Management of Sports Injuries.ppt
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MANAGEMENT OF MANAGEMENT OF SPORTS INJURIESSPORTS INJURIES
Dr. Yanuarso, SpOTDr. Yanuarso, SpOT
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““Do not go where the path may lead, Do not go where the path may lead, go instead where there is no path… go instead where there is no path… and leave a trail.”and leave a trail.”
- Ralph Waldo - Ralph Waldo EmersonEmerson
Can’t Beat the First!Can’t Beat the First!
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AcuteAcute ChronicChronic
Most are preventable!Most are preventable!Training Training Methods Methods
EquipmentEquipmentDietDiet
InjuriesInjuries
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ACUTE INJURIESACUTE INJURIES
ContusionContusion
AbrasionAbrasion
LacerationLaceration
Sprain/StrainSprain/Strain
Subluxation/Subluxation/ DislocationDislocation
FractureFracture
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ACUTE INJURIESACUTE INJURIES
Blunt injury to soft tissuesBlunt injury to soft tissues
SwellingSwellingHematomaHematomaBruiseBruise
Common in contact sportsCommon in contact sports
ContusionContusion
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ACUTE INJURIESACUTE INJURIES
Management:Management:
Cold compressCold compress
Anti-inflammatories/Anti-inflammatories/ PainkillersPainkillers
Warm compress Warm compress *only after swelling *only after swelling subsidessubsides
ContusionContusion
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ACUTE INJURIESACUTE INJURIESAbrasionAbrasion
Break in the skinBreak in the skin
Epidermis or DermisEpidermis or Dermis
Scratch,ScrapScratch,Scrapee
BleedingBleeding
InfectionInfection
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ACUTE INJURIESACUTE INJURIESAbrasionAbrasion
Management:Management:
S-A-I-D protocolS-A-I-D protocolSS - soak- soak soapsoap scrubscrub
AA - antibiotics- antibiotics anti-tetanusanti-tetanus
II - irrigate- irrigate
DD - dress- dress*Painkillers*Painkillers
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ACUTE INJURIESACUTE INJURIESLacerationLaceration
Extends to SubcutaneousExtends to Subcutaneous Tissue and FatTissue and Fat
CutCut - over bony prominenceover bony prominence- by a sharp object- by a sharp object
Greater amount of bleedingGreater amount of bleeding
BiteBite
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ACUTE INJURIESACUTE INJURIESLacerationLaceration
Management:Management:
S-A-I-D protocolS-A-I-D protocol
Adhesive stripsAdhesive strips
SuturingSuturing
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ACUTE INJURIESACUTE INJURIESStrainStrain SprainSprain
Different entitiesDifferent entitiesSame managementSame management
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StrainStrain
-involves muscles involves muscles or tendonsor tendons
Tendon connects muscle to boneTendon connects muscle to bone
Example - Achilles tendonExample - Achilles tendonCalf muscle Calf muscle Calcaneus Calcaneus
Can progress to a tearCan progress to a tear
SprainSprain
- involves ligaments- involves ligaments
Connects one bone to anotherConnects one bone to another
Example - AnkleExample - Ankle
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ACUTE INJURIESACUTE INJURIESSprain/StrainSprain/Strain
Management:Management:
C-R-I-M-E-S protocolC-R-I-M-E-S protocol
C C - compression- compression
R R - rest- rest
I I - ice- ice
M M - medication- medication
E E - elevation- elevation
S S - support- support
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ACUTE INJURIESACUTE INJURIESSubluxation/Subluxation/ DislocationDislocation
Also involve jointsAlso involve joints
1 and 2 steps1 and 2 stepsbeyond a sprainbeyond a sprain
SprainSprain - normal joint - normal joint relationshiprelationship
SubluxationSubluxation - abnormal - abnormal
close proximityclose proximity
DislocationDislocation - complete loss - complete loss
dislocationdislocationsubluxationsubluxation
sprainsprain
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Usually done in a hospitalUsually done in a hospitalCan also be done on the fieldCan also be done on the field
Put the joint in place then immobilizePut the joint in place then immobilizeX-rays!X-rays!
C-R-I-M-E-SC-R-I-M-E-S
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ACUTE INJURIESACUTE INJURIES
surgerysurgery
FractureFractureInjuring force enough toInjuring force enough to break bonebreak bone
EmergencyEmergency
castingcastingsplintingsplinting
Immobilize prior Immobilize prior to moving patientto moving patient
C-R-I-M-E-SC-R-I-M-E-S
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CHRONIC INJURIESCHRONIC INJURIES
Secondary to:Secondary to:Repetitive traumaRepetitive trauma
OveruseOveruse
Result of:Result of:Poor trainingPoor training
Bad formBad form
Lousy genesLousy genes
Improper equipmentImproper equipment
Faulty dietFaulty diet
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CHRONIC INJURIESCHRONIC INJURIES
TrainiTrainingngRecovRecoveryery
FormForm TechniqueTechnique
EquipmentEquipment
GenesGenes
FluidsFluidsDietDiet
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CHRONIC INJURIESCHRONIC INJURIES
Low Back PainLow Back Pain
Jumper’s KneeJumper’s Knee
Achilles TendinitisAchilles Tendinitis
Tennis ElbowTennis Elbow
Golfer’s ElbowGolfer’s Elbow
RC TendinitisRC Tendinitis
Stress FractureStress Fracture
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CHRONIC INJURIESCHRONIC INJURIES
Low Back PainLow Back Pain*Very common*Very commonSeveral factors:Several factors:Over-trainingOver-training
Poor warm-up & cool downPoor warm-up & cool down
Weak abdominalsWeak abdominals
Tight hamstringsTight hamstrings
Improper shoe wearImproper shoe wear
Inappropriate bedInappropriate bed
Hard MassagesHard Massages
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Low Back PainLow Back PainManagementManagement::
Anti-Anti-inflammatoriesinflammatories
Warm Compress/ShowerWarm Compress/Shower
PT ModalitiesPT Modalities- UltrasoundUltrasound- Electrical StimulationElectrical Stimulation- LaserLaser- Hot Moist PackHot Moist Pack- Traction- Traction
(SWAMP)(SWAMP)
CHRONIC INJURIESCHRONIC INJURIES
Self TherapySelf Therapy
Muscle RelaxantsMuscle Relaxants
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ChiropractorsChiropractors
YogaYoga
AcupunctureAcupuncture
ReflexologyReflexology
PilatesPilates
Low Back PainLow Back PainManagementManagement::
CHRONIC INJURIESCHRONIC INJURIES
(CRAMP(CRAMPY)Y)
MagnetsMagnets
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CHRONIC INJURIESCHRONIC INJURIESPatellar TendinitisPatellar Tendinitis
““Jumper’s Knee”Jumper’s Knee”
Excessive contraction of theExcessive contraction of the Quadriceps muscleQuadriceps muscle
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CHRONIC INJURIESCHRONIC INJURIES
RR -- RestRest
SS -- Self TherapySelf TherapyII -- IceIce
PP -- PT ModalitiesPT Modalities
Infrapatellar Infrapatellar Brace/StrapBrace/Strap
AA -- Anti-inflammatoriesAnti-inflammatories
P-A-R-I-SP-A-R-I-Sprotocolprotocol
Patellar TendinitisPatellar TendinitisManagementManagement::
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CHRONIC INJURIESCHRONIC INJURIESAchilles TendinitisAchilles Tendinitis
Common in RunnersCommon in Runnersand Sprintersand Sprinters
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Management:Management:
SameSame
PPT ModalitiesT ModalitiesAAnti-inflammatoriesnti-inflammatoriesRRestestIIceceSSelf Therapyelf Therapy
CHRONIC INJURIESCHRONIC INJURIESAchilles TendinitisAchilles Tendinitis
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Golfer’s ElbowGolfer’s ElbowTennis ElbowTennis Elbow
ExtensorsExtensors FlexorsFlexors
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Lateral EpicondylitisLateral EpicondylitisMedial EpicondylitisMedial Epicondylitis
Faulty BackhandFaulty Backhand Faulty SwingFaulty Swing
Dominant HandDominant Hand Dominant Hand*Dominant Hand*
Tennis ElbowTennis Elbow Golfer’s ElbowGolfer’s ElbowBadminton ElbowBadminton Elbow
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Principle of Counterforce Bracing:Principle of Counterforce Bracing:Constrains muscular expansionConstrains muscular expansionBroadens muscle originBroadens muscle origin
BraceBraceSteroidsSteroids
Golfer’s ElbowGolfer’s ElbowP-A-R-I-SP-A-R-I-Sprotocolprotocol
ManagementManagement::
Badminton ElbowBadminton Elbow
SurgerySurgery
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Pain on Overhead ActivitiesPain on Overhead Activities
ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”
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AcromionAcromion
SupraspinatusSupraspinatus
ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”
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SurgerySurgery
Watch out forWatch out forFROZEN SHOULDER!FROZEN SHOULDER!
SteroidsSteroids
P-A-R-I-SP-A-R-I-S
ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”
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May also affect boneMay also affect bone
STRESS FRACTURESSTRESS FRACTURES
Responds to Responds to Conservative ManagementConservative Management
Takes longer to heal Takes longer to heal (2 to 3 months)(2 to 3 months)
Casting?Casting?
Exertional Compartment SyndromeExertional Compartment Syndrome
PeriosteitisPeriosteitis
CHRONIC INJURIESCHRONIC INJURIES
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Thank YouThank YouVery Much!Very Much!
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AnyAnyQuestions?Questions?