CQ1: How are sports injuries classified and managed?
WAYS TO CLASSIFY SPORTS INJURIES
Assessment of TOTAPS: Hard Tissue and Soft Tissue:
Hard-tissue injuries
Soft-tissue injuries
Direct vs Indirect
Soft tissue vs Hard tissue
Overuse Injuries
Tears, Sprains and Contusions
Skin abrasions, Lacerations, Blisters
Inflammatory Response
What is TOTAPS? Protocol for assessing injuries.
Fractures
Dislocations
Soft tissue Injury: Injuries occurring to any the of body tissue , other than bone or teeth. Can occur after excessive stretching of the tissue or excessive external force, possibly leading to severing.
Hard-tissue Injury;
Sprains: Occurs when a joint capsule and its connecting lligaments are stretched beyond the normal range of motion, known as torn ligament fibres. Assessed in a grading system, grade 1 (slight tear,) grade 2 (partial tear,) or grade 3 (a complete rupture.)
Can cause damage to the stability leading to pain, swelling, and the inability to complete normal movements.
Example: A Netball player lands and twists their ankle into an unnatural position, leading to a grade 2 sprain.
Strains: Occurs when muscle fibres or tendons are overstretched or torn at some degree, resulting in bruising. Strains may additionally be categorised into grades like sprains, depending on the severity and the number of fibres affected. For example, an AFL players tear their hamstring (Muscular strain) due to inadequate warm-ups.
Contusions: Caused by a direct force or blow to an area of soft tissue. For example, an foot strikes the gastrocnemius of another player during a football match. Contusions can lead to internal bleeding.
Skin Abrasions: Occur when a force impacts the skin, causing superficial damage, no deeper than the epidermis of the sli, causing slight bleeding. The external force will casue the outside layer of the skin to scrape or split, For example, netball player falls over on bitumen courts, possibly leading to possible dirt or foreign materials lodging itself into the abrasion.
Lacerations: Irregular tear in the skin, leaving an open wound. Can lead to infection. Deep lacerations may require stitching. For example, an ice-hocker player gets hit with the hockey stick on his hand, causing his hand to cut open.
Blisters: When fluid collects underneath the epidermal layer of the skin, consistent rubbing occurs, causing blisters. For example, a basketball player wearing new shoes to a match, causes blisters through high intensity and quick changes of direction during play.
There are three phases of the inflammatory response:
Phase 1 - The inflammatory stage: Blood flow will increase to the area causing pain and swelling around the site of the injury. The will redurce range of motion and will damage cells surrounding the tissue area.
Phase 2 - The repair and regenerative stage: Begins 48 hour post injury and can last anywhere between 3 days to 6 weeks. Damaged tissue is broken dow, fibres a prepared and scar tissue forms.
Phase 3: Remodelling and repair stage - Can take up to months as scare tissue production is increased and replacement tissue is strengthened. Can replace scar tissue if roper treatment is sought from health professionals. Athelet must balance rest and excerise. Full health will not be achieved until this phase is complete.
TREATMENT
RICER: Rest, Ice,Compression, Elevation, Referral.
Rest - To decrease blood flow to the injured site. E.g lying down. Ice - Reduce swelling, pain and vasoconstriction of blood vessels. E.g. ice pack. Compression - Constrction and reducing of swelling. E.g bandage. Elevation - Restrict blood flow and reduce pain, bleeding and swelling. E.g. raise injury to the level of the heart. Referral - Provde treatment and rehabilitation plans as early as possible, identifying the injury. E.g through physiotherapists.
AVOID STRATEGIES OF HARM FOR SOFT TISSUE:
Do not use Heat as it increases swelling and bleeding. Aboid heat packs. Do not use Alcohol as it increases swelling and bleeding and delay healing. Do not Run or continue to excerise, as it aggravates the injury in pain, swelling and bleeding. Do not Massage as it increases swelling and bleeding. These are all best avoided for the first 48-72 hours of the injury.
A hard tissue injury is any injury to the skeletal system resulting in fractures, dislocations or damage to teeth.
5 symptoms of inflammation: bleeding, swelling, redness, pain, heat and loss of fucntion.
Common hard tissue injury, also known as breaks. A fracture is a broken bone and can be classified into to 3 types.
Closed fracture: Remains inside the body and does not pierce the skin. For example, a netball player falls over and lands on their wrist. Through excessive weight, the wrist fratures.
Open Fracture: A break that pierces the skin so that the bone can be seen. Known as compound fractures. Can lead to an open wound and bleeding. For example, a tibia and fibula compound fracture occur in due to contact sports such as rugby as a result on high energy collision in a tackle, placing excessive pressure on the bone that they can withstand.
Complicated fracture: Where the bone causes further damage to major nerves, organs or blood vessels. Can be life threatening. May be occur when an athlete particpates in pole vaulting and falls from a high place, further leading to a complication of tetanus.
There are 3 types of a fracture:
Incomplete: Does not break the whole way through the bone, so that the bone is still in one piece, but has a break in it. For example, a basketball player falls over placing excessive force on their wrist, leading an hairline fracture in the carpals.
Complete fracture: Breaks clean through the bone, so that there are now two parts. Can occur in boxing match, when more force is applied to the bone than the bone can take, leading to a complete fracture of the cheekbone.
Comminuted fracture: Result in more than two arts of the bone. Smashing of the bone or simply multiple fractures in one bone. For example, an opponent of a rugby game tackles a player, leading the opponent to a comminuted fracture in the patella due to excessive force.
Management of fractures:
Immobilise the area, reduce pain, prevent further damage, and reduce bleeding.
Dislocations occur when there is an abnormal separation in a joint between two bones. Dislocated joints results in much damage to the surrounding soft tissues including sprains to ligaments and strains to muscles. Caused by excessive force and can be either a direct or indirect injury.
Signs and symptoms: Pain at the joint, swelling at the joint, brusing around the joint, deformity, tenderness, or the inability to move.
Management: Do not move the joint or attempt to relocate. Check for circulation, support the area and apply ice packs.
Assessment in Injuries
First Aid - DRSABCD. Danger - Check for danger to self, others and casualty, Depending on the sport, stop play. Response - Check for response. Communicate with them and receive information on the occurance of the injury. Send - Contact or reach out to medical attention if required. Airway - Ensure casualty are conscious and breathing. CPR - If casualty is not breathing. Defibrillation - Use as soon as possible if CPR is required and is necessary.
First Aid - STOP: On-field assessment. S - Stop the athlete from particpating and stop the game if necessary. T - Talk to the injured athele. What happened? How did it happen? Does it hurt anywhere else? O - Observe whilst talking to the athlete. Are they distressed> Positioned unusually? Can the athlete move the injured site? P - Prevent further injury by ensured a detailed assessment of TOTAPS.
T - Talk about the history of the incident and individual. Where they are experiencing pain and on what scale. O - Observe the injured site and expose and compare to another body part if possible for swelling, discolouration or deformity. T - Touch and compare the uninjured side regarding tenderness, temperature and pain. A - Active movement. The athlete is able to move through full range of motion, only to the point of pain. Do not exceed pain threshold. P - Passive movement. A physiotherapist or sports traer on the sit assist in full range of movement only to the point of pain. S - Skills test. Athlete performs progress skills test of necessary skills such as running, jumping and hopping to see if they are of the ability to return to play.
Commonly known as a stress fracture, they are tiny fractures of a bone. These are caused by repetitive force or occur due to weakness within the bones due to osteoporosis.
Definition
Assessment of Injuries
Management
Dash Points
Dot points
Direct injuries are injuries sustained at the site of an external force. For example, a collision in a rugby tackle leads to fractured arm.
Indirect injuries are injuries sustained from an internal force. For example; a netball twists an ankle and sprains it.