The Concept of Sports Injury

1. The Concept of Sports Injury • Sports Medicine • Mike Carroll

2. Defining Sports Injury • To qualify as an injury under (ISS), that injury must meet the following criteria • occurs as a result of participation in an organized practice or game • requires medical attention by a team athletic trainer or physician • results in restriction of the student athlete’s participation or performance for one or more days beyond the day of the injury

3. Acute vs. Chronic • Acute injuries- characterized by rapid onset, resulting from a traumatic event • Acute injuries are followed immediately by a pattern of signs and symptoms, such as pain, swelling, and loss of function • Caused by critical force, such as: football

4. Acute vs. Chronic • Chronic injuries-characterized by a slow, insidious onset, implying a gradual development of structural damage • Not associated with a single traumatic event, rather, they develop progressively over time • Often occur in athletes who are involved in activities that require repeated, continuous movements, such as running • sometimes referred to as overuse injuries • common sites for injuries: Achilles tendon, patellar tendon, rotator cuff

5. Tissues Involved • Soft Tissue- includes muscles, fascia, tendons, joint capsules, ligaments, blood vessels and nerves • Injuries involve contusions (bruises), sprains (ligaments/capsules), and strains (muscles/tendons) • Skeletal Tissue- any bony structure in the body • Example: Ankle Sprain? Fractured Wrist?

6. Catastrophic Injuries • involve damage to the brain and/or spinal cord and are potentially life threatening or permanent • HS and College: includes skull or spinal fracture • Direct Catastrophic- result directly from participation in the skills of a given sport (sustaining a neck fracture during a tackle in football) • Indirect Catastrophic- caused by systematic failure resulting from exertion while participating in a sports activity ( suffering a heat stroke during a cross-country run)

7. Sprains • Sprains- injury to a joint and the surrounding structures, primarily ligaments and/or joint capsules • Severity of sprains is highly variable depending on the forces involved

8. Sprains • SNAI- Describes three categories of sprains, based on the level of severity • First-Degree • Second-Degree • Third-Degree

9. First-Degree Sprains • the mildest form of sprain • only mild pain and disability • demonstrate little or no swelling • associated with minor ligament damage

10. Second-Degree Sprain • more severe; imply more actual damage to the ligaments involved • increase amount of pain and dysfunction • swelling is more pronounced and abnormal motion is present • such injuries tend to reoccur

11. Third-Degree Sprain • most severe form • imply a complete tear of the ligament(s) • extensive damage, pain, swelling • hemorrhage will be significant • considerable loss of joint stability

12. Strains • Strains- injuries to muscles, tendons, or the junction between the two, commonly known as the musculotendinous joint (MTJ) • Most common location of a strain is the MTJ

13. Strains • SNAI presents three categories of strains • First-Degree Strains • Second-Degree Strains • Third-Degree Strains

14. First-Degree Strain • mildest form with little associated damage to muscle and tendon structures • pain is most noticeable during use • there may be mild swelling and muscle spasm present

15. Second-Degree Strain • imply more extensive damage to the soft-tissue structures • pain, swelling, and muscle spasm are more pronounced and functional loss in moderate • these types of injuries are associated with excessive, forced stretching or a failure in the synergistic action in the muscle group

16. Third-Degree Strain • most severe form and imply a complete rupture of the soft-tissue structures • may occur at a variety of locations, including the bony attachment of the tendon (avulsion fracture), the tissues between the tendon and muscle (MTJ) or in muscle itself • a defect may be apparent through the skin with significant swelling

17. Contusions • What is a contusion? • bruise or injury to soft tissue that does not break the skin

18. Contusions • Contusions result from a direct blow to the body surface, which cause a compression of the underlying tissue(s) as well as the skin

19. Contusions • are typically characterized as being associated with pain, stiffness, swelling, ecchymosis (discoloration), and hematoma (pooling of blood)

20. Contusions • if not treated properly, such injuries to muscle tissue can result in a condition known as myositis ossificans, which involves the development of bonelike formations in the muscle tissue

21. Fractures • Fractures and dislocations represent two categories of injuries involving either bones or joints of the body • Defined by the National Safety Council as “a break or crack in a bone”

22. Fractures • NSC recognizes two categories of fractures • Closed • Open or Compound

23. Fractures • Closed: bone ends not breaking through the skin • Open/Compound: bone ends breaking through the skin

24. Fractures • Open/Compound fractures are potentially more serious because of the risk of infection related to the open wound • Control of bleeding may be necessary depending on the severity and location of the wound

25. Fractures • NSC provides the following descriptions of signs and symptoms: • Swelling, Deformity, Pain and Tenderness, Loss of use, Grating Sensation, History of the Injury

26. FracturesSigns & Symptoms • Swelling- caused by bleeding; it occurs rapidly after a fracture • Deformity- This is not always obvious. Compare the injured with the uninjured opposite body part when checking for deformity • Pain and Tenderness- Commonly found only at the injury site. The athlete will usually be able to point to the site of pain. A useful procedure for detecting fractures is to feel gently along the bones • Loss of Use- Inability to use the injured part. Guarded motion occurs because movement produces pain, and the athlete will refuse to use the injured limb • Grating Sensation- Do not move the injured limb in an attempt to see if a grating sensation called crepitation can be felt (sometimes heard) when broken bone ends rub together • History of Injury- Suspect a fracture whenever severe forces are involved, especially in high-risk sports such as tackle football

27. Traumatic Fractures • Five Types: Green Stick, Tranverse, Oblique, Comminuted, Impacted • Copy illustration of each type in your notes • http://www.tinyurl.com/5s8yuep

28. Stress Fracture • Stress Fracture- small crack or break in a bone related to excessive, repeated overloads; also known as overuse fracture or march fracture • Signs and Symptoms often confused with less serious sports-related injuries • Often present physician with a difficult diagnosis, because during the initial phases, X-ray examinations may not show the fracture

29. Salter-Harris Fracture • Salter-Harris Fracture- category of fractures unique to the adolescent athlete that involves the epiphyseal growth plate • Five types of SH fractures based on there location of the fracture line(s) across the epiphyseal region of the bone • Epiphysis- Cartilaginous growth region of the bone (end of bone, knob)

30. Dislocations • defined as “the displacement of contiguous surfaces of bones comprising a joint” • Two types: subluxation and luxation • can occur in any articulation • Shoulders and fingers are most common sites of dislocations

31. Dislocations • Subluxation- takes place when the bones of a joint are only partially displaced • Luxation- when the bone of a joint are totally displaced

32. Dislocations • Remember that sprains involve damage to the tissues surrounding joints- capsules and ligaments • dislocations presents many of the same signs and symptoms • first aid treatment involves combine care given for sprains and fractures