CH 8 Sport Injuries

8/2/2019 CH 8 Sport Injuries

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Sport Books Publisher 1

Out of Harms Way:

Sport Injuries

Chapter 8


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Outline:

Biomechanical principles of injury

Injury treatment and rehabilitation

Pain: natures warning system Soft tissues injuries

Dislocations

Fractures

Concussions

Overuse injuries

Injury prevention


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Biomechanical Principles ofInjury


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Tissue Types

Each type of tissue possesses uniquemechanical characteristics

Epithelial Muscle Connective Nervous


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Loading

To best understand the biomechanicalcharacteristics of tissue we examine its

behaviour under physical load

Under load a tissue experiences deformation

Deformation can be visualized throughdeformation curve


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit

Deformation LargeSmall

Loa

d

High

Low


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Loa

d

High

Low

Elasticity:

capacity of a tissue

to return to its original shapeafter removal of load


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Loa

d

High

Low

Plastic region begins

Tissue no longer posesses

elastic properties


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Loa

d

High

Low

Permanent tissue deformation

(does not return

to original shape)

Resulting in micro-failure

or injury (e.g. sprains)


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Loa

d

High

Low

Macro- or completes failure(e.g. torn ligament)

Tissue becomes completely

unresponsive to loads


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Loa

d

High

Low

Area = strength of the material


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A

C

B

Elastic Region

Plastic Region

Ultimate Failure

Elastic Limit


Load

High

Low

Slope = stiffness (or resistance to

deformation) of the material


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Tissues Response to Training

Loads

1. Training load =/ elastic limit

Micro-failure making of new tissue Positive training effect

2. Training load > elastic limit Permanent failure

Injury


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Forces Acting on Tissue

TENSION TORSIONBENDINGCOMPRESSION SHEAR


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Injury treatment andrehabilitation


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Treatment

Received by patient from a health

care professional Promotes healing

Improves quality of injured tissue

Allows quicker return to activity

Rehabilitation

Therapists restoration of injured

tissue +patient's participation

Individualized for each athlete


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Healing Phases


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Inflammatory

ResponsePhase

2 4 days

Inflammatory

ResponsePhase

hrs 6 wks

InflammatoryResponse

Phase

3 wks - yrs


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Inflammatory Response Phase

Inflammation begins atthe time of injury

Signs

Redness

Swelling

Pain

Increased temperature

Loss of function

Protect

Rest

Cryotherapy Decreases swelling,

bleeding, pain and

spasms Compression

Decreases swelling

Elevation Decreases swelling


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Fibroplastic Repair Phase

Repair and scarformation

Granulation tissue fillsthe gap

Collagen fibres aredeposited by fibroblasts

Signs seen in thephase1 subside

Rehab-specificexercises

Restore range of motionand strength

Manual massagetherapy and ultrasound

Help break down scar Protective taping and

bracing


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Maturation-Remodeling Phase

Remodeling or realigning of the scar tissue

More aggressive stretching and strengthening

To organize the scar tissue along the lines oftensile stress

Include sport-specific skills and activities


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Pain: natures warning system


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Pain

Natures way of telling us something is

wrong

One of the best indicator of when it is bestto resume play


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Problem with Ignoring Pain

Pain

Masking with

medications

Continued

participation

Pushing injured

tissue closer to

yield-level point

Gastrointestinal

complicationsAddiction


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Soft tissues injuries


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Contusions


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Bruise

Compressing force crushes

tissue E.g. charleyhorse quadriceps

Discoloration and swelling

Myositis ossificationabnormal bone formation in asevere contusion

Life-threatening if the tissueinvolved is a vital organ

P-R-I-C-E


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Strains and Sprains


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STRAIN

Tendon or muscletissue is stretched

or torn

SPRAIN

Ligament or the joint

capsule is stretched pr

torn


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Grades of sprains and strains

GRADE 1 Slightly stretched or torn; few muscle fibres

GRADE 2 Moderately stretched or torn, more muscle fibres

GRADE3 Complete rupture

Surgery required

E.g. ACL tear


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Common Strains

Quadriceps Adductors Hip flexors Hamstrings Rotator cuffs


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Hamstring Strains

Most frequently strained muscles

Mechanism:

Rapid contraction in a lengthened position E.g. sprinting and running

Due to strength imbalance Hamstring strength >>> quadriceps strength

Emphasize hamstrings and quadricepsequally


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Ankle Sprains

During running, walking, dancing or stepping off acurb

Most common = lateral ankle sprain Inversion

Common reoccurrence Decreased proprioception

Symptoms Rapid swelling

Point tenderness Rehabilitation

Decreases reoccurrence

Incorporation of balance exercises


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Dislocations


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Great enough forces push the joint beyond itsnormal anatomical limits

Joint surfaces come apart

Subluxation When supporting structures (e.g. ligaments) are

stretched or torn enough

Bony surfaces partially separate

Most common = fingers

Can become chronic


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Dislocation of the Shoulder


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Most mobile most unstable joint

Categories of dislocation: Partial (subluxation)

Complete

Most common Head of humerus slips anteriorly

Falling backwards on extended arm

Symptoms Swelling, numbness, pain, weakness,

bruising

Capsule and/or rotator cuff tears

Brachial plexus injury

Require medical treatment to relocatehead of humerus back to glenoidfossa


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Fractures


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Simple fracture

Stays within the surrounding

soft tissue Compound fracture

Protrudes from the skin

Stress fracture Results from repeated low

magnitude loads

Avulsion fracture Involves tendon or ligament

pulling small chip of bone


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Concussions


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Injury to the brain

Mechanism: Violent shaking or jarring action of

the head

Brain bounces against the inside ofthe skull

Symptoms Confusion

Temporary loss of normal brainfunction

REST

No such thing as minorconcussion and shaking off


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Overuse injuries


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Due to

Repeated and accumulated microtrauma

Non-sufficient recovery

Results from

Poor technique

Poor equipment

Too much training

Type of training


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Tendonitis


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Symptoms Pain (aggravated by movement) Tenderness

Stiffness near joint

Inflammation of tendon as a result of a small tearin the tendon

Tendonitis

Excessive ,

repetitive

motion

Improper

technique

Age(loss in

elasticity)


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Tennis Elbow

Lateral epicondylitis

Affect forearm extensors Attach to lateral epicondyle

Extend wrist and fingers

Contributing factors Excessive forearm pronation and wrist

flexion

Gripping racquet too tightly

Improper size3 grip Excessive string tension

Excessive racquet weight

Topspins

Hitting ball off-centre

G f d


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Gofers and

Little League Elbow

Medial epicondylitis

Affects tendons of forearm flexors Attach to medial epicondyle

Flex wrist and fingers

May result in collateral ligament andulnar nerve injury

May affect medial humeral growthplate in young children (little leagueelbow)


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Jumpers Knee

Patellar tendonitis

Affects infrapatellar ligament

Caused by:

Repetitive eccentric kneeactions

Eccentric load during jumppreparation >>> body weight


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Bursitis


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Inflammation of the bursae

Tiny fluid-filled sacs

Lubricate and cushionpressure points between boneand tendons

Results from overuse and

stress Age is also a factor

Most common

Shoulder, elbow and hip

Inflammation and painaggravated by movementand direct pressure


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Shoulder Impingement


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Excess movement of thehumeral head + lack of space

Inflammation of bursae orrotator cuff tendon

Result of muscle imbalancesin shoulder muscles Weak shoulder depressors

Strong shoulder elevators

Balanced strength training


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Stress Fractures


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Stress fracture

Results from repeated

low-magnitude forces

1. Small disruption of theouter bone layer

2. Weakened bone3. Cortical bone fracture

NOT a shin splint

Shin splints

Pain along inside tibial

surface

Involve pain andinflammation

NO disruption of cortical

bone


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Injury prevention


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Protective Equipment


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Warm Up and Cool Down


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Keeping Fit and Flexible

Use it or lose it

Especially important during the off-season

Preparing the muscle for placingdemands


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S t B k P bli h 59

Eating and Resting

In order to function effectively bodymust receive

Proper nutrient Adequate rest

Avoid over-training and lack of sleeping

Documents

CH 8 Sport Injuries