Physical Activity Injuries Lecture 2 FDSc FISM year 1 Janis Leach

Recap of Lecture 1 Roles of a therapist? Causes of injury?

Today's lecture Classification of injury What can it tell us and how can it help us as therapists?

Lecture objectives At the end of this lecture you should be able to: differentiate types of skin wounds and fractures differentiate between a sprain/strain Be aware of grading systems Complete an assessment of the hip

Classifications Skin injuries Muscle tears Joint injuries Tendon injuries Ligament injuries Bone injuries Lecture outline

Orientation Produce a list of different types of injuries

Classification of Injury Extrinsic – due to external violence Intrinsic- due to stress developed within the athlete Examples?

Classification of Injury Acute Ties in with inflammatory phase Sub-Acute Proliferation phase ( scar formation ) Chronic Unresolved

Skin injury Haematoma, contusion or bruise - is due to a direct blow, usually with a blunt instrument

ABRASION an injury often of the glancing type, where the surface of the skin is broken but there is no complete tear throughout the whole depth

LACERATION LINEAR WOUNDS WITH DAMAGE TO THE FULL THICKNESS OF THE SKIN

Puncture wound where the depth of the wound is greater then the length or breadth

Blisters injuries to the skin where one layer is detached from the layer beneath. The gap between becomes filled with with fluid exuded from the injured cells

Burns involve damage to the skin as the result of heat

INTRINSIC MUSCLE INJURY STRAIN / TEAR GRADE 1 GRADE 2 GRADE 3

GRADE 1 Small number of torn fibres Localised pain No loss of strength

GRADE 2 Significant number of torn fibres Pain and Swelling Pain on movement Reduced strength Reduced ROM

GRADE 3 Complete rupture

Extrinsic Muscle Injury CONTUSION accumulation of blood and lymph within a muscle HAEMATOMA within a space or tissue

Haematoma Intermuscular Latin for between Intramuscular Latin on the inside

Muscle physiology

Haematoma

Calcification MYOSITIS OSSIFICANS - deposits of calcium and eventually bone are laid down in the muscle, usually as a result of a direct blow It is usually as a result of impact which causes damage to the periostium as well as the epymysium. The bone will grow 2 to 4 weeks after the injury and become mature bone within 3 to 6 months.

Tendon Injury Tendonitis - generalised oedema and inflammation causing pain and loss of function Peritendonitis - inflammation of tissues surrounding the tendon

Tendon Injury Rupture - complete Rupture - partial

Grade 1- Ligament Injury Some stretched fibres No laxity on testing Pain

Grade 2 – Ligament Injury Considerable fibres torn Evidence of laxity Pain Definite end point

Grade 3 – Ligament Injury Complete tear Excessive joint laxity No firm end point

Joint injury Traumatic synovitis - damage to the lining of the joint Loose bodies - pieces of bone that interfere with the joint mechanically (Osteochondritis Dissecans) Dislocation - complete disruption of the joint surface areas Subluxation - misalignment of joint surface but still some overlap

Bone Injury Sudden injury (Fracture) Stress fracture (repetitive forces) Pathological (Underlying bone disease i.e. tumor or cyst

Bone Injury/ Fractures Closed Open (compound) Avulsion

PATTERNS OF FRACTURE Transverse (broken straight across) Oblique (as above but at an angle) Spiral (broken due to twisting motion) Comminuted (shattered bone) Compression (vertabrae) Greenstick (usually found in children)

Bursitis Subcutaneous prepatellar bursa becomes distended with fluid caused by irritation Housemaids knee

Review What is the difference between a strain and a sprain? How does an intermuscular and intramuscular haematoma differ? Name four patterns of fracture? What is the difference between a dislocation and a subluxation?

Task In pairs you are going to assess the ankle, knee and hip joint on each other.