Recognizing Different Sports Injuries

Recognizing Different Sports InjuriesChapter 9Acute vs. Chronic InjuriesAcute InjuriesNew injuriesCaused by traumaPhysical injury or wound produced by internal or external force

Chronic InjuriesResult from overuseHappen over a period of timeTypes of Synovial Joints

Types of Synovial JointsTypes of Bones According to ShapeLongLonger than wideHelp with movementShortShort and cube shapedCarpals and tarsalsFlatFlat and wideprotectionIrregularDifferent sizes and functions

5 Functions of BonesProvide shape and supportAllow movementGive the muscles a place to attachProtectionProtect internal organsStore mineralsCalcium and phosphorusHematapoiesis (produce blood cells)Parts of a Long BoneDiaphysis main shaft of a boneHollow, cylindrical, covered by compact boneEpiphysis ends of a boneGrowth area; growth plateArticular cartilage covers the end or epiphysisProtection during movement, and cushions jointPeriosteum dense, white membrane that covers diaphysisInterlaced with muscle tendons, blood vessels, and osteoblasts (bone-forming cells)

Growth PlatecoveringLines jointsLong shaftFractures = breaks/cracks in bonesAcute injuriesResult of extreme stress and strains placed on the bone

Fractures (Fx)Partial or complete tissue disruption that can be closed or openSerious musculoskeletal injurySigns/Symptoms:Possible deformity, point tenderness, swelling, pain with both active and passive ROMForcesTension, compression, bending, twisting, and shearingTypes of Acute FracturesGreenstick Fx:Incomplete breakBone that have not ossifiedBones bend

Transverse Fx:Straight line across bonedirect blow from the side

Spiral Fx:S shapedFoot is planted and body gets twisted

Types of Acute Fractures

Comminuted Fx:Broken into 3 or more fragmentsHard blow or fallDifficult to heal

Linear Fx:Bone splints length wiseLanding from tall height or landingForce applied to ends of bone

Oblique Fx:Break is at an angle; similar to spiralOne end stabilized and the other twists

Video ClipsTypes of Fractures - 2 min

How X-rays work - 2 min

Stress FractureChronic or overuse FxBegins as dull ache and progressively gets worse; becomes very point tenderEarly on pain during activityLate stages pain after activityCommon sites: tibia (shin) and metatarsalsFracture HealingRequires immobilizationArms/legs: 6 weeksHands/feet: 3 weeks

Osteoblasts in the periostium form new bone cells as a callus on the fracture site

After immobilization normal stresses will help the bone re-model and heal

DislocationWhen at least 1 bone of a joint is forced completely out of alignment or placeCommon: fingers, elbow, and shoulderOnce dislocated = greater chance of dislocating againShoulders most commonly dislocate in the anterior directionSling and swathe best way to immobilizeSeperated shoulder is an AC joint sprain not a dislocationSubluxationAt least 1 bone comes partially out of its normal alignment or articulation and then goes back into placeCommon: shoulder and patella (kneecap)

Need x-ray to rule out fx for dislocation and subluxationReturn to play determined by soft tissue damageWrite the Question and AnswerWhat is the difference in acute and chronic injuries?Draw a long bone and label the 4 parts.What are the 4 types of bones (classified by shape) and give an example of each?List the 5 functions of bones.What are the types of acute fractures?What is a stress fracture?What is the difference in a dislocation and subluxation?

Comminuted Fx

Greenstick Fx

Oblique Fx

Spiral Fx

Transverse Fx

Ligament SprainsLigaments connect bone to boneGives support to a jointSprain damage to a ligament3 grades of sprainsGrade 1 some pain, no loss of function, mild pt. tenderness, mild swellingGrade 2 partial tearing of fibers and joint instability, pain, moderate loss of functionGrade 3 complete tear, severe instability and swelling, extreme pain, and full loss of function

Ligament DamageLigaments connect bone to boneTry to restore joint stability after a ligament injuryInelastic scar tissue forms, so ligament never regains the original tension it hadMust increase strength around the jointContusionContusion = BruiseFrom a direct blow Tissue is compressed against object and the boneCauses bleeding under the skinMyositis OssificansCalcium deposits form in the muscleTissue often compressed between object and boneFrom repeated blows When a muscle is bruised repeatedlyQuadriceps and bicepsExtremely painful and decreases ROMPad an area to prevent more bruisingMuscle StrainStrain stretch or tear of a muscle or tendonTendon connects muscle to bone3 grades of strainsGrade 1 some fibers stretched or torn. Movement it painful, but have full ROMGrade 2 more fibers torn; AROM extremely painful; feel depression or divot at tear; swelling and discolorationGrade 3 complete tear; possible total loss of AROM; extremely painful but goes away because nerves are severed or cut

Muscle StrainsGrade 3 strain (rupture)Any muscle strain requires lengthy rehabReturning too early will re-injure the muscle

Muscle GuardingInvoluntary muscle contractions that occur in response to a musculoskeletal injuryBodys way to splint the injuryMuscle CrampsPainful involuntary contractionCalf, hamstring, and abdomenOften result of dehydrationLoss of water and electrolytesTreatmentStretch, replace water and electrolytesMuscle SorenessMuscular pain that is caused by overexertion during exerciseAs a person gets older muscle soreness is more common2 Types Acute-onset muscle sorenessHappens with muscle fatigueDuring and just after exerciseDelayed-onset muscle soreness (DOMS)Most intense 24-48 hours after exerciseGoes away 3-4 days laterStretch and iceInflammationUsually thought of as bad, but is an essential part of the healing processOnce an structure is damaged, inflammation must occur to start the healing processSigns and SymptomsPain, swelling, warmth, redness, loss of function-itis means inflammationTendonitisInflammation of a tendonMost common overuse injuryPain, swelling, maybe warmth and crepitus

Crepitus crackling feeling or sound

TreatmentREST or at least change activities to decrease stressTendon sticks to surrounding structures when movingTenosynovitisInflammation of a tendon and the synovial sheath (or covering) it slides throughSheath is present to reduce friction and help movementTendinitis makes the tendon sticky so it becomes difficult to move through the sheathREST, change activities, medications, iceBursitisInflammation of a bursae

Bursae fluid filled sac at joints that help with movement and provide protectionWhen inflammed the bursae produces more fluid which makes the space crowded and produces painREST, change activities, medications, ice

NeuritisInflammation of a nerveS&S of a nerve injuryNumbness, tingling, loss of sensation, burningCommon Nerve injuriesStinger brachial plexus is stretched in shoulderfunny bone ulnar nerve is hit in elbowThe Healing ProcessOccurs after all injuriesCant speed up the healing process, but things can be done to slow it down

Consists of 3 phases:Inflammatory response phaseFibroblastic repair phaseMaturation-remodeling phase

The phases overlap - continuumPhases of Healing Process Overlap

1. Inflammatory Response PhaseBegins as soon as injury occursInflammation must occur or other phases wontMost critical partThe damaged cells are cleaned upDamaged cells release chemicals that will help healing laterLasts approximately 2-4 days following the injury2. Fibroblastic Repair PhaseRegenerative activity leads scar formationScar formation begins a few hours after the injury and lasts for 4-6 weeksSigns and symptoms of inflammation go awayAs scar formation progresses tenderness and pain go away3. Maturation-Remodeling PhaseLong term processThe scar remodels and becomes stronger as it changes shapeCollagen fibers of scar are parallel to forcesTissue has normal appearance, but scar is not as strong as uninjured tissueStrong scar is present in about 3 weeksBegins 2-3 weeks after injury and lasts for several years