1. Ch. 3 Injuries and the Healing Process
Athletic Training
Ch. 3 Injuries and the Healing Process

2. Objectives SWBAT list the 3 phases of healing
SWBAT list the vital signs and state the normal values for each
SWBAT demonstrate assessment and documentation of vital signs
SWBAT describe and/or demonstrate 4 types of ROM
SWBAT describe and demonstrate treatment modalities including cryotherapy, thermotherapy, contrast bath, electrical modalities, massage and counterirritant balms
SWBAT state the purpose of treatment modalities including cryotherapy, thermotherapy, contrast bath, electrical modalities, massage and counterirritant balms
SWBAT list the 5 phases of rehabilitation

3. Three Phases of the Healing Process
Inflammation - is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. This is the body’s response to injury that starts the healing process. It is usually accompanied by swelling, pain, redness, heat, muscle spasm and loss of function. All of this can reduce blood flow.
Tissue Repair
Regeneration – scar tissue may replace the damaged tissue

4. Vital Signs The 4 vital signs are- Temperature Pulse Respiration
Blood pressure

5. Temperature Can be taken in the - mouth (oral) - 98.6oF
rectum oF
armpit (axillary) oF
ear (tympanic) – 98.6oF
forehead (temporal) 98.6oF

6. Vocabulary Febrile - elevated temp.
Afebrile - without fever or normal temp.
Hyperthermia - increased body temp.
Hypothermia - lowered body temp.

7. Pulse A measure of the heart rate Adults - 60-80 bpm
Children bpm.
Check the pulse at the –
wrist (radial artery)
neck (carotid artery)

8. Vocabulary Tachycardia - > 100bpm Bradycardia - < 60 bpm
Also note the rhythm and force of the pulse.

9. Respiration
Adults rpm
Children rpm

10. Vocabulary Dyspnea – difficult breathing Apnea – lack of breathing
Also note the depth and regularity of the breath.

11. Blood pressure The force of the blood on the wall of the
arteries. Consists of the systolic and diastolic
pressure.
Systolic is the pressure when the heart is contracted and is recorded as the top number. It is the first sound you hear
Diastolic is the pressure when the heart is relaxed between beats and is recorded as the bottom number. It is the last sound you hear.

12. Blood Pressure
Measured with a –
Sphygmomanometer
Stethoscope

13. Blood Pressure
Hypotension < > Hypertension (low BP) (high BP)

14. Oxygen saturation Measured with a pulse oximeter
Normally >97% at rest
Hypoxia – low oxygen level in blood = <90%

15. Also take note of – Skin color Pupils – PEARL, Strabismus, Nystagmus
LOC – level of consciousness
Distal Sensation (feeling) and Motor Function (movement)
Movement
All of these will be covered in more detail in later chapters

16. Thearpuetic modalities
The following basic treatment plans apply primarily to orthopedic injuries.

17. Cryotherapy Ice is applied to acute injuries for the first 48-72 hours
Controls pain, swelling, and inflammation
Preserves tissue
Reduces blood flow to the injured area
Time of application is 15 – 20 minutes.

18. Cryotherapy Modes of application include-
Ice bag – best to used crushed ice
Ice massage – rub with an ice cube
Cold whirlpool or tub – should be 50o – 60o F. No open wounds, can’t elevate
Gel packs – the blue re-freezable packs or liquid packs. These can be dangerous and carry risk of frostbite or chemical burn.
Cold Spray – chemical evaporants. Can provide some immediate pain relief.

19. Thermotherapy
Heat treatment. This is used after the acute phase or on chronic injuries.
Increase blood flow
Decrease stiffness
Relax muscles
Increase metabolism
Time of application is 15 – 20 minutes.

20. Thermotherapy Modes of application include-
Hot packs – use several layers of towels to prevent burns
Warm whirlpool or tub – should be 102o to 105o F. No open wounds.
Ultrasound – using sound waves to heat deep tissues in the body.
Diathermy – Heats deep body tissues with electromagnetic currents.

21. Contrast Bath
Alternating use of heat and cold to increase circulation

22. Electrical Modalities
Relieve pain
Decrease muscle spasm
Reeducate muscle
Decrease swelling

23. Electrical Modalities
Modes of application include-
NMES
TENS
INF
Shortwave
Microwave
Laser

24. Topical Analgesics
Also know as analgesic balms or counterirritant balms. Some examples are Ben-Gay® or Icy Hot ®.
Not heat modalities
Cause nerve stimulation in the skin that overrides the pain signal from the injury
Most have ingredients that give a feeling of warmth or cooling.

25. Massage Relax muscle Loosen tight fascia or scar tissue
Decrease swelling
Relieve pain
Increase blood flow.

26. Rehabilitation
For serious injuries and surgical cases the athlete needs rehabilitation exercises before returning to full participation.

27. Goals of rehab Initial healing Decrease swelling ROM and flexibility
Muscle strength and endurance
Balance and Proprioception
Functional activity
Sport Specific activity
Return to full participation

28. 5 Phases of Rehab (as outlined in this book)
Post-surgical/acute injury – wound healing and swelling control, protection with crutches, sling, splint, cast, etc.
Early exercise – ROM and isometrics
Intermediate exercise – isotonic and WB exercises
Advanced exercise – full WB, sport movements
Initial sports re-entry – partial practice, sport activities with AT

29. 4 Types of Movement Active (AROM) – athlete provides movement
Passive (PROM) – athletic trainer moves the body part
Active Assistive (AAROM) – athletic trainer assists the athlete with movement
Resistive (RROM) – athletic trainer provides resistance to oppose the movement of the body part
These will be covered in more detail and practiced in later chapters

30. Range-of-Motion ROM ROM is measured with a goniometer.
See p. 30 for Typical ROM of many joints

31. Return t0 play
When they have full ROM, full strength, and can pass functional tests the physician will usually clear them for full participation.
Throughout the rehab process it is important to have them maintain CV conditioning, abdominal work and some sport skill so they are ready when the physician clears them for return.

32. Vocabulary
Review the terms on p