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Injuries and the Healing Process Olympic High School Sports Medicine Chapter 12,13.

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Presentation on theme: "Injuries and the Healing Process Olympic High School Sports Medicine Chapter 12,13."— Presentation transcript:


2 Injuries and the Healing Process Olympic High School Sports Medicine Chapter 12,13

3 Vocabulary Chapter 13 n RICE n Muscle n Tendon n DOMS n Myositis n Fasciitis n Ectopic calcification n Creptitation n Synovia n Articulation n Osteochondrosis n Apophysis n Osteoblasts n Osteoclasts n Wolff’s law n Callus n Mechanoreceptors n Muscle guarding n Trigger point n Open fracture n Closed Fracture

4 Types of Injuries n Strains/Sprains n Grade 1- slight stretch but no deformity, mild to mod. Pain, localized swelling n Grade 2- some tearing of fibers, mod. Instability, mod. Severe pain, swelling n Grade 3- total rupture, major instability, severe pain at first then little or no pain, swelling is great n Contusion n Bruise, hematoma, ecchymosis n Tendinitis : inflammation of tendon n Overuse injury, pain, swelling, crepitus n Bursitis : inflam. Of bursa n Swelling, pain, increased pressure n Wound Injuries: blister, abrasion, laceration, skin avulsion, incision, puncture Tenosynovitis: same as tendonitis but inflamed tendon/synovial sheath.

5 Types of Injuries continued: fractures

6 Types of Injuries continued n Muscle Cramps/spasm: muscle contraction/tightness due to fatigue or injury n Myositis Ossificans: calcification of muscle due to excessive bleeding. n Dislocation: complete displacement of bone with the joint n Subluxation: partial displacement of bone with the joint n Epiphyseal Injuries: growth plate injuries. Salter fractures for epiphyseal fractures n Nerve Injuries: –Hypoesthesia: a diminished sense of feeling –Hyperesthesia: an increased sense of feeling such as pain or touch –Paraesthesia: numbness, prickling, or tingling, which may occur from a direct blow or stretch to an area n Kyphosis: round back, forward-thrust head, winged scapulae, flat chest. Tight pectoral muscles n Lordosis: sway back or hollow back. Tight lower back muscles with weak abdominal muscles. Lineman or gymnasts most susceptible. n Scoliosis: lateral curvature of the spine n Genu Valgum: knock knee n Genu Varum: bowleg

7 How do injuries happen? n What are the possible injuries that can happen in this slide?

8 Mechanical Forces and Strengths n Compression Force: A force that with enough energy crushes tissue. A contusion occurs if too much force is applied n Tension Force : a force that pulls and stretches tissue. Sprains/strains, avulsions, ruptures n Shearing Force: a force that is transverse to fibers. sprains

9 Example of injuries

10 Pain –Two types of soreness »Acute-onset muscle soreness - accompanies fatigue, and is transient muscle pain experienced immediately after exercise »Delayed-onset muscle soreness (DOMS) - pain that occurs hours following activity that gradually subsides (pain free 3-4 days later) n Potentially caused by slight microtrauma to muscle or connective tissue structures –Prevent soreness through gradual build-up of intensity –Treat with static or PNF stretching and ice application within hours of insult

11 n Muscle Stiffness –Does not produce pain –Result of extended period of work –Fluid accumulation in muscles, with slow reabsorbtion back into bloodstream, resulting in swollen, shorter, thicker muscles --resistant to stretching. –Light activity, motion, massage and passive mobilization assists in reducing stiffness

12 Vocabulary n Vasoconstriction n Vasodilation n Regeneration n Phagocytosis n Serum n Synthesis/lysis n Cryokinetics n Modality n Conduction n Convection n Conversion

13 Inflammatory Response n Occurs first for 3-4 days n Swelling, redness, pain, heat, loss of function. n This occurs to protect the body n Acute Inflammation - n Before inflammation begins intact blood vessels vasoconstriction up to 10 minutes n Then blood coagulation begins to seal broken vessels n Then vasodilatation- blood viscosity increases slowing blood flow and swelling then serum seepage min. n Phagocytosis starts to clean out debris n Internal swelling: 1. Throboplastin is sent 2. Thromboplastin and calcium is sent. 3. Thrombin to fibrinogen into final fibrin clot

14 Inflammatory Response n Repair Phase- Fibroplastic( scar formation) n Regeneration n Regrowth of lost cells n Last up to 3 weeks following injury n Primary healing- heal around edges healing- n Secondary healing – gaps heal toward each other n Remodeling n Increase scar tissue first 3 weeks n Last 3 months to a year n Factors that impede healing n 1. Extent of the injury n 2. Edema/hemorrhage n 3. Poor vascular supply n 4. Separation of tissue n 5. Muscle spasm n 6. Atrophy n 7. Infection n 8. age

15 Pain Perception n Pain - n Is described by: burning, sharp, dull, aching, tingling n Deep pain is different than superficial pain –How n Psychological aspects of Pain n Must treat the whole athlete n Personality differences plays a role in pain perception n Referred Pain - n Visceral pain has a tendency to radiate and give rise to pain that becomes referred to skin’s surface

16 COLD AND HEAT n Types of cold: n Ice bag, ice massage, ice boot, cold whirlpool, ice bucket, chemical spray n Physiological effects of cold n Decrease in local temperature up to 4” n Vasoconstriction of capillaries w/in first min., vasodilation 5 min., vasoconstriction 20 min. (Hunting effect) n Decrease local cell metabolism n Decrease blood flow n Decrease nerve velocity n Decrease excitability of muscle n Analgesic effect (numb) which will decrease spasm

17 Cold and Heat cont. n Types of heat n Conduction-transmission of heat between two objects n Convection-heat produced by a moving mass(gas or liquid) n Conversion-heat by electrical current n Radiation- ultraviolet light n Physiological effects of heat n n Increase elasticity of muscles & tendons n n Increase blood flow- vasodilation n n Decrease spasm n n Increase local cell metabolism n n Increase excitability of muscle n n Increase temp. to 3mm depth

18 n Indications of cold n Acute trauma n Anti-inflammatory n Decrease pain n Decrease spasm n Post exercise n Prior to therapy n Contraindications n Before or during activities n Hyper/hypo sensitive to cold n Circulatory inefficiency n Indications of heat n Post acute phase n Decrease spasm n Decrease pain n Help wound healing n Prior to exercise n Contraindications n Acute injuries n Hyper/hypo sensitive to heat n Circulatory problems

19 Different Modalities n Heat Therapies n Short-wave diathermy: High frequency electrical current. Used for: bursitis, capsulitis, osteoarthritis, spasm, strains Heat depth= up to 2 inches n Ultrasound: High frequency sound waves causes molecules to vibrate and warm Used for: joint contractures, scar tissue, tendonitis, bursitis, skeletal muscle spasm, and pain n Paraffin bath: Hot wax used for extremities especially the hand. n Massage Techniques: n Effleurage- stroking, Petrissage- kneading, friction-heat, tapotement- percussion, vibration-rapid shaking

20 Contrast Baths and other Modalities n Hot and cold modality n Physiological effects: n Same as heat/cold n Flushing affect. Brings in new material for repair and flushes out edema n When should you use contrast bath? –When swelling has subsided (48-72 hours) n Time interval for treatments n 4 min. cold then 1 min hot 4 times end in cold= 24 min. n 3 min. cold then 2 min hot 4 times end in cold= 23 min n 2 min. cold then 3 min hot 4 times end in hot= 20 min n 1 min. cold then 4 min hot 4 times end in hot= 20 min n Or 5 min. cold/ 5 min. hot

21 Treatment times and Temperatures n Ice bag, ice boot, ice whirlpool (55-65 degrees) - 20 min. n Ice massage 5-10 min. n Warm whirlpool ( degrees), moist heat pack –10 min. n Ultrasound- 5-7 min. n Muscle stim min.

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