Pdhpe HSC Notes 2020 PDF

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PDHPE HSC Notes

Sarah Mok

2020

SPORTS MEDICINE

How are sport injuries classified and managed? Ways to Classify Sport Injuries Direct

DISHO Description + external force causes injury to the body at the point of impact. + generally results in fractures, dislocations, sprains, and bruises.

Indirect

+ caused by an intrinsic force (a force within the body). + usually occurs when an internal force causes injury without the presence of an external force. + reasons for cause: result of inadequate warm up, ballistic movement or the fault of execution of a skill. + occur to skin, blood vessels, muscles, nerves, ligaments and tendons Soft or all tissues other than bones or teeth. Tissue + they can be acute (occurs suddenly) such as a sprain or chronic (for a longer period of time). + Most common soft tissue injuries are tears and contusions (bruisesblood vessels have broken). Hard + these injuries occur to bones, teeth cartilage and joints. + more serious than a soft tissue injury, the most common being a hard Tissue tissue fracture. Overuse + caused by excessive training, repetitive movement or incorrect training techniques. + causes pain and inflammation. + often contributes to stress fractures (small incomplete bone fractures caused by repetitive pounding usually on hard surfaces).

Example + a collision between two players of a sport or a shoulder dislocation caused by a tackle in football. + a sprinter tearing a hamstring during a race + trying to stop yourself from falling and dislocating your shoulder or tear ligaments. + sprains + strains + torn cartilage + contusions + abrasions + + + + +

broken arm fracturing of any bone dislodging a tooth shin splints stress fractures

Soft Tissue Injuries Tears

+ + + + + Sprains + + Contusions + + + + Abrasions + + Lacerations + + + Blisters + + +

BALSTC Nature (causes and effects) Tissue excessively stretched or lengthened results in pain, muscle spasm and muscle weakness. localised swelling, cramping or inflammation and some loss of muscle function may also be caused. severe tears are often extremely painful and disabling. is a stretched or torn ligament. falling, twisting or getting hit can be causes. pain, swelling, bruising and immobility are all symptoms. wound where the skin is not broken. blood vessels are injured or bleeding. caused when blood vessels are damaged or broken as a result of a blow to the skin. causes pain and shallow bleeding. may be embedded with dirt and debris. requires gentle cleansing and sterilising to prevent infection. an irregular open wound caused by a blunt impact to soft tissue. is a deeper injury that is seen in abrasions. larger blood vessels involved and more bleeding. a small pocket of fluid within the upper layers of the skin. may be caused by overexposure to UV rays, reaction with medication or friction with the skin. irritated skills and an influx of water causes stinging and pain.

-

Inflammatory response 3 phases (stages) Phase One: 3-4 days (inflammatory phase) + Pain + Red + Swelling + Loss of function/mobility + Increased blood flow to area + Leakage of fluid -> swelling + Formation of blood vessels - promote healing + Ice - 20 minutes on 20 minutes off Phase Two: 3-4 days-6 weeks (repair and regenerate stage) + Elimination of debris + Formation of new fibres + Production of scar tissue Phase Three 6 weeks - months (remodelling phase) + Increase production in scar tissue + Replacement tissue needs to be strengthened and developed + Restoring flexibility (range of motion) + Regaining full function + Fitness testing + Return to play

Management of Soft Tissue Injuries RICER R

Word Rest

I

Ice

+ + + + + + +

C

Compression

+ decreases bleeding + - reduces swelling

E

Elevation

+ decreases bleeding + reduces swelling + reduces throbbing

R

Referral

+ to understand the nature and extent of the injury + to eek guidance in a program of rehabilitation

-

+

Why? to reduce bleeding into the injury and prevent further damage. To reduce: pain blood flow swelling spasm enzyme activity tissue demand for oxygen

How? + place in a comfortable position. + elevate and support injury.

Time + until beginning a program of careful mobilisation.

+ crushed ice in a wet towel and wrap around the injury, or + frozen gel packs using a towel as an insulator, or + immersion in a bucket of iced water. + wrap an elastic bandage over the area. + cover above and below the site. + raised injured area above the level of the heart by placing a support under the injury.

+ -20 minutes every hour up to four days.

+ - appointment with a doctor or physiotherapist.

+ at the time of the injury. + reapplied periodically for at least 24 hours. + whenever possible during the day. + for the following two to three nights. + as soon as possible following the injury.

Immediate Treatment of Skin Injuries + Wound washed with soap and warm water, antiseptic be applied, dressing applied tetanus injection may be required

+ May be embedded with dirt and debris (foreign materials) + gentle cleansing and sterilisation of wound to prevent infection + Apply a non-stick bandage

Hard Tissues Injuries FSSCD Injury

Types

Simple

Fractures Compound

Stress Fractures

Dislocations

Common sites: + finger + jaw + shoulder + elbow + spine + hip + knee

+ + + + + + + + + + + + + + + + + +

Nature (causes and effects) small breaks in the bone. as a result from direct injuries such as falls. the bone does not protrude through the skin. pain, swelling an limited mobility result. 6 to 8 weeks recovery time. bone that protrudes out of the skin. results from very hard direct injuries. intense pain, bleeding, swelling and immobility result. requires urgent medical attention. also known as fatigue fractures. result from overuse injuries such as running on hard surfaces. bone may have small, incomplete breaks. pain and swelling are experienced. a joint that slips out of place. occurs when end of bones are forced from their normal position. results from blow, fall or other trauma to the joint. swelling, intense pain and immobility are experienced. subluxation: when a bone is removed from joint and replaced.

Manage Hard Tissue Injuries -

assessment for medical attention + use of DRSABCD + controlling bleeding + treating shock + splint and bandage to immobilise the area + immediate medical assistance + RICER

-

immobilisation + restricts movement in injured area using splints and bandages.

Assessment of Injuries TOTAPS + assesses the extent of injury to a player + determine whether the injured person can return play + If movements can be done without pain, then further assessment can proceed. Talk

find out what happened, nature of injury

Proceed if no suspected spinal injury

Observe

Injured area, look for any swelling, redness, bleeding, deformity and compare limbs

Proceed if no obvious swelling, deformity or bleeding is present

Touch

Gently touch to feel for swelling or deformity, try to locate exact point of pain

Proceed if no obvious emotions/ little or no pain registered

Active Movement

Ask athlete to gently perform range of motion movements by themselves

Proceed if athlete can flex, extend and rotate limb with little or no pain

Passive Movement

Assessor carefully moves joint through its full ROM to identify pain, instability

Proceed if full ROM with little or no pain

Skills Test

Ask athlete to perform a few relevant skills required during the game e.g. stand, walk, jog, jump, sidestep

Proceed if athlete can perform skills without pain, in not > RICER

How does sport medicine address the demands of specific athletes? Children and Young Athletes -

Medical - AED Definition

Asthma

Difficulty breathing when reduction in wide of airway to lungs = less air available

Key Points

+ 1 in 10 Australian children suffer from Asthma + can be life threatening + airway narrows makes it difficult to breath Symptoms: + coughing, tightness in chest + shouldn’t be an excuse to avoid training + muscles around bronchioles narrowing (bronchioles swell and increase mucus).

Diabetes

A disease in which the body does not produce or properly use insulin.

Type 1: + not enough insulin is produced Hypoglycaemia: + low blood sugar levels (headaches and dizziness)

How do these affect participation in sport? What are the risks? + being active can effect asthma people. + coughing and wheezing can lead to discomfort and fatigue. + activity can provoke attack.

Guidelines for safe participation with these conditions. What sports are to be encouraged/discouraged? + swimming is best form of exercise for people with asthma. + managed à usually easily managed, have a warm up, medication significantly helps. + control breathing during activity. + intensity should be kept steady + discourage distance running.

+ if diet is inappropriate performance will decline. + decreased energy due to low blood sugar levels can lead to fatigue or blackouts.

+ exercise helps lower glucose level.

+ seizures can occur at any time causing loss of control + seizures can go unnoticed leading to serious injury or death

+ stay away from water activities + wear head gear for all sports + ensure the child is well hydrated + do not continue exercise if the child

Hyperglycaemia: + high blood sugar levels + taking the right amounts of insulin + tired and blurred vision Epilepsy

A disruption to brain function, causing a brief alteration to the level of consciousness and resulting in seizures or fits.

+ treated with medication + fatigue and extreme

-

Overuse Injuries Definition

Small incomplete bone fractures caused by repeated pounding, usually hard surfaces. Stress Fractures

Growth Plate Injuries

Key Points

Common Examples (injuries and sports)

+ on the increase from pressure to perform + running is a major concern. + shin splints, stress fractures, tennis elbow are examples. + recovery time is crucial and essential. + - coaches should ensure correct technique, cross training and recovery time.

+ shin splints from running on hard surfaces or in poor quality footwear. + gradual onset of pain which tends to be localised. + pain increasing + local swelling and tenderness

Growth plates are a part of young people’s long bones. They are soft and regulate growth of bones until maturity.

Shoulder - Baseball Pitching + very common. + caused from the same repetitive movement. Shoulders - Swimming + gymnastics, hyper flexion and hyperextension of elbows, hips and knees. + all result from overuse and high intensity action.

How can sports (competition and training) be modified to avoid these overuse injuries? + maintaining physical conditions that do not involve the injured part of in pounding movements. For example, swimming. + avoid overtraining, vary training environments. E.g. 1500m runners should train on a variety of surfaces. + use of corrective devices (e.g. orthotics) and exercises (prescribed by physio) to improve body mechanics if stress fractures were caused by biomechanical factors. + Balance activities. Discourage children from training/playing in one position (e.g. baseball pitcher). Give them experience at all positions to develop their skills. + rational approach to training and participation (growth velocity). + ensure rest days between training. + seek medical evaluation for injuries. + don’t repeat the same motion. + effective coaching focused on correct technique can reduce the risk of overuse injuries.

Definitions

Guidelines for Thermoregulation in children’s sport

+ hypothalamus responds to changes in body temperature trying to stay at core temp + when it is hot we sweat and blood vessels dilate (expand), when it’s cold we shiver and blood vessels contract.

+ 10 to 15 year old’s should intake 150 to 450mL of water prior to activity and 75-200mL every 15 -20 minutes during physical activity. + sports such as soccer and rugby should be played in cooler months. + encourage sensible clothing to be weather protective. + allow frequent drink breaks.

+ Hypothermia: low body temperature + Hyperthermia: high body temperature Thermoregulation + children can’t regulate their body temperature as effectively as adults. + more at risk of hypothermia and hyperthermia.

-

Appropriateness of Training What’s the difference between weightlifting and weight training? What are the concerns of weight training for children?

Appropriateness of Resistance Training

+ weightlifting: training for maximum strength or bulk + weight training/strength training/resistance training: training specific muscle groups to improve performance. Concerns for children: + can lead to imbalances between muscle groups. + may contribute to injury due to overloading growing bones and muscles. + if properly designed, resistance training can improve performance, body image, improve general health, e.g. decrease risk of cardio vascular disease and diabetes and improve emotional health and wellbeing.

Guidelines for weight training in pre-pubescent children.

+ + +

basic exercises with little or no weight. light resistance only. gradually increase the number of exercises and volume. + keep it simple. + use own body weight and gravity as resistance (e.g. push ups or sit ups).

Guidelines for weight training in pubescent and adolescent children. + strict emphasis placed on safe lifting technique rather than load. + continue progressive loading exercises. + introduce more advanced exercises with little or no resistance.

Adult and Aged How do these affect participation in sport? What are the risks?

Guidelines for safe participation in sport and activity

What options are available for aged people with these conditions?

+

+ + +

pre-screening stress test exercise under supervision and using programs devised by medical professionals + physical activity is beneficial to all people + can maintain or reduce the loss of cardiovascular functioning in the elderly.

+ +

+ +

+

+ Heart Conditions +

+

Fractures and Bone Density

+ +

+

blood vessels lose elasticity with age. Blood pressure increases, the heart may weaken and max. Stroke Volume decreases. this limits the capacity for aged athletes to compete/exercise at high intensities. risk heart attack, stroke. Risks are higher if the person has a pre-existing condition. bone density decreases with age – increases the risk of fractures. women’s bone density decreases faster than men’s osteoporosis is a condition that affects males and females bones become brittle due to decreased mineral content (especially calcium).

avoid contact/collision sports. avoid sports where falls are likely (gymnastics). + regular aerobic, weight bearing exercise can reduce the loss of bone density.

low-moderate intensity begin slowly and progress gradually.

aerobic, low impact safe activities such as swimming or aerobics. + resistance training helps maintain bone density.

+

Flexibility and Joint Mobility

flexibility is a health-related component of fitness – it’s important to maintain flexibility throughout the life span. + flexibility is lost through ageing as muscles tend to lose elasticity. + lack of flexibility will limit movement which can lead to instability around joints and injury.

+

never too late to incorporate mobility/flexibility into exercise regimes. + warm-up/down becomes increasingly important with age. + begin exercise or sport with low intensity activities before competing or raising the intensity.

+

stretching/mobility exercises such as Pilates or yoga help maintain flexibility. + avoid stretching that causes pain.

Female Athletes Key Points

Eating Disorders

+ are characterised by behaviour such as purging, binge eating and starving. + the most common eating disorders are anorexia nervosa and bulimia nervosa. + range of sports that require what is considered to be an ideal body shape to compete. + important for coaches, mangers and family to be aware of the signs and symptoms of these eating disorders.

Iron Deficiency

+ is a condition where the lack of iron in the body lead to a reduction in the number of red blood cells. + iron à is used to produce red blood cells which help store and carry oxygen in the blood. + females need twice as much iron as males due to the loss of iron during menstruation.

Bone Density

+ is how strong the bones of an individual are. + low bone density à is when a person has weak bones and become more prone to a disease called osteoporosis.

How do these affect participation in sport? What are the risks? Specific sports that are an issue + certain body shape or type that is seen to be the right type for participation. + pressure from coaches or fellow competitors can lead to the onset of various eating disorders. + Examples: o marathon running o gymnastics o tennis o diving + without adequate iron levels the body will not be able to operate as efficiently during physical activity. + athletes who avoid red eat will struggle to get the necessary levels or iron the body needs. + endurance athletes à training leads to an increased number of red blood cells and therefore a need for more iron arises. + sweat loss àincreased risk of iron deficiency.

+ female endurance trainers are at risk of a menstrual cycle dysfunction called amenorrhea. (menstrual cycle completely stops). + caused by imbalance between the calories lost in physical activity and calories gained through eating. + imbalance increases to menstrual dysfunction and hormone imbalances.

Guidelines for safe participation in sport and activity + not over exercising. + ensuring that energy intake is maintained so that the athlete has enough energy to participate in physical activity.

+ supplementation may be needed for endurance athletes or for vegetarians.

+

Pregnancy

Benefits for Mother: + more energy + prepared for the physical demands of labour + quicker recovery after labour + faster return to pre-pregnancy fitness and healthy weight. Benefits for Baby: + extra blood vessels are formed so that there is more opportunity to exchange nutrients between the mother and the baby.

+ first trimester the baby is still small enough to be protected by the pelvic bones. + second trimester is when risks start to arise as the baby is bigger and not as well protected. + lifting weights are potentially dangerous. + Examples: o swimming o walking o jogging

+ not seen as a reason to stop physical activity. + physical activity should occur during physical activity. + sport that has minimal contact is recommended due reduce the risk of harm to the baby and the mother.

What role does preventative actions play in enhancing the wellbeing of the athlete? Phys...