OPTION 3 SPORTS MEDICINE Overview How are sports injuries classified and managed? (Classifying Injuries, soft/hard tissue injuries, totaps) How does sports medicine address the demands of specific athletes? (child/aged/female athletes) What role do preventative actions play in enhancing the wellbeing of the athlete? (prescreening, sports policies, environmental considerations, fluid intake, acclimatisation) How is injury rehabilitation managed? return to play policies) (rehab procedures, How are Sport Injuries classified
and managed?!? How Are Sports Injuries Classified? Direct injuries are caused by an external force applied to the body e.g. injury caused by tackle/collision Examples of injuries that result from external forces: Haematomas (corks) Contusions (bruise) Joint and ligament damage Dislocations and bone fracture Indirect injuries are caused by an intrinsic force e.g. hamstring tear while
sprinting http://www.youtube.com/watch?v=sPZEntyFzdk&feature=related Actual injury can occur away from the impact site. EG falling with an outstretched arm can result in dislocated shoulder http://www.youtube.com/watch?v=xPxR1p9DvK8 Activity Explain why it is necessary to classify injuries How Are Sports Injuries Classified? Overuse injuries are caused by the overuse of specific body parts e.g.
tennis elbow shin splints heel and knee pain Caused by excessive and repetitive force is placed on the bones Little or no pain may be experienced initially, so can go undetected Large amount of overuse injuries result from poor training plans Poor technique also leads to overuse. Poor tennis backhands - tennis elbow Many endurance based sports need to be particularly careful of overuse injuries.
http://www.youtube.com/watch?v=l8TZLIVDxXM How Are Sports Injuries Classified? Soft tissue injuries -Damage that only occurs skin deep e.g. Lacerations, tears These are the most common forms of injury Includes:
Skin injuries blisters, cuts Muscle injuries tears or strains of muscle fibres and contusions (bruise Tendon injuries tears or strains of tendon fibres (tendonitis) Nadal had this in knees Ligament injuries- tears or strains of ligament fibres A Strain is a partial or complete tear of a muscle or tendon (bone to muscle) A Sprain is a partial or complete tear of a ligament (bone to bone) Types of Soft Tissue injuries Abrasions caused as a result of the skin being scraped. The wound needs to be cleansed and sterilised in order to prevent infection. Lacerations are when the skin has incurred an irregular tear. It may require stitches depending on the depth of the cut.
Blisters are caused by a collection of fluid below or within the epidermal layer of the skin ,they occur because of friction. Calluses is when a build up of dead skin forms at a site where friction has occurred Immediate Treatment of skin Injuries
Danger - play continuing around the injury Blood and bodily fluids increase the risk of infectious diseases Bleeding needs to be controlled immediately to slow down blood flow Pressure should be applied to the wound with elevation being applied After dressing is applied, place ice so that it will decrease bleeding Assessment - see if it is a simple or complex injury E.g. Is it just a blister or a deep cut requiring stitches Cleansing Clean using clean water or saline solution Take out foreign material (grass/dirt), though leave in deep material Make sure clothes are also clean before athlete returns Antiseptic should be applied to the skin injury Dressing should be adhesive (band aid) or non adhesive (allow large wounds which may weep. Dressing should not get damp as this encourages infection Referral - should be made for complex injuries, such as head injuries or deep wounds Soft tissue scenarios
What would you do in the following situations: 1. During a ruck, a football player gets stomped on the thigh by another player 2. When attempting a rebound, a basketball player lands on somebody elses foot and rolls over on her ankle 3. A tennis player reaching out for a shot falls and skids across the bitumen court, grazing their entire right side 4. A soccer player falls over during training onto a broken piece of glass that embeds deeply into their hand 5. A gymnast falls heavily off the beam onto their wrist. Their wrist bends back sharply on impact How Are Sports Injuries Classified? Hard Tissue injuries occur when the damage is done to the bone e.g. Fractures
They range from severe fractures and dislocations to bruising of the bone http://www.youtube.com/watch?v=QnnPhc_ZjWk Perform practical activity: Application of arm slings/leg splints Inflammatory response Phase one, the inflammatory stage is characterised by pain, increase
blood flow to the area (which cause pain because of excess fluid to the area) redness, heat, swelling, loss of function and mobility Phase two, the repair and regenerative stage is characterised by formation of new fibres and the production of scar tissue. The longer the inflammation occurs, the worse the scar tissue will be Phase three, the remodelling stage is characterised by increased production of scar tissue and replace of tissue that needs to be strengthened Types of Hard Tissue Injuries Classifications of Fractures: simple/closed - bone broken but the skin over it is intact. Complicated/open the skin over fracture is not intact and bone is breaking through Compound The bone is broken in more than one place Stress fractures are bone fractures that develop slowly and are caused by overuse
Dislocations are displacement of a bone at a joint How are sport injuries Analyzed ? TOTAPS T- Talk O- Observe T- Touch A Active movement P Passive movement S- Skills test
ACTIVITY - research in depth this principle How are sport injuries managed? R -REST - prevent further injury. Remain inactive for 48-72hrs I -ICE reduces pain ,blood flow, swelling. The application of ice causes blood vessels to constrict, thus reducing circulation and resulting in less inflammation. This also reduces scar tissue. C - Compression- decreases bleeding and bruising through applying pressure with a elastic bandage. This helps reduce swelling by reducing fluid build up. It also provides support for the injured site. E - Elevation- raise above heart level to decrease bleeding. The elevation reduces the volume and pressure of blood flow to the area. R - Referral seek guidance for rehab
Most of what RICE does is reduces the blood flow, and speeds up rehab For soft tissue injuries and to stop bleeding, abrasions, calluses, blisters , lacerations How are sport injuries managed? Things to avoid Application of heat (old school). Heat packs, spas etc Drinking alcohol Activity
Massage All these activities stimulates blood flow to the area and therefore swelling and inflammation reduces rehab Sports Injury Flow Chart
Revision Sports injuries that are caused by agents from within the body are called? Sports injuries that are caused by factors outside the body, such as another player or a piece of equipment are called? Tennis elbow is an example of what type of injury? The structure that joins a bone to another one is what? Soft tissue injuries that continue over a long period of time are called? Another term for a bruise
A strain occurs when this is stretched beyond its range of movement Soft tissue undergo this response when damage occurs Damage to these structures within soft tissue causes bleeding to occur Bruising occurs following soft tissue injury due to the tissue damage and the? This process whereby an athlete will regain their function of the injured area Gravel rash is an example of? Blisters occur due to the process of what? The management routine followed for soft tissue injuries is what? This action reduces pain and swelling of the injured area Bleeding of a skin injury can be decreased by applying what? When two bones at a joint are displaced from each other, what is this called? The routine followed for a thorough assessment of injury is called what? Revision Exam-style questions
1 Explain how sporting injuries can be classified. (8 marks) 2 Contrast the management of soft-tissue injury and hard-tissue injury. (8 marks) 3 Describe the inflammatory response and the role it plays in injury rehabilitation. (8 marks) 4 Assess each step of the TOTAPS procedure and the role it plays in the assessment of a sporting injury. (12 marks) Sports Medicine: How does sports medicine address the demands of specific athletes? Students learn about: children and young athletes - medical conditions (asthma, diabetes, epilepsy) -overuse injuries (stress fractures) -thermoregulation -appropriateness of resistance training adult and aged athletes
-heart conditions fractures/bone density - flexibility/joint mobility female athletes: -eating disorders - iron deficiency. -bone density -pregnancy. Children and Young Athletes. Exercise and play are important parts of a childs physical, mental and social development. Children and young people obtain the following benefits from participating in physical activity: enjoyment social interaction improved motor and communication skills greater aerobic fitness improved coordination
increased strength development of self-esteem promotion of physical activity into adulthood Children and Young Athletes. Children are not little adults. They have specific physical capabilities, and special care should be taken when they are involved in sport. Young athletes cannot cope with the same level of training as adults. Intensive training can often be boring, restrictive and socially isolating for maturing young performers. What the syllabus asks you to know children and young athletes - medical conditions (asthma, diabetes, epilepsy) - overuse injuries (stress fractures) - thermoregulation
- appropriateness of resistance training Children and Young Athletes. Condition. Symptoms. What its caused by/what it affects. How to prevent Why it hinders physical performance. Asthma Coughing. Wheezing.
Tight feeling in the chest or throat. affects children, 1/7 adolescents. Affects the breathing airways on exposure to triggers airways narrow making it difficult to breathe. Warm up and cool down. EIA (exercise induced asthma) has symptoms such as
coughing and wheezing. It makes it hard for the athlete to breathe. Can be treated with a puffer 4 puffs every 4 mins. Diabetes Dizziness. Sweating. Poor coordination. headache. Hypoglycemia low blood sugar.
Hyperglycemia high blood sugar. (hypo. Is much more common in sport) Eat plenty of sugars and drink plenty of water. Athletes feel as though they have no energy to continue. They may collapse (move from danger, give sugar and get medical assistance.) or fall unconscious (treat with DRABCD)
epilepsy. Fatigue. Brain activity and electromagnetic impulse becomes No flashing lights. Seizures. Treatment: protect from danger. DONT restrain or put anything in Asthma
Asthma is a narrowing of the airways that makes breathing difficult. Strenuous physical activity can trigger an asthma attack in some sufferers. This is called exercise-induced asthma and is very common among asthmatics. Factors that make the condition worse include cold, dry air and exercise of significant intensity and duration. The following points should be noted when training asthmatics: Ensure the person has an adequate warm-up. Dont ask the person to perform if he or she has had an asthma attack recently. Provide opportunity for rest. Have the person use preventative medication, if necessary, and ensure it is with the person at all times. Take extra care in cold or dry weather, or if the person is suffering from a respiratory infection. Know the athletes limits. Be aware of asthma management techniques and familiar with the individual persons asthma management plan.
Diabetes Diabetic athletes should prepare themselves for the demands of training or participation by adhering to specific dietary requirements and by monitoring their blood glucose levels. If diabetics engage in over strenuous activity they can develop hypoglycaemia. This can cause collapse, and even unconsciousness. If the person develops hypoglycaemia and is still conscious, a glucose substance should be given Epilepsy Epilepsy is a condition characterised by seizures that make individuals unable to control their movements When participating in physical activity it is important to know that fatigue and extremes of body temperature can trigger an epileptic seizure.
If an epileptic episode occurs: Allow the seizure to occur unrestrained. Ensure there is a safe space around the affected person. Allow the person to rest after the seizure has ceased. Overuse Injuries Children should not overtrain, particularly on hard surfaces. To avoid overuse of particular muscles and joints: children should be allowed to play a number of sport and exercise in a variety of positions. Coaches and parents should help to avoid overuse injuries by ensuring appropriate conditioning and stretching programs are undertaken Stress fractures repeated trauma on a bone which leads to small cracks in the bones. Mostly occur around the growth plates on the hips and knees.
Children and Young Athletes: Thermoregulation. The process to control the body's core temperature. Young athletes take longer to become acclimatise to heat. They cannot loose as much heat through evaporation for their sweating mechanism does not fully develop until they are older. Children are more prone to dehydration and extremes of temperature (both hot and cold) than are adults. Therefore, children should not exercise for long periods of time (more than 30 minutes) in any extremes of weather conditions. They should be encouraged to drink small amounts of water frequently to replace any lost fluids, and to wear appropriate clothing
Children and Young Athletes: Matching of opponents. Ensure athletes are matched in size, maturity and skill level. This does not only decrease injury but also increases enjoyment. Contact sports especially benefit from this. Children and Young Athletes: Resistance training. The best exercises for developing strength in children are those where they lift their own body weight. It is acceptable to use resistance training (using light weights and large numbers of repetitions), as long as it is closely supervised
and correct technique is taught. Generally though, there is no need for young athletes to be in resistance training. Activity - Discuss the appropriateness of resistance training for children http://www.youtube.com/watch?v=esrqV8IVorQ - What the syllabus asks you to know adult and aged athletes Heart conditions Fractures/bone density Flexibility/joint mobility
Adult and aged athletes: Heart conditions As we age, our cardiovascular system becomes less efficient and this leads to a decreased ability to carry oxygen. Problems associated with this process can include a weaker heart, narrowed and less elastic blood vessels, and high blood pressure. The lungs are also less elastic, which makes breathing harder. Participants in aerobic events are therefore those most affected by heart problems. Older athletes should avoid strenuous exercise and should exercise at approximately 6075 per cent of their maximum heart rate. A wide variety of physical activities are suitable as they do not place excessive stress on the cardiovascular system. They include walking, cycling, golf and bowls. Adult and aged athletes: fractures/ bone density.
Bones that are more brittle and less dense will fracture more easily as a result of falls, impact from other people or objects or even sudden muscle contractions. Stress fractures are also common among athletes with reduced calcium, especially those women who are amenorrhoeic or have low oestrogen levels. Particular care should be taken with older females in avoiding contact sports and situations that involve sudden changes in direction. Bone development relies on physical activity, thus strength training (resistance training) should be an important consideration. Adult and aged athletes: Flexibility and joint mobility Flexibility decreases with age because of a loss in elasticity of tendons, ligaments and muscles.
Regular, gentle and slow stretching is recommended. Participation in activities such as yoga and tai chi can also assist in maintaining flexibility. Swimming or exercise in an aquatic environment, such as aqua aerobics, is ideal for maintaining joint mobility. It also allows light stretching to be done in a non-weight-bearing environment. It is important for older athletes to maintain flexibility to assist with being mobile. Adult and aged athletes: trainers should consider Flexibility. Medications. Past injuries
AGED ATHLETES Medical conditions Lifestyle. Lower intensity program Bone density. What the syllabus asks you to know female athletes:
- Eating disorders Iron deficiency. Bone density Pregnancy Female Athletes: eating disorders. Approximately 5 per cent of women can be expected to develop an eating disorder at some stage in their lives. It appears that high-level physical activity can be a risk factor for eating disorders only if other predisposing factors exist; for example, poor self-esteem. For some women, extreme exercise is a way of dealing with conscious or unconscious emotional conflicts, just as others may engage in extreme gambling or excessive
alcohol consumption for the same reason. Female Athletes: eating disorders. Anorexia nervosa is common among elite female athletes, particularly in those involved with appearance sports (such as gymnastics, diving, ice skating and body building) and endurance sports (such as long-distance swimming, running and triathlon). Women are 2 times more likely to have eating disorders due to pressure from sport. http://www.youtube.com/watch?v=RRzdzcP3Aug&feature=related Disordered eating leads to starvation and dehydration, both of which impair performance.
Female Athletes: iron deficiency Females need twice as much iron as males. This difference is mainly due to blood loss during menstruation; iron is a major constituent of blood. Female athletes also need more iron during training. Iron is also lost from the mother to her foetus during pregnancy. Iron is needed in the blood to carry oxygen and carbon dioxide, and in important muscular and energy-producing chemical reactions. Low iron can lead to anaemia. Loss of iron in menstruation and high sporting activity. To avoid this diets high in red meats and leafy vegetables should be consumed. Female Athletes: pregnancy Pregnant women should participate in PA to enable healthy
development of the baby. Mild to moderate exercise is safe and beneficial for pregnant women. Many elite athletes have trained and performed at various stages throughout and after pregnancy with no apparent problems. Benefits of exercising during pregnancy: Controlled maternal weight Decrease risk of gestational diabetes Increase of baby weight Female Athletes: Bone Density Bone density refers to the thickness and strength of bones. Calcium deficiency is associated with osteoporosis and bone fractures in older females. This is particularly dangerous for women going through and after menopause. Calcium is necessary for bone strength, and is also required in
the blood to allow muscles and nerves to function correctly. Revision Discuss the implications for a coach of training a young athlete with asthma. (4marks) Account for the considerations that need to be made when coaching aged athletes. (5marks) Discuss why it is important to assess the physical, psychological and social needs of all athletes. (6marks) Discuss the impact that medical conditions such as heart conditions, poor bone density and joint immobility may have on exercise options for the adult and aged athlete. (6marks) Analyse the impact of thermoregulation for children and young athletes participating in sport. (4 marks) Describe the sport participation options that are available for aged people with medical conditions. (5marks)
What role does preventative action play in enhancing the wellbeing of the athlete? Physical preparation Pre screening: Provides information of the athletes history, capability or any pre existing injuries. This is usually completed as a questionnaire and provides a starting point for exercise programs to be tailored to their needs. Effective pre-screening will consider:
Age, Gender Health status Previous experience of PA. Risk factors for exercise related complications include:
Being over 40 Being overweight Having HBP or cholesterol levels Having diabetes Smokers Being pregnant Being physically inactive Physical preparation Skill and Technique Many injuries result due to bad technique and skill This places extra responsibility on coaches to teach proper technique EG tackling in rugby needs proper technique When coaching, coaches can break the skill down into parts, promoting safety.
Physical preparation Physical fitness Physical fitness is important in any sport, but they all need to work on components specific to their sport. EG. Netballers work on speed and agility, hand eye coordination as well as cardiovascular endurance. It would be pointless for them to train for strength Even within netball, different positions need to focus more on different components. EG. Mid court do more running so more endurance, shooters speed bursts. Physical preparation Warm up/Cool Down Warm up prepares the body for activity, lasting around 15mins Purpose of warm up:
Increase blood flow and oxygen to muscles Increase body temperature Stretch muscles, ligaments Mental preparation Usually involves some general activity, stretching and then specific activity for the chosen sport Cool down assists body to return to normal state after exercise They reduce muscle soreness and tightness and reduce DOMS A gentle activity followed by stretching generally occurs Activity - research some preventative measures put in place by clubs and sports to decrease injuries
Sports policy and the sport environment Rules of sports and activities When playing sport, players must respect the rules and those who enforce the (officials) The more dangerous the game, the more strict the rules need to be. EG. Rugby league say no high tackles Players are penalised on (and off judiciary) the field Some rules are also for players safety Heat rule (roof close) Rugby Union scrum http://www.youtube.com/watch?v=1PJOdeMPDio
Sports policy and the sport environment Modified rules for children Introduced to reduce the risk of injuries to players This can be completely new games or new versions of old ones EG: Kanga Cricket no fielder allowed 10m of batting wicket, everyone bats and bowls equal amounts to encourage participation Walla Rugby no pushing in scrum, contact reduced Sports policy and the sport environment Matching of opponents A child's physical attributes(age and size)and skill level need to be equal. Ensuring that young athletes are matched in size, maturity and skill level not only decreases injury but generally leads to greater enjoyment, thus less likely to drop out Grading in sport can minimise mismatching
Rugby league has weight for age competitions that has been brought in due to the increase Polynesian population playing. Activity Discuss the advantages and disadvantages for weight for age competitions (a competition that potentially places bigger heavier young athletes with older lighter athletes). Sports policy and the sport environment Use of protective equipment Many sports require athletes to wear protective equipment to reduce injuries. Some sports, protective gear is optional. It needs to be correctly fitted, correct size and in good condition Purpose of protective gear is to: Absorb energy from a direct blow (helmet/
mouth guard) Limit excess movement (studs in football) Activity: List protective equipment for: Cricket Hockey Why do people choose not to wear protective gear? Should it be optional? Whose choice should it be? Sports policy and the sport environment Safe Ground, Equipment and facilities Ground should be free from obstruction (sprinkler heads, glass) Posts should be well padded for training and game Ground should be secure from spectators http://www.youtube.com/watch?v=ePtTZZkaVqA
Ideally, substitute players and spectators should be rested out of the sun.EG at beach volleyball umbrellas put up etc. All equipment should be maintained to a safe working standard and be regularly checked Environmental considerations temperature regulation Method Definition Description Convection Heat is lost due to the air flow across the body
-Cold breeze causes heat loss -clothing is used to protect against convective heat loss if the air is hotter than the body, heat gain will result Radiation Heat radiates from a warm object to a cold object -electromagnetic waves -hot days: heat from the ground and the sun will warm up the athlete. -on a cold day heat will be lost from an athlete to their surroundings
Conduction Heat exchange occurs when two objects of differing temperature contact with each other -a swimmer loses heat to the cold water - a netball player may gain heat from contact with a hot playing surface. Evaporation Heat is lost when sweat is evaporated from the bodies surface
-a lot of heat is lost during exercise-heat being lost from the skins surface then allows heat from deeper inside the body to be moved outwards Climatic conditions Temperature, humidity rain and wind Air temp and humidity are vital factors in thermoregulation (the process where the body aims to remain at 37C. If the air is dry and there is a breeze, sweat can easily evaporate. This is when the body cools itself effectively. When temps get higher then 25C, caution is needed Because body temp regulation mechanisms dont work effectively in hot and humid conditions, hyperthermia (bodys temp rising high) Problems can also occur in cold and windy climates. If air temp is cold, combined with wind, there is the wind chill factor. Low core body temperature is called hypothermia.
Being exposed to cold water is more dangerous then cold air as the water is a better conductor, thus we loose more heat in cold water. Climatic conditions Altitude and Pollution Altitude http://www.youtube.com/watch?v=zZeWGHUWW3E Aerobic performance is greatly affected by altitudes higher than 1500m At altitude, the air is less dense (less oxygen) Therefore, it is important for athletes to acclimatise before training
Pollution Any pollution is detrimental to an athlete Lung function is affected by air pollution. Carbon Monoxide (found in car fumes etc) reduces oxygen capabilities. Pollution can trigger asthma attacks and respiratory illnesses. Climatic conditions Fluid intake and Acclimatisation
Fluid Intake Guidelines Exercise of high intensity leads to water loss from the skin and lungs increase. When exercising in heat, high sweat loss mean that the water loss is even greater. All athletes should begin any event well hydrated Small drinks every 15 minuets recommended during competition Lack of body fluid can lead to extremely high body temperatures and dehydration. Acclimatisation Is the bodys adaptation to the climate conditions, such as changes in temperature, humidity, altitude and wind Heat acclimatisation affects Increased sweat rate Decreased heart rate
Benefits of altitude training include Increase in red blood cells Increase in blood capillaries Improved heart function Environmental considerations - temperature regulation Discuss the effect that various climatic conditions have on safe sporting participation Hot and humid days Cold windy days Rain Different altitudes Pollution Mike is a triathlete who is about to compete in a triathlon. It is a hot, humid day without a cloud in the sky 1. Outline the temperature regulation process that would be in action during the
event. 2. Discuss actions that Mike and the organisation can take in order to minimise the risk of heat illnesses Taping and bandaging Taping or strapping for injury prevention (known as prophylactic taping) involves the application of non elastic adhesive tape that provides support and restricts any excessive movement that might result in injury. Examples include:
Volleyball and Australian footballPlayers often have their fingers taped to prevent dislocation and other tissue damage. Basketball and netballPlayers tape their ankles to prevent ligament sprains and tears Remember that taping can never provide the joint with the same stability and support as are supplied by the bodys natural supports; that is, connective tissues and muscles. Athletes should therefore be encouraged to undertake strengthening exercises for the sites of the body where injury is likely. They should not rely only on taping Taping and bandaging
An additional advantage of taping is that when a joint over-extends, the tape pulls on the skin of the athlete, and this can make the athlete aware of the joint position more quickly. This will allow the athlete to initiate muscle action to correct the situation. Taping can also be used during the rehabilitation phase to provide strength, stability and support, thus preventing re-injury. http://www.elastoplastsport.com.au/Video/Default.aspx - ankle http://www.youtube.com/watch?v=x_pN3XuR6Xs&feature=fvw wrist http://www.youtube.com/watch?v=x_pN3XuR6Xs&feature=fvw - thumb Activity - Using the links above, use masking tape to practice taping up your ankle wrist and thumb
Taping and bandaging Taping for isolation of injury One of the major aims of taping is to limit movement, or allow only limited movement. When a joint has been injured, to prevent additional damage and to promote recovery, taping can be used to isolate or immobilise the joint. For instance, a sling can be applied to an injured shoulder. If done correctly, taping can isolate the joint and prevent any extreme movements that might have an impact on the healing process. Taping for immediate treatment of injury
As well as being used for rehabilitation, taping is used in the immediate treatment of injury. The most common uses of taping for immediate treatment of injury are: to control bleeding and prevent infection to apply pressure that will reduce swelling to immobilise and support an injured part. If they are carelessly applied they will cause discomfort, allow possible infection and actually hamper the repair process. Preventative Actions Revision 1. 2. 3. 4.
5. 6. 7. 8. 9. Evaluate the importance of physical preparation in preventing sports injuries ? Explain how a well developed sports policy can protect the wellbeing of athletes? Describe how modified sports contribute to the safe participation of young athletes? Analyse how climatic conditions can impact safe sporting participation? Evaluate strategies an athlete could employ to support the bodys temperature? Select one sport of your choice. Critically analyse how sport policies, rules and equipment within your chosen sport can promote safe participation? Evaluate the role taping plays in both the prevention and treatment of injuries. Justify the need for sports policies and rules and safe grounds, equipment and facilities to ensure the wellbeing of those participating in sports
Explain the guidelines for fl uid intake How is injury rehabilitation managed? Rehabilitation procedures Rehabilitation after injury can take some time depending on the type and severity of the injury. A qualified doctor or physiotherapist should supervise the process. The aims of any rehabilitation program are to: restore optimal function of the injured area return the athlete to competition quickly and safely prevent re-injury. Rehabilitation procedures Progressive Mobilisation
Its used to help regain athletes full ROM Prolonged immobilisation has shown to lead to atrophy (smaller) of bones, tendons, ligaments and cartilage. Once swelling has gone, gentle movement can occur. Thorough checks should be made to ensure that there is no fracture at the sitean X-ray may be required. Rehabilitation procedures Stretching During healing, the muscle length decreases Stretching should be performed regularly after a warm-up, and should always remain within the pain-free range PNF stretching is the best (partner assisted)
Conditioning An athlete should continue fitness by work uninjured muscle groups. EG. Hockey player sprains their ankle should work upper body or quad/hamstring flexibility etc Total Body Fitness the maintenance of flexibility, strength and endurance should be promoted with activities that are specific to the sport or activity, and that do not endanger recovery from injury. Total body fitness is achieved athlete returns to pre-injury state. Rehabilitation procedures Training An athlete who has finished a treatment and rehabilitation program is not ready to return to full competition. If the athlete were to return to competition at this stage there would be a significant risk of re-injury because movement skills,
specific game skills and confidence have not been re-established. The final stages of rehabilitation involve developing muscle coordination and speed to full capacity be game ready Training should be as close to competition standards. Some professionals will re-enter competition as a couple grades lower to get used to demands of the game (AFL especially) Rehabilitation procedures Use of Heat and Cold Heat Heat is used to increase circulation. The general physiological responses of the body to heat are: decreased pain increased ability to stretch relaxation
increased blood flow Heat should never be used at the acute level when swelling is present Cold The term used to describe the use of cold for treatment is cryotherapy. When used with rest, compression and elevation, cold treatment is especially effective in the treatment of swelling and pain associated with acute injuries. Stiffness is increased after cold treatment. Cold should be applied at regular intervals during the first 2448 hours of an injury, but not for longer than 30 minutes at a time.
Investigate shoulder and hamstring rehabilitation procedures (14 day program) Return to play Returning to play or competition is not just a matter of waiting for the required time to pass. Active rehabilitation, will ensure that the athletes injury has recovered and that fitness and skills are close to pre-injury levels. Indicators of readiness to return to play Athlete is pain free with full ROM No swelling, full strength
Athlete should be able to perform normal sport requirements There may be mild soreness but no significant pain Activity analyse a professional players decision to play out a season without surgery, but then get it in post season. Consider fans, money, media, players welfare, representative opportunities Return to play Monitoring Progress (pre and post-test) The physical condition and the psychological condition of the athlete should be monitored when the athlete returns to play. This might involve: visual observations of the athlete interviews and discussions with the athlete ongoing testing (comparison of results pre-injury to current status) observation of video footage of the athlete
If a player pulls up in a game or training session, they are not to return to play as further damage may occur. Return to play Psychological readiness An athlete may be physically ready, but they must also be psychologically and emotionally. A player may be hesitant/scared of return or re injury Players who are not ready emotionally, will not perform at 100%, so game like training is important. Again, playing in the reserves team can build confidence The athlete, coach and medical staff should all feel confident in the physical and psychological readiness of the athlete to return to play. Return to play
Specific Warm up procedures An athlete who has been injured might need to go through a longer, harder or more specific warm-up and stretch routine than other athletes. Extra time and care might be needed at the injury site and surrounding tissues to ensure adequate flexibility, blood flow and readiness to perform. Return-to-play policies and procedures Coaches and sport administrators play an important role in establishing guidelines for athletes who are managing injury and deciding whether to play with injury and when to return to the sporting arena. Return-to-play policies and procedures vary with sports. They may be determined by overall governing bodies or by individual sporting clubs themselves.
Who determines this may depend on the nature and severity of the injury itself. Priority must at all times be given to player welfare with medical advice guiding decisions and policy. Return to play Ethical Considerations Pressure to participate The issue of determining when an athlete returns to training and competition can be very difficult. The decision has short-term and long-term health consequences. Athletes who do not allow for an appropriate recovery period after injury place themselves at risk of
further complications. Unfortunately, there is a temptation for some athletes to return to competition Internal pressures include: boredom a drive for success a fear of losing ones position in the team a sense of letting down the team. External pressures include: financial pressures pressure from the media pressure from sponsors
expectations of other players, family or the coach Use of pain-killers Return to play Ethical Considerations The use of pain-killing drugs is becoming more common in many sports. The pressures on athletes to return to performance increase the use of these medications. The use of pain-killing drugs is attractive for athletes, and for the sporting clubs who rely financially on their athletes taking the field. With financial and various other pressures increasing, and with advances in drug technology, the use of medications to allow athletes to return to play before full recovery is an increasingly important issue.
Revision Identify the internal and external pressures that may be experienced by an injured athlete when deciding whether to return to play. Outline measures an athlete should utilise to know when he or she is ready to return to play after an injury. Discuss who should be responsible for deciding whether an athlete continues to play with an injury. Outline the problems that can be associated with leaving this decision to the athlete. Explain the problems that can be associated with leaving this decision to people other than the athlete. Describe the rehabilitation procedures an athlete would undertake after tearing a hamstring Explain how graduated exercise can assist an athlete to return to play