1 / 35

Warm-up

Warm-up. What are some things that happen to the body when it is injured? Is swelling a good thing? Is scar tissue a good thing? Do you have any scars? Is pain physiological or psychological?. TISSUE RESPONSE TO INJURY. SPORTS MEDICINE PRINCIPLES OF ATHLETIC TRAINING.

jade-nunez
Download Presentation

Warm-up

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Warm-up • What are some things that happen to the body when it is injured? • Is swelling a good thing? • Is scar tissue a good thing? • Do you have any scars? • Is pain physiological or psychological?

  2. TISSUE RESPONSE TO INJURY SPORTS MEDICINE PRINCIPLES OF ATHLETIC TRAINING

  3. THE INFLAMMATORY RESPONSE • ACUTE OR CHRONIC • ACUTE HAS A SHORT ONSET • CHRONIC HAS A LONG ONSET AND LONG DURATION

  4. ACUTE INFLAMMATION • THREE PHASES • ACUTE, REPAIR, AND REMODELING • PHASE 1: ACUTE • INITIAL BODY RESPONSE • 3 TO 4 DAYS • REACTION DESIGNED TO: a. Protect b. Localize c. Rid the body of some injurious agent in preparation for healing and repair

  5. ACUTE INFLAMMATION • MAIN CAUSES OF INFLAMMATION ARE : • TRAUMA • CHEMICAL AGENTS • THERMAL EXTREMES • PATHOGENIC ORGANISMS • CELLULAR DEATH OCCURS FROM THE TRAUMA • DEATH OF TISSUE MAY BE CAUSED BY LACK OF OXYGEN

  6. ACUTE INFLAMMATION • R.I.C.E PRINCIPLE SHOULD BE USED TO DETER TISSUE DEATH R.est- stay of injured area I.ce- apply ice immediately for 15-20 minutes C. ompression- depending on the area injured a compression wrap should be applied (never on the lower leg) E.levation- elevate the injured area above the heart

  7. ACUTE INFLAMMATIONVASCULAR RESPONSE • VASOCONSTRICTION: IN THE FIRST HOUR BEFORE INFLAMMATION OCCURS • DECREASE IN THE DIAMETER OF THE BLOOD VESSEL • COAGULATION BEGINS TO SEAL BROKEN VESSELS AND IS FOLLOWED BY ACTIVATION OF CHEMICAL INFLUENCES • VASODILATION: INCREASE THE DIAMETER OF THE BLOOD VESSEL • LEADS TO SWELLING (EDEMA) • EXUDATES OF PLASMA AND CONCENTRATION OF RED BLOOD CELLS • THE CELL WALL BECOMES MERE PERMEABLE

  8. ACUTE INFLAMMATIONBLEEDING AND EXUDATES • THE EXTENT OF FLUID IN THE INJURED AREA IS HIGHLY DEPENDENT ON THE EXTENT OF DAMAGED VESSELS AND THE PERMEABILITY OF THE INTACT VESSEL

  9. WARM-UP • AN INJURY THAT JUST HAPPENED IS CONSIDERED AN __________ INJURY? • WHAT IS EDEMA? • WHAT IS ECCYMOSIS? • WHAT DOES R.I.C.E. STAND FOR? • THE INITIAL BODIES RESPONSE TO INJURY IS DESIGNED TO DO WHAT? • WHAT IS VASODIALATION? • IT HAS BEEN DETERMINED THAT THE IMMEDIATE APPLICATION OF ICE REDUCES THE HEALING TIME BY?

  10. PHASE II: REPAIR PHASE(HEALING) • FOLLOWS INFLAMMATORY PHASE • 48-72 HOURS TO APPROXIMATELY 6 WEEKS • THIS PHASE OCCURS WHEN THE AREA HAS BECOME CLEAN THROUGH THE REMOVAL OF CELLULAR DEBRIS, ERYTHROCYTES AND THE CLOT • THIS PHASE DEPENDS ON HOW WELL WE TREAT THE PATIENT DURING THE ACUTE PHASE!

  11. TYPES OF HEALING • TISSUE REPAIR IS ACCOMPLISHED THROUGH THREE PROCESSES • RESOLUTION: THERE IS LITTLE TISSUE DAMAGE AND NORMAL RESTORATION • GRANULAR TISSUE: OCCURS IF RESOLUTION IS DELAYED • REGENERATION: REPLACEMENT OF TISSUE BY THE SAME TISSUE

  12. HEALING cont. • GRANULATION TISSUE IS SCAR TISSUE • THE PROXIMITY OF THE INJURY DETERMINES THE AMOUNT OF SCAR TISSUE • GRANULATION HEALING HAS 2 TYPES: • PRIMARY HEALING: LOW SCAR TISSUE • SECONDARY HEALING: GAP IN INJURY

  13. PHASE III: REMODELING(REHABILITATION) • OVERLAPS THAT OF REPAIR • FIRST 3 TO 6 WEEKS ARE CHARACTERIZED BY INCREASE PRODUCTION OF SCAR TISSUE AND INCREASED STRENGTH OF THEIR FIBERS • STRENGTH OF SCAR TISSUE CONTINUES TO INCREASE FROM THREE MONTHS TO YEARS • THE SCAR TISSUE IS ONLY AS STRONG AS THE DEMANDS THAT YOU PLACE ON IT

  14. CHRONIC INFLAMMATION • SWELLING THAT LAST FOR MONTHS TO YEARS • RESULT OF REPEATED MICRO TRAUMA AND OVERUSE

  15. SOFT TISSUE HEALING • ALL TISSUES OF THE BODY EXCEPT FOR BONE • THE BODY AS 4 TYPES OF SOFT TISSUE: • EPITHELIAL TISSUE: SKIN • CONNECTIVE TISSUE: TENDONS, LIGAMENTS, CARTILAGE, FAT, BLOOD VESSELS • MUSCLES • NERVOUS TISSUE: BRAIN, SPINAL CORD, & NERVES

  16. CARTILAGE HEALING • ARTICULAR CARTILAGE HAS LIMITED CAPACITY TO HEAL • CARTILAGE HAS LITTLE TO NO DIRECT BLOOD SUPPLY • THE CLOSER THE CARTILAGE IS TO A BLOOD SUPPLY THE MORE LIKELY IT WILL HEAL (BUT IT WILL TAKE TIME)

  17. LIGAMENT & MUSCLE HEALING • UNDERGOES THE THREE PHASES OF ACUTE, REPAIR AND REMODELING • FULL LIGAMENT HEALING WITH SCAR MATURATION MAY TAKE AS LONG AS TWELVE MONTHS • MUSCLE MUST HAVE REHABILITATION STRENGTHENING EXERCISES IN A PROGRESSIVE MANNER TO HEAL COMPLETELY

  18. NERVE HEALING • NERVE CELLS DO NOT REGENERATE • REGENERATION CAN TAKE PLACE WITHIN A NERVE FIBER • THE CLOSER THE INJURY IS TO THE NERVE CELL THE MORE DIFFICULT REGENERATION BECOMES

  19. MODIFYING SOFT-TISSUE HEALING • HEALING PROCESS IS UNIQUE IN EACH ATHLETE. • DIFFERENT TISSUE VARY IN THEIR ABILITY TO HEAL (CARTILAGE) • AGE AND NUTRITION MAY ALSO AFFECT HEALING • MANAGEMENT CONCEPTS: • ANTI-INFLAMMATORY DRUGS- DECREASE VASODILATION • THERAPEUTIC MODALITIES: COLD, HEAT, ULTRASOUND, ELECTRIC STIM • THERAPEUTIC EXERCISE: STRENGTH AND RANGE OF MOTION ARE THE KEY a. IMMOBILIZATION IS NOT ALWAYS GOOD FOR INJURIES

  20. FX HEALING TAKES TIME, COACHES, TRAINER, & ATHLETES MUST BE PATIENT FX HEALING FOLLOWS THE SAME THREE PHASES OF HEALING BUT IS MORE COMPLEX ACUTE PHASE: TRAUMA HEMORRHAGE BONE DEATH REPAIR PHASE: GRANULATION WOVEN BONE CALLUS FORMATION REMODELING PHASE: RESORPTION OF CALLUS TRABECULAR BONE BONE FRACTURE HEALING

  21. IN GENERAL ACUTE FX HEALING HAS 5 STAGES HEMATOMA FORMATION CELLULAR PROLIFERATION CALLUS FORMATION OSSIFICATION REMODELING HEMATOMA FORMATION: ACUTE INFLAMMATION USUALLY LAST ABOUT 4 DAYS HEMATOMA FORMS AROUND THE ENDS OF THE BONE AND A CLOT FORMS ACUTE FX HEALING

  22. FX HEALING • CELLULAR FORMATION • HEMATOMA BEGINS ORGANIZATION OF GRANULAR TISSUE AND GRADUALLY BUILDS A FIBROUS JUNCTION BETWEEN THE FRACTURED ENDS • THESE CELLS INITIALLY PRODUCE A FIBROUS CALLUS, THEN CARTILAGE, AND FINALLY WOVEN BONE

  23. FX HEALING • CALLUS FORMATION • SOFT CALLUS: FORMED WITHIN 1-2 WEEKS • UNORGANIZED NETWORK OF WOVEN BONE AT THE ENDS OF THE FRACTURE • LATER ABSORBED AND REPLACED BY BONE • SOFT CALLUS STAGE THE INTERNAL AND EXTERNAL CALLUS ARE PRODUCED • THESE CALLUS START TO IMMOBILIZE THE FX

  24. FX HEALING • HARD CALLUS • IN 3-4 WEEKS THE HARD CALLUS STARTS TO FORM INTERNALLY FIRST FOLLOWED BY THE EXTERNAL CALLUS • THE HARD CALLUS CONTINUES TO GROW UP TO 3-4 MONTHS • THE HARD CALLUS IS A GRADUAL CONNECTION OF BONE FILAMENT TO THE WOVEN BONE AT THE FRACTURE ENDS

  25. FX HEALING • OSSIFICATION: • OCCURS WHEN THE BONE HAS BEEN PROPERLY IMMOBILIZED AND THE BONE ENDS BECOME CROSSED WITH THE LAYING DOWN OF PRIMARY BONE • THE CALLUSES ARE ABSORBED BY THE OSTEOCYTES (BONE CELLS) • THE FRACTURE HAS BEEN BRIDGED AND FIRMLY UNITED

  26. FX HEALING • REMODELING • OCCURS AFTER THE CALLUS HAS BEEN ABSORBED AND THE NEW BONE HAS BEEN LAID DOWN • THIS CAN LAST UP TO YEARS • THE REMODELING PHASE IS CONSIDERED COMPLETE WHEN THE FX HAS BEEN RESTORED TO ITS FORMER SHAPE OR HAS DEVELOPED A SHAPED THAT CAN WITHSTAND IMPOSED STRESSES

  27. MANAGEMENT OF ACUTE FX • BONES MUST BE IMMOBILIZED UNTIL X-RAYS REVEAL THE HARD CALLUS HAS FORMED • SOME DOCTORS ALLOW THE ATHLETE TO RETURN TO ACTIVITY AT THIS STAGE AS LONG AS THE FX IS NON-WEIGHT BEARING AND IMMOBILIZED • ITEMS THAT MAY AFFECT THE HEALING PROCESS • POOR BLOOD SUPPLY • POOR IMMOBILIZATION • INFECTION

  28. PAIN

  29. PAIN • MAJOR INDICATOR OF INJURY! • PAIN RECEPTORS (NOCICEPTION) • TYPE C FIBERS (SLOW) • TYPE A FIBERS (FAST) • TYPE C RATE OF .5 TO 2 METERS PER SECOND • TYPE A RATE OF 5 TO 30 METERS PER SECOND

  30. PAIN • TYPE C ARE THE SLOW TRAINS TO THE BRAIN AND CARRY THE DULL ACHING TYPE PAIN • TYPE A ARE THE FAST TRAINS TO THE BRAIN AND CARRY THE SHARP STABBING TYPE PAIN • BOTH THESE TRAINS TELL THE BODY TO RELEASE ITS OWN PAIN KILLERS

  31. PAIN CATEGORIES • ACUTE VERSUS CHRONIC: • ACUTE PAIN IS PAIN THAT IS LESS THAN SIX MONTHS IN DURATION • ACUTE PAIN IS WHEN TISSUE DAMAGE OCCURS AND SERVES AS A WARNING! • CHRONIC PAIN HAS A DURATION LONGER THAN SIX MONTHS

  32. PAIN CATEGORIES • REFERRED PAIN: OCCURS AWAY FROM THE INJURY SITE • 3 TYPES OF REFERRED PAIN • MYOFASCIAL PAIN: TRIGGER POINTS • SLCEROTOMIC & 3. DERMATOMIC: BONE, MUSCLE, FASCIA, OR SKIN AREAS SUPPLIED BY A SINGLE NERVE ROOT • THESE TYPES OF PAIN CAN CAUSE DEPRESSION, ANXIETY, FEAR & ANGER

  33. VARIATIONS IN PAIN SENSITIVITY • PAIN MODULATION: PAIN IS A MIXTURE OF BOTH PHYSIOLOGICAL AND PSYCHOLOGICAL • MANAGEMENT CAN BE A MAJOR CHALLENGE • PAIN ASSESSMENT: VERY DIFFICULT • USE A SCALE OF 1 TO 10 • USE WORDS LIKE: NONE, SLIGHT, MILD, MODERATE, SEVERE

  34. TX OF PAIN • KEY IS TO STOP PAIN-SPASM-PAIN CYCLE! • HEAT AND COLD • ANALGESIA • PAIN GATE THEORY (HEAT, ICE, TENS, ACUPUNCTURE, COUNTERIRRITANT, ELECTRIC STIM) INJURED ATHLETE

  35. PSYCHOLOGICAL ASPECT OF PAIN • TOUGHEST PART OF MY JOB • PLAY WITH PAIN AND NOT INJURY??? • CRY WOLF SYNDROME • EASIER TO DETERMINE WITH THE “TOUGH” ATHLETES?

More Related