sports med

1. OPTION 3 – SPORTS MEDICINE
Overview
• How are sports injuries classified and managed?
(Classifying Injuries, soft/hard tissue injuries, totaps)
• How does sports medicine address the demands of
specific athletes? (child/aged/female athletes)
• What role do preventative actions play in enhancing
the wellbeing of the athlete? (prescreening, sports policies,
environmental considerations, fluid intake, acclimatisation)
• How is injury rehabilitation managed? (rehab procedures,
return to play policies)

3. How are Sport Injuries classified
and managed?!?

4. How Are Sports Injuries Classified?
• Direct injuries are caused by an external force applied to the body e.g.
injury caused by tackle/collision
• Examples of injuries that result from external forces:
– Haematomas (corks)
– Contusions (bruise)
– Joint and ligament damage
– Dislocations and bone fracture
• Indirect injuries are caused by an intrinsic force e.g. hamstring tear while
sprinting
• http://www.youtube.com/watch?v=sPZEntyFzdk&feature=related
• Actual injury can occur away from the impact site. EG falling with an
outstretched arm can result in dislocated shoulder
• http://www.youtube.com/watch?v=xPxR1p9DvK8
• Activity – Explain why it is necessary to classify injuries

5. How Are Sports Injuries Classified?
• Overuse injuries are caused by the overuse of specific body parts e.g.
– tennis elbow
– shin splints
– heel and knee pain
• Caused by excessive and repetitive force is placed on the bones
• Little or no pain may be experienced initially, so can go undetected
• Large amount of overuse injuries result from poor training plans
• Poor technique also leads to overuse. Poor tennis backhands - tennis elbow
• Many endurance based sports need to be particularly careful of overuse
injuries.
• http://www.youtube.com/watch?v=l8TZLIVDxXM

6. How Are Sports Injuries Classified?
• Soft tissue injuries -Damage that only occurs skin deep e.g. Lacerations, tears
• These are the most common forms of injury
• Includes:
– Skin injuries – blisters, cuts
– Muscle injuries – tears or strains of muscle fibres and contusions (bruise
– Tendon injuries – tears or strains of tendon fibres (tendonitis) – Nadal had this in knees
– Ligament injuries- tears or strains of ligament fibres
• A Strain is a partial or complete tear of a muscle or tendon (bone to muscle)
• A Sprain is a partial or complete tear of a ligament (bone to bone)

7. Types of Soft Tissue injuries
• Abrasions caused as a result of the skin being scraped. The
wound needs to be cleansed and sterilised in order to prevent
infection.
• Lacerations are when the skin has incurred an irregular tear.
It may require stitches depending on the depth of the cut.
• Blisters are caused by a collection of fluid below or within the
epidermal layer of the skin ,they occur because of friction.
• Calluses is when a build up of dead skin forms at a site where
friction has occurred

8. Immediate Treatment of skin Injuries
• Danger - play continuing around the injury
– Blood and bodily fluids increase the risk of infectious diseases
• Bleeding – needs to be controlled immediately to slow down blood flow
– Pressure should be applied to the wound with elevation being applied
– After dressing is applied, place ice so that it will decrease bleeding
• Assessment - see if it is a simple or complex injury
– E.g. Is it just a blister or a deep cut requiring stitches
• Cleansing – Clean using clean water or saline solution
– Take out foreign material (grass/dirt), though leave in deep material
– Make sure clothes are also clean before athlete returns
• Antiseptic – should be applied to the skin injury
• Dressing – should be adhesive (band aid) or non adhesive (allow large wounds which
may weep.
– Dressing should not get damp as this encourages infection
• Referral - should be made for complex injuries, such as head injuries or deep wounds

9. Soft tissue scenarios
• What would you do in the following situations:
1. During a ruck, a football player gets stomped on the thigh
by another player
2. When attempting a rebound, a basketball player lands on
somebody else’s foot and rolls over on her ankle
3. A tennis player reaching out for a shot falls and skids
across the bitumen court, grazing their entire right side
4. A soccer player falls over during training onto a broken
piece of glass that embeds deeply into their hand
5. A gymnast falls heavily off the beam onto their wrist. Their
wrist bends back sharply on impact

10. How Are Sports Injuries Classified?
• Hard Tissue injuries occur when the damage is done to the bone e.g. Fractures
• They range from severe fractures and dislocations to bruising of the bone
• http://www.youtube.com/watch?v=QnnPhc_ZjWk
• Perform practical activity:
– Application of arm slings/leg splints

11. Inflammatory response
• Phase one, the inflammatory stage is characterised by pain, increase
blood flow to the area (which cause pain because of excess fluid to the
area) redness, heat, swelling, loss of function and mobility
• Phase two, the repair and regenerative stage is characterised by
formation of new fibres and the production of scar tissue. The longer the
inflammation occurs, the worse the scar tissue will be
• Phase three, the remodelling stage is characterised by increased
production of scar tissue and replace of tissue that needs to be
strengthened

12. Types of Hard Tissue Injuries
• Classifications of Fractures:
• simple/closed - bone broken but the skin over it is intact.
• Complicated/open –the skin over fracture is not intact and
bone is breaking through
• Compound – The bone is broken in more than one place
• Stress fractures are bone fractures that develop slowly and
are caused by overuse
• Dislocations are displacement of a bone at a joint

13. How are sport injuries Analyzed ?
TOTAPS
• T- Talk
• O- Observe
• T- Touch
• A –Active movement
• P –Passive movement
• S- Skills test
• ACTIVITY - research in depth this principle

14. How are sport injuries managed?
• R -REST - prevent further injury. Remain inactive for 48-72hrs
I -ICE – reduces pain ,blood flow, swelling. The application of ice causes
blood vessels to constrict, thus reducing circulation and resulting in less
inflammation. This also reduces scar tissue.
C - Compression- decreases bleeding and bruising through applying
pressure with a elastic bandage. This helps reduce swelling by reducing
fluid build up. It also provides support for the injured site.
E - Elevation- raise above heart level to decrease bleeding. The
elevation reduces the volume and pressure of blood flow to the area.
R - Referral –seek guidance for rehab
• Most of what RICE does is reduces the blood flow, and speeds up rehab
• For soft tissue injuries and to stop bleeding, abrasions, calluses, blisters ,
lacerations

15. How are sport injuries managed?
• Things to avoid
– Application of heat (old school). Heat packs, spas etc
– Drinking alcohol
– Activity
– Massage
• All these activities stimulates blood flow to the area and
therefore swelling and inflammation reduces rehab

16. Sports Injury Flow Chart

17. Revision
• Sports injuries that are caused by agents from within the body are called?
• Sports injuries that are caused by factors outside the body, such as another player or a
piece of equipment are called?
• Tennis elbow is an example of what type of injury?
• The structure that joins a bone to another one is what?
• Soft tissue injuries that continue over a long period of time are called?
• Another term for a bruise
• A strain occurs when this is stretched beyond its range of movement
• Soft tissue undergo this response when damage occurs
• Damage to these structures within soft tissue causes bleeding to occur
• Bruising occurs following soft tissue injury due to the tissue damage and the?
• This process whereby an athlete will regain their function of the injured area
• Gravel rash is an example of?
• Blisters occur due to the process of what?
• The management routine followed for soft tissue injuries is what?
• This action reduces pain and swelling of the injured area
• Bleeding of a skin injury can be decreased by applying what?
• When two bones at a joint are displaced from each other, what is this called?
• The routine followed for a thorough assessment of injury is called what?

18. Revision
• Exam-style questions
1 Explain how sporting injuries can be classified. (8 marks)
2 Contrast the management of soft-tissue injury and hard-tissue
injury. (8 marks)
3 Describe the inflammatory response and the role it plays in injury
rehabilitation. (8 marks)
4 Assess each step of the TOTAPS procedure and the role it plays in
the assessment of a sporting injury. (12 marks)

19. Sports Medicine: How does sports medicine
address the demands of specific athletes?
Students learn about:
• children and young athletes
- medical conditions (asthma, diabetes, epilepsy)
-overuse injuries (stress fractures)
-thermoregulation
-appropriateness of resistance training
•adult and aged athletes
-heart conditions fractures/bone density
- flexibility/joint mobility
•female athletes:
-eating disorders
- iron deficiency.
-bone density
-pregnancy.

20. Children and Young Athletes.
• Exercise and play are important parts of a child’s physical, mental
and social development. Children and young people obtain the
following benefits from participating in physical activity:
• enjoyment
• social interaction
• improved motor and communication skills
• greater aerobic fitness
• improved coordination
• increased strength
• development of self-esteem
• promotion of physical activity into adulthood

21. Children and Young Athletes.
• Children are not little adults.
• They have specific physical capabilities, and special care should be
taken when they are involved in sport.
• Young athletes cannot cope with the same level of training as
adults.
• Intensive training can often be boring, restrictive and socially
isolating for maturing young performers.

22. What the syllabus asks you to know
children and young athletes
- medical conditions (asthma, diabetes, epilepsy)
- overuse injuries (stress fractures)
- thermoregulation
- appropriateness of resistance training

23. Children and Young Athletes.
Condition. Symptoms. What it’s caused
by/what it affects.
How to prevent Why it hinders physical
performance.
Asthma Coughing.
Wheezing.
Tight feeling in
the chest or
throat. affects ¼
children, 1/7
adolescents.
Affects the breathing
airways on exposure
to triggers airways
narrow making it
difficult to breathe.
Warm up and cool
down. EIA
(exercise induced
asthma) has
symptoms such as
coughing and
wheezing.
It makes it hard for the
athlete to breathe. Can be
treated with a puffer 4
puffs every 4 mins.
Diabetes Dizziness.
Sweating. Poor
coordination.
headache.
Hypoglycemia – low
blood sugar.
Hyperglycemia – high
blood sugar.
(hypo. Is much more
common in sport)
Eat plenty of
sugars and drink
plenty of water.
Athletes feel as though they
have no energy to continue.
They may collapse (move
from danger, give sugar and
get medical assistance.) or
fall unconscious (treat with
DRABCD)
epilepsy. Fatigue. Brain activity and
electromagnetic
impulse becomes
No flashing lights. Seizures. Treatment:
protect from danger. DON’T
restrain or put anything in

24. Asthma
• Asthma is a narrowing of the airways that makes breathing difficult. Strenuous
physical activity can trigger an asthma attack in some sufferers.
• This is called ‘exercise-induced asthma’ and is very common among asthmatics.
• Factors that make the condition worse include cold, dry air and exercise of
significant intensity and duration.
• The following points should be noted when training asthmatics:
• Ensure the person has an adequate warm-up.
• Don’t ask the person to perform if he or she has had an asthma attack
recently.
• Provide opportunity for rest.
• Have the person use preventative medication, if necessary, and ensure it is
with the person at all times.
• Take extra care in cold or dry weather, or if the person is suffering from a
respiratory infection.
• Know the athlete’s limits.
• Be aware of asthma management techniques and familiar with the individual
person’s asthma management plan.

25. Diabetes
• Diabetic athletes should prepare themselves for the demands of training or
participation by adhering to specific dietary requirements and by monitoring
their blood glucose levels.
• If diabetics engage in over strenuous activity they can develop hypoglycaemia.
This can cause collapse, and even unconsciousness.
• If the person develops hypoglycaemia and is still conscious, a glucose substance
should be given

26. Epilepsy
• Epilepsy is a condition characterised by seizures that make
individuals unable to control their movements
• When participating in physical activity it is important to know that
fatigue and extremes of body temperature can trigger an epileptic
seizure.
• If an epileptic episode occurs:
• Allow the seizure to occur unrestrained.
• Ensure there is a safe space around the affected person.
• Allow the person to rest after the seizure has ceased.

27. Overuse Injuries
• Children should not overtrain, particularly on hard surfaces.
• To avoid overuse of particular muscles and joints:
– children should be allowed
– to play a number of sport and exercise in a variety of positions.
– Coaches and parents should help to avoid overuse injuries by ensuring appropriate
conditioning and stretching programs are undertaken
• Stress fractures – repeated trauma on a bone which leads to small
cracks in the bones.
• Mostly occur around the growth plates on the hips and knees.

28. Children and Young Athletes:
Thermoregulation.
• The process to control the body's core temperature.
• Young athletes take longer to become acclimatise to heat.
They cannot loose as much heat through evaporation for
their sweating mechanism does not fully develop until they
are older.
• Children are more prone to dehydration and extremes of
temperature (both hot and cold) than are adults.
• Therefore, children should not exercise for long periods of
time (more than 30 minutes) in any extremes of weather
conditions.
• They should be encouraged to drink small amounts of water
frequently to replace any lost fluids, and to wear appropriate
clothing

29. Children and Young Athletes:
Matching of opponents.
• Ensure athletes are
matched in size, maturity
and skill level.
• This does not only
decrease injury but also
increases enjoyment.
• Contact sports especially
benefit from this.

30. Children and Young Athletes:
Resistance training.
• The best exercises for developing strength in children are those
where they lift their own body weight.
• It is acceptable to use resistance training (using light weights and
large numbers of repetitions), as long as it is closely supervised
and correct technique is taught.
• Generally though, there is no need for young athletes to be in
resistance training.
• Activity - Discuss the appropriateness of resistance
training for children
http://www.youtube.com/watch?v=esrqV8IVorQ

31. What the syllabus asks you to know
• adult and aged athletes
- Heart conditions
- Fractures/bone density
- Flexibility/joint mobility

32. Adult and aged athletes:
Heart conditions
• As we age, our cardiovascular system becomes less efficient and
this leads to a decreased ability to carry oxygen.
• Problems associated with this process can include a weaker heart,
narrowed and less elastic blood vessels, and high blood pressure.
• The lungs are also less elastic, which makes breathing harder.
• Participants in aerobic events are therefore those most affected by
heart problems.
• Older athletes should avoid strenuous exercise and should exercise
at approximately 60–75 per cent of their maximum heart rate.
• A wide variety of physical activities are suitable as they do not place
excessive stress on the cardiovascular system. They include
walking, cycling, golf and bowls.

33. Adult and aged athletes:
fractures/bone density.
• Bones that are more brittle and less dense will fracture more
easily as a result of falls, impact from other people or objects or
even sudden muscle contractions.
• Stress fractures are also common among athletes with reduced
calcium, especially those women who are amenorrhoeic or have
low oestrogen levels.
• Particular care should be taken with older females in avoiding
contact sports and situations that involve sudden changes in
direction.
• Bone development relies on physical activity, thus strength
training (resistance training) should be an important
consideration.

34. Adult and aged athletes:
Flexibility and joint mobility
• Flexibility decreases with age because of a loss in elasticity of
tendons, ligaments and muscles.
• Regular, gentle and slow stretching is recommended.
• Participation in activities such as yoga and tai chi can also
assist in maintaining flexibility.
• Swimming or exercise in an aquatic environment, such as
aqua aerobics, is ideal for maintaining joint mobility.
• It also allows light stretching to be done in a
non-weight-bearing environment. It is important for
older athletes to maintain flexibility to assist with
being mobile.

35. Adult and aged athletes: trainers
should consider
AGED
ATHLETES
Flexibility.
Past
injuries
Medical
conditions
Bone
density.
Lower
intensity
program
Medications.
Lifestyle.

36. What the syllabus asks you to
know
•female athletes:
- Eating disorders
- Iron deficiency.
- Bone density
- Pregnancy

37. Female Athletes: eating disorders.
• Approximately 5 per cent of women can be expected to
develop an eating disorder at some stage in their lives.
• It appears that high-level physical activity can be a risk
factor for eating disorders only if other predisposing
factors exist; for example, poor self-esteem.
• For some women, extreme exercise is a way of dealing
with conscious or unconscious emotional conflicts, just
as others may engage in extreme gambling or excessive
alcohol consumption for the same reason.

38. Female Athletes: eating disorders.
• Anorexia nervosa is common among elite female athletes,
particularly in those involved with ‘appearance’ sports (such as
gymnastics, diving, ice skating and body building) and
endurance sports (such as long-distance swimming, running
and triathlon).
• Women are 2 times more likely to have eating disorders due
to pressure from sport.
• http://www.youtube.com/watch?v=RRzdzcP3Aug&feature=related
• Disordered eating leads to starvation and dehydration, both of
which impair performance.

39. Female Athletes: iron deficiency
• Females need twice as much iron as males. This difference is
mainly due to blood loss during menstruation; iron is a major
constituent of blood.
• Female athletes also need more iron during training.
• Iron is also lost from the mother to her foetus during
pregnancy.
• Iron is needed in the blood to carry oxygen and carbon
dioxide, and in important muscular and energy-producing
chemical reactions.
• Low iron can lead to anaemia.
• Loss of iron in menstruation and high sporting activity.
• To avoid this diets high in red meats and leafy vegetables
should be consumed.

40. Female Athletes: pregnancy
• Pregnant women should participate in PA to enable healthy
development of the baby.
• Mild to moderate exercise is safe and beneficial for pregnant
women. Many elite athletes have trained and performed at
various stages throughout and after pregnancy with no
apparent problems.
•Benefits of exercising during pregnancy:
•Controlled maternal weight
•Decrease risk of gestational diabetes
•Increase of baby weight

41. Female Athletes: Bone Density
• Bone density refers to the thickness and strength of bones.
Calcium deficiency is associated with osteoporosis and bone
fractures in older females.
• This is particularly dangerous for women going through and
after menopause.
• Calcium is necessary for bone strength, and is also required in
the blood to allow muscles and nerves to function correctly.

42. Revision
• Discuss the implications for a coach of training a young athlete
with asthma. (4marks)
• Account for the considerations that need to be made when
coaching aged athletes. (5marks)
• Discuss why it is important to assess the physical, psychological
and social needs of all athletes. (6marks)
• Discuss the impact that medical conditions such as heart
conditions, poor bone density and joint immobility may have on
exercise options for the adult and aged athlete. (6marks)
• Analyse the impact of thermoregulation for children and young
athletes participating in sport. (4 marks)
• Describe the sport participation options that are available for
aged people with medical conditions. (5marks)

43. What role does preventative
action play in enhancing the
wellbeing of the athlete?

45. Physical preparation
• Pre – screening:
• Provides information of the athletes history, capability or any pre existing
injuries.
• This is usually completed as a questionnaire and provides a starting point
for exercise programs to be tailored to their needs.
• Effective pre-screening will consider:
– Age,
– Gender
– Health status
– Previous experience of PA.
• Risk factors for exercise related complications include:
– Being over 40
– Being overweight
– Having HBP or cholesterol levels
– Having diabetes
– Smokers
– Being pregnant
– Being physically inactive

46. Physical preparation
• Skill and Technique
• Many injuries result due to bad technique and skill
• This places extra responsibility on coaches to teach proper
technique
• EG tackling in rugby needs proper technique
• When coaching, coaches can break the skill down into
parts, promoting safety.

47. Physical preparation
• Physical fitness
• Physical fitness is important in any sport, but they all need to
work on components specific to their sport.
• EG. Netballers work on speed and agility, hand eye co-
ordination as well as cardiovascular endurance.
• It would be pointless for them to train for strength
• Even within netball, different positions need to focus more on
different components. EG. Mid court do more running so more
endurance, shooters speed bursts.

48. Physical preparation
• Warm up/Cool Down
• Warm up prepares the body for activity, lasting around 15mins
• Purpose of warm up:
– Increase blood flow and oxygen to muscles
– Increase body temperature
– Stretch muscles, ligaments
– Mental preparation
• Usually involves some general activity, stretching and then
specific activity for the chosen sport
• Cool down assists body to return to normal state after exercise
• They reduce muscle soreness and tightness and reduce DOMS
• A gentle activity followed by stretching generally occurs
• Activity - research some preventative measures put in place by clubs and
sports to decrease injuries

49. • Rules of sports and activities
• When playing sport, players must respect the rules and those
who enforce the (officials)
• The more dangerous the game, the more strict the rules need to
be. EG. Rugby league say no high tackles
• Players are penalised on (and off – judiciary) the field
• Some rules are also for players safety –
– Heat rule (roof close)
– Rugby Union scrum
– http://www.youtube.com/watch?v=1PJOdeMPDio
Sports policy and the sport environment

50. • Modified rules for children
• Introduced to reduce the risk of injuries to players
• This can be completely new games or new versions of old ones
• EG:
– Kanga Cricket – no fielder allowed 10m of batting wicket, everyone bats
and bowls equal amounts to encourage participation
– Walla Rugby – no pushing in scrum, contact reduced
Sports policy and the sport environment

51. • Matching of opponents
• A child's physical attributes(age and size)and skill level need to be
equal.
• Ensuring that young athletes are matched in size, maturity and skill
level not only decreases injury but generally leads to greater
enjoyment, thus less likely to drop out
• Grading in sport can minimise mismatching
• Rugby league has weight for age competitions that has been
brought in due to the increase Polynesian population playing.
• Activity – Discuss the advantages and disadvantages for weight
for age competitions (a
competition that potentially places
bigger heavier young athletes with
older lighter athletes).
Sports policy and the sport environment

52. • Use of protective equipment
• Many sports require athletes to wear protective equipment to
reduce injuries. Some sports, protective gear is optional.
• It needs to be correctly fitted, correct size and in good condition
Sports policy and the sport environment
•Purpose of protective gear is to:
•Absorb energy from a direct blow
(helmet/mouth guard)
•Limit excess movement (studs in football)
Activity: List protective equipment for:
•Cricket
•Hockey
•Why do people choose not to wear protective gear? Should it be
optional? Whose choice should it be?

53. Sports policy and the sport environment
• Safe Ground, Equipment and facilities
• Ground should be free from obstruction (sprinkler heads, glass)
• Posts should be well padded for training and game
• Ground should be secure from spectators
• http://www.youtube.com/watch?v=ePtTZZkaVqA
• Ideally, substitute players and spectators should be rested out of
the sun.EG at beach volleyball – umbrellas put up etc.
• All equipment should be maintained to a safe working standard
and be regularly checked

54. Environmental considerations
- temperature regulation
Method Definition Description
Convection Heat is lost due to the
air flow across the body
-Cold breeze causes heat loss
-clothing is used to protect against
convective heat loss if the air is hotter than
the body, heat gain will result
Radiation Heat radiates from a
warm object to a cold
object
-electromagnetic waves -hot days: heat
from the ground and the sun will warm up
the athlete.
-on a cold day heat will be lost from an
athlete to their surroundings
Conduction Heat exchange occurs
when two objects of
differing temperature
contact with each other
-a swimmer loses heat to the cold water - a
netball player may gain heat from contact
with a hot playing surface.
Evaporation Heat is lost when sweat
is evaporated from the
bodies surface
-a lot of heat is lost during exercise-heat
being lost from the skins surface then
allows heat from deeper inside the body to
be moved outwards

55. Climatic conditions –
Temperature, humidity rain and wind
• Air temp and humidity are vital factors in thermoregulation (the
process where the body aims to remain at 37’C.
• If the air is dry and there is a breeze, sweat can easily evaporate. This
is when the body cools itself effectively.
• When temps get higher then 25’C, caution is needed
• Because body temp regulation mechanisms don’t work effectively in
hot and humid conditions, hyperthermia (body’s temp rising high)
• Problems can also occur in cold and windy climates. If air temp is
cold, combined with wind, there is the wind chill factor.
• Low core body temperature is called hypothermia.
• Being exposed to cold water is more dangerous then cold air as the
water is a better conductor, thus we loose more heat in cold water.

56. Climatic conditions –
Altitude and Pollution
• Altitude
• http://www.youtube.com/watch?v=zZeWGHUWW3E
• Aerobic performance is greatly affected by altitudes higher than
1500m
• At altitude, the air is less dense (less oxygen)
• Therefore, it is important for athletes to acclimatise before training
• Pollution
• Any pollution is detrimental to an athlete
• Lung function is affected by air pollution. Carbon Monoxide (found in
car fumes etc) reduces oxygen capabilities.
• Pollution can trigger asthma attacks and respiratory illnesses.

57. Climatic conditions –
Fluid intake and Acclimatisation
Fluid Intake Guidelines
• Exercise of high intensity leads to water loss from the skin and lungs increase.
• When exercising in heat, high sweat loss mean that the water loss is even greater.
• All athletes should begin any event well hydrated
• Small drinks every 15 minuets recommended during competition
• Lack of body fluid can lead to extremely high body temperatures and
dehydration.
Acclimatisation
• Is the body’s adaptation to the climate conditions, such as changes in
temperature, humidity, altitude and wind
• Heat acclimatisation affects
• Increased sweat rate
• Decreased heart rate
• Benefits of altitude training include
• Increase in red blood cells
• Increase in blood capillaries

58. Environmental considerations
- temperature regulation
• Discuss the effect that various climatic conditions have on
safe sporting participation
– Hot and humid days
– Cold windy days
– Rain
– Different altitudes
– Pollution
• “Mike is a triathlete who is about to compete in a triathlon. It
is a hot, humid day without a cloud in the sky”
1. Outline the temperature regulation process that would be in action
during the event.
2. Discuss actions that Mike and the organisation can take in order to
minimise the risk of heat illnesses

59. Taping and bandaging
• Taping or strapping for injury prevention (known as prophylactic taping)
involves the application of non elastic adhesive tape that provides support
and restricts any excessive movement that might result in injury.
• Examples include:
• Volleyball and Australian football—Players often have their fingers
taped to prevent dislocation and other tissue damage.
• Basketball and netball—Players tape their ankles to prevent ligament
sprains and tears
• Remember that taping can never provide the joint with
the same stability and support as are supplied by the
body’s natural supports; that is, connective tissues and
muscles.
• Athletes should therefore be encouraged to undertake
strengthening exercises for the sites of the body where injury
is likely.
• They should not rely only on taping

60. Taping and bandaging
• An additional advantage of taping is that when a joint over-extends, the
tape pulls on the skin of the athlete, and this can make the athlete aware
of the joint position more quickly.
• This will allow the athlete to initiate muscle action to correct the situation.
Taping can also be used during the rehabilitation phase to provide
strength, stability and support, thus preventing re-injury.
• http://www.elastoplastsport.com.au/Video/Default.aspx - ankle
• http://www.youtube.com/watch?v=x_pN3XuR6Xs&feature=fvw – wrist
• http://www.youtube.com/watch?v=x_pN3XuR6Xs&feature=fvw - thumb
Activity - Using the links above, use masking tape to
practice taping up your ankle wrist and thumb

61. Taping and bandaging
Taping for isolation of injury
• One of the major aims of taping is to limit movement, or allow only limited
movement. When a joint has been injured, to prevent additional damage
and to promote recovery, taping can be used to isolate or immobilise the
joint. For instance, a sling can be applied to an injured shoulder.
• If done correctly, taping can isolate the joint and prevent any extreme
movements that might have an impact on the healing process.
Taping for immediate treatment of injury
• As well as being used for rehabilitation, taping is used in the immediate
treatment of injury. The most common uses of taping for immediate
treatment of injury are:
• to control bleeding and prevent infection
• to apply pressure that will reduce swelling
• to immobilise and support an injured part.
• If they are carelessly applied they will cause discomfort, allow possible
infection and actually hamper the repair process.

62. Preventative Actions Revision
1. Evaluate the importance of physical preparation in preventing sports injuries ?
2. Explain how a well developed sports policy can protect the wellbeing of
athletes?
3. Describe how modified sports contribute to the safe participation of young
athletes?
4. Analyse how climatic conditions can impact safe sporting participation?
5. Evaluate strategies an athlete could employ to support the body’s
temperature?
6. Select one sport of your choice. Critically analyse how sport policies, rules and
equipment within your chosen sport can promote safe participation?
7. Evaluate the role taping plays in both the prevention and treatment of injuries.
8. Justify the need for sports policies and rules and safe grounds, equipment and
facilities to ensure the wellbeing of those participating in sports
9. Explain the guidelines for fl uid intake

63. •
How is injury rehabilitation managed?

64. Rehabilitation procedures
• Rehabilitation after injury can take some time depending on the
type and severity of the injury. A qualified doctor or
physiotherapist should supervise the process.
• The aims of any rehabilitation program are to:
• restore optimal function of the injured area
• return the athlete to competition quickly and safely
• prevent re-injury.

65. Rehabilitation procedures
• Progressive Mobilisation
• Its used to help regain athletes full ROM
• Prolonged immobilisation has shown to lead to atrophy (smaller)
of bones, tendons, ligaments and cartilage.
• Once swelling has gone, gentle movement can occur.
• Thorough checks should be made to ensure that there is no
fracture at the site—an X-ray may be required.

66. Rehabilitation procedures
• Stretching
• During healing, the muscle length decreases
• Stretching should be performed regularly after
a warm-up, and should always remain within the
pain-free range
• PNF stretching is the best (partner assisted)
• Conditioning
• An athlete should continue fitness by work uninjured muscle groups.
• EG. Hockey player sprains their ankle – should work upper body or
quad/hamstring flexibility etc
• Total Body Fitness
• the maintenance of flexibility, strength and endurance should be
promoted with activities that are specific to the sport or activity, and
that do not endanger recovery from injury.
• Total body fitness is achieved athlete returns to pre-injury state.

67. Rehabilitation procedures
Training
• An athlete who has finished a treatment and rehabilitation
program is not ready to return to full competition.
• If the athlete were to return to competition at this stage there
would be a significant risk of re-injury because movement skills,
specific game skills and confidence have not been re-established.
• The final stages of rehabilitation involve developing muscle
coordination and speed to full capacity – be game ready
• Training should be as close to competition standards. Some
professionals will re-enter competition as a couple grades lower to
get used to demands of the game (AFL especially)

68. Rehabilitation procedures
Use of Heat and Cold
Heat
• Heat is used to increase circulation. The general physiological responses of the
body to heat are:
• decreased pain
• increased ability to stretch
• relaxation
• increased blood flow
• Heat should never be used at the acute level – when swelling is present
Cold
• The term used to describe the use of cold for treatment is ‘cryotherapy’.
• When used with rest, compression and elevation, cold treatment is especially
effective in the treatment of swelling and pain associated with acute injuries.
• Stiffness is increased after cold treatment. Cold should be applied at regular
intervals during the first 24–48 hours of an injury, but not for longer than 30
minutes at a time.

69. • Investigate shoulder and hamstring
rehabilitation procedures (14 day program)

70. Return to play
• Returning to play or competition is not just a matter of waiting for
the required time to pass.
• Active rehabilitation, will ensure that the athlete’s injury has
recovered and that fitness and skills are close to pre-injury levels.
Indicators of readiness to return to play
– Athlete is pain free with full ROM
– No swelling, full strength
– Athlete should be able to perform normal sport requirements
– There may be mild soreness but no significant pain
• Activity – analyse a professional players decision to play out a
season without surgery, but then get it in post season. Consider
fans, money, media, players welfare, representative opportunities

71. Return to play
Monitoring Progress (pre and post-test)
• The physical condition and the psychological condition of the
athlete should be monitored when the athlete returns to play.
• This might involve:
• visual observations of the athlete
• interviews and discussions with the athlete
• ongoing testing (comparison of results pre-injury
to current status)
• observation of video footage of the athlete
• If a player pulls up in a game or training session, they are not to
return to play as further damage may occur.

72. Return to play
Psychological readiness
• An athlete may be physically ready, but they must also be
psychologically and emotionally.
• A player may be hesitant/scared of return or re injury
• Players who are not ready emotionally, will not perform at 100%,
so game like training is important.
• Again, playing in the reserves team can build confidence
• The athlete, coach and medical staff should all
feel confident in the physical and psychological
readiness of the athlete to return to play.

73. Return to play
Specific Warm up procedures
• An athlete who has been injured might need to go through a longer, harder or
more specific warm-up and stretch routine than other athletes.
• Extra time and care might be needed at the injury site and surrounding tissues
to ensure adequate flexibility, blood flow and readiness to perform.
Return-to-play policies and procedures
• Coaches and sport administrators play an important role in establishing
guidelines for athletes who are managing injury and deciding whether to play
with injury and when to return to the sporting arena.
• Return-to-play policies and procedures vary with sports. They may be
determined by overall governing bodies or by individual sporting clubs
themselves.
• Who determines this may depend on the nature and severity of the injury
itself. Priority must at all times be given to player welfare with medical advice
guiding decisions and policy.

74. Return to play
Ethical Considerations
Pressure to participate
• The issue of determining when an athlete returns to training and competition can
be very difficult.
• The decision has short-term and long-term health consequences. Athletes who do
not allow for an appropriate recovery period after injury place themselves at risk of
further complications.
• Unfortunately, there is a temptation for some athletes to return to competition
Internal pressures include:
• boredom
• a drive for success
• a fear of losing one’s position in the team
• a sense of letting down the team.
External pressures include:
• financial pressures
• pressure from the media
• pressure from sponsors
• expectations of other players, family or the coach

75. Return to play
Ethical Considerations
Use of pain-killers
• The use of pain-killing drugs is becoming more common in many
sports. The pressures on athletes to return to performance increase
the use of these medications.
• The use of pain-killing drugs is attractive for athletes, and for the
sporting clubs who rely financially on their athletes taking the field.
• With financial and various other pressures increasing, and with
advances in drug technology, the use of medications to allow
athletes to return to play before full recovery is an increasingly
important issue.

76. Revision
• Identify the internal and external pressures that may be experienced
by an injured athlete when deciding whether to return to play.
• Outline measures an athlete should utilise to know when he or she is
ready to return to play after an injury.
• Discuss who should be responsible for deciding whether an athlete
continues to play with an injury.
• Outline the problems that can be associated with leaving this
decision to the athlete.
• Explain the problems that can be associated with leaving this
decision to people other than the athlete.
• Describe the rehabilitation procedures an athlete would undertake
after tearing a hamstring
• Explain how graduated exercise can assist an athlete to return to play