Injuries & the Healing Process

1. Injuries & the Healing Process Chapter 3

2. Objectives Understand: • Inflammation process in healing • Treatment rationale of ice vs. heat Identify: • Principles of physical rehabilitation and range of motion • More common musculoskeletal disorders • Athlete’s vital signs • Distinguish between acute and chronic injury management

3. The Inflammation Process • Injury (strain, sprain, contusion, open wound): the body immediately begins the process of healing. • Healing: the process where the body repairs damage tissue. • Inflammation: one component of the healing process, where the body begins to repair itself.

4. The Inflammation Process • Acute Injury: muscle strain or ligament sprain, tissue is torn, capillaries are damaged, and cells die, interference in blood and oxygen supply. • Bodies Reaction: sending specialized cells to the injured site attempting to limit damage and begin healing (blood clotting, contracting muscles, which splints the area to restrict further movement, and reduce blood flow.) • Bodies Reaction: pain, swelling, redness, heat, and loss of function. Hey guys

5. Acute Injury & Healing Process • Pain: pressure on nerve endings from internal hemorrhage and cellular response to lack of oxygen. • Swelling: (edema) accumulation of fluids in the damage area. • Hemorrhage, lymph fluid, and synovial fluid contributes to swelling and pressure. • Gravity also increases swelling. • Redness: increased blood supply (the body provides the site with nutrients for repair).

6. Healing Process Three Phases of the Healing Process: • Inflammation- redness and swelling (2-4 days) • Initial repair- (tissue repair) scare tissue is the first tissue the body generates. (2-4 weeks) • Regeneration-replace all damaged tissue with new and healthy tissue. (1 year)

7. Vital Signs Vital Signs: measures that monitor life (heart rate, breathing, pulse) Pulse: Adult 60-80 beats/minute; child 80-100 beats/minute • Rapid, but weak pulse-shock, bleeding, diabetic coma, and/or heat exhaustion. • Rapid, but strong pulse-heat stroke and/or severe fright. • Strong, but slow pulse-skull fracture and/or stroke. • No pulse -cardiac arrest and/or death. • Take pulse neck (carotid artery) and wrist (radial artery)

8. Vital Signs Respiration-adult 12-20 breaths/minute, child 20-25 breaths/minute • Shallow breathing-shock • Irregular/gasping-cardiac related • Frothy blood from the mouth-chest fracture (rib fracture) in upper lateral portion of chest (arm pit). Watch, feel, and count (rise and fall of chest)

9. Vital Signs Temperature-oral 98.6 degrees • Hot, dry skin-disease, infection, and/or over-exposure to environmental heat. • Cool, clammy skin-trauma, shock, and/or heat exhaustion. • Cool and/or dry skin-over-exposure to cold.

10. Vital signs Skin Color • Red Skin-heat stroke, diabetic coma, and/or high blood pressure. • White(pale)-insufficient circulation, shock, fright, hemorrhage, heat exhaustion, and/or insulin shock. • Blue-blood is poorly oxygenated. • Non-white athlete-examine inner lip, gum, fingernail beds. (they still exhibit a paling of skin)

11. Vital Signs Pupils: • Constricted (sunlight)-during traumatic situation: central nervous system and/or intake of depressant drug. • Dilated (dark room) or unequal-during traumatic situation: head injury, shock, heat stroke, hemorrhage, and/or intake of stimulant drug. • Pupils fail-brain injury, intake of alcohol, or drug poisoning. PEARL-Pupils Equal And Reactive to Light (examination of the eyes)

12. Vital Signs State of Consciousness: Level of Consciousness (LOC) • Mental awareness • Memory and ability to recall • Response to commands, directions, events, etc. AVPU-alert, verbal, responds to pain, and unresponsive.

13. Vital Signs Movement (Four Patterns): • Active (athlete provides movement) • Passive (trainer moves body part) • Assistive (trainer assists the athlete with movement) • Resistive (trainer provides resistance to oppose the movement of the body part)

14. Vital Signs Abnormal Nerve Stimulation: • Motor (movement)-athlete contracts affected muscle • Sensory (feeling)-athlete touch (i.e. sharp vs. soft) Blood Pressure Adult: 120(systolic)/80(diastolic) • Heart contracts(blood out), systolic pressure can be determined, as heart relaxes(blood in), diastolic pressure is determined.

15. Treatment ICE vs. HEAT • Ice-first 48-72 hours-Reevaluate and if swelling, pain, redness still present continue with ice. Reduces: swelling, blood flow, pain • Ice packs-15 minutes-no directly to skin • Ice message-5-10 minutes-move ice continuously • Whirlpool-15 minutes-perform rehab movements-downfall, not elevated. • Cold spray-no longer then 10 seconds-damage to skin, only cools surface.

16. Treatment Heat- increased blood flow, reduced muscle stiffness, muscular relaxation. • Hot packs-towels to protect skin. • Hot whirlpool-follow-up treatment, rehab movements. Contrast bath-follow-up treatment (hot/cold water immersion) heat pack and ice packs

17. Treatment EXERCISE- movement of the body (muscles) • increases circulation at a deeper level. • Strength • Regain lost range of motion Therapeutic Modalities:decrease pain, swelling, muscle spasm (utilized with exercise) • Electrical -currents • Heat-short wave and microwave • Light-ultraviolet • Cold • Air • Water • Message • Laser

18. Injury Management Acute vs. chronic: • Acute-quick onset, short duration (PRICES) • Chronic-Long duration, repeating. Continued PRICES, but is coupled with exercise, therapeutic modalities, heat, and contrast treatments.

19. Physical Rehabilitation GOAL- return injured athlete to pre-injury level of strength, power, endurance, flexibility, and confidence as quickly and safely as possible. • Arranged by Athletic Trainer upon physicians protocol. • Pain-should be avoided • Athlete follows the program.

20. Physical Rehabilitation Five Phases designing a Program: • Post-surgical/acute injury • Early exercise • Intermediate exercise • Advanced exercise • Initial sports re-entry Various rates of recovery should be expected.

21. Physical Rehabilitation Athlete needs to return: • Joint range of motion (ROM)-normal movement of a joint • Muscle Flexibility • Muscular Strength • Muscular Power • Endurance • Balance • Proprioception • Kinesthetic awareness • Cardiovascular Fitness (total body conditioning)

22. General Musculoskeletal Disorders • Arthritis: inflammation of a joint • Atrophy: decreasing in size of organ or tissue due to degeneration of cells • Bursitis: inflammation of bursa sac • Contracture: fibrosis of muscle tissue producing shortening of the muscle (doesn’t generate strength) • Contusion: a bruise, skin is not broken, direct blow • Dislocation: displacement of one or more bones or a joint or organ from original position • Epicondylitis: (pitchers elbow, tennis elbow) inflammation of the epicondyle and the tissues adjoining them to the humerus

23. Disorders Continued • Fasciitis: inflammation of a fascia • Myositis: inflammation of muscle tissue • Myositis Ossificans: inflammation of muscle, with formation of bone • Sprain: • stretching or tearing of joint structure (ligaments and joint capsules) • Strains stretching or tearing of muscle and tendons • Subluxation: partial or incomplete dislocation • Tendinitis: Inflammation of the tendon