1. Basics of Tissue Injury
Ch. 2
Athletic Training for Student Assistants

2. Objectives Explain the various types of tissue injury
Explain tissue Repair and Healing
Explain various bone injuries
Explain bone repair and healing

3. Soft Tissue Injuries Contusion Abrasion Laceration Puncture Incision
Amputation
Avulsion
Contrecoup
Sprain
Strain

4. Contusion
Called Bruise
A closed wound that bleeds under the skin

5. Abrasion The scraping off of a layer/s of skin
May or may not bleed depending on how many layers are removed

6. Laceration Jagged, irregular opening in the skin
Caused by a non cutting object such as a wall or pole

7. Puncture Occurs when a pointed object enters the body through force
Object such as a nail or tack

8. Incision Open wound made by a cutting object such as a scalpel.
Rarely seen in athletics

9. Amputation
An open wound in which part of the body is completely torn away

10. Avulsion The partial tearing away of a body part.
Can happen when a ring get caught in a basketball hoop.

11. Contrecoup
Injury that occurs on the opposite side of the initial injury
Usually occurs in the brain as the head hits against an un yielding surface
Example: the posterior part of the skull makes contact with the ground and the brain hits the anterior part of the skull.

12. Sprains and Strains
Sprain – A wound that bleeds internally and that does damage to the Ligaments
Strain – A wound that bleeds internally and that does damage to the Tendons or muscles

13. Stages of Soft Tissue Healing
Stage I : Acute Inflammatory
Stage II: Repair
Stage III: Remodeling

14. Stage I: Acute Inflammatory
Inflammatory response phase
When a body part is injured cells in the area die
There is an increase in blood flow to the area
This brings cells and chemicals needed for the healing process
Phagocytes: Specialized cells that engulf and eat up the dead cells
Leukocytes: infection-fighting white blood cells
Platelets: Carry blood-clotting materials
Lasts as long as four days

15. Stage II: Repair Fibroblastic Repair Phase
The injured area is now filled up with blood, cells, and chemicals to help rebuild the area.
Fibroblasts begin to build up scar tissue around the injured area.
This stage lasts six weeks to as long as three months depending on extent of injury

16. Stage III: Remodeling Maturation-Remodeling Phase
This is the body’s way of building tissue strength in tendons, ligaments, and muscles to be able to withstand the stress that is put on them by activity and exercise.
Can take as long as three years to complete

22. Injury Videos

23. Bone Injuries
Dislocations
Fractures

24. Dislocation Articulation – where two bone come together (joint)
A Dislocation occurs when a force displaces a bone so that the ends no longer match up

25. Fractures Avulsion Stress Spiral Longitudinal Compression Oblique
Comminuted
Greenstick
Transverse
Depressed
Blowout
Pathological
Epiphyseal

26. Avulsion Fracture
When a tendon or ligament pulls so hard that it pulls off a piece of the bone.
Common with sprains, strains, and dislocations

27. Stress Fractures Also know as a fatigue fracture
Occurs as an overuse injury with repetitive stress
Can not be seen by an x-ray at first

28. Spiral Fractures
A torsional force along the length of the bone causes this type of fracture
Looks similar to a stripe on a candy cane

29. Longitudinal Fracture
Fracture that runs the length of the bone
Usually occurs by an impact

30. Compression Fracture
Occurs when opposing forces are applied to the bone at the same time
Happens often in the spine

31. Oblique Fracture Diagonal fracture across a bone
Takes longer to heal in a weight bearing bone due to the fact that it does not stay in place very well

32. Comminuted Fracture Happens when a bone is crushed into smaller pieces
Can happen by blunt force trauma

33. Greenstick Fracture
When the bone bends and only fractures half way through it is called a greenstick fracture
Happens mainly in adolescents

34. Transverse Fracture Travels across the bone, perpendicular to the bone
Cause by an impact that is perpendicular to the bone

35. Depressed Fractures Usually occurs in the skull from a direct impact
This impact makes an indention in the skull

36. Blowout Fracture
Occurs when an eye is pushed hard backwards and down into the eye socket
Small bones under the eye are crushed and embedded into the eye muscles

37. Pathological Fracture
A disease process like a bone tumor can weaken the bones so that a little stress will fracture them
Improper nutrition and eating disorders are the most common cause among adolescent athletes

38. Epiphyseal Fracture Fracture of the epiphseal or growth plate
Occur mainly in the long bones of adolescent athletes
Do not occur in adults

39. Bone Healing
Stage I: Acute
Stage II: Repair
Stage III: Remodeling

40. Stage I: Acute Bleeding occurs in the area
Osteoclasts begin to “Eat” the debris or reabsorb it to the body
Osteoblasts begin to add new layers to the outside of the bone tissue
Continues for about four days

41. Stage II: Repair
Osteoclasts and osteoblasts continue to regenerate bone
A bony splint (fibrous callus) forms
The fibrous callus is transformed into a sleeve of hard callus bone
The process of turning callus into bone starts at about week three and continues for about three months

42. Stage III: Remodeling Takes several years to complete
Callus is reabsorbed and replaced with a fibrous cord of bone that is formed around the fracture site
If a bone never heals it is called a nonunion fracture
Nonunion fractures are common in the scaphoid bone of the wrist