Injury Prevention

Unit 5

Injury Prevention

The best method of managing and caring for athletic injuries is to ________________them from occurringMany factors are important in the prevention process

EquipmentBracingTapingCoaching TechniquesBody MechanicsUniversal Precautions

Protective Equipment

_______________and fit are essential in prevention of injuriesShould be designed to prevent injury and_________ injured parts against further injuryMinimal ____________ interferenceCause ________________to other participantsSimple to_________________________________________ and reliableNot expensive

Protective Equipment

The hazard demonstrated in each individual sport dictate the need for specific types of protection

Contact SportsPadding must protect _________________points_________________Such as head, neck, kidneys, genitalia have priority for protection

High_________________ hazards (ball/puck sports)Helmets, face masks, eye protection needed

__________________protection

Protective Equipment

Modifications and improvements in sport equipment are continually being madeProtective equipment can be abused

By using equipment as a ___________________against their opponentPlayers who take dangerous risks and rely on equipment to protect them

Legal Concerns

Manufacturers and purchasers of sports equipment must foresee all possible uses and misuses of equipmentMust__________ the user of any potential __________in the use or ___________of the equipment

Legal Concerns

To decrease possibilities of injuries and litigation:Buy protective equipment from___________________Buy the _______________ equipment resources permitEnsure equipment is assembled correctly-follow all instructions to the letterMaintain all equipment properlyUse equipment only for_________________________Warn athletes who use equipment of all risksUse great caution when customizing any equipment or don’t do it at allUse __________________________equipment

Selection and Fitting of Equipment

Correctly fitting equipment is very important for injury preventionTo fit athlete these factors should be considered:

S_____________S__________________StrengthAge and Physical DevelopmentS_________________

Design of Protective Equipment

______________________Forces are channeled away from anatomical structures

D____________________Forces are dispersed over a large area

M___________________________Forces are reduced through the use of a mechanical structure

R___________________Anatomical ranges of motion are reduced to prevent forces that cause injury

Head Protection

Nothing can eliminate the possibility of head injuryHelmets do help to significantly lessen head injury severityHead protection is advised/mandated in football, ice hockey, lacrosse, boxing etc..Helmets must fit correctly to function properly

Helmets

Helmets should be able to absorb force levels high enough to fracture the skullHelmets should be monitored often because fit can be altered by:

________________________internal padding__________________from cells, spread of facemask

National Operating Committee on Standards for Athletic Equipment has had a major influence

NOCSAE

All helmets must have NOCSAE certificationTo be NOCSAE approved:

Helmet must be able to tolerate forces to many different areasWithstand repeated blowsWithstand high mass low velocity impactsEven though helmet is certified does not mean it is fail-safe

NOCSAE Warning

Warning placed on all football helmets“Do not use this helmet to butt, ram or spear an opposing player. This is a violation of football rules, and can result in severe head, brain, neck injury, paralysis, or death to you and possible injury to your opponent. There is a risk these injuries may also occur as a result of accidental contact without intention to butt, ram or spear. No helmet can prevent all such injuries”

Face Protection

Four categoriesF____________________

Protect against flying or carried objects

M___________________Majority of dental injuries can be preventedAbsorbs shock of chin blows, helps prevent concussions

E____________________Wrestling and boxing

Eye protection devicesCorrective lenses, glasses, headgear

Trunk and Thorax Protection

Shoulder, ribs, spine and genitalia have insufficient soft tissue protectionShoulder Pads and Restraints

____________-quarterback or receiver______________-blocking and tackling athletesFlak jackets protect ribs and thoracic area

Breast Support- Sports BraGroin and Genitalia-Cup

Other Padding and Braces

S_______________________Restraining devices for chronic dislocated shoulderRestricts upper arm from being abducted and externally rotated

H______________________Collision and high velocity sports to protect vulnerable areas such as iliac crest

A______________ and ______________ supports

Designed to give relief and permits movement

Limb Protection

F________________Socks and Shoes

Shin_____________________Hard shelled, molded shin guards

Thigh_____________________Pads slip into ready-made pockets in the uniform

___________________SupportsKnee pads, Elastic sleeve, Bracing

___________________SupportsCommercial bracing and ankle taping

Hand, Wrist, Arm and Elbow ProtectionPadded gloves, mitts and boxing gloves

Footwear

Can mean the difference between success, failure and injury Socks

Poor fitted socks can cause abnormal stresses and cause irritationsSocks should be clean, dry and without holes

ShoesChronic abnormal pressure to foot can cause permanent structural deformities, calluses, blistersCan cause mechanical disturbances that affect total postural balances, effecting joints and muscles The bare human foot was designed to function on uneven surfaces

Shoes cont...

Shoes were created to protect against harmful surfacesLeft foot generally varies in size and shape from the right footIt is important to measure both feet and simulate the conditions under which they will perform with shoes onFit shoes at the end of the dayToes can be fully extended without being crampedWhen dealing with cleats- cleats should be positioned under two weight bearing joints

Foot pads

Can be helpful in treating a variety of foot problems as well as hip and kneeCommercial or Custom-made orthoticsCorns, bunions, fallen arches, pronated feetFoam, Felt, Plaster or aluminum and heel cups

Prophylactic Knee Braces

ProphylacticTo prevent or avoid

Effectiveness is controversialPlayers at greatest risk- Offensive and Defensive Lineman, Linebackers, Tight EndsDesigned to provide protection against lateral and medial, but not rotary forces

Knee Braces cont…

Studies are dividedDecrease, No difference and Increase in knee injuriesMore studies need to be conducted concerning:

Relative strength of bracesWeather they pre-stress the knee joint and produce injuries

Functional Knee Braces

C-_________________ orthopedic knee brace prescribed for the athleteFollowing serious knee joint injury that produces chronic______________________Designed to _____________to the cruciate ligamentsEffectiveness better documented

Taping

Used for the care and protection of the athleteAdhesive tape offers a number of possibilities

Retention of wound_____________________Stabilization of compression-type bandages that are used to control bleeding__________________ injuries to prevent additional injuriesProtect against __________________by limiting ROM

Taping Guidelines

Be sure the area is dry, clean and free of body hair Use some form of tape adherent to ensure bonding of the tape to the skinApply one layer of prewrap over adherentApply lubricated pad

Prevents cuts, blisters and rashes

Overlap each strip of tape to the previous strip by half

Taping Guidelines Cont.…

Avoid spaces between tape segmentsSpaces may result in blistering

Smooth and mold the tape to the natural contour of the area Try to make athlete comfortable, but maintain dorsiflexionAfter wrapping/taping is complete check for comfort and impaired circulation

Taping Usage

Tape is available in variety of widths, strength and elasticityTape should adhere readily when appliedStretch and elastic should be used for smaller, more angular body partsTape should be stored in a cool place

Temperatures greater than 75 degrees may alter the adhesive ability

Taping Usage Cont...

To tear tape, hold firmly on each side of the proposed tear line, and pull the free end away at an angle so that the forces crosses the lines of the fabric at a sharp angleEdges should be straight, no loose threadsSpecial cutters are made for tape removalAvoid cutting over bony prominencesLook for blisters and skin irritations as the tape is removed

Effectiveness of Taping

ControversyTaping only should be used in conjunction with________________________Improperly applied wrap/tape can _____________ an injury and create postural imbalances

Arguments for and against Taping

ForMost studies agree that taping does contribute to a lower incidence of injury/re-injuryProphylactic taping is superior to lace on braces for the first 20 minutes, after that they are equal

AgainstTape usually becomes loose with wearThe skin is mobile, thus taping can not be effectiveTaping weakens the leg musclesMoisture develops between skin/tape, thus affecting tape adherenceTape tears under stress

Complications of Taping

Skin allergiesSkin irritationsBlistersLacerationsReactions to tape adherent

Common Taping Procedure

Routine Non-Injury Ankle TapingHave athlete sit on table with leg extended, the lower part of the calf past the edge of the tableHave athlete hold foot at a 90 degree angle in dorsiflexionApply a coat of tape adherent to protect the skin

Ankle Taping

Apply a foam pad over the instep and back of the heelApply a layer of prewrap to the ankleUsing 11/2 inch tape, apply an anchor around the ankle about 5-6 inches above the malleolusApply another anchor at the distal third of the longitudinal arch, making sure not to constrict the base of the fifth metatarsal

Ankle Taping

Apply 2-3 stirrups in consecutive orderBegin on the medial part of the calfPull up on the lateral aspect of the leg with moderate tensionThis places the foot into slight eversion

Apply circular strips form the point of the proximal anchor, moving downward until the malleolus is completely covered

Ankle Taping

Apply arch strips down to the distal anchorApply a heel lock

Start high on the instep, bring the tape along the ankle at a slight ankleHook the heelLead the tape under the archFinish by coming up on the opposite side by the starting point

Cover the ankle again with a second layer of tape (optional)

Prophylactic Thumb Taping

Protects the joints and surrounding musclesHave athlete fully extend and adduct the fingers, by keeping the thumb in a relaxed, neutral positionStand in front in the athleteApply rewrap to the forearm, wrist and thumb

Thumb Taping

Using 1 inch tape place an anchor strip around the wrist and another around the distal end of the thumbFrom the anchor at the tip of the thumb to the anchor around the wrist, apply 4 strips in a series on the dorsal side of the thumbHold these strips in place by applying one locking strip around the wrist and one encircling the tip of the thumb

Thumb Taping

Add a series of three “spica” stripsThe first spica is started on the radial side at the base of the thumb and carried under the thumb, completely encircling it and then crossing the starting pointThe strip should continue around the wrist and finish at the starting pointThe following 2 spica strips should overlap the preceding strip by at least 2/3 inch and move downward on the thumbPlace a final locking strip around the wrist

Elbow Hyperextension Taping

Have athlete stand with the elbow flexed at least 30-45 degrees, and the forearm in neutral positionTaper should stand facing the armApply adhesive spray to the areaApply prewrap from mid-humerus to the mid-forearmApply two anchor strips loosely around the arm, approximately 2-3 inches above and below the elbow joint

Elbow Hyperextension Taping

Construct a checkreinPlace a 4 inch strip of tape against the center of a 10 inch strip of tape, thereby “blanking out’ the center portion of the longer stripPlace the checkrein so that is spans the two anchor strips with the blanked out side facing down

Elbow Hyperextension Taping

Place 5 additional 10 inch strip of tape over the first checkrein (tape fan)Finish by securing the checkrein with three locking strips both above and below the elbow jointA figure-8 elastic wrap can be added over the taping to prevent the tape from slipping because of perspiration

Sports Medicine Professional Obligations

Ethical and Legal responsibility to each athlete they work withAthletes welfare should be __________________________ considerations-coaches, parents etc...Do not allow -_________________ considerations influence judgementIf pressure is exerted an question of judgement arises a _________________________should be called for- Physician has final call

Sports Medicine Obligations

If find unsafe coaching practices of facilities:Notify appropriate______________If advice is ignored report the findings and recommendations should be made to the ___________________________ Use careful judgement to ensure frivolous remarks are not madeSame situation applies for use of _______________________ drugs

Treat every athlete equallyBe loyal to the coaches, team, physicians, etc.

Coaching Techniques

Coach is responsible for -__________________ skillsCoaches should impart a proper game -_____________ and an overall safety awareness“Win at all costs” syndrome is dangerous and shows little regard for the safety of the athletesCoaches can show concern by meeting with team members and parents to inform about potential injuries and means of prevention

Coaching ObligationsWarn athletes of potential for _____________________injuriesInsist on blocking and tackling techniques that reduce the chance of injuryMust provide or delegate appropriate person to give emergency care and first aid in absence of a sports med professionalAt least one member of any coaching staff should have training in CPR and first aidSafety and well being of athlete must always ________ _______________Body MechanicsC_______________________

More than half the total body weight is located in the upper part of the body, which is supported by thin bonesCenter of gravity _________ ______________ as it is lowered- for example widening the stanceMusculature serves as a ____________________by absorbing impact and distributing it over a larger area

Body Mechanics

PostureSpine has 3 curves that help maintain balanceThe head weighs close to 14 pounds and is balanced on top of 7small cervical vertebrae

Particular vulnerable to injury____________________________ muscles is an important protective measure

Body Mechanics

Musculoskeletal System FactorsH___________, congenital or acquired defects may predispose athlete to a specific type of injuryP____________ deviations are often major underlying cause of sport injuries

For example a consistent pattern of knee injury may be related to asymmetries within the pelvis and the legs

Knee Disorders

Genu Valgum_________________________Weight bearing line passes to the lateral side of the center of the knee jointResults of the inward angling of the thigh and lower legCauses the body weight to be borne on medial aspectMore prone to medial knee injuries

Knee Disorder

Genu Varum_____________________________Opposite of Genu ValgumThe extra stress is placed on the lateral aspects Athlete more prone to lateral knee injuriesIf severe should be directed into non-contact activity (same for Genu Valgum)

Spinal Abnormalities

K______________________Round BackAbnormal curvature of thoracic spineForward Head and Flat chestBasketball players, gymnasts, weight lifters common to have this deviationSusceptible to anterior dislocations of arm

Spinal Abnormalities

L__________________Abnormal curvature of lumbar spineSway backFootball linemen and gymnasts are prone

S_________________Lateral curvature of the spineCan be attributed to unequal leg length

Universal Safety Precautions

Universal body substance precautions with all body fluids, blood being most commonWhen a wound is oozing or bleeding, __________________________________________________Wear ________________for all routine procedures_______________with germicide soap before and after using latex glovesChange gloves after each treatmentDiscard gloves that are torn, cut or punctured into a biohazard container

Universal Safety Precautions

Wear a protective face mask/eyewear if a procedure may drop or spry into eyes, nose or mouthDispose used needles, scalpel blades and other sharp items into a__________________________________________pricks should be reported to a physician Clean all tables and counters regularly with a______________________Use an approved pocket mask shield when giving artificial respiration

Universal Safety Precautions

_________________, coaches, athletes, etc. about the risks for contacting and spreading contagious diseasesIf athlete has blood on their uniform

They must be brought out of play until blood can be cleaned upA solution of bleach and water is used to remove the blood from the uniform

Precautions serve to protect not only the sports medicine professional, but also the athlete

The End

Any Questions???