Pdhpe - HSC Notes Sports Medicine (Option One) PDF

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Pdhpe - HSC Notes Sports Medicine (Option One)...

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HOW ARE SPORTS INJURIES CLASSIFIED AND MANAGED? WAYS TO CLASSIFY SPORTS INJURIES —DIRECT AND INDIRECT ● Direct—Caused by an external force applied to the body ● Includes fractures, dislocations, sprains, bruises ● Indirect—Caused by an intrinsic force; a force within the body ● Includes pulling a muscle due to irregular movement ● Can be caused by inadequate warm up, exercise movement, wrong execution of a skill —SOFT AND HARD TISSUE ● Soft tissue—Everything  in the body except bones and teeth, two types ● Acute—Occurs suddenly, such as pulling a muscle, sprains, strains ● Chronic—Injury builds up over a period of time ● Hard tissue—Includes  bones and teeth ● Can include fractures, dislocations, dislodging a tooth —OVERUSE ● Overusing a specific body region over a long period of time ● Puts stress on parts of the body which causes injury, causing pain and inflammation ● Young children are most at risk as their bones are still developing, fragile and their bodies are not built for the repetitive nature ● Injuries include shin splints, tendonitis, tennis elbow SOFT TISSUE INJURIES —TEARS, SPRAINS, CONTUSIONS ● Tears—Occur when the tissue is stretched more than it normally does/can, two types ● Sprains—Stretching/tearing of a ligament ○ Ligaments attach bone to bone, provide stability and are not very flexible ● Strain—A muscle/tendon gets torn/stretched ○ Muscles get a lot more blood supply than ligaments, meaning they get more energy to recover quicker ● (Sprains) can be classified into three degrees, according to its severity ○ First degree– little damage, Second degree– moderate damage, Third degree– extensive damage ● Contusions—Bruises, caused by the crushing of soft tissue ● It interrupts the blood flow to the surrounding tissues ● Haematoma—  bleeding outside the vessels due to injury —SKIN ABRASIONS, LACERATIONS, BLISTERS ● Skin abrasions—Caused  by friction ● Causes pain and shallow bleeding since the skin is scraped ● Can get infected—needs to be cleansed and sterilised to prevent ● Laceration—The flesh has incurred an irregular tear ● Longer than one centimeter needs to be referred to a doctor ● Blisters—Collection of fluid below/within the surface layer of the skin giving rise to intense pain ● Can cause clear liquid/blood if a blood vessel has been ruptured ● Occurs when: ○ New equipment is being worn/used ○ Equipment is used for a long time ○ Activity requires sudden change of direction, causing friction in a sports shoe

—INFLAMMATORY RESPONSE ● The body trying to heal itself as quickly as it can ● May last three to four days, three phases ● Phase one—Inflammatory  stage, three days ○ Pain, redness, swelling ⚬ Increased blood flow to the area ○ Loss of function and mobility ⚬ Leakage of fluid causing swelling (oedema) ○ Damage to cells and surrounding tissue ⚬ Formation of many blood vessels to promote healing ● Phase two—Repair  and regenerate stage, may last from three days to six weeks ○ Elimination of debris (rubbish, dead cells, tissue, muscles, capillaries) ○ Formation of new fibres (found in muscles), not strong not flexible ○ Production of scar tissue (other tissue to replace torn tissue), very strong, not flexible ■ Need to start stretching scar tissue, new fibres need resistance going through it ● Phase three—Remodelling  stage, can last from six weeks to many months ○ Increased production of scar tissue ○ Replacement tissue that needs to strengthen and develop in the direction that the force is applied (the direction the muscle lengthens and shortens) ■ Rehabilitation, trying to get body back to pre-injury stage ■ Excessive exercise too early causes further damage ■ Too little exercise allows large quantities of scar tissue to form, which lacks strength and flexibility ● Immediate treatment aims to reduce swelling, prevent further damage and ease pain ● In the long term: ○ Restore flexibility ⚬ Prevent recurrence ○ Regain full function ⚬ Return the player to the field as soon as possible ● Management is RICER ○ Rest  to reduce chance of further injury and bleeding ○ Ice to reduce swelling, pain, blood flow ○ Compression, tight bandaging, decrease bleeding, reduce swelling ○ Elevation decreases bleeding, reduces throbbing, above the heart ○ Referral  to a doctor to understand the nature and extent, seek guidance for rehabilitation HARD TISSUE INJURIES —FRACTURES ● Break in a bone, two types ● Simple—(Closed), the bone breaks but remains underneath the skin ● Compound—(Open), the bone breaks and protrudes through the skin ● Management of fractures requires: ○ Use of DRSABCD due to bleeding or shock ⚬ Treating shock ○ Bandage to immobilise the area ⚬ Controlling bleeding ○ Immediate medical assistance ⚬ Use of a splint —DISLOCATION ● The displacement of a bone at a joint ● The real damage is to ligaments that have been stretched or ruptured (technically not a hard tissue) ● The common signs and symptoms of dislocation are: ○ Deforming and swelling ⚬ Pain and tenderness ⚬ Loss and function ● Management requires: ○ Securing with a splint to fully immobilised (restrict the movement of) the injury ○ Ice, elevation and support using a bandage

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○ Immediate medical attention Subluxation—The bone ‘pops out’ and ‘pops in’ with movement (rolling shoulder) It stretches the ligaments, but may not cause additional damage at the time ○ The joint will be vulnerable and require rehabilitation and, possibly, surgery When treating a dislocation, follow these guidelines ○ Never attempt to relocate the displaced bone at this might increase the damage ○ Seek medical attention

ASSESSMENT OF INJURIES —TOTAPS (TALK, OBSERVE, TOUCH, ACTIVE AND PASSIVE MOVEMENT, SKILLS TEST) ● Talk, Observe, Touch, Active movement, Passive movement, Skills test ○ DRSABCD is for life-threatening injuries/situations ● Determines what sort of injury, its extent and whether or not the injured person can return to the field ● Assess and diagnose an injury ● Talk—Find out exactly what happened, which provides valuable information about the nature of the injury ● Observe—Look at the injury for any sign of deformity/swelling. The easiest way to assess this is to compare both sides of the body ● Touch—Gently feel the injury for any sign of deforming/swelling, try to pinpoint the area of pain ● Active movement—Ask  the player to perform a range of joint movements (flexion, extension) and rotation. If this is done with no pain, further assessment can proceed ● Passive movement—Physically  mobilise the joint (flexion, extension) using a range of movements aimed at identifying painful areas and any inability in the joint ● Skills test—Ask  them to perform a skill required in the game (sidestep). Succession will allow the player to return to the game ● Should there be a risk of further damage through continued play, it is advisable to remove the player from the game ● ● ● Identify specific examples of injuries that reflect each of the classifications. Soft tissue acute—Pulled  hamstring Direct injury—Bruise  to the shoulder from tennis ball Soft tissue chronic—Tennis  shoulder Indirect injury—Pulled  hamstring Soft tissue (tear) strain—Pulled  hamstring Hard tissue—Chipping  a tooth Soft tissue (tear) sprain—Ankle  sprain Fracture (simple)—Broken  radius underneath the skin Skin abrasion—Scraped  skin from the floor Fracture (compound)—Broken  tibia protruding from skin Contusion—Bruise to the back Dislocation—Finger  Laceration—Cut with a knife Subluxation—Shoulder  rolled back into place Blister—Equipment used for a long time Manage soft injuries injuries: ● RICER (Rest, Ice, Compression, Elevation, Referral) Rest to reduce chance of further injury and bleeding Ice to reduce swelling, pain, blood flow Compression, tight bandaging, decrease bleeding, reduce swelling Elevation decreases bleeding, reduces throbbing, above the heart (getting gravity to play part in reducing blood flow to area) Referral to a doctor to understand the nature and extent, seek guidance for rehabilitation 3-5 days, about 72 hours ●

Immediate treatment of skin injuries

Manage hard tissue injuries: ● Assessment for medical attention Talk—Find out exactly what happened, which provides valuable information about the nature of the injury Observe—Look at the injury for any sign of deformity/swelling. The easiest way to assess this is to compare both sides of the body Touch—Gently feel the injury for any sign of deforming/swelling, try to pinpoint the are of pain Active movement—Ask  the player to perform a range of joint movements (flexion, extension) and rotation. If this is done with no pain, further assessment can proceed Passive movement—Physically  mobilise the joint (flexion, extension) using a range of movements aimed at identifying painful areas and any inability in the joint Skills test—Ask  them to perform a skill required in the game (sidestep). Succession will allow the player to return to the game ●

Immobilisation

Perform assessment procedures to determine the nature and extent of injury in simulated scenarios.

HOW DOES SPORTS MEDICINE ADDRESS THE DEMANDS OF SPECIFIC ATHLETES? CHILDREN AND YOUNG ATHLETES —MEDICAL CONDITIONS (ASTHMA, DIABETES, EPILEPSY) ● Any medical conditions are managed effectively to allow participation without negative health impacts Asthma ● Affects airways, constriction which allows less air into the lungs ● Usually begins with coughing and wheezing and can lead to considerable fatigue ● Makes breathing difficult ● Can be triggered by strenuous activity, prolonged activity, cold dry air ● Exercise induced asthma—The  airways are dilated during physical activity but constrict immediately when activity ceases, leading to an asthma attack (EIA) ● Cause is related to the cooling process of nerve endings in the air passageway, which is more extreme in running-type activities ● Swimming in warm water carries far less risk, as inspired air is saturated with warmer water vapour and the nerve endings are not cooled to the same degree ● The following measures help sufferers work with and possibly control their asthma: ○ Activity should be preceded by controlled breathing and relaxation exercises ○ Use a gradual warm-up and conclude with a leisurely warm-down ○ Exercise intensity needs to be steady ○ If medication is required, it is essential to use it before exercise ○ Adequate water must be consumed ○ If attacks are triggered by environmental factors, remove the athlete from that environment ● May limit activities, but does not necessarily stop exercise ● Swimming is the preferred form of exercise, as the warm, moist environment is less likely to cause an attack ○ During breathing, air is forced out of the lungs and into the water, which improves lung function

● Treat asthma using the rule of four—4 puffs, 4 breaths (1 puff, 1 breath, etc.), 4 minutes Diabetes ● The body does not produce or properly use insulin ● Type one—Caused  by the body’s inability to produce insulin (genetic) ● Type two—Caused  by the body’s inability to produce enough insulin or use it effectively ○ A lifestyle disease (diet, lack of exercise), more common ● Pancreas produces insulin, and is important in breaking down carbohydrates (which produces energy) ● Leads to high blood glucose levels ● Insulin injection before activity to allow for energy ○ Must balance insulin by way of injection, food intake and exercise for optimal physical performance ● Well balanced diet, complex carbs (release energy slowly) to allow insulin to break it down easily ● Exercise increases the utilisation of sugar, pre-game meal required to raise blood sugar levels and hourly glucose supplementation (a banana) if exercise is protracted Epilepsy ● Due to fatigue, extremes of temperature, over stimulation ● Disruption to brain function, messages to body from brain interrupted ○ Causes a brief alteration to the level of consciousness and resulting in seizures or fits ● Generally believed that, if seizures occur on a daily or weekly basis, collision sports should be avoided ● If controlled through medication or occurs only during sleep, epilepsy should not prevent participation in a wide range of sporting activities ● The circumstances of each individual should be assessed and they should be guided by their doctor ● Some activities (swimming alone, scuba diving, rock climbing) must be completely avoided, as a seizure may go unnoticed or cause loss of control, leading to serious injury or death ○ No contact, individual/solo sports ● Be aware of problem, treatment, safety considerations (swimming, etc) —OVERUSE INJURIES (STRESS FRACTURES) ● Injuries often related to growth imbalances in muscles, tendons, bones ● Growth plates injured ● Bones grow faster than muscles, tendons causing painful inflammation ● Possible fractures due to lack of coordination through fatigue ● Children most susceptible because of different growth rates in bone and soft tissue ● Examples include swimmer’s shoulder, runner’s knee, stress fractures ● The most common causes are: ○ High training volume and intensity ⚬ High training frequency (number of times a week) ○ Lack of good general level of fitness ⚬ Inadequate warm-ups ○ Biomechanical problems leading to stress on particular parts of the body ○ Unsuitable equipment such as running shoes that do not provide proper support ○ Poor technique or changes in techniques leading to joint stress ○ Strength and flexibility imbalances leading to poor body alignment ● To avoid risk, suggested to have days of non-training and monitor the volume and intensity of their exercise activities ● Signs and symptoms of stress fractures include: ○ Gradual onset of pain, which tends to be localised ○ Pain increasing if it is not adequately treated ○ Local swelling and tenderness ● Stress caused to the bone (common type occurs in the lower leg—shin splints) ● Adequate treatment requires: ○ Immediate rest lasting from four to eight weeks, depending on the severity of the injury

Frequent use of ice to reduce inflammation Possible use of anti-inflammatory medication Maintaining physical condition by purpusing activities that do not involve the injured part in pounding movements—for example, swimming ○ Use of corrective devices and exercises to improve body mechanics if stress fractures were caused by biomechanical factors Ensure appropriate conditioning and stretching Duration of training, correct gear, rule changes (big gears not allowed on kids bikes in races) Avoid overusing body part—vary sports, positions Rules to restrict repetition (cricket, baseball limit number of ovals/balls pitched) Use appropriate equipment—modified ○ ○ ○

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—THERMOREGULATION ● Children have larger surface area—more opportunity to lose fluids ● Children sweat less, could become overheated ● Less muscle—decreased heat generation, increased risk of becoming cold ● How the body can control its own temperature regardless of the outside ● Children do not have the same ability to lose heat through evaporation at the same rate as adults ○ Their sweat glands release fluid more slowly and are less responsive to temperature change ○ Rely more on radiation and convection to lose heat ● They have shorter tolerance time in extreme heat, increasing the possibility of dehydration ● Research suggests children have a higher chance of developing hypothermia from exposure to cold when compared to adults, placing them at greater risk in these environments ● Stable internal temperature should remain at around 37-38° ● Reduce length bouts of activity ● Avoid extremes of weather ● Encourage frequent replacement of fluids ● Wear appropriate clothing —APPROPRIATENESS OF RESISTANCE TRAINING ● Can pre-adolescent children improve strength through resistance training, is growth sustained, will it cause injury ● A strength training program for children must be an integral part of an overall program designed to improve skill and fitness ● It should not be competitive ● It is important that strength specialisation (focusing on power/absolute strength) be avoided, as this can lead to imbalances between muscle groups and contribute to injury ● Overall, there is considerable benefit from well-supervised programs and little risk of injury if guidelines are followed ● Can improve strength mainly through improved neural capacity, coordination ● Training should begin with body weight exercises, instruct proper technique, allow appropriate rest, not load excessively, have slow accurate movements with relatively light loads, work large muscle groups, not be competitive—keep activity enjoyable ● Ensure appropriate warm-up ● Performed only under close supervision

ADULT AND AGED ATHLETES —HEART CONDITIONS ● Heart conditions—Include  individuals who suffer from high blood pressure, have experienced a heart attack or other heart problems, or have a bypass surgery ● Prescreening must occur ● Prescribed exercise conveys considerable benefit with little risk to people in these groups ○ Reduces blood pressure in mandatory hypertensive patients by an average of 11 systolic and nine diabolic points ● To gain maximum benefit, exercise needs to be combined with a balanced diet with low fat and salt intake ● People with existing heart conditions should obtain medical clearance before starting an exercise program ● Aerobic (walking, cycling, jogging, swimming) exercise present the best options for people who have not been active for a period of time ● The ‘steady state’ heart rate is considered safe as long as it is 10 or more beats per minute lower than levels that trigger abnormal signs/symptoms (nausea, shortness of breath, dizziness, abnormal heart rhythm, chest pain) ○ Level can be determined by stress tests which show how the limit of one’s heart rate (what they can not go over during exercise) ● The key principles for sports participation for people with heart conditions are: ○ Initially, they require medical clearance ⚬ Progress must be gradual ○ The program should be tailored to individual tastes ⚬ Exercise must be aerobic ○ Activity needs to be of moderate intensity ○ The program must be sustainable as benefits accrue only after a period of months —FRACTURES/BONE DENSITY ● Osteoporosis (more prevalent in women than men) ○ Musculoskeletal condition in which there is deterioration in the bone structure—the bones become thin and weak, leading to an increased risk of bone fracture ● Exercise is particularly important to older women because it contributes significantly to delaying postmenopausal bone density loss ● Inactivity should be avoided as this encourages calcium discharge from bone, making it weaker ● Exercise programs should focus on improved fitness ○ Balance, strength, coordination, aerobic capacity, flexibility ● Lessen pain, increase confidence and broaden the range of activities available ● Types of exercise and sports options available include: ○ Endurance activities—walking, cycling, swimming ○ Low impact and balance activities—aerobics

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○ Low range strengthening exercises focusing on the limbs, trunk and back Aim is to develop postural retraining—to teach safe ways of performing movements (lifting) and to avoid further fraction

—FLEXIBILITY/JOINT MOBILITY ● Exercise has a positive effect ● Arthritis, aching joints and tight muscles, respond positively to exercise programs that focus on safe stretching and improving the range of motion in joints ● Programs should increase balance and stability and aim to reduce fractures caused by falls ● Programs need to: ○ Be low impact ⚬ Be specific to a person’s physical limitations ○ Consider existing medical conditions that might limit movement ● Options available include walking, cycling, swimming, flexibility classes and aqua-aerobics ● Tai chi has also gained popularity as it is safe, controlled, low impact and promotes balance FEMALE ATHLETES —EATING DISORDERS ● Characterised by behaviour such as purging, binge eating, starving ● Most common are anorexia nervosa and bulimia nervosa ● Twice the risk of developing eating disorders, which may result from: ○ Exposure to peer influence, magazines, televisions and other forms of media that make athletes susceptible to the pressures of weigh...