1. The document provides an overview of common athletic injuries for various body parts including the head, spine, shoulder, elbow, wrist, hand, hip, thigh, knee, ankle, and foot. It describes mechanisms of injury, signs and symptoms, and treatment approaches for injuries such as concussions, strains, sprains, fractures, and dislocations. 2. Assessment of athletic injuries involves obtaining a history, observing and inspecting the injured area, palpating for swelling or pain, performing special tests, and considering the injury mechanism. Injuries are often graded based on severity. 3. Emergency situations like airway obstructions or hemorrhaging require immediate primary and secondary surveys to assess breathing, circulation

1. Injuries in athletes:
assessment and management for track
and field events.
RADHIKA CHINTAMANI

2. An athletic injury is any injury that is sports or physical activity relates
and results in keeping individual out of practice, activity, or
competition on the day following the injury; or any injury requiring
medical attention.
• Emergency medical care and cardiac resuscitation
• Advanced trauma life support(ATLS)
Rapid and complete assessment with immediate institution of
emergent therapy.

3. Trimodal trauma mortality distribution
Time after injury Injury type Salvage potential
Seconds to minutes Catastrophic; neurologic, cardiac Minimal
Minutes to hours Intracranial haemorrhage;
visceral, thoracic
Good with proper intervention
Weeks Organ failure, sepsis variable

4. Injury Mechanism
Force and its effects
- Elastic limit: maximum load that a material can sustain without
permanent deformation
- Failure: loss of continuity; rupturing of soft tissue or fracture of bone
- Anisotropic: having different strengths in response to loads from
different directions
- Axial force: force acting along thee long axis of a structure
- Compressive force: axial loading that produces a squeezing or crushing
effect on a structure

5. - Tensile force: axial loading that is opposite that of compressive force; a pulling force
that tends to stretch the object to which it is applied
- Shear Force: a force that acts parallel or tangent to a plane passing through an
object
- Stress: the distribution of force within a body; quantified as force divided by the
area over which the force acts
- Strain: amount of deformation with respect to the original dimensions of the
structure

6. Torque and its Effects
Bending: loading that produces tension on one side of an object and compression
on the other side
Torsion: twisting of a structure around its longitudinal axis

7. Skin injury
Classification
- Abrasions: shear, in one direction
- Blisters: repeated shear, one or more directions
- Skin bruises: compression
- Incisions: clean cut

8. - Lacerations: combination of tension and shear
- Avulsions: complete separation of skin from underlying tissues
- Puncture: sharp object penetrates skin and underlying tissus with tensile loading

9. Other soft tissue injury classification
- Contusions: compression injury involving accumulation of blood and lymph within a muscle;
a bruise
- Ecchymosis: superficial tissue discolouration
- Hematoma: localized mass of blood and lymph confined within a space or tisssue
- Strain and sprain: abnormally high tensile force- haemorrhage and swelling

10. Degrees of strains and sprains
- 1st degree: pain, only micro-tearing of the collagen fibres. Mild discomfort, local tenderness,
mild swelling and ecchymosis.
- 2nd degree: severe pain, more extensive rupturing of tissue. Detectable joint instability , and/
or muscle weakness and limited joint range of motion.
- 3rd degree: severe pain, major loss of tissue continuity, loss of range of motion and complete
instability of joint.

11. Bone injuries classification
- Fracture: disruption in the continuity of a bone
- Stress fracture: result from repeated loading with relatively lower magnitude forces
- Osteopenia: reduced bone mineral density that predisposes the individual to fractures

12. Epiphysal injury classification
Type I: complete separation of the epiphysis from the metaphysis with no fracture to the bone
Type II: separation of the epiphysis and a small portion of the metaphysis
Type III: fracture of the epiphysis
Type IV: fracture of a part of the epiphysis and metaphysis
Type V: compression of the epiphysis without fracture, resulting in compromised epiphyseal
function

13. Nerve injury classification
• Tensile injuries: high speed accidents
• Compressive injuries

14. Emergency situations
Obstructed airway emergencies
– Partial airway obstruction
– Total airway obstruction
Cardiopulmonary emergencies
Unconscious
Hemorrhage
- external bleeding
- internal haemorrhage
Fractures
Shock

15. Hyperthermia
– Preventing heat emergencies
– Heat cramps
– Heat exhaustion
– Heat stroke
– Emergency care

16. Emergency plan
A process that activates emergency health care services of the facility and
community
Pre-established plan to determine:
- Who will render emergency care control the situation
- What care will be provided
- Who will call EMS
- Who will supervise the other activity areas if supervisors must leave those
areas to assist at the accident scene
- The procedures for proper use and disposal of items and equipment
exposed to blood or bodily fluids

17. Primary injury assessment
Assess unresponsiveness
Open the airway
- Head tilt/chin lift method
- Jaw thrust method
- Heimlich manoeuvre
- Abdominal thrust
- Finger sweep
Establish breathing
Establish circulation
Disability
Exposure

18. Secondary injury assessment
History of injury
Observation and inspection
- Respiration
- Skin colour
- pupils
Palpation
Special tests

19. Moving injured participant
- Unless ruled out, assume that a spinal injury is present
- Spine board close
- Chest secured first
- Lift stretcher- transport individual feet first

21. Assessing an injury
Emergency situation evaluated using primary and secondary survey
On-the-field vs off-the-field assessment
- After primary survey is completed, the on-the field assessment ascertains if moderate or
serious injury is present
- Once off the field or court, a more through exam can be conducted

22. History of the injury
• Primary complaint
• Mechanism of injury
• Symptoms
• Disability
• Medical history

23. Observation and inspection
Observation
- Symmetry and appearance
- Motor function
Inspection of injury site

24. Palpation
Skin temperature
Swelling
Point tenderness
Crepitus
Fractures

25. Special test
• Joint range of motion
• Resisted manual muscle testing
• Stress tests
• Functioning testing

26. Soap notes
• Subjective evaluation
• Objective evaluation
• Assessment
• Plan

27. Injuries to the lower extremity:
foot, ankle and lower leg
Assessment
- History: current and past injury status
- Observation and inspection: anterior, posterior, side and non-weight bearing view
- Palpations: bony and soft tissue palpations
- Special tests:
- Joint range of motion
- Resisted manual muscle testing
- Neurologic examination
- Stress and functional test

28. Turf toe
- Jamming of great toe into end of shoe, or hyperextending the MTP joint of
great toe
- Football line backers and offensive lineman
- Pain, tenderness and swelling at MTP
- Ice therapy, NSAIDs, rest and protection from excessive motion.
- Running not permitted

29. Acute compartment Syndrome
- Direct blow to anterolateral aspect of leg
- Rapid accumulation of haemorrhage and edema
- Increasing pain and swelling
- Firm mass, tight skin, loss of sensation between great toe and second toe on the dorsum of
the foot and diminished pulse at the dorsalis pedis artery
- Ice and total rest

30. Lateral ankle sprain
- Stress at ankle during plantarflexion and inversion- anterior talofibular
ligament
- Cracking or tearing sound
- Swelling ecchymosis, point tenderness
- Ice therapy, compression, elevation and restricted activity

31. Muscle cramps
- dehydration, electrolyte imbalance, or prolonged muscle fatigue
- Ice, pressure and slow stretch

32. Achilles tendon rupture
- push- off of forefoot while knee is extending
- Sharp pain, pop sensation, swelling, bruising
around malleoli excessive passive dorsiflexion,
unable to stand on tiptoes and to balance on
affected leg

33. Knee injuries
Assessment
- History: current and past injury status
- Observation and inspection: all the views
- Palpation: bony, soft tissue, palpation for swelling
- Special test

34. Anterior cruciate ligament
- Knee hyperextened, twists, sudden deceleration or landing in an off-balance
position after jump
- Extrinsic factors: body movement, muscular strength, shoe surface interface and
skill level
- Intrinsic factors: joint laxity, limb alignment, notch dimensions and size of ligament
- Pain, joint effusion
- Minimal injury: Ice therapy, compression, elevation
and protected rest.
- Moderate injury: crutches- partial weight bearing,
range of motion exercises, isometric exercises, closed
kinetic chain exercises

35. Medial collateral ligament
- Lateral forces
- Pain and swelling
- Management

36. Meniscal injuries
- Tears: longitudinal
bucket- handle
horizontal
parrot- peak
- popping, grinding or clicking sensation- knee buckling, difficulty in deep squat and duck walk
- Pain and swelling
- Mild- ice, compression, elevation protected rest and crutches, joint effusion- aspiration

37. Thigh, hip and pelvis injuries
Assessment
- History: current and past injury status
- Observation and inspection: anterior, posterior, side and non-weight bearing view
- Palpations: bony and soft tissue palpations
- Special tests:
- Joint range of motion
- Resisted manual muscle testing
- Neurologic examination
- Stress and functional test

38. Quadriceps contusion- charley horse
- Anterolateral thigh
- Pain, swelling, hematoma
- Moderate- knee flexion only between 45 to 90 degree and
severe- unable to bear weight or fully knee flex
- Ice application and compressive wrap

39. Hamstring strain
- Rapid contraction or violent stretch
- Mild- tightness and tension in muscle
Moderate- tearing sensation-pain and weakness in knee flexion
Severe- sharp pain in posterior thigh, limping
- Mild and moderate: ice, compression, elevation, protected rest
and NSAIDs. Stretching, isometric contractons, PRE, swimming,
cycling, mild jogging.
Severe: surgery

40. Shoulder injuries
Assessment
- History: current and past injury status
- Observation and inspection: anterior, posterior, lateral view
- Palpations: bony and soft tissue palpations
- Special tests:
- Joint range of motion
- Resisted manual muscle testing
- Neurologic examination
- Stress and functional test

41. Sternoclaviocular joint sprain
- Compression from direct blow
- First degree: point tenderness and mild pain
ice, rest and immobilization
- Second degree: bruising, swelling and significant pain and unable to horizontally
adduct arm
ice, rest, immobilization. Range of motion (7-10 days). Strengtening (3 to 4wks)
- Third degree: prominent displacement of sternal end of clavicle and may involve
fracture. Pain sever when shoulder brought together by lateral force.
immobilize and refered to physician

42. Acromioclavicular joint sprain
- Direct blow, a fall on point of shoulder
- First degree: minimal swelling and pain
ice, NSAIDs
- Second degree: AC ligament torn, but coracoclavicular ligament is only mildly sprained but
intact
ice. NSAIDs, immobilize
- Third degree: complete tear of coracoclavicular and AC ligament
ice, immobilize and referred to physician

43. Glenohumeral joint sprain
- Arm forcefully abducted or abducted and externally rotated
- First degree: anterior shoulder painful,
- Second degree: joint laxity, pain, swelling, bruising and limited range of motion particularly
abduction
- ice, rest, NSAIDs, immobilization, range of motion exercises, strengthening and PNF
exercises
- External rotation and adduction delayed at least 3 weeks

44. Anterior Glenohumeral dislocation
- Excessive indirect forces that push the arm into abduction, eternal
rotation and extension
- Bankart lesion
- Intense pain, tingling and numbness. Sharp contour with promonent
acromion process. Unable to perform horizontal adduction
- Immobilization and ice

45. Elbow injuries
Assessment
- History: current and past injury status
- Observation and inspection: anterior, posterior, lateral view
- Palpations: bony and soft tissue palpations
- Special tests:
- Joint range of motion
- Resisted manual muscle testing
- Neurologic examination
- Stress and functional test

46. Dislocations
- Ulnar dislocations occur in individuals younger than 20.
- Hyperextension or sudden, violent, unidirectional valgus force
- Snapping or cracking sensation, pain, swelling, total loss of function and
deformity
- Ice, immobilization, refer to medical facility

47. Wrist and hand injuries
Assessment
- History: current and past injury status
- Observation and inspection: palmar and dorsal view
- Palpations: bony and soft tissue palpations
- Special tests:
- Joint range of motion
- Resisted manual muscle testing
- Neurologic examination
- Stress and functional test

48. Jersey finger
- Gripping an opponent’s jersey while simultaneously opponent twists and turns to get away
- Rapid extension- flexor digitorium profundus tendon

49. Mallet finger
- Rupture of the extensor tendon from distal phalanx due to forceful flexion of phalanx
- DIP immobilized in extension.

50. Distal radial and ulnar fractures
- Colles fracture: fracture of radius and ulna, just proximal to wrist, distal segment displacing
in a dorsal and radial direction
- Smith fracture: fracture of radius and ulna, just proximal to wrist, distal segment displacing
in volar direction.
- Immobilization and referred to physician

51. Head
Assessment of cranial injuries
- Primary survey
check ABC
level of consciousness (Glasgow coma scale)
- Secondary survey
vitals
history
Observation and inspection
palpation
special tests

52. Cranial injury mechanism
- Contrecoup injuries
- Focal injuries
- Diffuse injuries

53. Cerebral hematomas
- Epidural hematoma
- Subdural hematoma

54. Concussions
- Violent shaking or jarring action of brain, resulting in immediate or transient impairment of
neurologic function
- Signs and symptoms: consciousness, headache, memory loss, nausea, tinnitus, pupillary
changes, confusion, dizziness and loss of coordination
- Concussions graded by length of mental impairment and loss of memory before and after
the injury

55. - Grade 1: no loss of consciousness, may be slight mental confusion,
dizziness, unsteadiness and brief loss of judgement.
- Grade 2: transitory loss of consciousness- 3 to 4mins. Mental confusion,
moderate dizziness, unsteady gait, blurred vision, tinnitus and
headache. Post traumatic memory loss. Postconcussion syndrome
- Grade 3: unconsciousness- 2-5 mins. Retrograde amnesia
- Grade 4: knocked out. Confused on regaining consciousness, lucid state
before becoming fully alert and oriented. Posttraumatic memory loss or
retrograde amnesia
- Grade 5: coma, altered vitals, unequal pupils, paralysis of one side of
body, cardiorespiratory impairment
- Grade 6: severe head trauma- massive intracranial bleeding,, total
respiratory collapse and death.

56. Injuries to spine
Assessment
- History
- Observation and inspection: posture and scan exam, inspection of injury site and gross
neuromuscular assessment
- Palpation: anterior, posterior aspect
- Special tests
joint range of motion
resisted manual muscle testing
neurologic assessment
stress and functional tests

57. Cervical injuries
Cervical strains and sprains
- Extreme motion or in association with a violent muscle contraction or
external force
- Pain, stiffness, restricted ROM, spasm and increased pain during ctive
contraction or passive stretching
- Sprains symptoms persist longer
- Rest, cryotherapy, NSAIDs, cervical collar.
Superficial heat, gentle stretching and isometric
exercises. Resistance exercise

58. Thoracic injury
Compression fracture
Running- repetitive loads leads to progressive compression fractures

59. Lumbar injury
Lumbar fractures and dislocation:
- Commonly L1 at thoraco-lumbar junction
- Hyperflexion or jack-knifing of trunk- crushes anterior aspect of vertebral body
- Localised, palpable pain- may radiate down the nerve root if bony fragment compresses a
spinal nerve

60. References
• M. K. Anderson and S. J. Hall. Fundamaentals of sports injury
management. Lippincott Williams and wilkins.
• J. E. Zachazewski, D. J. Magee, W. S. Quillen. Athletic injuries
and rehabilitation. Philadelphia, Saunders, 1996.
• D. J. Magee. Orthopaedic physical assessment, 5th
ed.
Saunders, 2011.
• Brukner and khan. Clinical sports medicine, 3rd
ed. MaGraw-hill.