Learning Objectives

2. Learning Objectives • Discuss the role of overtraining in increasing the risk of exercise-related injury • List the signs and symptoms of overtraining • Discuss possible causes of muscle strains and ways in which they can be avoided • Define tendonitis and discuss how it should be treated

3. Learning Objectives, continued • Discuss ligament sprains and how to avoid them • Describe the most common injuries to the lower extremities • Outline a general plan for reducing the incidence of exercise-related injuries • Discuss the general guidelines for the treatment of injuries • Define cryokinetics, and discuss its use in the rehabilitation process

4. Risks and Causes of Injury from Increased Physical Activity Main Causes of Exercise Injury Improper Training Techniques • Overtraining syndrome: a major cause of injury (10%/2-weeks) • Too much exercise with not enough recovery time • Excessive distance or duration • Drastic changes in exercise routine/bad form Inadequate Shoes • Runners especially benefit from proper footwear • Use shoes specifically designed for your activities Alignment Abnormalities in Legs and Feet

5. Intrinsic and Extrinsic Risk Factors in Exercise Intrinsic Factors (see p. 345) • Age • Body size and composition • Physical fitness level • Bone density and structure • Gender (hormones) • Muscle flexibility and strength Extrinsic Factors • Environmental conditions (terrain, surface, weather) • Equipment (footwear, clothing) • Type of activity (competitive vs. leisure) • Intensity and amount of activity • Warm-Up

6. Common Conditions and Injuries Back Pain • Cause: Muscle weakness in abdomen & lower back • Prevention: Increase flexibility & strength, reduce body fat, & improve muscle imbalances Acute Muscle Soreness • Cause: Excessive duration or intensity of exercise-alteration in the chemical balance within muscle, fluid accumulation in muscle, injury to muscle tissue • Prevention: Begin and end exercise sessions gradually, not suddenly Delayed-Onset Muscle Soreness (1-2 days after) • Cause: Excessive duration or intensity of exercise, microscopic tears in the muscle • Prevention: Refrain from strenuous or prolonged exercise

7. Common Conditions and Injuries, continued Muscle Strains (pulled muscle) • Cause: Overstretched muscle or muscles forced to shorten against a heavy load, damage to muscle fibers 3 degrees of strain: 1. A few muscle fibers are stretched or torn, painful but ROM is possible 2. Many muscle fibers are torn, extremely painful, visible soft, sunken area in muscle 3. Muscle is torn completely, movement impossible, surgery is necessary • Prevention: Limit stress on muscles, and always warm-up

8. Common Conditions and Injuries, continued Tendonitis • Cause: Swelling (inflammation) in the tendon • Prevention: Avoid joint overuse Ligament Sprains • Cause: Excessive force applied to a joint • Prevention: Use a brace and refrain from high-stress activities Torn Cartilage • Cause: High force or unusual movements • Prevention: Limit activities producing excess stress on the joint or movements taking the joint outside its normal range of motion

9. Muscle Strain Figure 12.1

10. Common Injuries to Lower Extremities Patellofemoral Pain Syndrome (PFPS) • Cause: Patella gets “off track” causing wear and pain, misalignments of the thigh muscles, overuse, obesity • Prevention: Avoid stress on the knee, strengthen quadriceps, and use proper footwear Shin Splints (pain in the front lower leg) • Cause: Muscle/tendon irritation, or inflammation of the connective tissue in the lower leg, microscopic breaks in tibia and fibula, common runner’s injury • Prevention: Run on soft surfaces, wear well-padded, shock-absorbing shoes, and advance exercise slowly

11. Common Injuries to Lower Extremities Stress Fractures Tiny cracks or breaks in the bone (long bones of the foot) • Cause: Excessive force applied to the leg or foot, individuals with high arches are in risk • Prevention: Avoid overtraining by increasing exercise load gradually and maintain flexibility in the legs and hips • The impact of the foot on the running surface = 2.5 times the body weight. Runner 150 lbs – generated force when the foot strikes the pavement = 375 lbs!

12. Patellofemoral Pain Syndrome Figure 12.3

13. Shin Splints Figure 12.4

14. Stress Fractures Figure 12.5

15. Managing Injuries Techniques for treating less-severe injuries Initial Treatment of Exercise-Related Injuries • Objectives: decrease pain, limit swelling, prevent further injury • R.I.C.E: Rest, Ice, Compression, Elevation Rehabilitation (increasing use as pain lessens) • Minor injury rehabilitation occurs naturally • Drawbacks: Progress is slow, damaged area may get re-injured, lack of more aggressive treatment may prevent return of full functioning Cryokinetics: new rehabilitation technique • Regiment of alternating ice with light exercise

16. The Cryokinetic Process Figure 12.6

17. Preventing your injury • Identify and eliminate ways in which your exercise may cause you an injury. • Complete test 12.1 on p. 363

18. Preventing Unintentional Injuries Unintentional injuries are the #1 killer of people ages 15-34 in the U.S. Risk Factors for Unintentional Injury • Having an unsafe attitude • Being overly confident • Craving excitement / thrill-seeking • Using alcohol or drugs • Stress • Environmental factors (storing unsafe or combustible chemicals, using equipment wrong)

19. Leading Causes of Death Among Young Adults Table 12.1

20. Treating Unintentional Injuries Best method: Take a first-aid or CPR course Choking • Abdominal thrusts under the diaphragm (Heimlich maneuver) Poisoning • Check the label for key information and contact the Poison Control Center and/or 911 • Poison in the eye – lukewarm water, flood the eye for 15 min. • Poison on the skin – water for 10 min • Inhaled poison – open doors, windows, CPR… • Swallowed poison – clean the victim’s mouth, rinse, drink water, CPR

21. Treating Unintentional Injuries Bleeding • Lie the person down, remove dirt or debris from the wound, apply pressure until the bleeding stops(at least for 20 min), don’t remove any bandages, get to an emergency room ASAP (wear gloves) Stopped Breathing or Heartbeat • Call 911 immediately and if trained, perform cardiopulmonary resuscitation (CPR) • 30 compressions/ 2 breaths • AED

22. The Heimlich Maneuver Figure 12.7

23. Summary • The main factors associated exercise-related injuries are improper training techniques, inadequate shoes, and alignment problems in the legs and feet • Exercises to increase flexibility and strength, reduce body fat, and improve muscle balance between the stomach and back can decrease your risk of developing back problems • Tendonitis, or inflammation of a tendon, is one of the most common of all overuse problems associated with physical activity • Common injuries to the lower extremities include Patellofemoral Pain Syndrome (PFPS), shin splints, and stress fractures

24. Summary, continued • When treating injuries, remember the R.I.C.E. (rest, ice, compression, elevation) protocol and cryokinetics treatment • Risk factors for accidents and injuries include unsafe attitudes, stress, drug use, and an unsafe environment • Basic first aid involves knowing the Heimlich maneuver and how to treat bleeding and poisonings • Do not perform CPR unless you have been certified through the American Red Cross or other credible program