Note on Core 3 – Sports Medicine

Resource Description

 

How are sports injuries classified and managed?

• Ways to classify sports injuries

• Direct and indirect
• Soft and hard tissue
• Overuse

Direct and Indirect

Direct – caused by an external blow or force to the site of injury, eg a bruise on the thigh from a cricket ball

Injury – an injury caused by an internal force within the body

• Can occur away from the impact site, eg an outstretched fall leading to a dislocated shoulder
• Eg overstretched muscle – hamstring strain

Soft and Hard Tissue

Soft Tissue issue – injuries occurring to any tissue in the body other than teeth or bone, eg Skin abrasions

Hard Tissue Issue – injury involving damage to the bones or skeleton, severe fractures and dislocations to bruised bones, eg broken tooth

Overuse Injuries

Overuse – intense or unreasonable use of joints or body areas, generally causing pain and inflammation, eg, elbow injury from excessive tennis use

• Soft tear injuries

• Tears, sprains, contusions
• Skin abrasions, lacerations, blisters
• Inflammatory response

Tears, Sprains & Contusions

Tear – disruption of fibres of a muscle or tendon – occurs when they’re overstretched/contracted too fast, eg, torn pectoral muscle

Sprain – tear of a ligament supporting a joint, occurring during hyperextension, eg sprained ankle in netball (due to inversion)

Contusion – bleeding in soft tissue caused by a direct injury – leading to ruptured capillaries and pooled blood, eg a bruise

Skin Abrasions, Lacerations, Blisters

Abrasion – occurs when surface skin layers are broken, eg grazed knee from a slide tackle

Laceration – occurs when there is a deep cut or tear to the skin from contact with a sharp device, eg ice hockey player hit with the stick

Blisters – caused by friction/burning – leading to serum the skin, eg due to small shoe size

Inflammatory Response

Main roles;

• Defend against harmful substances, Disposing dead tissue and promoting new tissue, Increasing nutrition contents and WBC concentration to injured area

Stage 1 – Acute Inflammatory Phase – 

• Initial inflammation with pain and swelling, 48-72 hours – RICER important
• Vasoconstriction – decrease in blood flow to areas – preventing inflammation
• Vasodilation – blood vessels dilate to increase nutrient level

Stage 2 – Repair and Regeneration Phase – 

• Destructive phase – damage tissue is broken
• Scar tissue developed

Stage 3 – Remodelling – 

• Pairing phase leading to healing
• Rebuilding of cells, scar tissue converted to tissue

Management of Soft Tissue Injury

• For abrasions, lacerations and blisters – control bleeding, wash, dry and cover for infection control – don’t pop blisters etc
• Utilise RICER

• Rest – 48-72 hours

• Ice – to decrease swelling/circulation

• Compression – using wide elastic bandage to reduce swelling, limiting fluid buildup

• Elevate – above heart level to reduce blood flow as it’s working against gravity
• Referral – tell them to go to the Doctor
• Hard tissue injuries

• Fractures
• Dislocation

Fractures

• Break to any part of a bone in known as a fracture – type of fracture will depend on the severity of the break to the bone;

• Can be compound/open (outside body) or closed (inside the body)

• Breaks to the bone can be;

• Complete – bone is broken into two parts

• Incomplete – break is only part way through the bone (eg Greenstick fracture)

• Comminuted – when there are more than two breaks in the bone

• Complicated – the break pierces vessels and muscular organs etc

Eg a closed complete fracture of the humerus

Management of Fractures – 

• Use DRSABCD, control bleeding and treat shock to avoid stress
• Call medical assistance and refer them if it’s dealt with

Dislocation

• Where a bone has been removed from its joint structure – a severe one can cause tearing of muscles, ligaments and tendons of the joint

Eg dislocated shoulder 

• Signs and symptoms – deformity and swelling, pain and tenderness etc.

Management of Dislocations

• Try to support dislocation and do not attempt to place it back into place
• To reduce swelling apply RICER

Eg a rugby player who dislocated his shoulder from a tackle, should then be placed in a sling and see a medical practitioner

Management of Hard Tissue Injuries – 

Assessment for medical attention

• Requires fast attention of DRSABCD then TOTAPS
• Immediate treatment is required if hard-tissue injuries are harmful to the body etc, they should be placed still and then call an ambulance for a proper assessment

Immobilisation

• Immobilising joints to minimise movement of an injured area, eg using a sling for shoulder dislocation
• Assessment of injuries
• TOTAPS (Talk, Observe, Touch, Active and Passive movement, Skills Test) 
• Used to ensure that an athlete is conscious which provides information about the nature and extent of the injury, eg use Ankle joint

• Talk – ask victims questions to gather info, eg Did you hear any snaps/pops?

• Observe – visually examining the site of an injury, eg deformity, swelling and redness

• Touch – Feel the site without moving it, compare it with the corresponding sites, eg temp and shape

• Active Movement – ask if they can move the area, and range of motion

• Passive Movement – first aider moves area and determines range of movement

Skills Test – sport specific movements to determine whether they can play, eg jumping in basketball