1. Basic Athletic Training Chapter 3 Injuries and the Healing Process

2. Chapter Objectives
Describe the inflammation process in the healing of athletic injuries
Compare obtained values of vital signs to the standard values for a normal patient
Debate the treatment rationale of ice versus heat application
Distinguish between acute and chronic injury management
Explain the principles of physical rehabilitation and range of motion

3. The Inflammation Process
Inflammation (swelling) after an injury is essential for complete healing of injured anatomical structure.
Body sends specialized cells to injured area in an attempt to limit damage and to begin healing.
Five signs of inflammation
Pain
Swelling
Redness
Heat
Loss of function

4. The Inflammation Process
Three Phases of the Healing Process
Inflammation—post acute injury
Tissue repair—after swelling subsides, scar tissue develops, which takes two to three weeks
Regeneration—replace all damaged tissue with new and healthy tissue

5. Vital Signs
Vital signs monitor life such as heart rate and breathing rate
Pulse—heart rate
Normal adult—60-80 beats/minute
Child— beats/minute
Respiration—breathing rate
Normal adult—12-20 breaths/minute
Child—20-25 breaths/minute

6. Vital Signs Temperature—Indication of acute or chronic illness
Oral–98.6 degrees
Rectal–99.6 degrees
Axillary–97.6 degrees
Skin Color—Indication of acute or chronic illness
Red–heat stroke, diabetic coma, or high blood pressure
White (pale)–insufficient circulation, heat stroke, or shock
Non-white athlete–examine inner lip, gum area, and fingernail beds

7. Vital Signs
Pupils—traumatic situations, drug use, and head injury can cause pupils to change size
Constricted–central nervous system or depressant drug use
Dilated pupils–one or both, head injury, heat stroke, hemorrhage, or stimulant drug use
Unequal–failure to accommodate to light could indicate brain injury, drug poisoning, or alcohol intake

8. Vital Signs State of Consciousness Movement—Four basic patterns Alert
Verbal
Responds to pain
Unresponsive
Movement—Four basic patterns
Active–athlete provides movement
Passive–ATC moves body part
Assistive–ATC assists movement
Resistive–ATC provides resistance to oppose movement

9. Vital Signs
Abnormal Nerve Stimulation—Always check motor (movement) and sensory (feeling)
Blood Pressure—When heart contracts, systolic pressure is determined. As the heart relaxes, diastolic pressure can be determined

10. Treatment Rationale: Ice vs. Heat
Selection of ice or heat following injury is critical. Ice is used 48 to 72 hours following most injuries.
Application of ice
Reduces swelling and inflammation
Reduced blood flow to injury site
Reduced pain at the injury site
Ice bags
Chemical ice packs
Ice massage

11. Ice Treatment Cold whirlpool Cold water immersion Cold spray
Cold packs

12. Application of HEAT
Heat should not be used in the first 48 to 72 hours unless advised by a physician or certified athletic trainer.
Hot packs
Hot whirlpool
Contrast baths
Hot water and cold water immersion

13. Additional Therapeutic Techniques
Exercise
Increases circulation, strength, and range of motion
Therapeutic Modalities
Various electrical modalities are used to decrease pain, swelling, and muscle spasm.
Ultrasound
Electrical stimulating currents
Ultraviolet therapy
Low-post lasers

14. Additional Therapeutic Techniques
Massage
Counterirritants
Substances applied to the skin that cause a reaction
Joint mobilization

15. Acute vs. Chronic Injury Management
Acute Injuries (quick onset, short duration)
Response to an acute injury should include basic treatment of PRICES
Protection–remove athlete from participation
Rest–depends on severity of injury but could last 24 hours or longer
Ice–Apply cold to the area to help control bleeding and swelling
Compression–Use a compression wrap to control swelling. Applied too tight could interfere with circulation and nerve function
Elevation–Keep injured body part elevated above the heart
Support–If needed place athlete on crutches or in a sling

16. Acute vs. Chronic Injury Management
Chronic (of longer duration, repeating)
Characterized by continued use of PRICES
Exercise
Therapeutic modalities
Heat
Contrast bath treatment

17. Physical Rehabilitation
Five Phases of Physical Rehabilitation
Post-surgical/acute injury
Early exercise
Intermediate exercise
Advanced exercise
Initial sports re-entry
Basic Components of Physical Rehabilitation
Therapeutic exercise
Therapeutic modalities
Athlete education

18. Range of Motion (ROM) Range of Motion—normal movement of a joint
Assessing ROM is critical in evaluating injuries
Athletic trainer needs experience in using a goniometer

19. Questions ?