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Dave berg sports injuries

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    Dave berg sports injuries Dave berg sports injuries Presentation Transcript

    • ERINDANLE COLLEGE SPORTS INJURIES TALK
      • DAVE BERG, PHYSIO
      • BERG PHYSIOTHERAPY AND SPORTS INJURY CENTRE AT ERINDALE MEDICAL CENTRE
      • 6231 1155
    • Sport should be fun
    • ROLE OF PHYSIOTHERAPIST
      • MANAGEMENT OF MUSCULOSKELTAL INURIES IN PRACTICE
      • ON FIELD MANAGEMENT AND ASSESSMENT OF INJURIES
      • SCREENING FOR THE PREVENTION OF INJURIES
    • MUSCULOSKELETAL INJURIES
      • BONE
        • BREAKS, SPINAL INJURIES
      • MUSCLE STRAINS
        • TEARS, CORKS
      • TENDONS
        • IRRITATIONS, TEARS
      • LIGAMENTS
        • TEARS, SPRAINS
    • Musculoskeletal Injuries Cont
      • JOINT
        • MENISCAL, OSTEOCHONDRAL
        • DISLOCATIONS
      • OTHER SOFT TISSUE INJURIES
    • “ OTHER”
    • “ OTHER CONT”
    • BONE INJURIES
    • Bone Injuries
      • Usually high energy injuries
      • Immediate pain, usually associated with an audible crack
      • Deformity, Swelling, Pain to palpate, Pain to axially load.
      • Types of breaks
        • stress fracture, spiral fracture, transverse break
    • Stress Fractures
      • Begin as pain with activity
      • Progress to pain with activity and constant pain
      • Most commonly affected areas are the foot, shin and low back
    • Fracture Management
      • Fingers. Sign if not obvious is to press through length of bone.
      • Xray is gold standard test.
      • Surgery if displaced or rotated
      • four to six weeks if no surgery
      • Other breaks follow similar principles. Immobilisation or surgery depending on displacement.
    • Traumatic breaks
    • Muscle Injuries
      • Muscle Injuries are direct (corks), or indirect (tears).
      • Muscle tears are known as strains, and are classed one to three
      • Most commonly injured muscles are hamstring, calf, and quadriceps.
      • Muscle Tears have a very high recurrence rate.
    • Muscle Tears
      • Grade One Tear: 7-10 days
      • Grade Two Tear: 4-7 weeks
      • Grade Three Tears: >six weeks
      • Rehab of the muscle tear very important. Regaining strength, length and power.
      • Pain is not the guide. Tensile strength (ability to contract under load) does not recover till several weeks
    • Muscle Corks
      • Impact injuries
      • Usually poorly managed.
      • Immediate management should be ice with full stretch.
      • Definitely should not consume alcohol.
    • Ligament Injuries
      • Can be contact or non contact injuries.
      • Involve the joint being moved in a direction it does not want to go.
      • Pain is immediate
      • Ligament in ankle and knee are most commonly torn
    • Ligament Injuries Cont.
      • Injuries are graded one to three
      • Grade three injuries are full thickness tears and usually require surgery.
      • Grade two tears can generally be managed conservatively. >four weeks
    • Ankle Ligaments
      • Most commonly torn are the Lateral ligament and the syndesmosis)
      • Mechanism is usually rolling over the ankle, twisting on a fixed foot (syndesmosis), or falling over the heel usually from a height
    • Management of Ankle Injuries
      • Brace for four weeks if laxity present
      • Strength training to improve peroneal and gastroc muscle strength
      • Stretching to restore range of movement, particularly dorsiflexion
      • Balance or proprioception retraining.
    • Knee Ligaments
      • Most Commonly torn are the ACL and Medial Ligament.
      • ACL requires surgery. Is a non contact injury. Happens when stepping or cutting.
      • Medial ligament is usually a contact injury. Managed conservatively with a brace for four to six weeks.
      • Posterior Cruciate Ligament rarer. Hardly ever managed surgically even if fully torn.
    • Head Injuries
    • Head Injuries
      • Usually involve head contacting something solid eg another head or knee
      • If player is knocked out they should definitely not continue to play.
      • Aggression, twitching, vomiting, severe headache, amnesia, and blurred vision are all bad signs
      • Mandatory three weeks out if knocked out
    • Head Injuries
      • Three concussion episodes in one year should sit out the whole year.
      • Two impacts in rapid succession can result in death.
      • Should not consume alcohol, risk death
      • If knocked out should not drive home, should be monitored and should not sleep till that night.
    • Eye Injuries
      • Involves foreign object into eye socket.
      • Can result in loss of vision or eye.
      • Immediate hospital referral.
    •  
    • Joint Dislocations
      • Occurs when a joint is taken out its socket
      • Most commonly affected are the fingers shoulder, AC joint, and patella femoral joint. Ankles are uncommon
      • Knee and hip dislocations are rare and VERY serious
    • DISLOCATIONS CONT
    • Shoulder disclocations
    • SHOULDERS CONT
    • Shoulder dislocations
      • Mechanism outstretched arm forced backwards
      • In someone under 25 years, greater than 90 percent chance of doing it again
      • Once dislocated three times need surgery
      • Surgery follows six to nine month rehab period
    • Shoulder dislocations
      • Conservative approach after first dislocation MIGHT prevent subsequent episodes and therefore surgery.
      • Four to eight weeks off.
      • Strengthening of back and rotator cuff muscles.
      • Improved proprioception in shoulder.
      • Improved thoracic movement.
    • Other dislocations
      • Knee and hip dislocations require immediate hospital review. Person can lose their limb
      • Patellofemoral and AC dislocations are not surgical. Tend to respond very well to conservative treatment.
      • Finger dislocations can be surgical depending on direction of dislocation
    • Finger dislocations
    • Hip dislocation
    • Other joint injuries
      • Other intra articular structures can be damaged. These include bone cartilage interface, called osteochondral injuries, meniscus injuries.
      • Osteochondral injuries require prolonged rest or surgery.
      • Meniscal tears can settle with rest but often need surgery, especially if knee is locking
    • Tendon Injuries
      • Usually occur in older athletes when blood supply starts to lessen.
      • Can occur in younger athletes in high energy injuries.
      • Tendons most commonly torn are rotator cuff, achillies, patella.
      • These are usually surgical injuries.
    • Groin injuries.
    • Tendon Injuries Cont.
      • More common than tears are inflammations
      • Tendonitis starts as pain with activity and progresses to pain after activity.
      • Very difficult to manage once established due to the poor blood supply of tendons.
      • Best managed early with rest, anti inflams, and stretching and strengthening.
    • Back injuries
    • Back Injuries
      • Can be traumatic or due to overuse.
      • Stress Fractures can occur in sports where athletes bend backward a lot (gymnastics)
      • Any number of structures can be damaged, and exact diagnosis is much more difficult.
      • Back and neck injuries that occur on a football field or with high energy mechanism need to be taken very seriously
    • Many injuries can be prevented, but sometimes its just plain luck...
    • But don’t worry too much. After all, sport shouldn’t be taken too seriously, have fun!
    • AND BESIDES, INJURIES CAN HAPPEN ANYWHERE, ANYTIME.