1. I will describe various types of soft tissues in the body I will explain how tissues respond to trauma I will describe the types of soft tissue trauma I will demonstrate proper procedures for treating various soft tissue trauma I will analyze the indication and contraindication for cold application on a soft tissue injury I will analyze the indications and contraindications for heat application on soft tissue injuries

2. Warm up Think of an incident where you either witnessed or experienced a soft tissue injury to the skin, muscle, tendon or ligament. What happened? What did the injury look like? How was the injury treated?

3. Soft Tissue Soft tissues are the tissues that connect, support, and surround other structures and organs of the body, not being bone. Soft tissues include tendons, ligaments, fascia, skin, fibrous tissues, fat, synovial membranes (connective tissues), muscles, nerves, and blood vessels.

4. Skin Skin- outer covering of the body

5. Ligament Ligament- connects bone to bone

6. Muscle Muscle- tissue that when stimulated contracts and produces movement

7. Tendons Tendons- tissue that connects muscle to bone Achilles Tendon Ruptured Achilles Tendon

8. Soft tissue Injury A soft tissue injury is the damage of skin, muscles, ligaments, and tendons throughout the body. Common soft tissues injuries usually occur from a sprain, strain, a blow resulting in a contusion, or overuse of a particular part of the body

9. 5 signs of Inflammation Redness- due to vasodilatation and increase in blood flow Heat- due to vasodilation and increase in blood flow Swelling- due to increase in blood flow to the injured area and possibly from blood that leaks into the injured tissue (bruising) Pain- due to the pressure of fluids or swelling through the nerve endings Loss of function- due to swelling and pain

10. Contusion Bruise Sudden traumatic blow to body Not penetrate skin Usually injury to blood vessels Superficial, deep, or hemorrhage Hematoma: formation caused by pooling of blood and fluid w/in a tissue space

11. Contusion Symptoms: Swelling Point tenderness Redness Ecchymosis- purple discoloration of skin Treatment: PRICE Protection- protect from further injury by preventing them from moving Rest Ice- ice during the first 72 hours to reduce swelling and pain (ice for 15 to 20 minutes every 2 to 3 hours) Compression-use of pressure with bandage or wrap to reduce swelling Elevation- can minimize initial tissue bleeding and swelling

12. Partner Assignment In groups of 3, create a short cartoon strip which shows an incident resulting in a contusion.  Include at least five signs and symptoms of a contusion using the crayons markers and colored pencils.  Include whether it is superficial, deep, or a hemorrhage  Demonstrate knowledge and application of the treatment PRICE. Cartoon should take no more than 3-5 minutes to present to class.

13. Strains Strain- stretch, tear, or rip in the muscle and/or tendon Severe tension force Excessive muscle contraction Direct blow to the body Common sites: Hamstring Quadriceps Hip flexor Biceps Latissimus dorsi

14. Sports and strains? In what sports is someone more likely to get a strain? https://www.youtube.com/watch?v=t2G8KVzTwfw

15. Sports and Strains Soccer, football, hockey, boxing, wrestling, and other contact sports put athletes at risk for strains. Sports that feature quick starts (hurdling, long jump, running races, etc.). Gymnastics, tennis, rowing, golf-sports that require extensive gripping have a high incidence of hand strains. Elbow strains frequently occur in racquet, throwing, and contact sports.

16. Severity of Strains Grade 1 Some muscle fibers stretched or torn Some tenderness/pain with range of motion Grade 2 Number of muscle fibers torn Active contraction of muscle extremely painful Grade 3 Complete rupture of muscle Significant impairment or total loss of movement

17. Signs & Symptoms Localized swelling Cramping Inflammation Loss of function Pain General weakness Discoloration

18. Treatment Reduce swelling & pain through PRICE Protection- protect from further injury by preventing them from moving Rest Ice- ice during the first 72 hours to reduce swelling and pain (15 to 20 minutes every 2 to 3 hours) Compression-use of pressure with bandage or wrap to reduce swelling Elevation- can minimize initial tissue bleeding and swelling Anti-inflammatory drugs such as ibuprofen Severe Strain could require: Hard cast Surgery

19. Treatment: Compression Thigh Wrap (hamstring and Quadricep) https://www.youtube.com/watch?v=CSIIjax1lUo Welcome Mr. Liscombe, professor and athletic trainer! Watch then practice on a partner.

20. Strains Prevention Regular weight training Proper warm-up Stretching Proper mechanics Proper cool-down/ stretching Proper nutrition & hydration

21. Partner Assignment With a partner, create a short skit which shows an incident resulting in a strain.  Draw a picture of the injury and include at least five signs and symptoms of a strain using crayons, markers or colored pencils.  Include whether it is a grade 1, grade 2, or grade 3  Demonstrate knowledge and application of the treatment PRICE and the use of anti-inflammatory drugs.  Demonstrate knowledge and application of at least 4 prevention techniques. Skit should be between 3 to 5 minutes in length.

22. Sprain Sprain- stretched or torn ligament (connects bone to bone) Causes: Falling twisting Direct blow Common sites: Ankle Wrist Knee

23. Sports and sprains? In what sports is someone more likely to get a sprain? https://www.youtube.com/watch?v=PI5veHFijAk

24. Sports and Sprains All sports and exercises, even walking, carry a risk of sprains. The anatomic areas most at risk for a sprain depend on the specific activities involved. For example, basketball, volleyball, soccer, and other jumping sports share a risk for foot, leg, and ankle sprains. Sports such as football, basketball and soccer that involve running with sudden stops, cutting side to side, jumping and pivoting can increase the risk of a knee sprain.

25. Severity of Sprain First Degree: ligament has been stretched but not torn mild pain some swelling joint instability difficulty jogging or jumping. Second Degree (most common): partial tearing of the ligament significant swelling bruising moderate pain trouble walking Third Degree: ligament is completely torn Severe swelling Severe pain Extreme loss of motion Walking can be very painful

26. Signs and Symptoms Signs and symptoms: Pain Swelling Heat Redness Bruising Stiffness or difficulty moving the joint At the time of injury, you may hear or feel a pop in the joint

27. Treatment Reduce swelling & pain through PRICE Protection- protect from further injury by preventing them from moving (if ankle sprain, wear a shoe) Rest Ice- ice during the first 72 hours to reduce swelling and pain (15 to 20 minutes every 2 to 3 hours) Compression-use of pressure with bandage or wrap to reduce swelling Elevation- can minimize initial tissue bleeding and swelling Anti-inflammatory drugs such as ibuprofen Surgery may be needed for a tear in ligaments of the knee

28. Treatment: Compression http://www.youtube.com/watch?v=2fKvpqy_gWk Welcome Athletic Trainer John! Watch then practice on a partner. During skit making at the end of class, you can practice wrapping as the treatment requirement-compression

29. Prevention Balance training Strengthen the muscles around the joint Flexibility training of the hips, legs, and ankles Adequate preparation for the activity Taping and bracing the joint

30. Partner Assignment With a partner, create a skit or cartoon which shows an incident resulting in a sprain.  Include at least five signs and symptoms of a sprain using crayons, markers or colored pencils (if you do a skit, make sure you draw the injury on a piece of paper).  Include whether it is a first degree, second degree, or third degree  Demonstrate knowledge and application of the treatment PRICE and the use of anti-inflammatory drugs.  Demonstrate knowledge and application of at least 4 prevention techniques. Skit or cartoon should take no more than 3 to 5 minutes to present.

31. Soft tissue Overuse injuries Small amounts of body stress accumulate slowly but steadily. The result can be damage and pain. Common soft tissue overuse injuries include: Shin Splints: inflammation of the connective tissue that surrounds the tibia Tendonitis: an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle. Tennis Elbow: a painful condition that occurs when tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm

32. Small Group Assignment As a team, complete the following tasks:  Research the three soft tissue overuse injuries and fill in the appropriate information on your notes: Causes, Symptoms, Treatment, Prevention Each person will fill in their own notes  Create a short movie demonstrating knowledge on one soft tissue overuse injury (See Rubric) Get permission before beginning movie. Each group will create a movie on a different soft tissue injury  Once your group finishes, study your notes to prepare for the quiz tomorrow on soft tissues and injuries.  Each group will rotate to view each other’s videos Teacher will review information on soft tissue overuse injuries while students highlight and add to their notes.

33. Tendonitis Causes Most common cause: repetition of a particular movement over time Other causes: Injury to the tendon Tendinitis develops in people whose jobs or hobbies involve repetitive movements; aggravating the tendons.

34. Tendonitis Symptoms: Pain - if the affected area is moved the pain worsens Swelling Hot Red A lump that develops along the tendon A feeling that the tendon is crackling or grating as it moves

35. Tendonitis Treatment: Rest Ice Over-the-counter pain relievers Injection of cortisone Surgery in severe cases

36. Tendonitis Prevention: Avoid activities that place excessive stress on tendons Strengthening exercises around the tendon Cross training Stretching Use proper techniques when performing repetitive movements

37. Shin Splints Causes Shin splints are caused by repetitive stress on the shinbone and the connective tissues that attach your muscles to the bone. Especially common in runners and dancers

38. Shin Splints Symptoms: Soreness along the inner part of your lower leg Mild swelling in your lower leg

39. Shin Splints Treatment Rest Ice Take an over-the-counter pain reliever such as ibuprofen

40. Shin Splint Prevention: Choose the right shoes for your sport Cross train with a sport that is of less impact on the shins Warm up before working out Strength training exercises for lower legs

41. Tennis Elbow Cause: Tennis elbow is a painful condition that occurs when tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm.

42. Tennis Elbow Symptoms: Pain that radiates towards the forearm and wrist Tenderness Weakness

43. Tennis Elbow Treatment: Rest Ice Anti-inflammatory drugs

44. Tennis Elbow Prevention: Stretch arm muscles Strengthen arm muscles Wearing a brace Proper techniques

45. Assignment Quiz: Soft tissue and soft tissue injuries  What soft tissue connects bone to bone?  What soft tissue connect muscle to bone?  What soft tissue makes up the outer covering of the body?  What are the five signs of inflammation?  What does PRICE stand for?  What are three degrees of severity for a contusion?  What is the difference between a sprain and a strain?  What are two ways to prevent a strain?  What are two ways to prevent a sprain?  What strain is more severe-Grade 1 or Grade 3?