1. Mechanisms and Characteristics of Sports Trauma

2. (please note that some pictures may be graphic)
Basic Injury Terms
(please note that some pictures may be graphic)
Soft Tissue Trauma
The skin = wounds
Abrasion
Incision
Friction blister
Laceration
Avulsion
Puncture
Contusion

3. Abrasion - skin is scraped away against a rough surface. The
epidermis and dermis are worn away, exposing numerous capillaries
Incision - skin is sharply cut

4. Laceration - a wound where the flesh has been irregularly torn
Avulsion - skin is completely ripped from its source

5. Skin bruise - a blow compresses or crushes the skin surface producing bleeding under the skin - called a contusion
Puncture - penetration of skin by a sharp object

6. Friction blister - continuous rubbing over the surface of the skin
Friction blister - continuous rubbing over the surface of the skin causes a collection of fluid below or within the epidermal layer

7. Care for blisters Prevention: Treatment:
Talcum powder or petroleum jelly can protect skin against abnormal friction
Wearing tubular socks or 2 pairs of socks
Correct size shoe
Shoes must be broken in
Treatment:
Leave intact first 24 hrs.
Popping a blister depends on pain and severity
Avoid infection by cleaning with antiseptic soap
May use 2nd skin or moleskin
Doughnut pad may decrease pain

8. Soft Tissue Trauma Skeletal Muscle Trauma
Contusions: Superficial to deep
Hematoma may be formed by localization of the bleeding into a clot

9. Strains - stretch, tear or rip in the muscle tissue or tendon
Possible causes: abnormal muscle contraction due to a strength imbalance, electrolyte imbalance
May range from a minute separation of connective tissue and muscle fibers to a complete tendinous avulsion or muscle rupture

10. Soft Tissue Trauma Strains
Grade I = Some muscle fibers stretched or torn, mild tenderness, pain on active motion but full range of motion (ROM) is possible, no discoloration, mild loss of strength
Grade II = Some muscle fibers torn, extremely painful, loss of strength and movement, discoloration due to capillary bleeding, possible divot felt
Grade III = complete rupture, significant impairment or total loss of movement, pain is intense but quickly diminishes due to complete nerve separation

11. Soft Tissue Trauma Muscle Soreness 2 Types:
Acute-Onset Muscle Soreness - usually accompanies fatigue, during and immediately after exercise
Delayed-Onset Muscle Soreness (DOMS) - appears hrs after exercise. Most intense hrs later. Takes about 72 hrs to go away

12. Soft Tissue Trauma Tendon - attaches muscle to bone
Tendonitis - inflammation of the tendon-muscle attachments, tendon or both due to overuse
Gradual onset, diffuse tenderness, swelling, pain
Grade I = pain before, no pain during, pain after
Grade II = pain before, during and after but sill functional
Grade III = pain all the time and debilitating

13. Joint Trauma Ligaments Connect 2 bones
Primary Function = motion control and stability
Sprain = stretching or tearing of ligaments, joint capsule, or both

14. Cartilage Connective tissue that provides firm and flexible support
Because of its great strength, cartilage can be deformed without damage and still return to its original shape
Occurs throughout body and consists of 3 types:
Hyaline - nasal septum, trachea, larynx, articular ends of bones of the synovial joints
Fibrous - vertebral discs, meniscus
Elastic - external ear, eustachian tube

15. Hyaline Articular cartilage no direct blood supply
Receives nourishment from synovial fluid
Acts like a sponge
Articular cartilage
Motion control
Stability
Load transmission

16. Joint Trauma
Sprains
Grade I = some pain, mild pt. tenderness, mild loss of function, little to no swelling, little to no discoloration, no instability
Grade II = pain, moderate loss of function, swelling, and moderate instability
Grade III = extremely painful, major loss of function, severe instability, swelling, rupture of the ligament

17. Joint Trauma Dislocations: complete joint disruption
2nd to fractures in terms of disabling the athlete
Highest incidence = fingers, shoulder, elbow
1st time dislocations (all except finger) should always be treated as emergencies and 911 called (finger should be referred but not an emergency)

18. Skeletal Trauma
Acute Bone Fractures: disruption in the bone’s continuity
Depressed
Greenstick
Impacted
Longitudinal
Spiral
Transverse
Comminuted
Avulsion
Open or compound

20. Skeletal Trauma Stress Fractures Weakened areas of bone
Starts as stress reaction and progresses to stress fracture
Causes - theories include:
Coming back from injury too soon
Going from one event to another without proper training
Starting too quickly
Changing environment (running surfaces, shoes, etc.)
Postural and foot mal-alignments

21. Skeletal Trauma Stress Fractures
Common areas: tibia, fibula, metatarsals (3rd and 4th), calcaneus, femur, lumbar vertebrae (extension athletes), ribs, humerus
Signs and symptoms: progression of pain from intermittent to constant, more intense at night, focal to one spot, swelling, does not respond to treatment
Management: send athlete for xray to rule out fx; possible bone scan may be necessary if pain persists and xray is negative, usu. walking boot is recommended