Sports Medicine

HSC Option

How are sports injuries classified and managed?

• Ways to classify– based on the injury’s history, cause and typeinjury’s history, 1. A new injury occurring for the first time to a

particular body part is known as a primary injury (for example, breaking a particular finger for the first time).

2. If an injury is from a previous injury, due to poor treatment or an injury that has not fully healed, this is known as a secondary injury (for example, having a shin splint injury return after a few weeks due to poor treatment).

• Injuries can be classified according to the cause of the injury.

• An injury can be caused by an internal or external force and therefore classified as direct or indirect.– A direct injury is the result of an external

force impacting on a person.– An indirect injury is a result of internal

forces within the body, and can be the result of poor technique, lack of fitness or poor equipment.

DIRECT INJURIES

Some injuries are caused by direct forces generated from outside the body.

Direct injuries result in;

• Fractures

• Dislocations

• Sprains

• Bruises

Examples of direct injuries include;

• A shoulder dislocation caused by a tackle in football

• A broken bone caused by a collision between two hockey players

INDIRECT INJURIES

These injuries are caused by an intrinsic force (a force within the body).

Indirect injuries normally occur as a result of;• Inadequate warm-up• Ballistic movements• Excessive movement• A fault in the execution of a skill

They are the result of excessive strain being placed on muscles, tendons and

ligaments, causing irritation and possible damage.

Examples of indirect injuries include;• A sprinter tearing a hamstring muscle during a race• A volleyball player causing stress to ligaments in the knee joint

OVERUSE INJURIES

These result from intense or unreasonable use of joints or body areas.

Overuse injuries are provoked by repetitive, low-impact exercise such as

jogging or stepping.

Typical overuse injuries include;

• Anterior shin splints

• Tendonitis

• Injuries can also be classified based on the type of injury

• Soft tissue injuries– A soft tissue injury is related to body tissue

and generally results in internal bleeding. – Body tissue consists of:

• muscles, which are made up of cells and allow the body to move

• tendons, which are fibrous tissue that connects muscle to bones

• ligaments, which are fibrous tissue that connects bones to bones.

Soft Tissue InjuriesSoft Tissue Injuries

Tears and Contusions

A tear occurs when tissue is excessively stretched or severed. Two types of

tear are; Sprains – arise from the stretching or tearing of a ligament Strains – occur when a muscle or tendon is stretched or torn

Sprains

Ligaments are strong, rigid and relatively inelastic tissue. Their role is to

connect bone to bone, therefore providing joint stability. Sprains occur when

these ligaments are stretched or torn resulting in pain, swelling and the inability

to perform normal joint movements. Proper rehabilitation is recommended as

healing in the stretched position will cause permanent instability in the joint.

Healing is a slow process because ligaments have a relatively poor blood

supply.

Sprains can be classified according to the severity of ligament damage; First degree – little damage Second degree – moderate damage Third degree – extensive damage

Strains

Strains are different to tears in that they happen only to muscles and tendons. They cause considerable pain and bleeding may cause discolouration around the injury. Any movement in the form of stretching and any pressure on or around the injury will result in sharp pain.

There are three levels of strain; First degree – relatively little damage Second degree – moderate damage Third degree – extensive damage

Contusions

Impact with a player or object sometimes causes a contusion;• Vary in intensity• Some are superficial, remaining close to the skin• Others penetrate deeply, causing bone to bruise• Interrupt blood flow to surrounding tissue (causes a haematoma –

blood tumour – to form as the blood clots in the connective tissue membrane)

• Internal bleeding into the area may continue for a period of time

Skin Abrasions, Lacerations, Blisters and Calluses• All forms of skin trauma• Cause by the application of force e.g. scraping or friction• Cause concern and considerable discomfort

• Overuse– An overuse injury occurs as a direct result

of a repeated force on body parts, including bones, tendons and muscle.

– Common overuse injuries include shin splints, stress fractures, tendonitis and tennis elbow.

• Soft Tissue Injuries– Tears, sprains, contusions, skin abrasions,

lacerations, blisters

• When the body’s soft tissues are injured, they respond with a physiological reaction - the inflammatory response.

• the body’s immediate natural response following a soft tissue injury.

• The main functions of the inflammatory response are to protect the injured tissue from further damage, remove dead cells that have been injured, and enable the tissue to regrow through the production of new blood cells and tissue.

• The injury and repair process for soft tissue damage – Step 1 Initial tissue damage. – Step 2 Bleeding of the capillaries. Capillaries are

damaged, resulting in bleeding at the injured site.– Step 3 Clot formation. When bleeding stops, blood clots

and forms a bruise.– Step 4 Swelling of tissue. Tissue swells as a result of

fluid build-up at the injury site.– Step 5 Secondary tissue damage. Further damage to

tissue can be caused as a result of movement to the injury.

– Step 6 Removal of blood clot and tissue swelling. The healing process in the body starts to break down the blood clot and, as a result, the swelling of tissue reduces.

– Step 7 Healing of tissue. If tissues does not heal, a build-up of scar tissue can restrict movement.

– Step 8 Regaining function. Normal functioning at the site of the injury is restored after the injury has healed.

• Management of soft tissue injuries– Effective management of a soft tissue

injury is vital in the first 48–72 hours.– Soft tissue injuries are best treated

combining two methods of injury management: RICER and No HARM.

– These methods aim to:• reduce blood flow to the injured site• minimise the build up of scar tissue• reduce swelling• prevent further damage.

• Hard tissue injuries

• A hard tissue injury is one that relates to the bones or teeth. – Bones are the core component of the

skeletal system. – If they are injured, this will impact on the

support and protection of the body.

• Hard tissue injuries

complete, where the bone is broken intotwo parts

incomplete, where the break is only part-way through the bone

comminuted, where there are more than two breaks in the bone.

• Fractures can also be classified as:• closed, where the broken bones does not pierce through the

skin

• open, where the broken bone protrudes thought the skin

• complicated, where the broken bone damages a major nerve, organ or blood vessel.

Closed fracture Open fracture Complicated fracture

• Causes and symptoms– Fractures can be caused be either direct or

indirect force. – Signs and symptoms of fractures include:

• swelling • pain• deformity • limited movement.

• Management of a fracture– Immobilising a fracture is important to lessen the

pain, reduce bleeding and shock, and prevent further damage

• Managing a fracture involves

1 Follow DRABCD procedures.

2 Control any bleeding.

3 Identify the type of fracture.

4 Immobilise the fracture with broad bandages.

5 Ensure bandages do not cut off circulation.

6 Handle gently.

7 Call for medical help.

• Dislocation– When bones are displaced from a joint, – A dislocation can also result in damage to the

surrounding ligaments and muscles.

• Causes and symptoms– Excessive force can move bones out of their joint

sockets. – Shoulder and finger joints are more susceptible to

dislocations, as the surrounding ligaments are less supportive.

• Signs and symptoms :– pain – swelling– limited movement – bruising.– deformity

• Management of a dislocation

• Managing :

1 Follow the DRABCD procedure.

2 Do not attempt to put the joint back in place. (This must be done by a sports specialist, as there is a risk of nerve damage if the bone is not put back correctly.)

3 Seek medical help.

• Assessment of injuries– Minor and severe injuries can occur in a

wide range of sporting situations.– When faced with an injured person, it is

important that DRABCD procedures,– which may involve resuscitation, are

followed before the injury is assessed.

• If the injury is not life-threatening, a sports medicine practitioner can go through DRABCD as they enter the sporting area.

• The next step is to apply the STOP procedure:– Stop - Get the injured athlete to stop what

they are doing and, if necessary, stop the game to avoid any further damage

– Talk - Ask the injured athlete ‘What happened?’, ‘Where does it hurt?’ and ‘Did you hear anything?’

– Observe - Observe the injured area to see if there is any abnormality.

– Prevent - Prevent any further damage by conducting a more comprehensive assessment using TOTAPS

TOTAPS

TALK

OBSERVE

TOUCH

ACTIVE MOVEMENT

PASSIVE MOVEMENT

SKILLS TEST

Worst sporting Injuries Ever