Unit #4 Pathology of Injuries. ILLNOIS WESLEYAN UNIV. Mechanisms and Characteristics of Sports Trauma. Chapter 9. General Injury Mechanisms. Primary Injury: results directly from the stress of the sport Extrinsic Intrinsic Secondary Injury: injury caused by a previous injury.
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ILLNOIS WESLEYAN UNIV
a period of time
Acute Bone Fractures
TISSUE RESPONSE TO INJURY
THE INFLAMMATORY RESPONSE AND THE HEALING PROCESS
The amount of swelling present with any injury is highly dependent upon the extent of the tissue damage and the subsequent inflammatory response. Swelling basically comes from two sources: (1) capillary bleeding, and (2) leakage of edema, and is sometimes referred to as EXUDATE.
Permeability changes are going to be very limited in minor injuries where there has been little tissue damage. However, in more severe injuries, there may be a delayed response with delayed swelling which may not appear for many hours.
Histamine causes vasodilation and permeability changes.
Serotonin is a powerful vasoconstrictor.
Bradykinin increases permeability and causes pain.
Prostaglandins both encourage and inhibit inflammation, depending on the need.
Remodeling overlaps the repair and regeneration phase. Generally the first 3-6 weeks are characterized by the production of scar tissue and strengthening of its fibers. Strengthening of the scar tissuecontinues for 3 - 6 months followinginjury, and may take as long as a year to be completely healed (if infact it ever does).
An athlete has sustained a grade 2 lateral ankle sprain 3 weeks ago. It was given proper immediate and follow-up care. What repair has taken place in the ankle during this time? What kind of sports performance would you expect from this athlete?
A basketball player complains of a swollen ankle that never became completely resolved since a sprain was sustained 9 months ago. What is thereason for this chronic swelling? What background information would you need to know (what questions would you ask)?
“…..if all you have is a hammer, then everything looks like a nail “.
Regardless of which method of follow-up therapy you choose, what would your knowledge of the inflammatory process tell you about the purpose of your treatment?
What treatment methods might be contraindicated?
Acute vs. Chronic inflammation?
Deciding when to begin therapeutic exercise, reconditioning, and/or a return to activity, is always a difficult decision. Based upon what you have learned about the inflammatory process and the body’s response to injury:
…”if the osteoclastic activity is greater than the osteoblastic activity, the bone becomes increasingly susceptible to stress fracture.”
…”decrease in activity and elimination of other factors in training that cause stress will allow bone remolding…”