Recognizing Different Sports Injuries Color of the Day!

© 2007 McGraw-Hill Higher Education. All rights reserved. Either acute or chronic in nature Acute Result of trauma Chronic Caused by repetitive, overuse activities Injury Types

Acute Traumatic Injuries

© 2007 McGraw-Hill Higher Education. All rights reserved. Fractures Broken bone Result of extreme stress and strain on bone Anatomical Characteristics Dense connective tissue matrix Outer compact tissue Inner porous cancellous bone

© 2007 McGraw-Hill Higher Education. All rights reserved. Fractures—Types Disruption Partial/complete Closed/open Through the skin Serious musculoskeletal condition Presents with: Deformity Point tenderness Swelling Pain on active and passive motion

© 2007 McGraw-Hill Higher Education. All rights reserved. How Do Fractures Occur?? Bones can be stressed or loaded to fail by: Tension Compression Bending Twisting Shearing Multiple factors can contribute Some bones will require more force than others >load = > Fracture Chances While force goes into fracturing the bone, energy and force is also absorbed by adjacent soft tissues

© 2007 McGraw-Hill Higher Education. All rights reserved. Fracture—Healing Generally require immobilization for some period Splint Hard cast Approx: 3-6 weeks

© 2007 McGraw-Hill Higher Education. All rights reserved. Definitions Joint Where 2 or more bones make contact. Allow movement Provide mechanical support Classified structurally and functionally. Ball and Socket Joint 2 movements occur here Shoulder joint, hip joint Hinge Joint 1 movement occurs here Knee joint

© 2007 McGraw-Hill Higher Education. All rights reserved. Definitions Ligament Connects bone to bone Tendon Connects muscle to bone

© 2007 McGraw-Hill Higher Education. All rights reserved. Dislocations and Subluxations Dislocation= FORCED OUT STAYS OUT At least one bone in a joint is forced completely out of normal and proper alignment High level of incidence in fingers, elbow and shoulder Subluxation= FORCED OUT GOES BACK IN Partial dislocations causing incomplete separation of two bones Often occur in shoulder and females patella

© 2007 McGraw-Hill Higher Education. All rights reserved. Dislocations and Subluxations

© 2007 McGraw-Hill Higher Education. All rights reserved. Dislocations and Subluxations S&S of dislocations Gross Deformity Almost always present Other factors Loss of limb function Swelling Point tenderness Additional concerns Avulsion fractures Growth plate separation “Once a dislocation, always a dislocator”

© 2007 McGraw-Hill Higher Education. All rights reserved. Dislocations and Subluxations

© 2007 McGraw-Hill Higher Education. All rights reserved. Dislocations and Subluxations Treatment First Time Rule out Fracture X-ray is the only absolute diagnostic technique Return to play determined by extent of soft tissue damage Full range of motion (ROM) compared bilaterally Full strength compared bilaterally

© 2007 McGraw-Hill Higher Education. All rights reserved. Sprain Damage to a Ligament Result of traumatic joint twist that causes stretching or tearing of connective tissue Graded based on the severity of injury Ligament will NOT regain original tension >Muscle strength = > joint stability

© 2007 McGraw-Hill Higher Education. All rights reserved. Strain Damage to Tendon or Muscle Causes Stretch Excess load

© 2007 McGraw-Hill Higher Education. All rights reserved. Strain Rehabilitation Lengthy process regardless of severity Will generally require 6-8 weeks Recovery Compression Elevation Movement

#3 Goal of the Day

© 2007 McGraw-Hill Higher Education. All rights reserved. Muscle Guarding Involuntary muscle contraction in response to pain following injury Not spasm which would indicate increased tone due to upper motor neuron lesion in the brain Following injury, muscles within an effected area contract to splint the area in an effort to minimize pain through limitation of motion

© 2007 McGraw-Hill Higher Education. All rights reserved. Muscle Cramps Painful involuntary contraction Causes: dehydration/electrolyte imbalance May lead to muscle or tendon injuries

© 2007 McGraw-Hill Higher Education. All rights reserved. Contusion Sudden blow to body Can be both deep and superficial Hematoma results from blood and lymph flow into surrounding tissue Minor bleeding results in discoloration of skin May be painful to the touch and with active movement

© 2007 McGraw-Hill Higher Education. All rights reserved. Contusion Cautious and aware of more severe injuries associated with repeated blows Calcium deposits may form with fibers of soft tissue Myositis ossificans

© 2007 McGraw-Hill Higher Education. All rights reserved. Nerve Injuries Two main causes of injury Compression Depression injury Tension Stretch Injury May be acute or chronic

© 2007 McGraw-Hill Higher Education. All rights reserved. Nerve Injuries Injuries can range from Minor  Severe  Life altering Healing process is very slow and long term Causes pain and can result in a host of sensory responses Pinch Burn Tingle Muscle weakness Radiating pain

© 2007 McGraw-Hill Higher Education. All rights reserved. Bursitis Bursa Fluid filled sac that develops in area of friction Signs and symptoms Swelling Pain Some loss of function Three most commonly irritated Subacromial Olecranon Prepatellar bursa

© 2007 McGraw-Hill Higher Education. All rights reserved. Bursitis Increased fluid production Increases in pressure due to limited space around anatomical structures

Bursitis

Chronic Injuries

© 2007 McGraw-Hill Higher Education. All rights reserved. Chronic Injuries Importance of Inflammation in Healing: Essential part of healing process Must occur following tissue damage to initiate healing Signs and Symptoms Pain, redness, swelling, loss of function and warmth If source of irritation is not removed then inflammatory process becomes chronic

© 2007 McGraw-Hill Higher Education. All rights reserved. Tendinitis Most common overuse problem in sports Gradual onset Often can’t put a finger on the pain Obvious signs of swelling and pain May also experience crepitus Key for treatment is rest and removal of irritants Work to maintain fitness but avoid activities that aggravate condition

© 2007 McGraw-Hill Higher Education. All rights reserved. Stress Fractures No specific cause but with a number of possible causes Overload due to muscle contraction Altered stress distribution due to muscle fatigue Changes in surface Rhythmic repetitive stress vibrations Begins with: Dull ache Progressively becomes worse over time Initially pain during activity  Progresses to pain following activity

© 2007 McGraw-Hill Higher Education. All rights reserved. Stress Fractures Early detection is difficult, bone scan is useful, x-ray is effective after several weeks Due to osteoblastic activity If suspected – stop activity for 14 days Generally does not require casting