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Chapter 8: Sports InjuriesOutline:
• Biomechanical principles of injury• Injury treatment and rehabilitation• Pain: nature’s warning system• Soft tissues injuries• Dislocations• Fractures• Concussions• Overuse injuries• Injury prevention
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4 Tissue Types:
Each type of tissue possesses unique mechanical Each type of tissue possesses unique mechanical characteristicscharacteristics
Epithelial Muscle Connective Nervous
BIOMECHANICAL PRINCIPLES OF INJURY
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Loading
• To best understand the biomechanical characteristics of tissue we examine its behaviour under ______________________
• Under load a ____________________________
• This change in shape (deformation) can be visualized through in the _________________________
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A
C
B
Deformation LargeSmall
Loa
dHigh
Low
Load Deformation Curve
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A
C
B
Elastic Region
Plastic Region
Ultimate Failure
Elastic Limit
Deformation LargeSmall
Loa
dHigh
Low
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A
C
B
Elastic Region
Plastic Region
Ultimate Failure
Elastic Limit
Deformation LargeSmall
Loa
dHigh
Low
7
A
C
B
Elastic Region
Plastic Region
Ultimate Failure
Elastic Limit
Deformation LargeSmall
Loa
dHigh
Low
8
A
C
B
Elastic Region
Plastic Region
Ultimate Failure
Elastic Limit
Deformation LargeSmall
Loa
dHigh
Low
If load continues to increase to ‘C’Macro- or complete failure
(e.g. torn ligament)
Tissue becomes completelyunresponsive to loads
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A
C
B
Elastic Region
Plastic Region
Ultimate Failure
Elastic Limit
Deformation LargeSmall
Loa
dHigh
Low
Area under the curve =
Slope =
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Tissues Response to Training Loads
1. Training load ____ elastic limit (B)– Positive training effect– Micro-failure
– the microscopic injuries cause temporary muscle soreness and weakness therefore need a rest period (e.g. a day off)
2. Training load ___ elastic limit– Negative training effect – More severe
*related to principles of training: overload (FITT), stress-rest intervals, overtraining
*optimal training occurs when tissue is stressed________________________
________________________________
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Forces Acting on Tissue
(pull) (squeeze) (twist)
Other terms: Valgus: outward angulation (of distal part away from midline)
Varus: inward angulation (..toward midline)
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• Injury Treatment– Received by patient from a health care
professional------
versus
• Injury Rehabilitation– Therapist’s restoration of injured tissue– patient's __________________– ______________________________– E.g. Athletic therapist (AT), Physiotherapist
(PT), Occupational Therapist (OT), Massage Therapist (MT), Chiropractor, etc.
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Inflammatory Response Phase (hours - 2 to 4 days)
• Inflammation begins at the time of injury
• Signs-----
• Treatment (PRICE) - Protect - Rest - Ice (Cryotherapy-Decreases
swelling, bleeding, pain, spasms)
- Compression (decreases swelling)
- Elevation (above level of the heart to return blood to heart and decrease swelling etc)
Healing PhasesHealing Phases::
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Fibroblastic Repair Phase (hours – 6 weeks)
• Injured tissue repair and scar formation
• Granulation ______________________
• _________ fibres are deposited by fibroblasts
• Signs seen in the phase1 subside
Treatment• Rehab-specific
exercises– Restore range of motion
and strength
• Manual massage (friction)
therapy and ultrasound– Help _____________
• Protective _________ _______________
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Maturation-Remodeling Phase
• Remodeling or ________________________ • Treatment:• More aggressive ______________________
– To organize the scar tissue along the lines of tensile stress
• Include sport-specific skills and activities
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PainPainPainPain
Pushing injured Pushing injured tissue closer to tissue closer to yield-level pointyield-level point
Pushing injured Pushing injured tissue closer to tissue closer to yield-level pointyield-level point
GastrointestinalGastrointestinalcomplicationscomplications
GastrointestinalGastrointestinalcomplicationscomplications
Pain•Nature’s way of telling us something is wrong•One of the best indicators of when the athlete is ready to resume activity
Inability to participate at optimal level or at all
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Injury Types:Overuse: • Progressive _____________________________________• Heals slowly (months)
_________:• Caused by abrupt force• Heals quickly
__________:• Repeated damage & inflammation due to neglected or
mistreated overuse or acute injuries• Accumulation of chronic _______________• Painful for tissue, pain-sensitive nerve endings• Heals slowly (years if un/mistreated)
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A: Soft Tissue Injuries:
1._____________ (a.k.a. Bruise)• Compressing force crushes tissue• E.g. “charleyhorse” – quadriceps• _____________________________• ______________ = severe pooling of
blood in bruise• Can be life-threatening if in vital organs
• Signs:______________________• Treatment: P-R-I-C-E• Myositis ossification – ____________
_______________________________
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____________
Tendon or muscle tissue is stretched
or torn
____________
_________or the joint capsule is stretched or
torn
2.Sprains and Strains
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Grades of sprains and strains
GRADE 1 (1st degree, mild) • Slightly stretched or torn; few muscle fibres (< ____% of fibres)• Signs:_______________________, no limitation of muscle mobility
or joint range of motion (ROM)
GRADE 2 (2nd degree, moderate)• Stretch or tear more muscle fibres (___________% of fibres)• Signs: tenderness,____________________, some limitation of
muscle mobility or joint ROM
GRADE3 (3rd degree, severe)• Stretch or tear ____________% of fibres (complete rupture)• Signs: severe tenderness, swelling, bruising, __________________
of muscle mobility/ROM, gap in tissue can sometimes be felt in complete rupture
• ______________________*See page 176 in text
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Common Strains
_____________ Adductors _____________ Hamstrings ________________
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• Occurs when great enough forces push the joint beyond its normal anatomical limits
a) _____________________: Joint surfaces come completely apart
e.g. ball of joint is forced out of socket as in a shoulder
b) ______________________(subluxation): When supporting structures (e.g. ligaments) are
stretched or torn causing bony structures to partially separate (i.e. pops out then pops in)
• Most common in finger, shoulder• Can become chronic
B: Dislocations:
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1. _____________________– Stays within the surrounding soft tissue
2. Compound (open) fracture– _____________________
3. ____________ fracture– Results from repeated low magnitude
loads (e.g. runners who overtrain)– Begins as a _________________
___________________________ – With continued use=weakened bone,
complete cortical bone fracture4. Avulsion fracture
– Involves tendon or ligament __________ _________________________________
C: Fractures: A crack, break or complete shattering of a bone
elbow
Compound fracture
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E: Overuse Injuries• Due to
– Repeated and accumulated microtrauma– Non-sufficient recovery
• Results from– _________________– __________________– ___________________– ___________________
*Note: words that end in “itis” = inflammationof the body part due to repetitive microtrauma (overuse)
e.g. stress fractures, tendonitis, bursitis
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• Symptoms– Pain (aggravated by movement)– Tenderness– Stiffness near joint
1. Tendonitis:1. Tendonitis: Inflammation of _____________________________________________________________
TendonitisTendonitis
))
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Injury Prevention: Injury Prevention:
1.
2.
- sport-specific activities
3.
-especially during off-season
-include flexibility activities
4.
5.
- Avoid overtraining
-Get proper sleep
-Cross-train in off-season
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