Mechanisms and Characteristics of Sports Trauma Care & Prevention Ms. Herrera

Mechanical Injury Trauma: “A physical injury or wound sustained and produced by an external or internal force.” Tissue/Structure properties Strength and load correlation

Tissue Stresses There are 5 tissue stresses that can lead to injury… Tension Stretching Compression Shearing Bending

Trauma Soft tissue trauma includes Bony trauma includes Bone Inert tissue skin, Joint capsules Ligaments Fascia Cartilage Nerve Bony trauma includes Bone Articular cartilage

Skin Skin is the largest organ in the body Has two main layers Epidermis and dermis Exposed and easily traumatized

Skin Injuries Wound classes: Friction blister Abrasion Incision Laceration Skin Avulsion Puncture wound Contusion (superficial)

Muscle Injuries Acute injuries Contusions Strains Tendon strains Muscle spasms Overexertional complications Muscle cramps Muscle guarding

Muscle Injuries cont’d Contusion: Bruise to the muscle Palpation demonstrates hardened area Ecchymosis Strains Stretch or tear in the muscle fibers Diagnosed based on a grading scale

Muscle Strains Grading Scale: Grade 1: Some fibers are stretched/torn TTP ROM WNL Grade 2: Several muscle fibers are torn. AROM is painful Depression felt upon palpation Ecchymosis Swelling Grade 3: Complete muscle rupture Pain intense initially, but then subsides Loss of function/ROM

Tendon Strains Tendons can produce… 8,700-18,000 pounds of force per square inch Tendon is twice as strong as the muscle it attaches. MOI: excessive tension in the musculotendinous unit

Muscle Injuries Muscle spasms DOMS Clonic vs. tonic DOMS Delayed onset muscle soreness Muscle cramps due to excessive heat or lack of electrolytes Muscle guarding

Chronic Muscle Injuries Myositis ossificans: calcification that occurs in the muscle. Fasciitis: Thin covering of the muscle becomes inflammed. Tendinitis: Tendon becomes inflammed. Muscle atrophy

Anatomy Joint capsule: Thick, fibrous tissue that holds a joint together. Ligaments Strongest at the middle Weakest at the ends Can tear & result in avulsion fx Provide joint protection during fast movements. Static stabilizers Muscles are dynamic stabilizers Synovial fluid: Joint lubricant (think WD-40) Synovial Joints: 6 different types

Anatomy Cont’d Cartilage (3 types) No direct blood or nerve supply Hyaline (i.e. trachea, bronchi) Fibrocartilage (i.e. meniscus, vertebral disks) Elastic (i.e. outer ear) No direct blood or nerve supply Bursa: fluid filled sacs that lubricate/protect the joint Bursitis?

Joint Sprains Trauma occurs when joint is pushed beyond its limits Ligaments and joint capsule become injured. Slow healing time Repeated traumas results in?

Dislocations Most common in fingers Recognizing a dislocation 2nd most common: Shoulders Recognizing a dislocation Loss of function Obvious, gross deformity Swelling and ttp

Bone Can be stressed/loaded to failure by… Tension Compression Bending Torsion shearing

Fracture Types

Fracture Types Cont’d Blowout Fx: orbital fossa Avulsion fx Stress fx Causes: RTP too soon after injury Improper training Starting training too quickly Changing running habits/environment

References Prentice William: Arnheim’s Principles of Athletic Training, 12th ed, New York,NY,2006, McGraw-Hill,246-269.