1. PE 902 ATHLETIC INJURIES, TREATMENT & PREVENTION

2. ANATOMICAL CONNECTIVE TISSUE Skeletal Bone – is a type of connective tissue consisting of both living cells and minerals deposited in a matrix. Consists of 3 major components: epiphysis (expanded, articulates), diaphysis (shaft of bone), epiphyseal plates (growth plate).

3. ANATOMICAL CONNECTIVE TISSUE Cartilage – is a type of rigid connective tissue that provides support and acts as a framework in many structures. Cartilage consists of structures that act like a sponge and trap large quantities of water which allows the cartilage to spring back after being compressed. Cartilage has a poor blood supply, thus healing after injury is very slow. There are 3 types of cartilage: Hyaline Cartilage – found on articulating surfaces of bone & in the soft part of the nose. Fibrocartilage – forms the intervertebral disks and menisci located in several joint spaces. Elastic cartilage – found in the auricle of the ear and the larynx.

4. ANATOMICAL CONNECTIVE TISSUE Tendons – attaches muscle directly to bone and primarily composed of collagen fibers. Ligaments – connect bone to bone and play a major role in normal movement and provides restraint to abnormal movement when stress is placed on a joint.

5. ANATOMICAL CONNECTIVE TISSUE Synovial Joints – are composed of 2 or more bones that articulate with one another to allow motion in one or more places.

6. ANATOMICAL CONNECTIVE TISSUE Muscles – muscle tissue is designed to contract and provide movement of other tissues and organs. 3 types of muscles: Smooth muscle – is found within the viscera, where it forms the walls of the internal organs and within many hollow chambers. Cardiac muscle – is found only in the heart and is responsible for its contraction and contracts as a single fiber rather than separate units. Skeletal muscles – is the striated muscle within the body responsible for the movement of bony levers. Consists of 2 portions: 1. Muscle Belly. 2. Tendons

7. ANATOMICAL CONNECTIVE TISSUE 4 Characteristics of Muscles 1.Ability to change in length or stretch - elasticity 2.Ability to shorten and return to normal length – extensibility 3.Ability to respond to stimulation from nervous system – excitability 4.Ability to shorten and contract in response to neural command - contractility

8. INJURIES TO CONNECTIVE TISSUE Ligament Sprains – A sprain involves damage to a ligament that provides support to a joint. A ligament is a tough, relatively inelastic band of tissue that connects on bone to another Degrees of Sprains: 1st Degree Sprains – Some stretching or perhaps tearing of the ligamentous fibers with little or no joint instability. Mild pain, little swelling, and joint stiffness. 2 nd Degree Sprains – There is some tearing and separation of the ligamentous fibers and moderate instability of the joint. Moderate-to- severe pain, swelling, and joint stiffness should be expected. 3 rd Degree Sprains – There is total rupture of the ligament, manifested primarily by gross instability of the joint. Severe pain may be present initially, followed by little to no pain due to total disruption of nerve fibers. Swelling may be profuse and marked stiffness. Requires some form of immobilization lasting several weeks.

9. INJURIES TO CONNECTIVE TISSUE Ligament Healing – Several studies have shown that actively exercised surgically repaired ligaments are stronger than those that are immobilized. Ligaments that are immobilized for periods of several weeks after injury tend to decrease in tensile strength and also show weakening of the insertion of the ligament to bone.

10. INJURIES TO CONNECTIVE TISSUE Bone Fractures – Fractures are extremely common injuries among the athletic population. They can be classified in 2 classes: Open Fracture – a fracture that involves enough displacement of the fractured ends that the bone actually disrupts the cutaneous layers and breaks through the skin. Closed Fracture – a fracture that involves little or no displacement of bones and thus little or no soft tissue disruption.

11. INJURIES TO CONNECTIVE TISSUE Types of Fractures Greenstick – occur when bones are still growing. Transverse – perpendicular crack through the entire bone. Oblique – diagonal crack with to jagged pointed ends. Spiral – diagonal crack across the bone with an element of rotation. Comminuted – complete break that contains multiple fragments and repaired with plates, screws or wires. Impacted – one end of the fracture is driven up into the other end. Avulsion – when a fragment of bone is pulled away at the bony attachment of a muscle, tendon or ligament. Stress – Most common and usually on weight bearing bones and is a result of overuse.

12. INJURIES TO CONNECTIVE TISSUE Types of Fractures

13. INJURIES TO CONNECTIVE TISSUE Joint Injuries Dislocation – Occurs when at least one bone in an articulation is forced out of its normal and proper alignment. Commonly occur in the shoulder joint, elbow, fingers and rarely in the hip joint. Subluxation – Is like a dislocation except that in this situation a bone pops out of its normal articulation but then goes right back into place. Commonly occurs in the shoulder joint with the collar bone.

14. INJURIES TO CONNECTIVE TISSUE Muscle Strains – If a musculotendinous unit is over- stretched or forced to contract against too much resistance exceeding its’ limit damage may occur to the muscle fibers at the muscle-tendon juncture, in the tendon or at the tendon attachment to the bone. Muscle Strains have 3 classifications:

15. INJURIES TO CONNECTIVE TISSUE Degrees of Strains 1 st Degree Strain – Some muscle or tendon fibers have been stretched or actually torn. Movement is painful but full range of motion is usually possible. 2 nd Degree Strain – Some muscle or tendon fibers have been torn and active contraction of the muscle is extremely painful. Usually you can feel a depression or divot exists somewhere in the muscle belly at the spot where the fibers have been torn. Some swelling may occur. 3 rd Degree Strain – (Complete Tear / Rupture) There is a complete rupture of muscle fiber. The athlete will have significant impairment to or perhaps total loss of movement. Pain is intense initially but diminishes quickly because of complete separation of the nerve fibers. This injury is most common in the biceps tendon and the Achilles tendon.

16. INJURIES TO CONNECTIVE TISSUE Tendinitis – A term that can describe many conditions of a tendon. Typically caused by overuse with physical activity and is one of the most common injuries. It is an inflammation response within the tendon. Contusions – Essentially a bruise, caused by a blow from some external object that causes the soft tissues to be compressed against the hard bone underneath. If the blow is hard enough, capillaries rupture and allow bleeding into the tissues. If the bleeding is superficial enough it will cause a bluish-purple discoloration to the skin that may last for several days.

17. TREATMENT OF INJURIES R.I.C.E – Rest, Ice, Compression, Elevation Rest – Restrict activity of the injured body part. During this period of time the athlete should continue to work on other areas of fitness that are not affected by the injury to be sure there is no other decline in performance after returning from the injury. Ice – The use of cold is the initial treatment of choice for virtually all conditions involving injuries to the musculoskeletal system. Should be used immediately after injury to decrease pain and promote clotting and reduce initial swelling. Ice should be used for at least 72 hours after an acute injury. Compression – Is likely the most important technique for controlling initial swelling. The purpose of compression is to reduce the amount of space available for swelling by applying pressure around an injured area. Best way to compress and injury is with the use of plastic wrap and Ace bandage. Elevation – The injured part, especially an extremity, should be elevated to eliminate the effects of gravity on blood pooling. Elevation assists vein drainage of blood and other fluids from the injured area back to the central circulatory system. The injured part should be elevated as much as possible during the first 72 hours.

18. TREATMENT OF INJURIES Sports Rehab – The primary goal of physical rehabilitation is minimize the effects of the inflammation and speed up and aid the healing process through various training techniques. Duration of the rehabilitation is often based on the severity of the injury and the available rehabilitation techniques for the injury.

19. INJURY PREVENTION Conditioning – Off-season conditioning is essential for an athlete seeking maximal in-season performance. Conditioning decreases risk of injury, rehab if an injury has occurred, promotes excellence, maintains knowledge of the sport and provides a bond with athlete and the sport and team. Stretching – Stretching helps increase an athlete’s flexibility which in-turn will help create a greater range- of-motion for the athlete’s joints to prevent structural damage to muscles, tendons and ligaments. The 2 basic stretching techniques are Ballistic and Static.

20. INJURY PREVENTION 2 Basic Types of Stretching 1.Ballistic Stretching – This type of stretching involves the use of repetitive bouncing motions. 2.Static Stretching – This type of stretching involves stretching a muscle to the point of discomfort and then holding it at that point for an extended period of time.