Which 2 sports have the highest incidence of concussion? 1.Professional horse jumping jockeys 2.Australian footballers
Physio role? Remove player from field of play! Exclude the presence of serious head injury or spinal injury If athlete’s unconscious assume presence of head injury and spinal injury and manage accordingly – hospital...for assessment and observation...
Bleeding Open and closed wounds – Incised: a cut from a sharp edge – Laceration: rough tear or crush to the skin – Abrasion: graze or superficial wound from a rough surface
– Contusion: bruise or internal bleeding – Puncture: an object entering the body – Velocity injury: a puncture wound at velocity will cause extensive damage, there may be an entry and exit wound
Physio role: From first aid perspective, dress wound to maintain sterile state and remove to hospital for treatment if required Sports medic on pitch side can stitch wounds as required
What are the Soft Tissues? Muscles & Tendons Ligaments, Joint Capsules, Bursa Bursa: Small fluid filled sacs. Provides cushioning between bones & tendons. Helps to reduce friction. Cartilage Nervous Tissue
Types of soft tissue injuries TRAUMATIC: Specific cause is identified Cause of injury easily identified OVERUSE: Develop slowly not attributed to one incident Specific injuries assoc with a particular sport
Injury Classification ACUTE : rapid onset, traumatic event with a clearly identifiable cause. CHRONIC: slow insidious onset, gradual development of structural damage. SUB-ACUTE: period between acute and chronic, usually 4-6 weeks post-injury.
Causes of Soft Tissue Injuries Intrinsic causes of injury – factors within the sports person Extrinsic causes of injury – factors outside the sports person
Muscle Injuries Muscle strain= tear in muscle fibres beyond its limit Causes: (i) forceful contraction of the muscle (ii) Overstretching the muscle
Muscle Injuries Classification of muscle strains Grade Extent of damageSymptoms Grade 1 5% or less muscle fibres Minimal pain Grade 2 5% - 99% Some muscle fibres still present Moderate / severe pain on contraction Limited ROM Grade 3 Complete ruptureNo contraction Less pain / no pain
Muscle Injuries Assessing a Muscle strain: 1.PAIN on movement / resistance 2.PAIN on contraction 3.PAIN on palpation Muscle most susceptible to injury? Rectus femoris (quad) Hamstrings Gastrocnemius (calf)
Ligament Injuries Ligament Properties: – Connects bone to bone Grade 1 –minimal swelling, bruising, pain Grade 2 – Moderate to severe swelling, bruising, pain Grade 3 – A lot of swelling, agony, may or may not bruise
Icing Limits Inflammatory process First 48-72 hours Methods: - Crushed ice in a towel, frozen veg, Ice bath, Chemical ice packs (pitch-side), Freeze spray / cryogel Application: -10 mins every 2 hours Dangers of leaving ice on too long - Ice burn - Nerve damage - Increase in blood flow
The aims of early management The management of STI in the first 72 hours: to reduce pain to reduce local tissue temperature to limit and reduce inflammatory fluid to reduce metabolic demands of the tissues to protect the damaged tissue from further injury to protect the newly-formed fibrin bonds from disruption to promote collagen fibre growth and realignment to maintain general levels of cardio-respiratory and musculoskeletal fitness / activity
Management of medical problems HYPOTHERMIA ‘Hypo’ = Below / under ‘Thermia’= heat - Condition in which a person’s body temperature is sufficiently below normal to cause distress and disorder of normal bodily functions. – Mental deterioration – Loss of coordination – Unconsciousness – Failure of breathing and circulation – Death
Hypothermia Signs / Symptoms: - Tiredness / exhaustion - Shivering - White / purplish appearance (bluish tinge to lips / fingers) - Clumsiness / falling/ tumbling - Weak grip and slowness in muscle contraction - Cold rigid arms and legs - Poor concentration, loss of interest, lethargy - Slurred speech
Hypothermia Treatment: Removal from cold, wet, windy conditions (shelter) Insulation to prevent further heat loss Passive or active re-warming Gentle and minimal handling Provision of nutritional and fluid support Transport to medical facility
Hypothermia Hypothermia hits stumbling Lebanese Gloucester 30 th Oct 2000 New Zealand Vs Lebanon Rugby League Group2
Hyperthermia Hypertherma = overheating of body Hyper = ‘ high’, therma = ‘heat’ Body can not effectively regulate excess heat / elevated temperatures Temperature > 37.5–39.9 °C Causes: – Exposure to excessive heat – Exposure to high humidity – High physical exertion – Dehydration
Hyperthermia Signs and Symptoms - Hot, dry skin - Dizziness / Fainting - Nausea / Vomiting - Headaches - Gastrointestinal problems e.g. Diarrhoea - Multi-organ dysfunction Treatment: - Cool / tepid water immersion - Rehydration - Sponging head, neck, trunk with cold water - Sit in shade
Dehydration Fluid Loss exceeds Fluid Intake Causes: - Excessive Sweating - Insufficient fluid intake - Hot & humid conditions - High intensity exercise
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