sport medicine for nurses and medical student to take lesson acute or chronic trauma. to know about clasi

1. SPORTS INJURIES
dr. Meiky Fredianto (K) Sport

2. • Occur during; sporting activity, event, or
training session
• Musculoskeletal structures; muscles,
ligaments, and bones
• Classified by location, type, body side,
and injury event

3. CATEGORIZED
 Acute injury or
 Overuse injury  Depending mechanism of injury and the
onset

4. Living Sports Healthy Life
Classification of Sports Injuries

5. ACUTE INJURIES
• Extrinsic causes
• Intrinsic causes
• Classified according to
- particular site injured (e.g. bone, cartilage,
joint, ligament, muscle, tendon, bursa,
nerve, skin)
- type of injury (e.g. fracture, dislocation,
sprain. or strain)
5

6. Living Sports Healthy Life
Fracture
Direct or
indirect
trauma
May be
closed or
open
(compound)
Another
type

7. • Managed by anatomical and functional realignment (4R)
• Non-displaced or minimally displaced  bracing or casting
• Displaced fractures reduction and immobilization
• A displaced,unstable fracture  surgical stabilization
• Growth plate fractures (children and adolescents)
• Soft tissue injury such as ligament or muscle damage

8. Joint
Dislocation  complete
Subluxation  partial
- All dislocations and subluxations result in
injuries to the surrounding joint capsule and
ligaments
- Complications neurovascular damage
- Should be X-ray to exclude fracture
- Treatment

9. Ligament
Sprain/ tear (grades I-III)
- A grade I represents stretched fibers
- A grade II considerable proportion of the
fibers, increased laxity but a definite end
point
- A grade III is a complete tear, excessive
joint laxity and no firm end point

10. Strain/ tear (grades I-III)
Contusion
Cramp
Myositis ossificans
Muscle
Acute compartment syndrome

11. CRAMP
• Painful involuntary muscle contractions that occur suddenly
and can be temporarily debilitating
• “Exercise Associated Muscle Cramping" (EAMC)
• Defined as "painful, spasmodic and involuntary contraction of
skeletal muscle that occurs during or immediately after
exercise
• Calf is the most common site

12. • Etiology unclear  altered neuromuscular control
• Increased excitatory and decreased inhibitory signals to the a
motor neuron
• Inhibitory techniques  stretching of the muscle or electrical
stimulation methods

13. • The treatment aimed at reducing muscle spindle and motor
neuron activity by reflex inhibition and afferent stimulation
• Passive stretching reduces muscle electromyographic activity
within IO to 20 seconds
• Passive tension should be applied to the affected muscle for
20 to 30 seconds or until fasciculation ceases

14. • No proven strategies for prevention of EAMC
• Regular muscle stretching, correction of muscle balance and
posture, adequate conditioning for the activity, mental
preparation for competition, and avoidance of provocative
drugs may all be beneficial
• Plyometrics or eccentric muscle strengthening  maintaining
adequate carbohydrate

15. Living Sports Healthy Life
Overuse Injuries
 Three distinct challenges
Diagnosis
Treatment
Understanding why the injury occurred
 Cause
Extrinsic
Intrinsic

16. Living Sports Healthy Life
Overuse injuries; predisposing factors

17. Extrinsic cause
Training errors
Surfaces
Shoes
Equipment
Environmental conditions
Psychological factors
Inadequate nutrition

18. Intrinsic Factors
Malalignment
Leg length discrepancy
Muscle weakness
Muscle imbalance
Lack of flexibility
Sex, size, body composition
Others (genetic, endocrine,
metabolic)

19. Living Sports Healthy Life
Principles of Injuries Prevention

20. PRIMARY PREVENTION
20
Health promotion and injury prevention (e.g.
ankle braces being worn by an entire team,
even those without previous ankle sprain)

21. SECONDARY PREVENTION
• Early diagnosis and intervention to limit the
development of disability or reduce the risk
of re·injury
• Early RICE/ PRICE treatment
21

22. TERTIARY PREVENTION
Rehabilitation to reduce and/or correct an
existing disability attributed to an underlying
disease
22

23. Other important factors that
may assist in the prevention
of injury:
• Warm-up
• Stretching
• Taping and bracing
• Protective equipment
• Suitable equipment
• Appropriate surfaces
• Appropriate training.

24. Living Sports Healthy Life

25. Stretching
• Increased flexibility attained through stretching
decreases injuries, minimizes and alleviates
muscle soreness, and improves performance
• With respect to injury, pre- exercise stretching in
isolation (with or without warm-up) does not
decrease overall injury rates
• Regular stretching resulted in approximately
32% reduction in injuries
• by Peter Magnusson and others

26. THE ROLES OF DIFFERENT TYPES OF
STRETCHING
• Three different types of stretching exercises-static, ballistic, and
proprioceptive neuromuscular facilitation (PNF)
• More recently, some authors have also discussed Dynamic stretching

27. STATIC STRETCHING
• Static stretching, the stretch position is assumed slowly and gently and
held for 30-60 seconds
• Tension strong enough to initiate the inverse myotatic stretch reflex with
subsequent muscle relaxation
• Increased stretch approximately 30 seconds, then relaxed
• Overstretching may cause injury
• Least amount of tension  safest method of increasing flexibility

28. BALLISTIC STRETCHING
• Stretched to near its limit, then stretched further with a bouncing movement
• Quick bouncing causes a strong reflex muscle contraction
• This technique is not commonly used, except in gymnastics, ballet, and
dance

29. PROPRIOCEPTIVE NEUROMUSCULAR
FACILITATION STRETCHING
• Alternating contraction and relaxation of both agonist and antagonist
muscles
• PNF stretching produce greater flexibility gains than other stretching
techniques
• Disadvantage is that there is a tendency to overstretch
• Performed with a partner who is aware of the potential dangers of the
technique

30. PRINCIPLES OF STRETCHING
• Warm-up prior to stretching
• Stretch gently and slowly
• Stretch to the point of tension but never pain

34. Living Sports Healthy Life
Pertolongan Pertama
Prinsip PRICE (protection, rest,
ice, compression and elevation)
harus diterapkan sedini mungkin
dan dilanjutkan setidaknya 24-
72 jam pertama

35. 1. PROTECTION
Perlindungan jaringan yang rusak
sangat penting untuk mencegah
kerusakan lebih lanjut dan
memungkinkan proses
penyembuhan dimulai secara
efisien dan efektif.

36. 2. R E S T
Pada tahap awal, istirahat adalah salah satu komponen terpenting
dari prinsip P.R.I.C.E namun sering terbengkalai atau diabaikan.

37. 3. I C E
Es harus dibungkus dan tidak
boleh dioleskan langsung ke kulit
karena bisa menyebabkan sensasi
‘ice burns’.
Efek yg diharapkan:
-Vasokontriksi
-Mengurangi nyeri
-Mengurangi spasme otot
-Menurunkan laju metabolisme
(mengurangi resiko nekrosis)

38. C O M P R E S S I O N
Diterapkan untuk meminimalkan jumlah pembengkakan yang terbentuk setelah cedera dan
harus diterapkan selama 24 sampai 72 jam pertama sejak timbulnya luka. Metode yang
paling efektif adalah dengan menggunakan elastic bandage

39. E L E V A T I O N
Elevasi memungkinkan gaya gravitasi untuk mengalirkan cairan dari tempat yang
cedera. Ini membantu dalam mengurangi pembengkakan yang nantinya dapat
menurunkan rasa sakit yang terkait dengan edema

41. THANK YOU