BlazeSports Institute for Applied Science CDSS Level I
Curriculum 1
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Injury Prevention for Athletes with Physical Disabilities
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We would like to thank the following people for their
contributions to the content of this presentation: Ben Johnson,
EdD, CDSS Professor and Chair Dept. of Physical Education and
Exercise Science Brooklyn College City University of New York
Jackie McParlane, DO, FACOEP Director - Emergency Medicine
Residency Program Botsford Hospital Farmington Hills, MI 3
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OBJECTIVES This session will provide basic sport science
insights into how injuries occur in sport and physical activity and
their prevention through proper planning and training and
conditioning programs. The goal is to provide the participant with
an understanding of how acute and chronic injuries occur and
ultimately can be reduced or even eliminated through sound planning
and training. 4
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OBJECTIVES 1.The session participant will identify the areas of
specialization under the sports medicine umbrella and learn the
important components of the coachs role in the absence of a
Certified Athletic Trainer (ATC). 2.The session participant will
learn about the relationship of stress and strain on
musculoskeletal tissues and how each relates to both acute and
chronic injuries. 3.The session participant will learn about the
components of fitness and the principles of training and
conditioning. 4.The session participant will learn to identify
specific aspects of disability sport and physical activities that
may contribute to injury. 5
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SPORTS MEDICINE The American College of Sports Medicine (ACSM)
defines sports medicine as multidisciplinary, including the
physiological, biomechanical, psychological, and pathological
phenomena associated with exercise and sport. 6
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WHAT IS YOUR ROLE? Coaching Physical Education Sport Psychology
Personal Fitness Training Strength & Conditioning Sports
Nutrition Exercise Physiology Biomechanics Athletic Training Sports
Physical Therapy Physician Physicians Assistant Sports Massage
Therapy Sports Dentistry Osteopathic Medicine
Orthotists/Prosthetists Sports Chiropractic Performance Enhancement
Injury Care & Management 7
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THE COACH Understand the role and responsibility of each person
on the sports medicine team Know the state laws surrounding the
ability to function as a health care provider Certified in CPR and
First Aid Directly responsible for injury prevention by ensuring
athletes have the proper level of fitness to participate Must
engage in professional development 8
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THE COACH Ensure the competitive environment (field of play) is
as safe as possible Educate parents and athletes about inherent
risks related to participation Ensure proper training and
conditioning of athlete Monitor environmental conditions to ensure
safe participation Selecting, properly fitting and maintaining
equipment including protective equipment Explain importance of
proper nutrition and hydration When there is no Certified Athletic
Trainer 9
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TRAINING AND CONDITIONING Improper conditioning is one of the
major causes of sports injuries!! 10
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TRAINING AND CONDITIONING A FATIGUED athlete is more prone to
injury!! 11
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TRAINING AND CONDITIONING Specific Adaptations to Imposed
Demands SAID Principle 12
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TRAINING AND CONDITIONING Cardiorespiratory Fitness Flexibility
Muscular Fitness Components of Physical Fitness 13
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TRAINING AND CONDITIONING Cardiorespiratory (Energy) Fitness
Aerobic Anaerobic Components of Physical Fitness 14
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TRAINING AND CONDITIONING Cardiorespiratory Fitness Interval
Training Components of Physical Fitness 15
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TRAINING AND CONDITIONING Flexibility Static (passive) Dynamic
(active) Components of Physical Fitness 16
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TRAINING AND CONDITIONING Factors that Affect Flexibility
Anatomical Joint structure, age, gender Limited training affect
Training Activity level, resistance training, stretching exercises
Components of Physical Fitness 17
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Loading or Force Tension Compression Shear Bending Torsion
Deformation Change in shape/length Elastic limits of bone, tendons,
ligaments and cartilage Failure point of tissue 18 TRAINING AND
CONDITIONING Components of Physical Fitness Stress and Strain on
Tissue
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Force / Load Length/Deformation of Tissue Complete Failure of
Tissue Plastic Region Elastic Region Serious injury of tissue
begins Micro-injury of tissue begins with frequent repetition in
this range Normal range for most people 19
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TRAINING AND CONDITIONING Stretching Techniques Passive Static
Active Ballistic Dynamic Combined Proprioceptive Neuromuscular
Facilitation (PNF) Components of Physical Fitness 20
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TRAINING AND CONDITIONING Static Stretching Most common method
Excellent for increasing ROM Appropriate for all athletes Safest
method of stretching due to slow, controlled movements 30 second
hold 3-4 repetitions Components of Physical Fitness 21
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TRAINING AND CONDITIONING Ballistic Stretching Bouncing
movements Stretch not held Invokes stretch reflex Higher potential
for injury NOT recommended for increasing flexibility Different
from plyometric training Performed within existing ROM Components
of Physical Fitness 22
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TRAINING AND CONDITIONING Dynamic Stretching Functional,
sport-specific movements NO bouncing Ideal during warm-up
Incorporate multiple joints Maintain body temp Time efficient Not
as effective for ROM increase as static or PNF stretching
Components of Physical Fitness 23
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TRAINING AND CONDITIONING PNF Stretching First used in
neuromuscular rehabilitation Relax muscle with increased tone or
activity Can be ore effective than static stretching Usually
requires a partner Three Types Hold-Relax Contract-Relax Hold-Relax
with Agonist Contraction Components of Physical Fitness 24
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TRAINING AND CONDITIONING Muscular Fitness Flexibility Strength
Power Endurance Components of Physical Fitness 25
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Force Motion Motion Energy Energy Injury Potential 26
Components of Physical Fitness TRAINING AND CONDITIONING
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Strength The maximal force a muscle group can generate at a
specified velocity Velocity (v) = change in position change in time
v = displacement time Components of Physical Fitness 27
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TRAINING AND CONDITIONING Strength The maximal force a muscle
group can generate at a specified velocity Force (F) = mass x
acceleration acceleration (a) = change in velocity change in time
Components of Physical Fitness 28
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TRAINING AND CONDITIONING Components of Physical Fitness 29 F =
m ( v / t) Maximize or Minimize Force??? Force = Mass = Change in
Velocity = Time =
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TRAINING AND CONDITIONING Power The ability to generate force
rapidly Power = Work / time Components of Physical Fitness 30
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TRAINING AND CONDITIONING Endurance The ability to perform
repetitive muscular contractions against some resistance Components
of Physical Fitness 31
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TRAINING AND CONDITIONING Components of Physical Fitness 32
Muscle Balance Train anterior and posterior muscles uniformly
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TRAINING AND CONDITIONING Components of Physical Fitness 33
Muscle Balance
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TRAINING AND CONDITIONING Warm-up/cooldown Motivation Overload
Consistency Progression Intensity Specificity Individuality Stress
Safety Principles of Conditioning 34
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TRAINING AND CONDITIONING Warm-up 15-20 min. General Increase
heart rate, blood flow, body temp., respiration rate, perspiration
and decrease joint viscosity Stretching Static Vs Dynamic Specific
(technical skill) Principles of Conditioning 35
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TRAINING AND CONDITIONING Cooldown 5-15 min. Brings heart rate
back to baseline Prevents blood from pooling in lower extremities
Stretching helps relax muscles, maintain ROM Principles of
Conditioning 36
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TRAINING AND CONDITIONING Motivation Vary the training program
to keep it fresh Utilize proper goal setting to maintain motivation
Overload Gradually increase the imposed demands to realize
continual results Maintain muscle balance Principles of
Conditioning 37
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TRAINING AND CONDITIONING Consistency Training and conditioning
must take place 2-3 times per week to realize change Progression
Gradually increase the intensity of the program Intensity Increase
intensity rather than quantity/duration Principles of Conditioning
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TRAINING AND CONDITIONING Specificity Develop the program to
address specific fitness goals Begin with general fitness, then
move to sport-specific Aerobic, anaerobic, power, speed, endurance,
flexibility, etc. Individuality Adjust the training program to meet
the needs and progression of the individual athlete Principles of
Conditioning 39
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TRAINING AND CONDITIONING Stress If you are engaged in a
program that meets multiple times per week, understand that the
athlete has other stressful aspects to their life and may need time
away from training Safety Environment Education Principles of
Conditioning 40
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PERIODIZATION Individualized Organizes training and
conditioning into cycles Timely peak performance Helps reduce
injury Helps avoid overtraining Principles of Conditioning 41
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PERIODIZATION Principles of Conditioning 42
SeasonPeriod/PhaseType of Training Off-seasonTransition Period
(postseason) Unstructured, recreational Preparatory PeriodCross
training Hypertrophy/ endurance phaseLow intensity, high volume,
general Strength PhaseModerate intensity, moderate volume, begin
sport-specific PreseasonPower PhaseHigh intensity, decrease volume,
highly sport-specific In-SeasonCompetition PeriodHigh intensity,
low volume, skill training, strategy, maintain strength and
power
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AGE CONSIDERATIONS Youth Ensure emotional and cognitive
maturity to follow directions Focus on muscular strength and
endurance, flexibility, and cardiorespiratory endurance Limit heavy
loads and moderate progression Principles of Conditioning 43
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AGE CONSIDERATIONS Older Adults Consider pre-existing health
conditions Aerobic and resistance training beneficial Begin with
low-intensity and low-volume in untrained participants Moderate
progression Principles of Conditioning 44
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INJURY CONCERNS BY IMPAIRMENT/DISABILITY Athletes who use Sport
Chairs Athletes with Amputations Athletes with Cerebral Palsy
Athletes with Visual Impairment 45
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1.Most common injuries are strains & muscular injuries of
upper extremities 2.Overuse Injuries 3.Fractures of hands from
falls & collisions 4.Overdevelopment of anterior muscles,
weakness of posterior muscles 46 ATHLETES WHO USE SPORT CHAIRS
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AUTONOMIC DISREFLEXIA Can be life threatening! Conditions,
below the level of injury, that may lead to autonomic hyperreflexia
include : Full Bladder Constipation or a full bowel Pain Infection
Skin breakdown Ingrown toenail Sudden temperature changes in the
surrounding environment Symptoms may include: High blood pressure
Low heart rate Anxiety or agitation Severe pounding headache
Sweating above the level of the injury Nasal stuffiness 47
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Treatment Sit athlete up/dangle legs down Removal of Stimuli
Catheterization Loosen tight clothes Anti-hypertensive medication
Complications Seizures pulmonary edema myocardial infarction
cerebral hemorrhage AUTONOMIC DISREFLEXIA Can be life threatening!
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1.Risk for skin irritation or breakdown. 2.Use appropriate
padding and friction eliminating material ATHLETES WITH AMPUTATION
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Seizures relatively common in this population Increase in
lactic acid production => muscle fatigue Wheelchair users have
higher upper extremity strains, sprains, overuse Ambulatory
athletes have more knee injuries Be aware of the role spasticity
plays Crashes ATHLETES WITH CEREBRAL PALSY 50
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No visual cues May have different biomechanics May expend more
energy because of lack of visual cues Watch for earlier fatigue
& overuse injuries Crashes ATHLETES WITH VISUAL IMPAIRMENT
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Overuse Injuries Dehydration Heat Illness Cold Injury
Acclimatization Seizures Pressure Ulcers Prosthetics &
Orthotics Multiple Sclerosis Brittle Bones Concussions MEDICAL
ISSUES OF CONCERN Across the Spectrum
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OVERUSE/CHRONIC INJURIES REPETITIVE MOTION INJURIES Bursitis /
Tendinitis Plantar fasciitis Patellofemoral syndrome Sprains and
strains Stress fractures Lower back injuries
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54 DEHYDRATION
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Drink water before, during & after event DO NOT rely on
thirst as indicator of when to drink Drink COOL beverages Drink
480ml for every.45kg lost Begin fluid replacement immediately
Sports beverages should have carb concentration of 4-8% 55
DEHYDRATION
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NEVER consume energy drinks prior to competition 56
DEHYDRATION
59 HEAT ILLNESS Signs and Symptoms Heat Stroke Body temp 104
Hot, dry skin Staggering Disorientation Loss of consciousness
Tachycardia (100-120 bpm) ACTIVATE EMERGENCY ACTION PLAN
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60 COLD INJURY Athletes with SCI Less sensitive to the
sensation of cold on the skin surface Diminished perception of skin
temperature change Diminished capability to stabilize core
temperature Unable to induce shiver response
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61 COLD INJURY Prevention Strategies Educate athletes and
coaches on prevention, recognition and treatment Maintain proper
hydration and food intake Develop event and practice guidelines to
make participation decisions Proper clothing Rewarming
opportunities
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ACCLIMATIZATION 62
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Hypersynchronous discharge of the cerebral neurons Range of
types Factors Increasing Incidence of Seizures: Dehydration Stress
Hypoglycemia Hyperventilation Electrolyte Imbalance Head Trauma
SEIZURES 63
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PROSTHETICS & ORTHOTICS 64
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Most common in athletes with paralysis or athletes unable to
move themselves Can occur with orthotics & prosthetics Check
for ulcers/skin breakdown regularly Begin treatment as soon as
noted PRESSURE ULCERS 65
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Concerns in Sport Heat Over Exertion MULTIPLE SCLEROSIS 66
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Concerns in Sport Fractures Breaks Low Impact Exercise Improves
bone density OSTEOGENESIS IMPERFECTA 67
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Traumatic Brain Injury (TBI) Wear proper protective equipment
Ensure all equipment is maintained and safe Wheelchairs and
anti-tip bars CONCUSSIONS 68
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Maddocks questions combine scientific validity with a quick
simple and practical tool which can be administered either on-field
or on the sidelines. Any incorrect response indicates concussion
and requires removal from the playing field for further medical
evaluation CONCUSSIONS 69
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Which field are we at? Which team are we playing today? Who is
your opponent at present? Which half/period is it? How far into the
half is it? Which side scored the last touchdown/goal/point?
CONCUSSIONS 70
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www.cdc.gov/concussion CONCUSSIONS 71
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INJURY PREVENTION STRATEGIES 72 Safe environment Appropriate,
well maintained equipment Individualized training Warning signs of
injury Warm-up, stretching, and cool-down Appropriate training
prescription Mode, duration, frequency, intensity, progression
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Rest and Recovery FATIGUE FATIGUE FATIGUE The chance of
musculoskeletal injury increases significantly when fatigued 73
INJURY PREVENTION STRATEGIES
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Use basic common sense and logical thinking to prevent or
reduce injuries! Remember that FORCE leads to MOTION that leads to
ENERGY that leads to INJURY The bodys tissues have
physiological/biomechanical limitations that, if exceeded, will
lead to injury One must limit or reduce force applied to and by the
body while also avoiding extreme deformation of body tissues in
unnatural positions. Chronic fatigue and overtraining is the enemy
of the athlete with or without a disability TAKEAWAYS FROM THIS
PRESENTATION 74
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Baechle, T. R., & Earle, R. W. (Eds.). (2008). Essentials
of Strength Training and Conditioning - National Strength and
Conditioning Association (3rd ed.). Champaign, IL, USA: Human
Kinetics. Martens, R. (2004). Successful Coaching - American Sport
Education Program (3rd ed.). Champaign, IL, USA: Human Kinetics.
Prentice, W. E. (2008). Essentials of Athletic Injury and
Management (7th ed.). New York, NY, USA: McGraw-Hill. Spengler, J.
O., Connaughton, D. P., & Pittman, A. T. (2006). Risk
Management in Sport and Recreation. Champaign, IL, USA: Human
Kinetics. ADDITIONAL RESOURCES 75