Tissue’s Response to Injury Unit 4 Evaluation and Assessment of Athletic Injuries

Introduction The starting running back has sprained his ankle 2 days before the 1st playoff game. The coach, parents, and athlete want to know what can be done to make him well more quickly. Question: What does the athletic trainer need to know to answer their question?

Bell Work What are the names of these two muscles? What view are you in? How do you work them out?

Biceps Brachii Origin Insertion Short Head-coracoid process Long Head-supraglenoid tubercle of scapula Insertion Radial tuberosity

Triceps Brachii Long Head Lateral Head Medial Head Origin Long Head Infraglenoid tubercle of scapula Lateral Head Posterior humerus Medial Head Insertion Olecranon process of ulna

Objective By the end of the lesson: Define the 3 Phases of Healing Identify factors that impede healing

Three Phases of healing There are 3 phases that an injury will go through in order to heal. Inflammatory Response Phase Fibroblastic Repair Phase Maturation-Remodeling Phase

Time Span Interpret this graph. What does it mean? 3 2 1: Inflammatory Phase 2: Fibroblastic Phase 3: Maturation-Remodeling Phase 1 Injury 6 Wks Day 4 2-3 Yrs

Inflammatory Response Phase Once tissue is injured, the healing process begins immediately This phase is characterized by: Redness Swelling Tenderness/Pain Increased Temperature of tissue Loss of function

Inflammatory Response Phase Inflammation Process White blood cells are delivered to the site of injured tissue – begin the clean up! Vasoconstriction lasts for 5-10 minutes Chemical mediators then produce dilation – causing swelling Formation of a clot begins – scab/scar This phase lasts 2-4 days after initial injury

Inflammatory Response Phase This phase of healing is CRITICAL to the entire process of healing. If this response does not accomplish what it is supposed to do, normal healing cannot take place.

Inflammatory Response Phase On the 6th -7th day collagen fibers are deposited in a random formation which creates a scar As more fibers are laid down, the stronger the scar is – which begins the maturation phase

Fibroblastic Repair Phase Characteristics: 1. Fibers are created, causing a scab/scar in the tissue 2. Signs and symptoms of inflammation decrease Inflammatory Process: 1. Increased blood flow during this phase brings nutrients to the injury site – essential for growth 2. This stage can begin 2hrs after injury and last up to 4 wks

Fibroblastic Repair Phase Increased BF is essential to tissue growth

Fibroblastic Repair Phase What would happen if the inflammatory response and fibroblast phases are prolonged? What do you think would happen to the scar?

Maturation-Remodeling Phase Remodeling of the fibers creates scar tissue – according to the force it was subjected to What does this mean? If fibers were laid down properly during Phase 1 and 2, the scar tissue will be strong and return close to normal. If fibroblast stage was too long or too short, the tissue may not return to normal.

Maturation-Remodeling Phase With increased stress & strain (Rehab); fibers realign in maximum position = parallel to the lines of tension Tissue assumes normal appearance, but not as strong as normal tissue. By the end of 3 weeks a firm scar is formed This phase can last up to 3 years

Maturation-Remodeling Phase

Question What could make the healing process slow down? What factors could impede healing?

Answer Extent of injury Prolonged swelling Infection If severe, each phase could be prolonged Prolonged swelling Prevented by good first aid management Infection Not caring for an open wound can cause a delay in healing Age, health, nutrition The older we get, the greater the change in wound healing

Closure A wrestler receives a sudden twist to his right shoulder, causing a grade II muscle tear. What happens in the first hour of this injury? What is the timeline for an injury? How long is each phase?