1. Chapter 8: Sports Injuries Outline:
Biomechanical principles of injury
Injury treatment and rehabilitation
Pain: nature’s warning system
Soft tissues injuries
Dislocations
Fractures
Concussions
Overuse injuries
Injury prevention

2. Each type of tissue possesses unique mechanical characteristics
BIOMECHANICAL PRINCIPLES OF INJURY
4 Tissue Types:
Epithelial Muscle Connective Nervous
Each type of tissue possesses unique mechanical characteristics

3. Loading
To best understand the biomechanical characteristics of tissue we examine its behaviour under ______________________
Under load a ____________________________
This change in shape (deformation) can be visualized through in the _________________________

4. Load Deformation Curve
High C B
Load
Low A
Small
Large
Deformation

5. C B A High Load Low Small Large Deformation Ultimate Failure
Elastic Limit B
Load
Plastic Region
Elastic Region
Low A
Small
Large
Deformation

6. C B A High Load Low Small Large Deformation Ultimate Failure
Elastic Limit B
Load
Plastic Region
Elastic Region
Low A
Small
Large
Deformation

7. C B A High Load Low Small Large Deformation Ultimate Failure
Elastic Limit B
Load
Plastic Region
Elastic Region
Low A
Small
Large
Deformation

8. C B A High Load Low Small Large Deformation
Ultimate Failure C
Elastic Limit
If load continues to increase to ‘C’
Macro- or complete failure
(e.g. torn ligament)
Tissue becomes completely
unresponsive to loads B
Load
Plastic Region
Elastic Region
Low A
Small
Large
Deformation

9. C B A High Load Low Small Large Deformation Ultimate Failure
Elastic Limit
Slope = B
Plastic Region
Load
Elastic Region
Area under the curve =
Low A
Small
Large
Deformation

10. Tissues Response to Training Loads
1. Training load ____ elastic limit (B)
Positive training effect
Micro-failure 
the microscopic injuries cause temporary muscle soreness and weakness therefore need a rest period (e.g. a day off)
2. Training load ___ elastic limit
Negative training effect
More severe
*related to principles of training: overload (FITT), stress-rest intervals, overtraining
*optimal training occurs when tissue is stressed________________________
________________________________

11. Forces Acting on Tissue
(pull) (squeeze) (twist)
Other terms: Valgus: outward angulation (of distal part away from midline)
Varus: inward angulation (..toward midline)

12. Injury Rehabilitation
Injury Treatment
Received by patient from a health care professional --
versus
Injury Rehabilitation
Therapist’s restoration of injured tissue
patient's __________________
______________________________
E.g. Athletic therapist (AT), Physiotherapist (PT), Occupational Therapist (OT), Massage Therapist (MT), Chiropractor, etc.

13. Inflammatory Response Phase (hours - 2 to 4 days)
Healing Phases:
Inflammatory Response Phase (hours - 2 to 4 days)
Treatment (PRICE)
- Protect
- Rest
- Ice (Cryotherapy-Decreases swelling, bleeding, pain, spasms)
- Compression (decreases swelling)
- Elevation (above level of the heart to return blood to heart and decrease swelling etc)
Inflammation begins at the time of injury
Signs -

14. Fibroblastic Repair Phase (hours – 6 weeks)
Injured tissue repair and scar formation
Granulation _________ _____________
_________ fibres are deposited by fibroblasts
Signs seen in the phase1 subside
Treatment
Rehab-specific exercises
Restore range of motion and strength
Manual massage (friction) therapy and ultrasound
Help _____________
Protective _________ _______________

15. Maturation-Remodeling Phase
Remodeling or ________________________
Treatment:
More aggressive ______________________
To organize the scar tissue along the lines of tensile stress
Include sport-specific skills and activities

16. Nature’s way of telling us something is wrong
Pain
Nature’s way of telling us something is wrong
One of the best indicators of when the athlete is ready to resume activity
Pain
Pushing injured
tissue closer to
yield-level point
Gastrointestinal
complications
Inability to participate
at optimal level or at all

17. Injury Types: Overuse:
Progressive _____________________________________
Heals slowly (months)
_________:
Caused by abrupt force
Heals quickly
__________:
Repeated damage & inflammation due to neglected or mistreated overuse or acute injuries
Accumulation of chronic _______________
Painful for tissue, pain-sensitive nerve endings
Heals slowly (years if un/mistreated)

18. A: Soft Tissue Injuries:
1._____________ (a.k.a. Bruise)
Compressing force crushes tissue
E.g. “charleyhorse” – quadriceps
_____________________________
______________ = severe pooling of blood in bruise
Can be life-threatening if in vital organs
Signs:______________________
Treatment: P-R-I-C-E
Myositis ossification – ____________ _______________________________

19. 2.Sprains and Strains ____________
Tendon or muscle tissue is stretched or torn
____________
_________or the joint capsule is stretched or torn

20. Grades of sprains and strains
GRADE 1 (1st degree, mild)
Slightly stretched or torn; few muscle fibres (< ____% of fibres)
Signs:_______________________, no limitation of muscle mobility or joint range of motion (ROM)
GRADE 2 (2nd degree, moderate)
Stretch or tear more muscle fibres (___________% of fibres)
Signs: tenderness,____________________, some limitation of muscle mobility or joint ROM
GRADE3 (3rd degree, severe)
Stretch or tear ____________% of fibres (complete rupture)
Signs: severe tenderness, swelling, bruising, __________________ of muscle mobility/ROM, gap in tissue can sometimes be felt in complete rupture
______________________
*See page 176 in text

21. Common Strains Adductors Hamstrings _____________ _____________
________________

22. B: Dislocations:
Occurs when great enough forces push the joint beyond its normal anatomical limits
_____________________: Joint surfaces come completely apart
e.g. ball of joint is forced out of socket as in a shoulder
______________________(subluxation):
When supporting structures (e.g. ligaments) are stretched or torn causing bony structures to partially separate (i.e. pops out then pops in)
Most common in finger, shoulder
Can become chronic

23. C: Fractures: A crack, break or complete shattering of a bone
1. _____________________
Stays within the surrounding soft tissue
2. Compound (open) fracture
_____________________
3. ____________ fracture
Results from repeated low magnitude loads (e.g. runners who overtrain)
Begins as a _________________ ___________________________
With continued use=weakened bone, complete cortical bone fracture
4. Avulsion fracture
Involves tendon or ligament __________ _________________________________
elbow
Compound fracture

24. E: Overuse Injuries Due to Repeated and accumulated microtrauma
Non-sufficient recovery
Results from
_________________
__________________
___________________
*Note: words that end in “itis” = inflammation
of the body part due to repetitive
microtrauma (overuse)
e.g. stress fractures, tendonitis, bursitis

25. Symptoms 1. Tendonitis: Tendonitis Pain (aggravated by movement)
Inflammation of _______________________________________
______________________
Tendonitis )
Symptoms
Pain (aggravated by movement)
Tenderness
Stiffness near joint

26. Injury Prevention: 1. 3. -especially during off-season
-include flexibility activities 4. 2.
- sport-specific activities 5.
- Avoid overtraining
Get proper sleep
Cross-train in off-season