CH 8 Sport Injuries

Out of Harms Way: Sport Injuries
Chapter 8
Sport Books Publisher
Outline:
Biomechanical principles of injury Injury treatment and rehabilitation Pain: natures warning system Soft tissues injuries Dislocations Fractures Concussions Overuse injuries Injury prevention
Sport Books Publisher 2
Biomechanical Principles of Injury
Tissue Types
Epithelial
Muscle
Connective
Nervous
Each type of tissue possesses unique mechanical characteristics

Loading
To best understand the biomechanical characteristics of tissue we examine its behaviour under physical load
Under load a tissue experiences deformation
Deformation can be visualized through deformation curve

High
Elastic Limit
Ultimate Failure
B
Load
Plastic Region
Elastic Region
Low A Small
Deformation
Large
6
High
Elastic Limit
Ultimate Failure
Elasticity: capacity of a tissue to return to its original shape after removal of load
Load
Plastic Region
Elastic Region
Low A Small
Deformation
Large
7
High
Elastic Limit
Ultimate Failure
B
Load
Plastic Region
Plastic region begins

Elastic Region
Tissue no longer posesses elastic properties
Low A Small
Deformation
Large
8
High
Permanent tissue deformation (does not return Ultimate Failure to original shape)
Elastic Limit Resulting in micro-failure
B
Load
or injury (e.g. sprains)
Plastic Region
Elastic Region
Low A Small
Deformation
Large
9
High
Elastic Limit
Ultimate Failure
B
Load
Macro- or completes failure (e.g. torn ligament)
Tissue becomes completely unresponsive to loads
Elastic Region
Plastic Region
Low A Small
Deformation
Large
10
Area = strength of the material

High
Elastic Limit Ultimate Failure
C B
Load
Plastic Region
Elastic Region
Low A Small
Deformation
Large
11
High
Slope = stiffness (or resistance to deformation) of the material

Elastic Limit
Ultimate Failure
B
Load
Plastic Region
Elastic Region
Low A Small
Deformation
Large
12
Tissues Response to Training Loads

1.
Training load =/ elastic limit

Micro-failure making of new tissue Positive training effect
2.
Training load > elastic limit

Permanent failure Injury
Forces Acting on Tissue
TENSION
COMPRESSION
BENDING
SHEAR
TORSION
14
Injury treatment and rehabilitation
15
Treatment
Received by patient from a health care professional Promotes healing Improves quality of injured tissue Allows quicker return to activity
Rehabilitation
Therapists restoration of injured tissue +patient's participation Individualized for each athlete
16
Healing Phases
17
Inflammatory Response Phase
2 4 days
hrs 6 wks

3 wks - yrs
18
Inflammation begins at the time of injury Signs

Redness Swelling Pain Increased temperature Loss of function
Protect Rest Cryotherapy

Decreases swelling, bleeding, pain and spasms
Compression
Decreases swelling
Elevation
Decreases swelling
19
Fibroplastic Repair Phase

Repair and scar formation Granulation tissue fills the gap Collagen fibres are deposited by fibroblasts Signs seen in the phase1 subside
Rehab-specific exercises
Restore range of motion and strength
Manual massage therapy and ultrasound

Help break down scar
Protective taping and bracing

20
Maturation-Remodeling Phase
Remodeling or realigning of the scar tissue More aggressive stretching and strengthening
To organize the scar tissue along the lines of tensile stress
Include sport-specific skills and activities

Pain: natures warning system
22
Pain
Natures way of telling us something is wrong
One of the best indicator of when it is best to resume play
23
Problem with Ignoring Pain

Pain
Masking with medications
Continued participation
Pushing injured tissue closer to yield-level point
Addiction
Gastrointestinal complications
24
Soft tissues injuries
25
Contusions
26
Bruise Compressing force crushes tissue E.g. charleyhorse quadriceps Discoloration and swelling Myositis ossification abnormal bone formation in a severe contusion Life-threatening if the tissue involved is a vital organ P-R-I-C-E
Strains and Sprains
28
STRAIN Tendon or muscle tissue is stretched or torn
SPRAIN Ligament or the joint capsule is stretched pr torn
29
Grades of sprains and strains
GRADE 1
Slightly stretched or torn; few muscle fibres
GRADE 2
Moderately stretched or torn, more muscle fibres
GRADE3
Complete rupture Surgery required E.g. ACL tear
Common Strains
Quadriceps
Adductors
Hip flexors
Hamstrings
Rotator cuffs
31
Hamstring Strains
Most frequently strained muscles Mechanism:

Rapid contraction in a lengthened position E.g. sprinting and running
Due to strength imbalance

Hamstring strength >>> quadriceps strength
Emphasize hamstrings and quadriceps equally

Ankle Sprains

During running, walking, dancing or stepping off a curb Most common = lateral ankle sprain
Inversion
Common reoccurrence
Decreased proprioception
Symptoms
Rapid swelling Point tenderness
Rehabilitation
Decreases reoccurrence Incorporation of balance exercises
Dislocations
34
Great enough forces push the joint beyond its normal anatomical limits
Joint surfaces come apart

Subluxation
When supporting structures (e.g. ligaments) are stretched or torn enough Bony surfaces partially separate
Most common = fingers Can become chronic

Dislocation of the Shoulder
36
Most mobile most unstable joint Categories of dislocation:

Partial (subluxation) Complete
Most common
Head of humerus slips anteriorly Falling backwards on extended arm
Symptoms
Swelling, numbness, pain, weakness, bruising Capsule and/or rotator cuff tears Brachial plexus injury
Require medical treatment to relocate head of humerus back to glenoid fossa Sport Books Publisher
37
Fractures
38
Simple fracture
Stays within the surrounding soft tissue
Compound fracture
Protrudes from the skin
Stress fracture
Results from repeated low magnitude loads
Avulsion fracture
Involves tendon or ligament pulling small chip of bone
Concussions
40
Injury to the brain Mechanism:

Violent shaking or jarring action of the head Brain bounces against the inside of the skull
Symptoms
Confusion Temporary loss of normal brain function
REST No such thing as minor concussion and shaking off

Overuse injuries
42
Due to
Repeated and accumulated microtrauma Non-sufficient recovery
Results from
Poor technique Poor equipment Too much training Type of training
43
Tendonitis
44
Inflammation of tendon as a result of a small tear

in the tendon
Age (loss in elasticity) Excessive , repetitive motion Improper technique
Tendonitis
Symptoms
Pain (aggravated by movement) Tenderness Stiffness near joint
Tennis Elbow

Lateral epicondylitis Affect forearm extensors

Attach to lateral epicondyle Extend wrist and fingers
Contributing factors
Excessive forearm pronation and wrist flexion Gripping racquet too tightly Improper size3 grip Excessive string tension Excessive racquet weight Topspins Hitting ball off-centre
Gofers and Little League Elbow
Medial epicondylitis Affects tendons of forearm flexors

Attach to medial epicondyle Flex wrist and fingers
May result in collateral ligament and ulnar nerve injury May affect medial humeral growth plate in young children (little league elbow)
Jumpers Knee
Patellar tendonitis Affects infrapatellar ligament Caused by:
Repetitive eccentric knee actions Eccentric load during jump preparation >>> body weight
Bursitis
49
Inflammation of the bursae

Tiny fluid-filled sacs Lubricate and cushion pressure points between bone and tendons
Results from overuse and stress

Age is also a factor
Most common
Shoulder, elbow and hip
Inflammation and pain aggravated by movement and direct pressure

Shoulder Impingement
51
Excess movement of the humeral head + lack of space
Inflammation of bursae or rotator cuff tendon

Result of muscle imbalances in shoulder muscles
Weak shoulder depressors Strong shoulder elevators
Balanced strength training

Stress Fractures
53
Stress fracture Results from repeated low-magnitude forces

1. 2. 3.
Small disruption of the outer bone layer Weakened bone Cortical bone fracture NOT a shin splint
Shin splints Pain along inside tibial surface Involve pain and inflammation NO disruption of cortical bone
54
Injury prevention
55
Protective Equipment
56
Warm Up and Cool Down
57
Keeping Fit and Flexible
Use it or lose it
Especially important during the offseason
Preparing the muscle for placing demands

Eating and Resting
In order to function effectively body must receive

Proper nutrient Adequate rest
Avoid over-training and lack of sleeping


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CH 8 Sport Injuries

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Out of Harms Way: Sport Injuries

Sport Books Publisher

Biomechanical Principles of Injury

Sport Books Publisher

Each type of tissue possesses unique mechanical characteristics

Deformation can be visualized through deformation curve

Plastic region begins

Tissue no longer posesses elastic properties

or injury (e.g. sprains)

Area = strength of the material

Slope = stiffness (or resistance to deformation) of the material

Tissues Response to Training Loads

Training load =/ elastic limit

Training load > elastic limit

Forces Acting on Tissue

Sport Books Publisher

Injury treatment and rehabilitation

Sport Books Publisher

Sport Books Publisher

Sport Books Publisher

Inflammatory Response Phase

Inflammatory Response Phase

Inflammatory Response Phase

Inflammatory Response Phase

Inflammation begins at the time of injury Signs

Protect Rest Cryotherapy

Sport Books Publisher

Fibroplastic Repair Phase

Manual massage therapy and ultrasound

Protective taping and bracing

Sport Books Publisher

Include sport-specific skills and activities

Pain: natures warning system

Sport Books Publisher

Sport Books Publisher

Problem with Ignoring Pain

Masking with medications

Pushing injured tissue closer to yield-level point

Soft tissues injuries

Sport Books Publisher

Sport Books Publisher

Strains and Sprains

Sport Books Publisher

STRAIN Tendon or muscle tissue is stretched or torn

SPRAIN Ligament or the joint capsule is stretched pr torn

Sport Books Publisher

Grades of sprains and strains

Sport Books Publisher

Most frequently strained muscles Mechanism:

Due to strength imbalance

Emphasize hamstrings and quadriceps equally

Sport Books Publisher

Joint surfaces come apart

Most common = fingers Can become chronic

Dislocation of the Shoulder

Sport Books Publisher

Most mobile most unstable joint Categories of dislocation:

Sport Books Publisher

Sport Books Publisher

Injury to the brain Mechanism:

REST No such thing as minor concussion and shaking off

Sport Books Publisher

Sport Books Publisher