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Physical Activity Injuries Lecture 2 FDSc FISM year 1 Janis Leach
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Recap of Lecture 1 Roles of a therapist? Causes of injury?
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Today's lecture Classification of injury What can it tell us and how can it help us as therapists?
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Lecture objectives At the end of this lecture you should be able to: differentiate types of skin wounds and fractures differentiate between a sprain/strain Be aware of grading systems Complete an assessment of the hip
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Classifications Skin injuries Muscle tears Joint injuries Tendon injuries Ligament injuries Bone injuries Lecture outline
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Orientation Produce a list of different types of injuries
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Classification of Injury Extrinsic – due to external violence Intrinsic- due to stress developed within the athlete Examples?
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Classification of Injury Acute Ties in with inflammatory phase Sub-Acute Proliferation phase ( scar formation ) Chronic Unresolved
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Skin injury Haematoma, contusion or bruise - is due to a direct blow, usually with a blunt instrument
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ABRASION an injury often of the glancing type, where the surface of the skin is broken but there is no complete tear throughout the whole depth
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LACERATION LINEAR WOUNDS WITH DAMAGE TO THE FULL THICKNESS OF THE SKIN
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Puncture wound where the depth of the wound is greater then the length or breadth
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Blisters injuries to the skin where one layer is detached from the layer beneath. The gap between becomes filled with with fluid exuded from the injured cells
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Burns involve damage to the skin as the result of heat
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INTRINSIC MUSCLE INJURY STRAIN / TEAR GRADE 1 GRADE 2 GRADE 3
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GRADE 1 Small number of torn fibres Localised pain No loss of strength
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GRADE 2 Significant number of torn fibres Pain and Swelling Pain on movement Reduced strength Reduced ROM
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GRADE 3 Complete rupture
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Extrinsic Muscle Injury CONTUSION accumulation of blood and lymph within a muscle HAEMATOMA within a space or tissue
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Haematoma Intermuscular Latin for between Intramuscular Latin on the inside
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Muscle physiology
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Haematoma
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Calcification MYOSITIS OSSIFICANS - deposits of calcium and eventually bone are laid down in the muscle, usually as a result of a direct blow It is usually as a result of impact which causes damage to the periostium as well as the epymysium. The bone will grow 2 to 4 weeks after the injury and become mature bone within 3 to 6 months.
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Tendon Injury Tendonitis - generalised oedema and inflammation causing pain and loss of function Peritendonitis - inflammation of tissues surrounding the tendon
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Tendon Injury Rupture - complete Rupture - partial
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Grade 1- Ligament Injury Some stretched fibres No laxity on testing Pain
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Grade 2 – Ligament Injury Considerable fibres torn Evidence of laxity Pain Definite end point
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Grade 3 – Ligament Injury Complete tear Excessive joint laxity No firm end point
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Joint injury Traumatic synovitis - damage to the lining of the joint Loose bodies - pieces of bone that interfere with the joint mechanically (Osteochondritis Dissecans) Dislocation - complete disruption of the joint surface areas Subluxation - misalignment of joint surface but still some overlap
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Bone Injury Sudden injury (Fracture) Stress fracture (repetitive forces) Pathological (Underlying bone disease i.e. tumor or cyst
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Bone Injury/ Fractures Closed Open (compound) Avulsion
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PATTERNS OF FRACTURE Transverse (broken straight across) Oblique (as above but at an angle) Spiral (broken due to twisting motion) Comminuted (shattered bone) Compression (vertabrae) Greenstick (usually found in children)
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Bursitis Subcutaneous prepatellar bursa becomes distended with fluid caused by irritation Housemaids knee
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Review What is the difference between a strain and a sprain? How does an intermuscular and intramuscular haematoma differ? Name four patterns of fracture? What is the difference between a dislocation and a subluxation?
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Task In pairs you are going to assess the ankle, knee and hip joint on each other.
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