs with exercise.
• Management: Avoid triggers, warm-up, preventative medication, breathing techniques, reliever medication access.

Medical Conditions: Diabetes

• Body's inability to regulate blood glucose levels.
• Type 1: Pancreas cannot produce insulin.
• Type 2: Insufficient insulin production, often linked to lifestyle.
• Management: Monitor blood sugar, exercise intensity, awareness of hypoglycemia and hyperglycemia signs, administer insulin if required.

Medical Conditions: Epilepsy

• Neurological disorder with recurring sensory disturbance, loss of consciousness, or convulsions.
• Participation in sports encouraged, but avoid high-risk activities like motorsports due to potential loss of consciousness.

Soft Tissue Injuries

• Muscle or tendon injuries are strains, ranging from minor tears to complete ruptures.
• Bruises or contusions occur from impact with an object or opponent.
• Ligament injuries are sprains, ranging from minor to complete ruptures requiring surgery.
• Skin injuries:
  • Lacerations: Jagged cuts with bleeding.
  • Abrasions: Skin layers removed by friction.
  • Blisters: Fluid pockets caused by rubbing, can burst and lead to infections.

Hamstring Strain Management

• Classified as a soft tissue injury (muscle tear) and an indirect injury (internal force).

RICER Management:

• Rest: Immediately stop activity to prevent further damage, restrict movement, and reduce bleeding/swelling.

• Ice: Apply to reduce pain and swelling by restricting blood flow (vasoconstriction). Apply in 20-minute intervals every 2 hours for 24-48 hours.

• Compression: Apply continuously for 24-48 hours (except when icing). Wrap an elastic bandage tightly above and below the injury. Reduce swelling via restricted blood flow.

• Elevation: Raise injury site above heart level to reduce blood flow and swelling.

• Referral: Seek medical professional (physiotherapist) for diagnosis and rehabilitation plan.

• RICER improves recovery and allows the athlete to return to competition confidently.

Skin Injuries

• Blisters: Fluid pockets between skin layers due to friction, often from repeated activity, painful and can lead to infection if popped.
• Abrasions: Grazes from skin scraping across a surface, removing skin cells, causing pain and shallow bleeding, require cleaning to prevent infection.

Effects of Rest, Compression, and Elevation on Inflammatory Response

• Rest: Prevents further damage, restricts movement, and reduces bleeding/swelling, lowers blood flow, limiting swelling, and allowing recovery.
• Compression: Restricts blood flow, limits swelling phase of inflammation, allowing repair phase to begin.
• Elevation: Reduces swelling and blood flow, reduces pain, and allows the inflammatory process to transition to the repair phase.

Sports Medicine and Medical Conditions in Young Athletes

• Asthma: Constriction of airways impacts sports performance. Management includes a well-designed warm-up, asthma medications, coaches must be aware of individual athlete triggers and management.
• Epilepsy: Excessive brain activity leading to seizures. Coaches must know signs, symptoms, and management. Protect the athlete by clearing objects and providing padding. Avoid dangerous sports with loss of consciousness.
• Diabetes: Blood sugar regulation difficulties. Monitor blood glucose levels, provide breaks for food, ensure insulin injections are available, and coaches must know the signs of diabetic states.

Overuse Injuries in Young Athletes

• Caused by excessive, repetitive movements in still-developing bodies.
• Training plans should include adequate rest to allow recovery and prevent overuse injuries.
• Ensure correct sporting technique is developed.

Iron Deficiency and Bone Density in Female Athletes

• Iron deficiency: low blood iron, reducing oxygen to muscles, causing lethargy, fatigue, impacting athletic performance.
• Bone density (impacted by calcium and weight-bearing exercise): low bone density causes brittle bones that are more likely to fracture.
• Female athletes are at higher risk of iron deficiency due to blood loss during menstruation.
• Post-menopausal female athletes are at higher risk of low bone density issues such as osteoporosis.

Signs, Symptoms, and Management of Hard Tissue Injuries

• Involve damage to bones and teeth, including fractures and dislocations.
• Fractures: break, crack, or chip caused by trauma, excessive twisting, or repetitive movements; evident through pain, swelling, tenderness, potential deformity, or bleeding.
• Dislocations: Bone displaced from joint, causing pain, swelling, and deformity.
• Management: DRSABCD, control bleeding, immobilize limb (sling/splint), medical attention required.

Physical Preparation to Prevent Injury

• Pre-screening: Assess health levels before training, highlight predisposing factors, ensure sufficient fitness, and design personalized programs.
• Correct Skill and Technique: Increases efficiency, limits injury chances, and reduces strain.
• Achieving Good Fitness: Allows the athlete to meet physical demands of the sport and reduces the risk of injury.
• Warm-up and Cool-down: Prepares the body, aids recovery, includes general aerobic activity, stretching, and skill practice specific to the needs of the sport.

Australian Health Facilities and Services

• Public or private hospitals, aged-care facilities, specialist services, GP services, mental health facilities, in-home services (nursing, cleaning, food delivery).

Basketball Injury Classifications

• Classified as indirect because excessive strain on the ligament results in damage to the soft tissue.
• Classified as soft tissue because ligaments are tissues connecting bone to bone.

Sports Policies and Environment for Safe Participation

• Sports governing bodies provide guidelines, policies, and rules to promote a safe playing environment, meet legal duties of care, and reduce injury.
• All sports have rules enforced by referees.
• Matching of opponents, based on size.
• Protective equipment (mouthguards, helmets, gloves, shin pads), reduces injuries.
• Safe grounds, equipment, and facilities reduce the likelihood of injury (safe surfaces, goal post padding, sufficient lighting).
• Injuries can still occur despite policies and environmental considerations.

Socioeconomic Determinants of Health Inequities for Aboriginal and Torres Strait Islander Peoples

• Education: typically lower levels reduce health education and literacy, leading to poorer health choices.
• Employment: lower levels reduce income, limiting access to health resources and preventative measures.

Ottawa Charter Action Areas

• Developing Personal Skills: Improves education and health literacy, allowing healthier decisions (e.g., advertising campaigns on smoking).
• Building Healthy Public Policy: Laws and legislation to improve health status and reduce chronic disease (e.g., graphic images on cigarette packages).

Climatic Conditions and Athlete Safety

• Climatic conditions includes temperature, humidity, wind, rain, altitude, and pollution levels: impact athlete safety.
• Temperature: wear appropriate clothing to protect themselves from cold conditions and in hot conditions, athletes should wear light weight clothing made of breathable materials in order to thermoregulate.
• Humidity reduces the heat dispersion which can cause heat induced conditions.
• Wind and rain can make the field slippery or muddy, increasing the chances of injury through falls and collisions.
• Altitude can have positive physiological adaptations for the athlete, while raising safety and performance concerns.
• Air pollution can lead to breathing difficulties impacting on performance and health.