Sports Medicine: Injury Prevention and Management

Sports Medicine Module Overview

• The sports medicine module focuses on preventing, assessing, managing, and recovering from sports injuries
• Students explore how the extent of sports participation relates to sports injuries and study technical and scientific approaches to maintain athlete well-being
• Students research and debate sports medicine approaches and examine returning to play after injury

Key Inquiry Questions

• How are sports injuries classified and managed?
• How does sports medicine address the demands of specific athletes?
• What role do preventative actions play in enhancing the athlete's wellbeing?
• How is injury rehabilitation managed?

Learning Outcomes

• Explain how training approaches and other interventions enhance performance and safety in physical activity
• Select and apply strategies for managing injuries and promoting safety in sports
• Devise methods for gathering, interpreting, and communicating health and physical activity information
• Select appropriate options and strategies based on factors affecting performance and safe participation

Classifying and Managing Sports Injuries

• Ways to classify sports injuries include: direct/indirect, soft/hard tissue, and overuse
• Soft tissue injuries include: tears, sprains, contusions, skin abrasions, lacerations, blisters, and inflammatory response
• Hard tissue injuries include fractures and dislocations
• Injury assessment uses TOTAPS: Talk, Observe, Touch, Active and Passive movement, Skills test
• Soft tissue injuries managed with RICER: Rest, Ice, Compression, Elevation, Referral
• Hard tissue injuries managed with assessment for medical attention and immobilization

Sports Medicine and Athletes' Demands

• Children/young athletes’ considerations include medical conditions such as asthma, diabetes, and epilepsy
• Other children/young athlete considerations are overuse injuries, thermoregulation and resistance training appropriateness
• Adult/aged athletes' considerations include heart conditions, fractures/bone density, and flexibility/joint mobility
• Female athletes' considerations include eating disorders, iron deficiency, bone density, and pregnancy
• Implications of considerations are analyzed for their effects on young people's sports participation
• Sports participation options for aged people with medical conditions need explanation
• Iron deficiency and bone density’s impact on sports participation should be assessed

Preventative Actions for Athlete Wellbeing

• Physical preparation includes pre-screening, skill, technique, physical fitness, warm-up, stretching, and cool-down
• Sports policy and environment components include rules, activities, modified rules for children, matching opponents, and protective equipment
• Also important are safe grounds, equipment, facilities, environmental conditions, temperature regulation, fluid intake guidelines, and acclimatization
• Different sports are analyzed to prioritize preventative strategies and adequate preparation to prevent injuries
• Sports policies, rules, and equipment are critically assessed for promoting safe participation
• Strategies to support the body's temperature regulation mechanisms should be evaluated
• The impact of climatic conditions on safe sports participation should be analyzed
• Taping and bandaging techniques, including ankle, wrist and thumb should be demonstrated
• The role of taping is evaluated for injury prevention and treatment

Injury Rehabilitation Management

• Rehabilitation procedures involve progressive mobilization, graduated exercise, and training
• Use of heat and cold is important
• Strategies for return to play include assessing indicators of readiness
• Rehabilitation procedures for specific injuries, like hamstring tear and shoulder dislocation, are examined and justified

Return to Play

• Readiness indicators include being pain-free with good mobility, progress monitoring, and psychological readiness
• Specific warm-up procedures must be followed
• Policies and procedures for return to play must be followed
• Skill and physical tests should be researched and evaluated for indicating return-to-play readiness
• Policies and procedures regulating return-to-play timing should be critically examined
• Ethical pressure to participate and use of painkillers must be considered

Classifying Sports Injuries

• Injuries are classified as direct/indirect, soft/hard tissue, or overuse
• Direct injuries result from external forces
• Indirect injuries result from internal forces exceeding normal body function
• Soft tissue injuries affect muscles, ligaments, tendons, skin, organs, blood vessels, and nerves
• Hard tissue injuries affect bones or teeth
• Overuse injuries result from intense or unreasonable use of joints or body areas

Soft Tissue Injury Types

• Tears (strains) are muscle or tendon damage from overstretching, classified by severity
• Sprains are ligament tears from joints bending in unnatural directions, classified by severity
• Contusions are internal bleeding due to ruptured capillaries from crushed soft tissues
• Skin abrasions are skin scraping, lacerations are deep cuts, and blisters are fluid collections under the skin

Inflammatory Response

• The inflammatory response occurs immediately after tissue damage
• Phase 1 (Acute Inflammatory): lasts 2-3 days; blood vessels widen, fluid transfers, causing swelling, redness and pain
• Phase 2 (Repair phase): lasts 3 days-6 weeks; white blood cells fix damage, often leading to scar tissue
• Phase 3 (Remodelling phase): lasts 6 weeks to months; more scar tissue forms, injury heals

RICER Protocol

• Rest: reduces bleeding, prevents further injury
• Ice: reduces blood flow, swelling, spasms, and tissue oxygen demand
• Compression: decreases bleeding and swelling
• Elevation: decreases bleeding, swelling, and throbbing
• Referral: to understand the extent of the injury

Hard Tissue Injury

• Hard tissue injury is any injury to bones or teeth
• Fractures are bone surface disruptions, classified as simple, compound, or complicated
• Dislocations are joint separations causing ligament, muscle, capsule, and cartilage damage

Injury Management

• Management of fractures includes controlling bleeding, covering wounds, immobilizing the fracture, handling gently and seeking medical attention
• Dislocation management involves not moving the joint, checking circulation, supporting the area, and applying ice packs

Injury Assessment Steps

• DRSABCD (danger, response, send for help, airway, breathing, CPR, defibrillator) must be assessed before any movement of the individual
• STOP (stop, talk, observe, prevent further injury) must be assessed before any movement of the individual
• TOTAPS (talk, observe, touch, active/passive movement, skills test) steps are used to assess the nature and extent of the injury
• The game must be stopped before assessment

TOTAPS Procedure

• Talk: gather information about pain and individual history
• Observe: compare body parts for abnormalities, discoloration, or swelling
• Touch: compare body parts for abnormalities, discoloration, or swelling
• Active Movement: athlete checks range of movement
• Passive Movement: assessor tests ligaments, tendons, and joint stability
• Skills Test: determines if the injured area can handle sport-specific forces

Addressing Athletes Demands

• Children and young athletes have specific needs addressed by sports medicine
• Medical conditions such as asthma, diabetes and epilepsy require a unique specific approach

Medical Conditions - Asthma

• Asthma is inflammation of the airways, constricting bronchioles and limiting airflow
• Preventative inhalers can be used, environmental triggers should be avoided, as well as warming up and cooling down before exercise
• Steady intensity exercise is recommended rather than explosive movements

Medical Conditions - Diabetes

• Type 1 is when the body no longer produces insulin
• Type 2 is caused by inactivity and poor diet
• The athlete should balance insulin by medication, diet and exercise
• Glucose supplements help mitigate the bodies response to strenuous exercise

Medical Conditions - Epilepsy

• Epilepsy is a neurological, seizure inducing condition that occurs when disruption of normal brain activity happens
• Triggers should be avoided
• Ensure others are present and know the individuals management plan

Common Injuries - Overuse Including Management Techniques

• Overuse results from repetitive movements causing stress on body parts
• Varied training helps
• Supervision of treatment is useful

Thermoregulation

• Thermoregulation maintains a safe body temperature, avoiding hyperthermia (heat Exhaustion/heat stroke) and hypothermia (cold)
• Heat exhaustion = too much salt loss, heat stroke = inability to control internal temperature
• Athletes should lie in a cool place and/or drink lots of water; medical aid as well

Resistance Training Appropriateness

• Resistance training provides muscular strength and power improvements
• Key guidelines include focus on technique, strengthening large muscle groups, and performing 1-3 sets of 10-15 repetitions

Adult / Aged Athletes

• Exercise options include golf, cycling, tennis, lawn bowls, dancing, brisk walks and aerobics
• Bone fractures and a decrease and bone density occurs in many elderly individuals/athletes

Nutrients To Consider

• Calcium, Vitamin D and Phosphorus

Mobility Considerations

• Improving joint flexibility via sport slowly increasing range of motion is important

Female Athletes - Considerations

• Eating disorders affect menstrual cycle and nutritional intake
• bulimia is throwing up after meals, whilst anorexia is a lack of food intake
• Iron deficiency is more likely in women due to menstruation
• Eating calcium enriched foods and warming up before exercise improve bone density

Preventative Action Overview

• Correct preparation and pre-screening can reduce injuries
• Consider the implications of pre-screening more for men over 50, pregnant/asthmatic women, smokers, and those with family history
• Screen for disease, identify risk factors, and measure CVD and metabolic conditions

Skill Acquisition and Impact

• Consistent skill promotes reduced injuries
• Lack of technique raises the chances of injury

Sports Policy and the Environment

• Safety is impacted through rules and number of breaks

Matching Opponents

• Injury rates are reduced based on age, size, skill level, and proper protective gear

Equipment and Venue Considerations

• Unsafe or poorly maintained sports equipment or facilities increases risk of injury
• Consider temperature regulation, climatic conditions, fluid guidelines and acclimatization

Atmospheric Conditions

• Wind greatly increases the loss of heat as well as the liklihood of hyperthermia - dressing appropriately assists a lot
• Avoiding rain and staying dry assists a lot
• Higher and changing altitudes cause for higher radiation levels
• Contaminates interfere with a persons ability to effectively breath

Fluid Intake

• Monitoring pee color
• Drink 2L a day
• Drink at least 500ml 1 hour before exercise
• Drink 1.51 per kg of weight lost

Taping and Bandaging

• Bandaging can assist in a range of motion at a joint
• It can prevent future injury
• Increase stability, shift anatomic parts, and compress soft tissue as well as increase stability

Injury Rehabilitation

• Processes restore athlete to pre-injury level
• Utilising heat and cold to provide recovery as well slow bleeding/inflammation in ice packets

Return to Play - Procedures

• If an athlete wants to return the tests should be similar to what was recorded before and have psychological readiness
• Many protocols for return to play include: medical clearance, scans being completed and reviewed and also a fitness and skill test is done

Pressure

• Comes from coaches, teammates, fans, or financial loss if external
• The athlete personal desire can hinder the teams success if internal
• Pain killers assists temporarily but has a potential for long term consequences

Training Principles and Performance

• Effective training comes from many factors working together

Factors that affect performance

• The energy system, type of training and what an individual is trained to do

Fuel Source For Activity

• ATP/CP requires creation phosphate
• Lactic acid requires glycogen (carbons)
• Aerobic requires glycogen and proteins

Training Types

• Short anaerobic training is less than 25 seconds
• Medium anaerobic training is 25 second to 1 minute
• Long anaerobic is 1 to 2 minutes

Static Stretches

• The muscle should slowly be placed into position and stay in position for at least 30 seconds

Ballistic Actions

• Consists of repetitive motions

Contractions

• A mix of concentric actions for what an individual is trained to do

Reversibility

• Without consistency and athlete won't maintain

Warmup and Cool Down

• Assists in reducing the rate of injury that could come from a sport

RHR - Resting Heart Rate

• Is lower and is an indicator of more efficiency for trained workers

Haemoglobin

• Is the bodies ability to extract