Your SlideShare is downloading. ×
Managing sports injuries
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Managing sports injuries

348

Published on

Published in: Education
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
348
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
38
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. MANAGINGMANAGING SPORTSSPORTS INJURIESINJURIES
  • 2. PREVENTION OFPREVENTION OF INJURY IS BETTERINJURY IS BETTER THAN CURETHAN CURE potentially between 30 – 50% ofpotentially between 30 – 50% of sports injuries are preventablesports injuries are preventable
  • 3. Sporting injuries comeSporting injuries come from three main areas:from three main areas:  Human (54%)Human (54%)  Muscle weaknessMuscle weakness and imbalanceand imbalance  Inadequate warm up and cool downInadequate warm up and cool down  SpectatorsSpectators  CollisionCollision  Improper techniqueImproper technique  Terrain (31%)Terrain (31%)  Uneven groundUneven ground  Obstructions on groundsObstructions on grounds  Wet and/or slippery groundsWet and/or slippery grounds  Equipment (15%)Equipment (15%)  Unsafe protective equipmentUnsafe protective equipment  Inadequate, ill fitting protective equipmentInadequate, ill fitting protective equipment  Unpadded fixturesUnpadded fixtures
  • 4. PRINCIPLES OF PREVENTION 1. Prevent the incident occurring in the first place 2. Prevent complications arising from the incident 6. Prevent your intervention being harmful to the athlete 3. Prevent death 5. Prevent delay in the athlete’s recovery 4. Prevent the athlete becoming worse
  • 5. ELEMENTS IN THEELEMENTS IN THE PREVENTION OFPREVENTION OF INJURYINJURY Warm UpWarm Up Athletes should warm up beforeAthletes should warm up before allall trainings and competitions astrainings and competitions as close to the commencement asclose to the commencement as possible. They should warm uppossible. They should warm up with 5 – 10 minutes of lightwith 5 – 10 minutes of light activity, stretching and specificactivity, stretching and specific skills of the sport – until theyskills of the sport – until they have a light sweat.have a light sweat.  Warm up:Warm up:  Helps prepare the mind and bodyHelps prepare the mind and body for exercisefor exercise  Increases body and muscleIncreases body and muscle temperaturetemperature  Increases the blood and oxygenIncreases the blood and oxygen to the working musclesto the working muscles  Increases flexibilityIncreases flexibility StretchingStretching Stretching should be performedStretching should be performed during warm up and cool downduring warm up and cool down and should follow ‘Guidelines forand should follow ‘Guidelines for safe stretching’.safe stretching’.  Stretching:Stretching:  Lengthens muscles so there isLengthens muscles so there is minimal strain during exerciseminimal strain during exercise  Reduces the risk of injuryReduces the risk of injury  Maintains flexibility so musclesMaintains flexibility so muscles can respond effectively duringcan respond effectively during sporting activitysporting activity
  • 6. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… Cool DownCool Down Athletes should graduallyAthletes should gradually reduce activity for 5 – 10reduce activity for 5 – 10 minutes following training orminutes following training or competition, followed by staticcompetition, followed by static stretching.stretching.  Cool down:Cool down:  Prevents pooling of the bloodPrevents pooling of the blood in the limbs, which can leadin the limbs, which can lead to dizziness and faintingto dizziness and fainting  Aids the removal of wasteAids the removal of waste products from the muscles egproducts from the muscles eg lactic acidlactic acid  Helps maintain flexibilityHelps maintain flexibility  Enhances recoveryEnhances recovery  Reduces muscle sorenessReduces muscle soreness and stiffnessand stiffness Skill DevelopmentSkill Development The higher the skill level theThe higher the skill level the lower the rate of injury,lower the rate of injury, therefore skill developmenttherefore skill development and technique is crucial.and technique is crucial.
  • 7. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… FitnessFitness Fitness is important because it allowsFitness is important because it allows the athlete to perform at their bestthe athlete to perform at their best and assists in injury prevention.and assists in injury prevention. While injuries can occur at any timeWhile injuries can occur at any time they are more likely to occur at thethey are more likely to occur at the end of the sporting activity becauseend of the sporting activity because the athlete is tire, less able to copethe athlete is tire, less able to cope with physical demand and lesswith physical demand and less capable of performing skills to ancapable of performing skills to an adequate level due to fatigue.adequate level due to fatigue.  Components of fitness include:Components of fitness include:  Cardiovascular endurance (heart andCardiovascular endurance (heart and lungs delivering oxygen to thelungs delivering oxygen to the muscles over time)muscles over time)  Muscular endurance (musclesMuscular endurance (muscles continuing work over an extendedcontinuing work over an extended period of time)period of time)  Strength (muscles producing forceStrength (muscles producing force against resistance)against resistance)  Speed (to move as fast as possible)Speed (to move as fast as possible)  Power (producing maximum force inPower (producing maximum force in the shortest time)the shortest time)  Flexibility (range of movement aroundFlexibility (range of movement around a joint)a joint) Improving fitness:Improving fitness: Involves the principle of overload, theInvolves the principle of overload, the body must work harder than it is usedbody must work harder than it is used to, adapt to this higher level and thento, adapt to this higher level and then improve. This must be doneimprove. This must be done gradually; therefore only one FITTgradually; therefore only one FITT factor should be increased at a time.factor should be increased at a time.  FF FrequencyFrequency (number of(number of session per day/week)session per day/week)  II IntensityIntensity (how hard the(how hard the exercise is performed)exercise is performed)  TT TimeTime (length of time at the(length of time at the intensity required)intensity required)  TT TypeType (exercise must be(exercise must be specific to fitness component)specific to fitness component)
  • 8. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… Rules of the gameRules of the game Many rules are written for the safetyMany rules are written for the safety of the game, therefore athletesof the game, therefore athletes should learn both the written andshould learn both the written and unwritten rules of the game.unwritten rules of the game. Coaches should emphasise goodCoaches should emphasise good sportsmanship and fair play andsportsmanship and fair play and discourage violence or dangerousdiscourage violence or dangerous techniques.techniques. Sporting grounds/areasSporting grounds/areas Environments should be safe, beEnvironments should be safe, be sure of the following:sure of the following:  Level and firmLevel and firm  Free from obstructions eg sprinklerFree from obstructions eg sprinkler headsheads  Permanent fixtures should bePermanent fixtures should be padded, flexible and highly visiblepadded, flexible and highly visible  Spectators should be well away fromSpectators should be well away from the playing areasthe playing areas  Adequate matting is provided whereAdequate matting is provided where necessarynecessary  Have safe ground markingsHave safe ground markings EquipmentEquipment Check equipment for:Check equipment for:  Properly erected/constructedProperly erected/constructed  Stable or movable if necessaryStable or movable if necessary  Properly anchoredProperly anchored  Padded as appropriatePadded as appropriate  Checked before being used, especially ifChecked before being used, especially if supporting body weightsupporting body weight Change roomsChange rooms Should be:Should be:  Clean and tidyClean and tidy  Adequate size for the number of athletesAdequate size for the number of athletes using themusing them  Have adequate soap, paper towel, rubbishHave adequate soap, paper towel, rubbish bins, brooms, disinfectant available at allbins, brooms, disinfectant available at all times.times.
  • 9. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… Protective equipmentProtective equipment Should be:Should be:  Designed to protect againstDesigned to protect against injuryinjury  Light and comfortable to wearLight and comfortable to wear  In good conditionIn good condition  Correctly assembledCorrectly assembled  Correctly worn by the athleteCorrectly worn by the athlete  An appropriate size and fit andAn appropriate size and fit and not interfere with functionnot interfere with function  Appropriate for the sport andAppropriate for the sport and conditions encounteredconditions encountered Taping and BracingTaping and Bracing Taping and bracing can help toTaping and bracing can help to reduce injury or the chance ofreduce injury or the chance of injury by restricting theinjury by restricting the movement of the joint. It ismovement of the joint. It is effective in prevention andeffective in prevention and reducing the severity of injuries.reducing the severity of injuries. Fluid replacementFluid replacement When exercising it is important toWhen exercising it is important to replace lost fluids, especially inreplace lost fluids, especially in the heat, otherwise it can lead tothe heat, otherwise it can lead to dehydration, fatigue, reduceddehydration, fatigue, reduced performance, heat illness andperformance, heat illness and even death.even death. When exercising in heat or humidWhen exercising in heat or humid conditions: take it easy, wearconditions: take it easy, wear loose, light coloured clothing thatloose, light coloured clothing that permits air flow and drink before,permits air flow and drink before, during and after activity.during and after activity.  Note: It is possible to becomeNote: It is possible to become dehydrated in cooler conditionsdehydrated in cooler conditions  Children and elderly are moreChildren and elderly are more susceptible to heat illness sosusceptible to heat illness so must be closely monitored in hotmust be closely monitored in hot and humid conditions.and humid conditions.
  • 10. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… SunshineSunshine Australia’s harsh conditions,Australia’s harsh conditions, especially between 11 am and 3 pmespecially between 11 am and 3 pm can be harmful. The Australiancan be harmful. The Australian Cancer Society recommends:Cancer Society recommends: Slip on a shirtSlip on a shirt Slop on some sunscreenSlop on some sunscreen Slap on a hatSlap on a hat Wrap on a pair on sunglassesWrap on a pair on sunglasses ColdCold When exercising in the cold considerWhen exercising in the cold consider the following:the following:  Plan properly and avoid long breaksPlan properly and avoid long breaks  If long breaks occur re warm upIf long breaks occur re warm up  Wear warm clothingWear warm clothing  Dress in layers to trap heatDress in layers to trap heat  The layer closest to the body shouldThe layer closest to the body should be a natural fibre (wool or cotton)be a natural fibre (wool or cotton)  Cover heads, face and hands toCover heads, face and hands to reduce heat lossreduce heat loss  Wear wind and waterproof outerWear wind and waterproof outer clothingclothing Appropriate management of existingAppropriate management of existing illness/injuryillness/injury When ill or injured an athlete shouldWhen ill or injured an athlete should not train as it can cause tissue andnot train as it can cause tissue and organ damage and further damage toorgan damage and further damage to the injury.the injury.  Before returning to sports, athletesBefore returning to sports, athletes should ensure:should ensure:  The doctor or physio has given themThe doctor or physio has given them clearanceclearance  The injured part has full range ofThe injured part has full range of movementmovement  Injured area has full strengthInjured area has full strength  The injured area is pain freeThe injured area is pain free  There is no inflammation of theThere is no inflammation of the injured areainjured area Personal HygienePersonal Hygiene Bathing reduces body odour, keepsBathing reduces body odour, keeps skin healthy, is soothing to the skin,skin healthy, is soothing to the skin, prevents chafing and preventsprevents chafing and prevents blocked pores. Hand washingblocked pores. Hand washing reduces the risk of spreadingreduces the risk of spreading infection or illness. This is importantinfection or illness. This is important for the health of the athlete.for the health of the athlete.
  • 11. Elements in the prevention of injuryElements in the prevention of injury continued……continued…… Group hygieneGroup hygiene Golden RuleGolden Rule DO NOTDO NOT SHARESHARE  DO NOT share towels, razors,DO NOT share towels, razors, sponges, face washers, watersponges, face washers, water bottles or any other equipment thatbottles or any other equipment that may contain body fluidsmay contain body fluids  Discourage communal bathingDiscourage communal bathing areas such as spasareas such as spas  Ban spitting or urinating in teamBan spitting or urinating in team areasareas  Do not put hands in water bucketsDo not put hands in water buckets  Proper use of water bottles, nozzleProper use of water bottles, nozzle should not touch the lipsshould not touch the lips  All clothes, equipment and surfaceAll clothes, equipment and surface areas contaminated by blood mustareas contaminated by blood must be treated as potentially infectiousbe treated as potentially infectious and treated accordinglyand treated accordingly  All athletes should be vaccinatedAll athletes should be vaccinated against Hep Bagainst Hep B  All group areas should be dry andAll group areas should be dry and clean with adequate supplies ofclean with adequate supplies of cleaning products.cleaning products. Balanced competitionBalanced competition Competitions should not simply byCompetitions should not simply by age groups, try to balance through:age groups, try to balance through:  AgeAge  SizeSize  StrengthStrength  SkillSkill  GenderGender  DisabilityDisability  HeightHeight  WeightWeight Common SenseCommon Sense Tells you it is far better to preventTells you it is far better to prevent than manage!!!!than manage!!!!
  • 12. QUICK ON FIELD APPROACHQUICK ON FIELD APPROACH TO THE INJURED ATHLETETO THE INJURED ATHLETE SS STOPSTOP TT TALKTALK OO OBSERVEOBSERVE PP PREVENT FURTHER INJURYPREVENT FURTHER INJURY Severe injury – get helpSevere injury – get help Less severe – RICER regimeLess severe – RICER regime Minor injury – play onMinor injury – play on
  • 13. A DETAILEDA DETAILED ASSESSMENT OF THEASSESSMENT OF THE INJURED ATHLETEINJURED ATHLETE  TT TALKTALK  OO OBSERVEOBSERVE  TT TOUCHTOUCH  AA ACTIVE MOVEMENTACTIVE MOVEMENT  PP PASSIVE MOVEMENTPASSIVE MOVEMENT  SS SKILL TESTSKILL TEST
  • 14. A SUMMARY OF THE APPROACH TOA SUMMARY OF THE APPROACH TO AN INJURED ATHLETEAN INJURED ATHLETE If it is preventable – prevent it!!!If it is preventable – prevent it!!! Once it has happened –Once it has happened – DANGERDANGER Control dangers then assessControl dangers then assess injured athleteinjured athlete LIFE THREATLIFE THREAT Use DRABCUse DRABC INITIAL INJURYINITIAL INJURY Use STOPUse STOP ASSESSMENTASSESSMENT DETAILED INJURYDETAILED INJURY Use TOTAPSUse TOTAPS ASSESSMENTASSESSMENT INITIALINITIAL Manage appropriatelyManage appropriately MANAGEMENTMANAGEMENT REFERREFER STEP1 STEP2 STEP3 STEP4 STEP5
  • 15. ASSESSING THEASSESSING THE MANAGEMENT OFMANAGEMENT OF INJURIESINJURIES One is the most important with five being the least important.One is the most important with five being the least important. 1.1. Life EssentialLife Essential – such as unconscious, airway obstruction,– such as unconscious, airway obstruction, breathing difficulty or haemorrhage.breathing difficulty or haemorrhage. To be covered in ‘DealingTo be covered in ‘Dealing with Serious Injuries’.with Serious Injuries’. 2.2. Protected non-life essential internal organsProtected non-life essential internal organs – such as spinal– such as spinal cord, gastro-intestinal organs, kidney and external genetalia.cord, gastro-intestinal organs, kidney and external genetalia. To be covered in ‘Dealing with Serious Injuries’.To be covered in ‘Dealing with Serious Injuries’. 3.3. Hard tissue injuriesHard tissue injuries – such as fractures and dislocations– such as fractures and dislocations 4.4. Soft tissue injuriesSoft tissue injuries – such as muscle strains and ligament– such as muscle strains and ligament sprainssprains 5.5. Body surface damageBody surface damage – such as skin abrasions, lacerations,– such as skin abrasions, lacerations, or infections.or infections.
  • 16. INJURYINJURY CYCLECYCLE Prevention Incident Phase Prevention of Recurrence Acute Phase Rehabilitation Definitive Care
  • 17. HARD TISSUE INJURIES - fracturesHARD TISSUE INJURIES - fractures A fracture is a break in the bone, which can be as simple as aA fracture is a break in the bone, which can be as simple as a small crack with no visible deformity, or complex, in that itsmall crack with no visible deformity, or complex, in that it may affect life support close to the site of the fracture.may affect life support close to the site of the fracture. Common causes of fractures:Common causes of fractures: CAUSE DEFINITION EXAMPLE Direct contact with Others Implements The ground The bone is struck directly, breaking at the point of impact Forearm is hit by a hockey stick, resulted in a fractured ulna Indirect force on a body part Force is indirectly applied to the bone causing a fracture away from the point of impact. Landing on an out stretched arm, resulting in a fracture of the clavicle. Inappropriate muscular action, for example forceful contraction Muscles contract forcefully and strongly pull on bones causing a fracture An athlete jumping from a height, landing on their feet and fracturing their patella. Overuse, repeated trauma The repeated use (overuse) of a joint causes small fractures in the bone called stress fractures A runner who trains long distances may develop a stress fracture of a bone in the foot.
  • 18. FRACTURESFRACTURES  Types of fractures include:Types of fractures include:  ClosedClosed – the bone is fractured but there is no cut or– the bone is fractured but there is no cut or wound at the fracture sitewound at the fracture site  OpenOpen – a jagged end of the fractured bone protrudes– a jagged end of the fractured bone protrudes through the skin OR there is a cut near the fracture sight,through the skin OR there is a cut near the fracture sight, though the bone does not penetrate the skinthough the bone does not penetrate the skin  ComplicatedComplicated – the fractured bone damages the local– the fractured bone damages the local tissues or organs that it protects eg a lung punctured bytissues or organs that it protects eg a lung punctured by a fractured rib.a fractured rib.  Signs and symptoms of a fracture:Signs and symptoms of a fracture:  PainPain  Reduced movement or inability to move the injured partReduced movement or inability to move the injured part  Local bony tenderness at the injury siteLocal bony tenderness at the injury site  DeformityDeformity  Irregular alignment of the limbIrregular alignment of the limb  SwellingSwelling
  • 19. MANAGEMENT OF AMANAGEMENT OF A FRACTUREFRACTUREThe major objective is –The major objective is – Minimise movement of the injured body part by:Minimise movement of the injured body part by:  Immobilising the jointImmobilising the joint aboveabove the fracturethe fracture  Immobilising the jointImmobilising the joint belowbelow the fracturethe fracture  Support the injured area using a splint or slingSupport the injured area using a splint or sling 1.1. Immobilise and support the injured area using a splint or slingImmobilise and support the injured area using a splint or sling 2.2. Where an ambulance is close at hand (less than 45 minutes), it isWhere an ambulance is close at hand (less than 45 minutes), it is recommended that fractures be managed in the position found torecommended that fractures be managed in the position found to prevent further damage. This can be achieved with padding ratherprevent further damage. This can be achieved with padding rather than splinting.than splinting. 3.3. Check for signs of impaired circulationCheck for signs of impaired circulation 4.4. Seek qualified helpSeek qualified help 5.5. Arrange transport to the hospitalArrange transport to the hospital 6.6. ‘‘RICER’ regime and NO ‘HARM’ if appropriate for the injury and if itRICER’ regime and NO ‘HARM’ if appropriate for the injury and if it does not aggravate the pain.does not aggravate the pain.
  • 20. MANAGEMENT OF AMANAGEMENT OF A FRACTUREFRACTURE Splinting:Splinting:  Choose an appropriate splint – the body, the other limb, a smooth, firm object longChoose an appropriate splint – the body, the other limb, a smooth, firm object long enough to extend beyond the joint above and below the fractureenough to extend beyond the joint above and below the fracture  Pad the splint at the sites of contact and any hollowsPad the splint at the sites of contact and any hollows  Tie the splint to the injured limb above and below the fractureTie the splint to the injured limb above and below the fracture  Immobilise the joints above and below the fracture by tying the splint at those jointsImmobilise the joints above and below the fracture by tying the splint at those joints  Immobilise the fracture site and provide further support by bandaging above and belowImmobilise the fracture site and provide further support by bandaging above and below the fracturethe fracture  Check for signs of impaired circulationCheck for signs of impaired circulation Air splint:Air splint: An air splint is easy to apply, provides support and is comfortable. However, they canAn air splint is easy to apply, provides support and is comfortable. However, they can leak, are often not returned to medical clinics, are difficult to re-clean and sterilise, canleak, are often not returned to medical clinics, are difficult to re-clean and sterilise, can impair circulation if inflated too much and do not support upper arm or upper legimpair circulation if inflated too much and do not support upper arm or upper leg injuries.injuries. If they are used carefully place the injured limb in the splint, do up the zipper, inflateIf they are used carefully place the injured limb in the splint, do up the zipper, inflate until firm (ensuring you can touch the limb through the splint) and check circulation anduntil firm (ensuring you can touch the limb through the splint) and check circulation and sensation.sensation. Slings:Slings:  Low arm sling – provides support for the forearm and maintains it in a horizontalLow arm sling – provides support for the forearm and maintains it in a horizontal positionposition  High arm sling – provides support for the arm and elevates the forearmHigh arm sling – provides support for the arm and elevates the forearm  Improvisation – proper slings are best but improvising is an alternativeImprovisation – proper slings are best but improvising is an alternative  Knots – when bandages and slings are being used, use reef knots as they do notKnots – when bandages and slings are being used, use reef knots as they do not tighten and can be quickly released.tighten and can be quickly released.
  • 21. HARD TISSUE INJURIES –HARD TISSUE INJURIES – dislocationsdislocations A joint is the place where two bones meet, allowingA joint is the place where two bones meet, allowing movement and consists of the bones, joint capsule,movement and consists of the bones, joint capsule, ligaments, fluid and cartilage. A dislocation is when theligaments, fluid and cartilage. A dislocation is when the bones are forced out of position and may result inbones are forced out of position and may result in tissue damage and/or fractures. A subluxation is atissue damage and/or fractures. A subluxation is a partial dislocation where the bones or parts of the bonepartial dislocation where the bones or parts of the bone surfaces are still in contact.surfaces are still in contact. Signs and symptoms:Signs and symptoms:  PainPain  Inability to move the joint / loss of functionInability to move the joint / loss of function  SwellingSwelling  DeformityDeformity  Muscle spasmMuscle spasm  Tenderness over the injured jointTenderness over the injured joint  The athlete holding their limb in a preferred positionThe athlete holding their limb in a preferred position
  • 22. MANAGEMENT OF AMANAGEMENT OF A DISLOCATIONDISLOCATIONThe management of a dislocation is the same as that ofThe management of a dislocation is the same as that of a fracture.a fracture. The management of a dislocation involves theThe management of a dislocation involves the following steps:following steps: 1.1. Immobilise and support the injured area using a splint or slingImmobilise and support the injured area using a splint or sling 2.2. Check for signs of impaired circulationCheck for signs of impaired circulation 3.3. Seek qualified helpSeek qualified help 4.4. Arrange transport to the hospitalArrange transport to the hospital 5.5. ‘‘RICER’ regime and NO ‘HARM’ if appropriate for the injury and if itRICER’ regime and NO ‘HARM’ if appropriate for the injury and if it does not aggravate the pain.does not aggravate the pain. Due to the deformity associated with dislocations:Due to the deformity associated with dislocations:  pad the injury to the body, other limb or splint before being tiedpad the injury to the body, other limb or splint before being tied for immobilisationfor immobilisation  It may not be possible to effectively immobilise someIt may not be possible to effectively immobilise some dislocations, therefore allow the athlete or support person todislocations, therefore allow the athlete or support person to keep the injured area in the position of most comfort, and thenkeep the injured area in the position of most comfort, and then pad appropriately.pad appropriately.
  • 23. DISLOCATIONSDISLOCATIONS Common dislocations:Common dislocations:  Shoulder – are common because of the structure of the joint, firstShoulder – are common because of the structure of the joint, first time dislocations may have fractures and nerve damage. Refertime dislocations may have fractures and nerve damage. Refer to a doctor for relocation – DO NOT ATTEMPT THEto a doctor for relocation – DO NOT ATTEMPT THE RELOCATION.RELOCATION.  Fingers – may be associated with fractures, refer to a doctor forFingers – may be associated with fractures, refer to a doctor for relocation.relocation.  Patella – are not overly common but occur more often in teenagePatella – are not overly common but occur more often in teenage athletes, some relocate spontaneously as the muscle spasmathletes, some relocate spontaneously as the muscle spasm relaxes, however they still require medical attention.relaxes, however they still require medical attention. Why not to relocate a dislocation:Why not to relocate a dislocation:  The potential for fractures to existThe potential for fractures to exist  The muscles that cross the joint usually go into very forcefulThe muscles that cross the joint usually go into very forceful spasm, thus anaesthetic is often needed for relocationspasm, thus anaesthetic is often needed for relocation  The damage to ligaments or impingement of nervesThe damage to ligaments or impingement of nerves
  • 24. DISLOCATIONSDISLOCATIONS Common complications associated withCommon complications associated with dislocations:dislocations: The potential complications are the same as aThe potential complications are the same as a fracture and also include:fracture and also include:  Bleeding – there may be bleeding in the jointBleeding – there may be bleeding in the joint  Possible fractures – sometimes the inability to movePossible fractures – sometimes the inability to move the joint is due to a fracture not the dislocation. Hencethe joint is due to a fracture not the dislocation. Hence all dislocations should be immobilised, supported andall dislocations should be immobilised, supported and not moved/relocated without x-ray.not moved/relocated without x-ray.  Ligament damage – dislocation usually results in tornLigament damage – dislocation usually results in torn or ruptured ligaments around the joint and/or reducedor ruptured ligaments around the joint and/or reduced stability at the joint, which may cause the joint to bestability at the joint, which may cause the joint to be more prone to further dislocations.more prone to further dislocations. ALL DISLOCATIONS MUST BE REFERRED FORALL DISLOCATIONS MUST BE REFERRED FOR PROPER ASSESSMENT AND FOLLOW UP.PROPER ASSESSMENT AND FOLLOW UP.
  • 25. SOFT TISSUE INJURIESSOFT TISSUE INJURIES TYPE CAUSE INJURY ACUTE INJURIES Injuries that occur from a known, or sometimes unknown incident. Symptoms and signs develop rapidly. (i) Bruise (haematoma) Direct force applied to the body, such as being hit or kicked, or making contact with player, implement etc. Compression of soft tissue, resulting in damage to soft tissue and bleeding into the tissue eg bruise (haematoma) May bruise any soft tissue (muscle, skin & fat, periosteum) (ii) Sprain Joint is forced beyond its normal range of motion Ligament fibres are torn Categorised according to severity •First degree (mild) – very few fibres are torn •Second degree (moderate) large number of fibres are torn •Third degree (severe) –a complete rupture of the ligament (iii) Strain Muscle is overstretched or contracts too quickly The muscle and/or tendon fibres are torn. Categorised according to severity •First degree •Second degree •Third degree OVERUSE INJURIES Injuries that develop over a period of time. Symptoms and signs develop slowly i. continual, repetitive movements Inflammation and pain eg bursitis ii. Repeating the movement following a minor acute injury which was not noted and which is then aggravated by the repeated action. Repeated stress and microtrauma to soft tissue eg shin splints, tennis elbow
  • 26. AIMS OF MANAGEMENT OFAIMS OF MANAGEMENT OF SOFT TISSUE INJURIESSOFT TISSUE INJURIES  Minimise tissue damageMinimise tissue damage  Minimise inflammationMinimise inflammation  Prevent further tissue damagePrevent further tissue damage  Early and efficient removal of blood clot and tissueEarly and efficient removal of blood clot and tissue swellingswelling  Minimise scarring of damaged tissueMinimise scarring of damaged tissue  Regain full function before returning to playRegain full function before returning to play  Enable the doctor or physiotherapist to make an earlyEnable the doctor or physiotherapist to make an early diagnosis because the swelling will be lessdiagnosis because the swelling will be less  Reduce rehabilitation timeReduce rehabilitation time  Minimise the seriousness of the injuryMinimise the seriousness of the injury  Allow rehabilitation to begin soonerAllow rehabilitation to begin sooner  Allow early and complete return to sportAllow early and complete return to sport
  • 27. INITIAL MANAGEMENT TOINITIAL MANAGEMENT TO SOFT TISSUE INJURIESSOFT TISSUE INJURIES (first 48 – 72 hours)(first 48 – 72 hours) RR RESTREST II ICEICE CC COMPRESSIONCOMPRESSION EE ELEVATIONELEVATION RR REFER AND RECORDREFER AND RECORD
  • 28. RICERRICER R – Rest the athleteR – Rest the athlete  How – remove athlete from the field without further damaging andHow – remove athlete from the field without further damaging and rest from the activity causing the injuryrest from the activity causing the injury  Why – movement will increase blood flow to the injured site, mayWhy – movement will increase blood flow to the injured site, may cause blood clots to dislodge & begin bleeding again and may causecause blood clots to dislodge & begin bleeding again and may cause further damagefurther damage I – Ice applied to the injuryI – Ice applied to the injury  Apply ice directly over the injured site and surrounding tissue for 20 –Apply ice directly over the injured site and surrounding tissue for 20 – 30 minutes every 2 hours,30 minutes every 2 hours,  How – in a wet towel or plastic bag, in a frozen cup of waterHow – in a wet towel or plastic bag, in a frozen cup of water continuously moving over the site (ice massage) or a freezer gel bagcontinuously moving over the site (ice massage) or a freezer gel bag with a wet towel between the pack and the skinwith a wet towel between the pack and the skin  Why – Ice decreases swelling and painWhy – Ice decreases swelling and pain  Remember – check the athlete and move the ice around to avoid;Remember – check the athlete and move the ice around to avoid; cooling too fast, superficial tissues cooling and not deeper areas andcooling too fast, superficial tissues cooling and not deeper areas and oversensitivity to ice. Reassure that the initial cold pain will subsideoversensitivity to ice. Reassure that the initial cold pain will subside and do not apply ice direct to the skin to avoid ice burns.and do not apply ice direct to the skin to avoid ice burns.  Do not apply ice to – diabetics, persons with cardiovascular orDo not apply ice to – diabetics, persons with cardiovascular or circulation problems, persons with Raynaud’s phenomenon andcirculation problems, persons with Raynaud’s phenomenon and other diseases, special body area eg eyes.other diseases, special body area eg eyes.
  • 29. RICERRICER C – Compression applied to the injuryC – Compression applied to the injury  How – apply a firm, elastic, non-adhesive bandage over the ice packHow – apply a firm, elastic, non-adhesive bandage over the ice pack to hold it in place and provide compressionto hold it in place and provide compression  Why – reduces swelling and bleeding at the injury siteWhy – reduces swelling and bleeding at the injury site  Remember – look for numbness, tingling, coldness and pale blueRemember – look for numbness, tingling, coldness and pale blue skin when compressing as these are signs that the bandaging is tooskin when compressing as these are signs that the bandaging is too tight. Reapply not as tight and once ice is completed reapply a drytight. Reapply not as tight and once ice is completed reapply a dry bandage.bandage. E – Elevate the injured areaE – Elevate the injured area  How – raise the injured area above the level of the heart whereverHow – raise the injured area above the level of the heart wherever possible (when applying ice, when at home, between rehabilitationpossible (when applying ice, when at home, between rehabilitation exercises)exercises)  Why – elevation decreases bleeding, swelling and painWhy – elevation decreases bleeding, swelling and pain R – Refer and recordR – Refer and record  How – refer to a health care professional for diagnosis andHow – refer to a health care professional for diagnosis and management, record observations, assessment and initialmanagement, record observations, assessment and initial managementmanagement  Why – to obtain an accurate and definitive diagnosis and forWhy – to obtain an accurate and definitive diagnosis and for continuing management and rehabilitation.continuing management and rehabilitation.
  • 30. INITIAL MANAGEMENT TOINITIAL MANAGEMENT TO SOFT TISSUE INJURIES cont…SOFT TISSUE INJURIES cont… HH HEATHEAT AA ALCOHOLALCOHOL RR RUNNING OR EXERCISINGRUNNING OR EXERCISING MM MASSAGEMASSAGE
  • 31. In the first 48 – 72 hours theIn the first 48 – 72 hours the following factors should befollowing factors should be avoided:avoided:H – HeatH – Heat Such as sauna spa, hot water bottle, hot showerSuch as sauna spa, hot water bottle, hot shower and baths, hot liniment rubs as it increases theand baths, hot liniment rubs as it increases the bleeding to the area.bleeding to the area. A – AlcoholA – Alcohol As it increases swellingAs it increases swelling R – RunningR – Running Any exercise too soon can make the injury worseAny exercise too soon can make the injury worse M – MassageM – Massage Any use of massage and heat rubs in the first 48Any use of massage and heat rubs in the first 48 – 72 hours increases swelling and bleeding and– 72 hours increases swelling and bleeding and disrupts the healing process.disrupts the healing process.
  • 32. REHABILITATIONREHABILITATION Rehabilitation of an athlete is to ‘return the athlete to the previous levelRehabilitation of an athlete is to ‘return the athlete to the previous level of fitness, skill and competition’.of fitness, skill and competition’. Rehabilitation:Rehabilitation:  Begins during the definitive care of an injuryBegins during the definitive care of an injury  Continues through to prevention of further injuriesContinues through to prevention of further injuries  Is based on the ‘SAID’ principleIs based on the ‘SAID’ principle SS SpecificSpecific AA Adaptation toAdaptation to II ImposedImposed DD DemandsDemands  The more you do something the easier it becomes, provided there is noThe more you do something the easier it becomes, provided there is no painpain  Practice must be perfect and specific to the requirements of the athlete toPractice must be perfect and specific to the requirements of the athlete to achieve progressachieve progress  As the skills become easier, progress to a more difficult task, until itAs the skills become easier, progress to a more difficult task, until it becomes easy, and then progress again.becomes easy, and then progress again. Rehabilitation programs are generally set by a doctor or physiotherapist.Rehabilitation programs are generally set by a doctor or physiotherapist.

×