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Unit 18: Sport Injuries. Risk Factors and Preventative Measures

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Chris Softley

on 13 January 2016

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Transcript of Unit 18: Sport Injuries. Risk Factors and Preventative Measures

Unit 18: Sport Injuries
Criteria
P1 - Describe extrinsic and intrinsic factors in relation to sports injuries.

P2 - Describe preventative measures that can be taken in order to prevent sports injuries occurring.

M1 - Explain how risk factors can be minimised by utilisation of preventative measures.
Task 1 (Recap)
What is the difference between intrinsic and extrinsic factors?
Discuss in pairs you have 1 min
Extrinsic Definition
A risk or force from outside the body. These are external forces, such as from objects or other individuals making contact with someone.
Intrinsic Definition
A risk or force from within the body. These are internal forces, which are stresses from within the body
Extrinsic Factors

Coaching
Incorrect technique
Environment factors
Clothing and Footwear
Safety Checks
Below are the 5 extrinsic factors in relation to sports injuries.
1. Coaching
Poor Coaching.

Leadership.

Communication - suggesting incorrect techniques

Ensuring adherence to roles & governing bodies.
2. Incorrect Technique
Lifting or handling equipment

Poor sports techniques
3. Environmental Factors
Effects of the weather on surfaces.

slips and falls
uneven ground
cold conditions
4. Clothing and footwear
Protective equipment & clothing is damaged or ill fitting/there is too much or too little equipment

The wrong footwear for the activity or playing surface is worn

The wrong equipment/clothing is worn
5. Safety Checks
Environment safety checks (remove dangerous objects, consider slippery/dangerous surfaces etc...)

Equipment safety checks (check equipment is in good working order and the correct size for the participants)

Misuse of equipment (tampering with or modifying equipment will make it less useful and often dangerous. Likewise, the participants must use the equipment as intended)

First aid Provision (qualified and experienced first aiders AND full first aid kits should be present at any session)

Safety Checklist (the coach/instructor would be advised to have and complete a safety checklist to ensure all activities, equipment and facilities are safe) - this is usually known as a Risk Assessment



Intrinsic Factors
Training Effects
Individual Variables
Postural Defects
2. Individual variables
Injury history - a history of injuries can leave you with anatomical abnormalities (or weaknesses) which could put you at risk of an injury recurring or new injuries developing as a result of compensation/overuse by another body part



Poor preparation / sleep - Being alert and refreshed is vital for being able to make good decisions and executing skill and technique appropriately. A tired or ill prepared athlete (e.g. over or under aroused) will often make poor decisions e.g. late/dangerous tackles, react slower to obstructions and will often execute skills in a way that can lead to injury.



Level of fitness - having the correct fitness levels to play your sport will reduce the risk of injury. You should also be mindful of having the correct levels of fitness for the level of sport you play.
1. Training Effects
3. Postural defects
Postural Defects - any abnormalities of the spine can become degenerative (wear things down) and inhibit/prevent sporting performance. In particular, an athlete who experiences overuse and/or places excessive strain on the body will find that injuries will worsen if they have a postural defect.
Preventative Measures
1. Role of the coach
2. Equipment and the environment
1. Role of the Coach

Up to date knowledge of the sport/performer, including being aware of their strengths, areas for improvement and capabilities.

Have up to date and relevant qualifications (e.g. level 2 coaching, first aid, scrum factory etc...)

Adapt coach style to a performers ability/age/gender & fitness level

Communication is vital - make it clear, concise and always stress the health and safety considerations

Ensure players adhere to the rules and regulations

Ensure sufficient first aid is in place and a full risk assessment is in place and monitored on an ongoing basis


2. Equipment and Environment

Checking equipment for faults or issues over appropriateness for activity

Protective equipment should always be worn.
Developments in technology have allowed for the creation of a wide range of materials, clothing and equipment to be produced.
In all sports there will be specific equipment that should be worn, and there will be many options available for you to buy - this will help you to buy equipment / clothing that fits you perfectly and allows you to play freely but safely

Risk assessments of the environment and activities should be completed and appropriate control measures considered and enforced

The environment and equipment should be checked appropriately.
The user should not make any modifications to the equipment/environment and should avoid using anything that is damaged / shows a weakness
Anatomical differences and abnormalities (such as muscle imbalance) can put undue stresses on the body and joints, leading to injury

Poor physical preparation - e.g. not taking part in a thorough warm-up can lead to injury

Poor mental preparation can also lead to injury through loss of focus in the game.

Overuse - Injuries can also occur as a result of using the body too much, rest periods are essential for allowing the body to recover.
Scoliosis (a lateral/sideways bending of the spine) can lead to muscle imbalance and a wearing of one side of the body over another
Kyphosis (an excessive arching of the upper part of the spine) can cause technical issues in the excecution of sporting movement leading to soft and hard tissue damage
Lordosis (an excessive inward curve at the lower part of the spine) will place particular stress on the lower appendages, namely the pelvic area and associated joints.
Know about a range of sports injuries and their symptoms
P3 - Describe the physiological responses common to most sports injuries
P4 - Describe psychological responses common to sports injuries
M2 - Explain the physiological and psychological responses common to most sports injuries
D1 - Analyse the physiological and psychological responses common to most sports injuries
What injuries have you had?

How did you deal with it?
Physiological Responses
Blood Clotting
Damaged Tissue
Scar Tissue
Specific Injury Responses
Inflamation
Haematoma
Sprained Ankle
We will look into specific injuries in more depth for the next assessment
Intermuscular: bleeding within the compartment of the muscle - does not go into other parts of the muscle

Intramuscular: Blood gets into other parts of the muscle
Psychological Responses
Response to treatment and rehabilitation
Body responds differently to different injuries
When an injury occurs the primary damage response mechanism takes over
Pain and inflamation are the main signs
Inflamation
Fluid accumulates around the injurede area
Redness due to an increase in blood flow
Tender
Range of motion reduced
Remodelling process - development of scar tissue
Scar tissue forms around the injured tissue
The more severe an injury, the harder it is to restore the damaged tissue
Frustration
Isolation from team mates
Chronic injury: Long-term that have developed slowly - stress fractures

Acute Injury: Occur suddenly through instant trauma - sprained ankle
Anxiety
Frustration
Need for motivation
Use of goal setting
"When it happened and I saw my leg, all kinds of different thoughts were going through my head," he says, as he recalls the incident. That worry, at least, was quickly eased. "When I was on the way to the hospital, the doctor told me straight away that we would get through this, and that I would get back to where I was. That helped me feel sure this was something I could recover from. I believed in it, and the medical staff and specialists believed I was able to handle it mentally. I think I've done that."

Aaron Ramsey
What followed were long, monotonous days of gym sessions. Ramsey remained motivated through the boring routine by constantly setting himself goals. "The first three months were the hardest, in that gym, doing little things, where you don't think they are doing much to you. But you had to do them, and I think they have paid off eventually. I just took it day by day at the time, and set myself a target for the end of each week. Every day, I saw improvements. Overall, the rehabilitation period went pretty well."

Aaron Ramsey
Know how to apply methods of treating sports injuries
P5 - Describe first aid and common treatments used for
four different types of sports injury

Have you ever had a sports injury?
How was it caused?
How was it treated?
Sports Injuries
Key Terms:
Hard tissue injury - injury to bones, joints and cartilage
Soft tissue injury - injury to muscles, tendons, ligaments, internal organs and skin
What are these types of injury?
Fractures
Hard Tissue Damage
Dislocation
Stress Fracture
Shin Splints
Soft Tissue Damage
Haematoma
Intermuscular: bleeding within the compartment of the muscle - does not go into other parts of the muscle

Intramuscular: Blood gets into other parts of the muscle (spreads to other areas)
Abrasion
Sprain and Strains
What is the difference?
Concussion
Tendonitis
Tendon Rupture
Blisters
Cramp
Tennis Elbow
Back Pain
Cartilage injuries
Friction Burns
Emergency First Aid
Primary survey:
Secondary survey:
Cardiopulmonary resuscitation (CPR)
Have a go yourself!!
Shock
Bleeding
Further considerations
Common Treatments
Taping
Bandaging
Tubigrips
Splints
Limb Supports
Cryotherapy
Thermotherapy
Anesthetic Spray
Electrotherapy

Medical referral
GP
Physiotherapist
Specialist
Surgeon
Strength and conditioning coach
Nutrionist

High risk of infection
Must be dealt with immediately
Bone breaks the skin
Closed fracture
Do not break the skin
Bone breaks slightly
Does not cause much soft tissue injury
Incomplete fracture
Greenstick fracture
bone bends and splits
common with children due to the bones not being fully developed
Transverse fracture
Crack that is at right angles
Oblique fracture
break is diagonal across the bone
results in sharp ends
Spiral fracture
Break is spiraling
Twisting motion with a high amount of stress
Comminuted fracture
multiple fragments
needs screws and wires
long rehabilitation
Impacted fracture
both ends of the bones forced together
compress
can be complicated and can cause a long rehabilitation
Avulsion fracture
fragment of bone comes detached
this happens close to the ligament, tendon and muscle
Bones become disrupted and move out of place
Caused by impact with another player or falling
Shoulders, knees, ankles, elbows, fingers and toes
Ligament damage - overstretched
Not caused by traumatic injury
Happens in weight-bearing bones - tibia
High impact repetitive sports (road running, golf, gymnasts, netball)
Can be either superficial (towards the surface) or deep (further inside the muscle)
Damage to the skin
Friction burns
Minor injuries
Contact with playing surface
Sprain
Damage to ligaments
Sudden twist
Outside the normal ROM
More than one ligament can be damaged
Can either be stretched or torn
Sprains can be categorised into 3 categories:
First-degree: No tear. Stretching of the ligament
Second-degree: Partial tear of a ligament
Third-degree: Complete tear or detachment from the bone
Strain
Damage to the muscle or tendon
Overstretched or even complete rupture
Common in sports which require dynamic lunging (football/rugby)
Severity is determined by 3 grades
Grade 1: minor damage to the muscle fibres (less than 5%)
Grade 2: Muscle is not completely ruptured
Grade 3: Complete rupture of the muscle - requires surgery
Signs and symptoms:
Partial/complete loss of consciousness or functioning
Dizziness
Shallow breathing
Nausea and vomiting
'Seeing stars'
Loss of memory
Headache
Tendonitis?
Inflamation of a tendon
Symptoms:
Tenderness
Pain
Swelling
Skin may be warm
Reduced movement
Avoiding Tendonitis?
Avoid repetitive movements
Exercise strengthens the muscles around tendons (Netball player working on strengthening their gastrocnemius as they are on their toes a lot)
Warming up as this provides greater blood supply to the tendons
Its the bodies way of to repair the skin
Fluid develops under layers of skin
In response to a burn or friction
Preasure builds up under the skin
Very tender
Popping = increased likelihood of infection
Involuntary contraction
Bigger muscles are more susceptible
Lack of oxygen - deep breathing will help
Lack of water or salt - stretching or taking on more fluids will help
Massage helps reduce cramp
Tennis elbow
Happens due to hitting thousands of shots
Micro tears appear in the tendon
If you do not rest then the micro tears will become bigger
Repetitve movements
Equipment too large e.g handle too big
Racket is strung too tightly
Can affect many people
Can cause major disruptions to sports performance
Treatment = anti-inflammatory drugs
Physio
Massage
Sometimes the cause of the pain is in another part of the body
Cartilage helps cushion the impact of bone to bone
It helps absorb pressure and reduce friction
Damage is ofter due to wear and tear or overuse
Can be a sudden injury (bad tackle) or an injury caused over time (osteoathritis)
Symptoms - swelling/joint pain/stiffness/decreased ROM
Physiotherapy/pain killers/supportive equipment/lifestyle changes can help reduce pain
Treatment
apply an ice pack to the injury to reduce swelling (every 2-4 hours for 20 mins)
take paracetamol to reduce pain - do not use painkillers such as ibuprofen (can cause more damage)
Plenty of rest
Avoid drinking alcohol
See a GP
Do not play any sport for at least 3 weeks
Stay with someone for the first 48 hours
Only return to work/school when you are completely symptom free
Dr ABC

Danger - check the area for potential danger to yourself / remove potential hazards that could make the situation worse

Reponse - check for any response from the injured person. If not call for help immediately. Do not leave the injured person

Airway - be aware of potential neck injuries. Gently tip the head back and check if there are any objects within the mouth blocking the airway

Breathing - check to see if the person is breathing (up to 10 seconds). If not, send someone for an ambulance

Circulation - check for signs of circulation - if not CPR



Carried out if an unconscious person is breathing
Helps check all areas of the body for more damage
Should be carried out quickly and systematically
Bleeding - check the area and patient head-to-toe for blood
Head and neck - check for bruising and /or deformity. Gently feel the back of the neck
Shoudlers and chest - compare and feel for fractures
Abdomen and pelvis - feel for any abnormalities and see if the person feels any pain
Legs and arms - check legs, then arms, for fractures and any other clues
Pockets - check but be careful for sharp objects such as needles. If possible have a witness when this happens.
Recovery - put the person in the recovery position but if its a suspected neck injury then try to have other people supporting
Caused by a drop in blood pressure/volume
Can be secondary to many sporting injuries
Three classifications:
Cardiogenic - heart not pumping effectively
Hypovolemic - loss in bodily fluids resulting in low blood volume
Anaphylactic - severe allergic reaction
Signs and Symptoms
Increased pulse
Pale and clammy skin (sweating)
Fast, shallow breathing
Nausea or vomiting
Dizziness
Feeling weak
Can become unconscious
Treating shock
Contact emergency services
Cause must be addressed (e.g. fracture)
Lay the person down and raise their legs (flow of bloody to the vital organs)
Keep the person warm
Loosen any tight clothing
Your aim is to:
Stop the bleeding
Prevent shock
Reduce infection risk
Treatment:
Wear disposable gloves
Apply direct pressure using a bandage
If an object is in the cut then apply pressure to the side
Cover with a sterile dressing which is applied firmly
Get a professional opinion
Be aware of the potential of head injuries and concealed injuries for an unconscious person
With fracture you must minimise the movement
When risk of infection make sure you have covered the injury appropriately
Always summon qualified assistance or emergency services
Always complete an accident report form for legal reasons
Starter:
Read the Fabrice Muamba story - highlight key points about his life threatening injury
Plan and construct treatment and rehabilitation programmes for two sports injuries
P6 - Design a safe and appropriate treatment and rehabilitation programme for two common sports injuries, with tutor support.
M3 - Independently design a safe and appropriate treatment
and rehabilitation programme for two common sports injuries.
D2 - Evaluate the treatment and rehabilitation programme
designed, justifying the choices and suggesting alternatives where appropriate.

What is rehabilitation?
restoring an athlete to a normal state
it has 5 stages
should not be rushed
immediate first-aid and initial diagnosis is crucial
can be long, time consuming, painful and frustrating
What does rehabilitation mean to you?
Discuss
Task:
With a partner list the injuries you both have had
Pick two that are slightly different
Try to write down and compare the rehabilitation process for both injuries
Do they differ?
Do they follow a similar process?
Stages of Rehabilitation
1 - Acute stage
2 - Re-establishing functional activity
3 - Strengthening exercises
4 - On-going treatments
5 - Gradual increase in activity
Aims of injury rehabilitation
Ensure immediate first-aid is provided
Reduce pain and swelling
Minimise pain
Re-establish neuromuscular control of the injured area
Restore ROM of the affected joints
Restore lost muscular strength, power and endurance
Develop core stability, posture and balance
Maintain cardiovascular fitness to the level of sport you are playing at
http://emoryhealthcare.org/acl-program/index.html
Methods of improving lost ROM
Dynamic stretching - controlled movements
Static stretching - holding
Passive stretching - using another person
Active stretching - using the assistance of other muscle groups
Proprioceptive neuromuscular facilitation (PNF) - stretching with muscular contraction
All of these will help increase the ROM of an injured area as it will help increase the flexibility
Strengthening and conditioning exercises
Psychological considerations
Recording documentation and tracking of treatment
http://www.physioroom.com/news/english_premier_league/epl_injury_table.php
ROM will be dramatically reduced at both the injured area and possibly other areas of the body
Inflammation of the injured area and general damage will cause a loss in movement
Other areas will lose ROM because exercise is reduced
Stretching should be included within a rehabilitation programme!!
Aim is to develop:
muscular strength
muscular endurance
power
Muscular atrophy will occur through a lack of exercise (muscles decrease in size)
Examples can include:
WHY? HOW WILL THIS HELP?
WHAT HAVE YOU DONE BEFORE?
Healing Process
Inflammatory Response Phase
Repair Phase
Remodelling Phase
Start the healing
Inflamation occurs through a healing process
Getting rid of injury bi-products
Few hours after injury
Can last up to 6 weeks
Aim is to rebuild damaged tissue
Scar tissue will begin to form
What will this mean to the ROM?
Scar tissue try's to replicate the tissue that was there prior to the injury
Obviously this will not form exactly the same tissue as before
ROM will be reduced but as you are able to perform more exercises this will be increased
Type of injury and time away from training will cause a variety of psychological issues (as previously discussed)
Sometimes this can be both physicaly (pain threshold) and mentally
Motivation and anxiety are common issues that must be considered
Goal-setting is crucial within the rehabilitation process
SMART targets
Goal setting means that the athlete will be able to focus and will help them see progression
This is all about making sure that the athlete gets back fit and remains focussed.
accurate recording of the entire process is crucial
all factors of the rehabilitation should be accurately recorded
Try to include:
Prior assessment - background information about the client
Activities undertaken
Levels and development of the client
Problems or issues that arise
Complication such as illness or allergies
Important legal documents and forms (consent forms)
Dates for review/functional testing (aims, objectives etc)
Up to date information that may change during the duration of the treatment
Specific objectives including appropriate and measurable timescales and review dates
http://www.sportsinjuryclinic.net/rehabilitation-exercises
Good websites to use:
http://www.pponline.co.uk/encyc/0181.htm#
http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acl-injury/rehabilitation-acl-injury
http://www.physioroom.com/news/english_premier_league/epl_injury_table.php
Have a look at some current injuries in the premier league and their own rehabilitation plan!!
Full transcript