Topic 1:
General theory of
sports injury
F I TH 07
PREVENTING AND MANAGING SPORTS INJURIES
2023 - 2024 TERM 2
Objective
•sto understand the team in sport medicine
• to review functional musculoskeletal anatomy
• to understand the fundamental of injuries
• to identify the risk of sport injuries and the prevention strategies
Rest
Injury Return to sport
Injury Doctor Physio
Return to sport Pitchside training
Members in Sports
Medicine
Members in Sports
Medicine
Professional responsibility
Injury prevention
recognition and evaluation of the athlete
immediate care after injury
management of athlete after injury
performance enhancement
The Anatomical
Position
Anatomical
Terms:
Anatomical
Terms:
Anatomical
Movements
Anatomical
Movements
The Plane of
Movements
Cranium Cranium
Skull Skull
Clavicle Spine
Sternum Scapula
Humerus Humerus
Ribs Ribs
Spine Ulna
Ulna Radius
Radius Sacrum
Carpals
Phalanges
Pelvis
Femur Metacarpals Femur
Patella
Fibula
Fibula
Tibia Tibia
Tarsals Metatarasals
Phalanges
Common Injuries to the
bone
Fracture
Stress Fracture
Bruises
Growth plate damage
Tendons
Common injuries to
Tendons
Ligamen
ts
Ligament
Sprain
Grade 1
Stretching of
Grade 2
Partial teat of
Grade 3
Complete tear of
ligament ligament ligament
Little to no Slight laxity Complete loss of
laxity but no stability
Firm end gross No end point
point instability Swelling and joint
Mild Firm end effusion
swelling point Loss of motion
Tender to palpation Moderate May be associated
and painful if loaded swelling with a joint
Some decreased Moderate to severe dislocation
ROM joint tightness Positive special
w/decreased ROM test
Positive special test
Muscle
s
Muscle
Contraction
Open chain Vs Closed
chain
Muscle
Strain
Load and tissue elongation
curve
Mechanisms of
Injury
Collagen deforms under low loading
and fails at high loads
when the load is removed from
normal tissue during the elastic phase,
the material returns to its pre-stretch
length
injury occurs when the tissue is
stretched into the plastic phase,
causing tissue failure
Physiological Vs Pathological
Mechanisms of
Injury
Tendon is the least elastic
the most frequent site of injury in muscle strains is the myotendinal junction
“Tendinopathy” : a generic clinical descriptor of tendon injuries in sports
Mechanisms of
InjuryTRAUMA
DIRECT INDIRECT TRAUMA
An injury occurring from blunt Repeated microtrauma, leading
trauma or a sudden overload, to clinical signs and symptoms
and is known as
macrotrauma
For example:
Muscle tear or ligament sprain
Theoretical pathways of sports-induced
tissue damage
Mechanisms of
Injury
Upon direct or indirect trauma,
tissue dysfunction characterized by pain, inflammation, and altered internal tissue stress
functional disability, the athlete is capable for daily living but is limited in his or her
capacity to train and compete
Any activity loads and deform tissue, an effect known as stress / strain
describe through a load & tissue elongation curve
As connective tissue is deformed, it either stretches or tears, depending on
the loading’s
o Magnitude
o rate
Risk factors for sport
injuries
Intrinsic (within the athlete)
◦Age
◦Skill level
◦Fitness
◦Biomechanics
Extrinsic (external to the athlete)
◦ Playing environment
◦ Equipment used, e.g. bats, hard balls, shoes
◦ Training load
Thermal load
Athletes generate heat due to exercising muscles
Athletes also gain heat from, or lose heat to, the
surrounding environment.
Heat exchange is affected by:
Weather conditions – temperature, humidity,
wind.
Clothing, protective equipment worn.
Pre event and within event hydration, (rules?)
Intensity and duration of activity
Heat
exchange
Hyperthermia
An increase in body core temperature when heat production
exceeds heat loss
Overheating can lead to:
◦ Heat exhaustion
◦ Heat stroke
For all Sports with a risk of hyperthermia:
Must have ice and water at the venue!
Heat exhaustion
Signs: high heart rate, dizziness, headache, loss of
endurance/skill/confusion and nausea.
May still be cool/sweating, but there will be signs of
developing vasoconstriction (eg, pale colour).
If people feel unwell during exercise they should immediately
cease activity and rest in a shaded areawith a passing
breeze or fan, and also increase hydration.
Heat
stroke
Signs:
◦ Similar to heat exhaustion but with a dry skin
◦ Confusion
◦ Collapse.
Potentially fatal, must be treated immediately.
“Strip/Soak/Fan”:
◦ strip off any excess clothing; soak with water; fan;
◦ ice placed in groin and armpits is also helpful.
Ambulance
Heat and hydration
encourage pre-event hydration
To avoid dehydration athletes should start drinking
plenty of fluids several hours before starting exercise.
Drink at least 500ml 1 hour before exercise and at
least 150ml every 15 minutes during exercise
UV exposure
High UV increases
◦ heat stress
◦ risk of skin damage – sunburn / skin cancer
Prevention includes sunscreen, hats, sunglasses,
shade shelters.
Hypothermia
Occurs when the body’s core temperature falls below 35°C
Gradual onset, may not notice it until too late
May affect the heart, lungs and other major abdominal organs,
as well as the skin.
Negatively affects decision making and physical coordination
so sporting performance is reduced.
Physical performance decreases if the body core temperature
drops as little as 1°C
Hypothermia risk factors
Inadequate clothing, wet clothes
High wind chill factor
Immersion in cold water (21°C or less for longer than 15 – 20 mins)
Low body fat
Poor circulation (tight clothes, vascular disease)
Fatigue
Smoking
Age – very young or old
Hypothermia prevention
Wear suitable clothing, including hats and gloves if possible.
Warm up prior to activity
Maintain body temperature during breaks
Maintain hydration – warm, sweetened fluids may be suitable.
Risk factors – Inadequate
rehabilitation
The biggest risk factor for a sports injury is a previous injury.
All injuries should be fully rehabilitated to pre-injury status or
better before the athlete returns to play.
Underlying causative factors should be corrected if possible.
Also consider taping or bracing for return to sport.