Transcript How are sports injuries classified and managed?

Focus Question 1
How are sports injuries
classified and
managed?
WAYS TO CLASSIFY SPORTS INJURIES
Injuries are generally classified according to the cause
of the injury or the way it occurred.
e.g. Direct/Indirect
Other classifications can be used such as the type of
tissue damaged in the injury.
e.g. Hard Tissue/Soft Tissue
DIRECT
Caused by external forces to
the body
Injury occurs at the site of
the force
Can result in fractures,
dislocations, sprains and
bruises.
Examples include:
– A cricketer catching the
ball and getting a
dislocated finger
– A footballer hit high and
gets a broken cheekbone
INDIRECT
Can be caused by internal or
external forces and usually
results in an injury occurring
at a site away from the intial
force
Can occur as a result of poor
preparation or excessive
movement.
Can occur because of undue
strain on muscles, tendons or
ligaments and can cause
irritation and possible
structure damage.
Examples include.:
– Cyclist falls, puts out his
hand and dislocates
shoulder
– Netballer tears ligaments
from twisting
SOFT TISSUE
This includes:
– Muscles
– Tendons
– Ligaments
– Joint tissue
– Fatty tissue
Any injury to these are classified
as soft tissue injuries
Types of soft tissue injuries
include:
– Bruises (haematoma)
– Sprains (ligaments)
– Strains (tendons)
– Lacerations (skin)
– Dislocations (joints)
– Tendonitis (tendons)
HARD TISSUE
Hard tissue includes:
– Teeth
– Bones
Any injuries to these are
classified as hard tissue
injuries.
OVERUSE
• Caused by excessive use over a long period of time.
• Brought on by repetitive low impact exercise such as jogging or swimming.
• Causes include poor training techniques, high intensity too soon, poor
surfaces, inappropriate equipment and physical characteristics (flat feet, etc).
• Injuries characterized by pain and inflammation.
Common overuse injuries include:
Shin splints
Tendonitis
Stress fractures
Commonly called Repetitive Strain Injuries (RSI
SOFT TISSUE INJURIES
TEARS, SPRAINS, CONTUSIONS
Tears (Strains): a disruption of the fibres of muscle or
tendon. Occurs when the muscle/tendon is overstretched or
the muscle contracted too quickly
Sprains: a stretching or tearing of the ligament fibres,
muscles or tendons supporting a joint. Occurs when a joint
is extended beyond its range of movement.
Strains and Sprains can be classified according to severity
Grade 1 being the least serious up to Grade 3 being the
most serious
Contusions: a bruise (bleeding) into the soft tissue.
Generally caused by contact with a solid (usually blunt)
object.
SKIN ABRASION, LACERATION,
BLISTERS, CALLUSES
Skin abrasions: occur when the outer layer of the
skin is removed, usually a scraping action.
Lacerations: a cut, which will usually require
stitches, depending on the depth of the cut. This
is usually caused by a sharp object.
Blisters: occur because of friction, which causes a
pocket of fluid to form under the skin
Calluses: when a build-up of dead skin forms at a
site where constant friction has occurred.
INFLAMMATORY RESPONSE
This is the initial stage of repair involving
the first 48-72 hrs after the injury as the
body increases blood flow to the injured
site.
Phase 1 –
Inflammatory stage:
Redness
Heat
Swelling
Pain
Loss of
function
Phase 2 – Repair
stage (3 days to
six weeks)
Eliminate debris
Form new fibres
Produce scar
tissue
Phase 3 –
Remodelling stage
(6 weeks to months)
development of
scar tissue tissue
needs to
strengthen in the
direction force is
applied
dependant on
amount of
exercise and
rehab routine
aim to regain full
function
MANAGING SOFT TISSUE INJURIES
RICER (Rest, Ice, Compression, Elevation, Referral)
Rest: minimal movement for the first 48-72 hrs
Ice: causes blood vessels to constrict to decrease blood
flow. Apply for 20-30 mins every 2 hrs for 48-72 hrs.
Compression: ice should be firmly applied in a wide elastic
bandage. This reduces swelling and provides support.
Elevation: ensure the injury site is elevated above the
heart. This reduces the volume and pressure of blood flow
to the injury and reduces swelling.
Referral: a medical assessment should be sought ASAP to
as ascertain the full extent of the injury.
See Table 11.1 pg 410 of outcomes
SOFT TISSUE INJURIES –
MUSCLES/TENDONS/LIGAMENTS
ALWAYS THINK
RECOGNITION OF INJURY AND
APPROPRIATE MANAGEMENT- ACUTE –
CHRONIC?
USE:
R - REST
I – ICE
C – COMPRESSION
E – ELEVATION
R – REFERRAL
STRAINS/SPRAINS
SOFT TISSUE INJURIES
DEFINITELY NO:
H – HEAT
A – ALCOHOL / ASPIRIN
R – RUNNING (exercise)
M – MASSAGE
IN THE FIRST 24 – 72 HOURS OR
LONGER
KNOW SOME BASIC ANATOMY
The knee.
A minefield
to diagnose.
Leave it to
the experts!
LATERAL/MEDIAL ANKLE
ICE SHOULD BE AVAILABLE AT
ALL TRAINING AND GAMES
Where would you not apply ice to a
soft tissue injury?
IMMEDIATE TREATMENT OF
SKIN INJURIES
The immediate response aims to:
–
–
–
–
–
–
Prevent further damage and reduce the risk of infection
Reduce swelling
Erase or minimise pain
Restore flexibility
Regain full function
Prevent reoccurrence.
For abrasions/lacerations:
– Stop bleeding if necessary and clean the wound where possible
– Apply non stick sterile dressing
– Seek stitches if necessary
For burns:
–
–
–
–
Immediately apply cold running water
No ice or creams
Keep clean and sterile
Seek medical advice
HARD TISSUE INJURIES
FRACTURES
It is a break in a bone, which can be
as simple as a small crack with no
visible deformity, or complex, in that
it may affect vital organs close to the
fracture site.
Common causes include:
Direct contact with:
Others
Objects
The ground
Indirect force on another body part (falling and
landing on arm; fractured clavicle)
Inappropriate muscular action (jumping from a
height, landing on feet; fractured patella)
Overuse, repeated trauma (running; stress
fracture in foot)
Types of fractures include
Simple/Closed: the bone is fractured
but there is no wound at the site.
Open/compound: the jagged end of
a fractured bone protrudes through
the skin.
Complicated: the fractured bone
damages local tissues, i.e. organs
Signs and symptoms include:
Pain
Reduced/no movement
Local tenderness
Deformity
Irregular alignment
Swelling
DISLOCATIONS
It is where one bone is displaced from another
Signs and symptoms may include:
Loss of movement at the joint
Obvious deformity
Swelling and tenderness
Pain at the injury site
Subluxation: a partial dislocation where the joint
dislocates and then relocates.
FRACTURE - DISLOCATION
ALWAYS THINK
DAMAGE
DAMAGE TO
SOFT TISSUES
NERVES
BLOOD VESSELS
MINIMAL MOVEMENT - IMMOBILISE.
TRANSPORT - AMBULANCE IN ALL
CASES OF MAJOR FRACTURE OR
DISLOCATION.
A DISLOCATION IS A FRACTURE
UNTIL PROVEN OTHERWISE
FRACTURE - DISLOCATION
GREAT CARE!
FRACTURE - DISLOCATION
IMMOBILISATION?
DO NOT REDUCE!
ICE - SUPPORT - TRANSPORT
MANAGING HARD TISSUE
INJURIES
IMMOBILISATION
To another limb
To another part of the body
To a firm, smooth, straight object
Splint above the joint above the
fracture and below the joint below
the fracture
MEDICAL TREATMENT
Support the site with a sling or splint
Check for impaired circulation
Arrange for transport
Implement RICER if it does not cause
pain.
NEVER ATTEMPT TO REDUCE/RELOCATE A
DISLOCATION!
DO NOT ATTEMPT TO RE-ALIGN FRACTURED
LIMBS!
SEEK MEDICAL ATTENTION!
Complete application pg 413
ASSESSMENT OF INJURIES
PROTOCOL WHEN
INJURY/ILLNESS OCCURS – VITAL!
D.R.A.B.C.D.
T.O.T.A.P.S.
TOTAPS (Talk, Observe, Touch, Active
movement, Passive movement, Skills)
Talk: talk and find out exactly what happened. This will provide
valuable info about the nature of the injury.
Observe: look at the injury site and see if there are any signs of
obvious deformity. Compare opposite sides of the body.
Touch: gently feel the areas for any sign of deformity or swelling and
try to pinpoint the area of pain.
Active movement: ask the player to perform a range of movements
such as flexion, extension and rotation. If these can be done without
pain, proceed.
Passive movement: physically mobilize the joint as far or further
than the patient did actively, aiming to identify painful areas and any
instability
Skills test: ask the player to perform a range of skills necessary for
participation in the game, i.e. sidestep.
CLICK FOR ROLE PLAY ACTIVITY SCENERIOS
REMOVAL FROM THE
FIELD OF PLAY
ALWAYS THINK
DO NOT ATTEMPT TO REMOVE A
PLAYER FROM THE FIELD WHO:
IS UNCONSCIOUS.
HAS A SUSPECTED SPINAL INJURY.
HAS A MAJOR DISLOCATION/FRACTURE.
HAS A SUSPECTED INTERNAL INJURY.
HAS AN INJURY OR CONDITION THAT
COULD BE SERIOUSLY WORSENED BY
MOVEMENT.
REMOVAL FROM THE
FIELD OF PLAY
ALWAYS ENSURE AN AMBULANCE IS CALLED IN
THE ABOVE SITUATIONS – OR IF IN DOUBT –
PROTOCOL?
CONSIDER: ALL CONDITIONS MUST BE
MANAGED BY THE FIRST AID OFFICER UNTIL THE
AMBULANCE RESPONDS.
THIS WILL DEPEND UPON LOCATION.
ISOLATED AREAS – DISTANCE.
AVAILABILITY OF AN AMBULANCE.
TIME IS AN IMPORTANT FACTOR!
– YOU WILL BE OF GREAT ASSISTANCE TO THE FAO!!
Assessment can be stopped at any
stage if the player cannot proceed or
if danger is apparent.
If the player can perform to the
satisfaction of the assessor, the
player can return to the game.
If there is risk of further damage
through continued play, remove the
player from the game
HOW WOULD YOU MANAGE
THIS?
Focus Question 2
How does sports
medicine address the
demands of specific
athletes?
CHILDREN AND YOUNG
ATHLETES
MEDICAL CONDITIONS (ASTHMA,
DIABETES, EPILEPSY)
People with asthma have extrasensitive airways.
Triggers like dust, pollens, animals,
smoke and exercise may cause the
airways to swell and narrow.
This leads to wheezing, coughing and
difficulty breathing.
Management of an Asthma Attack
Steps to follow in case of asthma attack:
Sit the person comfortably upright. Stay
calm and reassuring.
Give 4 puffs of a blue reliever
puffer/inhaler. These are best given
through a spacer. Give one puff every 4
breaths for 4 puffs, holding the breath
for 2-4 seconds after a puff.
Wait 4 minutes. If there is no
improvement, give another 4 puffs.
If little or no improvement, call an
ambulance (000)
Some activities provoke an asthma
attack more than others – there is
significant risk with running, some
risk with cycling and little risk with
swimming. There is far less risk
swimming in warm water.
It is generally agreed that exercise is
of more benefit than no exercise at
all, even if it leads to an attack.
Diabetes
It is a complex hereditary or
developmental disease where the
supply of insulin is reduced or
eliminated.
Type 1 diabetes is usually hereditary and
the pancreas does NOT produce insulin at
all. It is treated with injected insulin.
Type 2 diabetes is usually developmental
and is usually the result of a sedentary
lifestyle and poor nutrition. Obesity is a
significant determinant for type 2. It is
treated with a managed diet and lifestyle
adjustments.
Hypo-glycemia
Low glucose levels.
Mild cases cause:
– Dizziness
– Weakness
– Disorientation
Severe cases can lead to:
– Convulsions
– Unconsciousness
– Brain damage
A hypo is generally a blood
sugar level below 3.0
Hypo food:
– Cordial/fizzy drink
– Jelly beans
– Juice
Hyper-glycemia
High glucose levels
Sufferers will be:
– Lethargic
– Thirsty
– Strong thirst
Can result in damage to:
– Eyes
– Kidney
– Nerves
If left untraced, can cause
a coma or death.
Occurs as a result of too
little insulin.
Requires an injection of
insulin and a doctor’s visit.
A hyper is generally a
blood sugar level of over
10.0
Exercise is seen as an important part of
the management of diabetes.
It is important that insulin levels are
balanced by either injection, food intake
or exercise. Diet needs to be well
balanced, with complex carbohydrates
forming a significant portion
Because exercise utilizes sugar, diabetics
need a pre-game meal to raise blood
sugar levels and hourly glucose
supplements if exercise is prolonged.
Precautions for Diabetics
Increase intensity and duration gradually
Undertake exercise regularly
Allow for adequate warm-up and cool-down
Always have a supply of hypo food
Constantly maintain blood sugar levels
EPILEPSY
Epilepsy is a brain disorder
characterized by recurring seizures
and fits. Seizures are caused by
sudden flurries of electrochemical
activity in the brain, which disrupts
the conversation between neurons.
Some people falsely believe that
exercise will trigger a seizure, but
this is not the case.
Some anti-epileptic drugs (AED’s)
cause fatigue, or problems with
concentration, vision or coordination.
Exercise-related risk factors
include:
Extreme fatigue
Lack of sleep
Dehydration
Electrolyte loss
Hyperthermia
Hypo-glycaemia
Safety suggestions include:
Consult with doctor/specialist regularly
Avoid known seizure triggers
Ensure you keep an adequate supply of
medication
Alert your teammates to your condition
Wear a medical bracelet
Wear protective equipment
Avoid contact sports, scuba diving, bungee
jumping and boxing
Avoid high altitudes
Let people know of your walking routes
OVERUSE INJURIES
Overuse injuries in children are
created by the same factors as for
adults.
– excessive training
– repetitive movements
– incorrect training techniques
Most overuse injuries in children
occur in the lower limbs.
Some examples include:
Achilles tendonitis: the tendons that connect the
heel bone to the calf muscle become inflamed.
Plantar fasciitis: the tissue that runs along the
arch of the foot becomes inflamed.
Stress fractures: repetitive pounding on foot and
anklebone causes hairline fractures.
Tendo-achilles bursitis: the fluid-filled sac
between the Achilles tendon and the heel bone
becomes inflames.
To avoid overuse injuries:
Be knowledgeable about overuse injuries
Use the right shoes
Manage training and competition loads
Avoid repetitive movements
Be sure the level of competition is within the
child’s range.
TREATMENT FOR STRESS
FRACTURE
IMMEDIATE REST 4-8WEEKS
FREQUENT USE OF ICE
POSSIBLE USE OF ANTI-INFLAMATORY
MEDICATION
MAINTAIN PHYSICAL CONDITIONparticipate in activities that don’t involve
the injured part in pounding movementse.g.swimming
Use exercises & corrective devices that
improve body mechanics if caused by
biomechanical factors
THERMOREGULATION
This is the process that
regulates and maintains the
body’s temperature
A young athlete’s temp. regulation
system is not as developed as adults.
They:
– Produce more heat when exercising
– Have less perception of the need for
rest and hydration
– Have less blood volume
– Have smaller sweat glands
– Lower hemoglobin concentration
– Lower cardiac output
– Acclimatize slower.
Measures to take to address
thermoregulation:
Consider weather conditions when
scheduling training and games
Encourage appropriate clothing
Incorporate water breaks and encourage
around-the-clock hydration
Be aware of warning signs of heat stress
MATCHING OF OPPONENTS
(Growth and Development, Skill
Level)
Most sporting codes match young
athletes according to age, and
sometimes skill level, strength, size,
etc.
Advantages of Disadvantages
matching by age of matching by
age
-Equal
-Differences in:
experience
-Size
-Mental maturity -Weight strength
-Equal skill
-Self-esteem
-Playing with
issues
peers
-Convenience
-Avoids health
risks
APPROPRIATENESS OF
RESISTANCE TRAINING
Resistance training for adolescents
usually focuses on their own body
weight. There are safe and widely
known exercises that can be used.
(push ups, bridges, sit ups).
When can a child start weight
training?
This depends on:
The child’s training base
Ability to learn new techniques
Their stage of growth
Equipment available
Quality of supervision
What type of training best suits
Guidelines should include:
Correct breathing and safe lifting techniques
Appropriate warm up and cool down
Progressive overload, but progress should be
conservative
Balance between muscle groups
Low resistance with high reps; no max lifts
Supervision
Should not be competitive & strength
specialisation should be avoided
ADULT AND AGED
ATHLETES
HEART CONDITIONS
As people age:
Blood vessels lose elasticity
Blood pressure rises
The heart may weaken
Maximum stroke volume decreases.
Some aged athletes may have heart attacks
or heart-related problems
Pre-screening is essential and work intensity
needs to be lower
Regular aerobic exercise can maintain or
lower the loss of cardiovascular functioning
Progress must be gradual
Activity needs to be of moderate intensity
FRACTURES/BONE DENSITY
Loss of bone density begins around 35 yrs
of age.
Regular aerobic and weight-bearing
activities can reduce this loss.
Osteoporosis sufferers should avoid
activities, which involve a risk of falling,
with focus on aerobic, low impact and
safety with pain-free movement.
Resistance training helps bone density
FLEXIBILITY/JOINT MOBILITY
Joint pain, arthritis and tight muscles
make flexibility training difficult.
Regular, gentle flexibility exercises
are essential.
Stretch to strain, not pain.
An increase in flexibility reduces
injuries, reduces likelihood of falls
and increases mobility
FEMALE ATHLETES
The following issues affect women
and girls participation in sport.
Sports trainers and coaches needs to
be aware of how these issues impact
on the females they coach.
SPECIAL DIETARY NEEDS-increased
iron & calcium requirements
EATING DISORDERS
Anorexia Nervosa
– Lack of nutrients in the
blood
– Degeneration of muscle
mass
– Characterized by selfstarvation and is
potentially lifethreatening
– Mainly affects teen
females
– They may exercises
excessively
Bulimia Nervosa
– Binge eating and
throwing up
– Sufferers tend to use
laxatives
– Exercise excessively
– Deprives body of
nutrients
– Leads to excessive
weight loss
– Damages the digestive
tract
IRON DEFICIENCY
Iron is an essential mineral for
haemoglobin
Deficiency leads to lethargy
Affects performance and involvement
Affects women more than men due to blood
loss through menstruation
If haemoglobin bellow 11g per 100mL =
anaemic
BONE DENSITY
Quantity of calcium in the bones
Can lead to fractures which result in poor
mobility and pain
Women need to be aware of osteoporosis
after menopause.
There is a need for adequate calcium
intake and participation in regular weightbearing activities.
PREGNANCY
Exercise is not only safe, but is
recommended.
Low impact, moderate exercise that
includes adequate warm up and cool
down can be beneficial in
maintaining fitness levels, muscle
tone, etc
MENSTRUATION
Its affect on performance varies from
person to person.
Moderate exercise can help relieve
menstrual stress.
Heavy exercise may cause the
absence of periods.
Focus Question 3
What role do preventative
actions play in enhancing the
well being of the athlete?
PHYSICAL PREPARATION
Pre Screening
Pre-screening of participants prior to exercise
is an important preventative measure. It
involves assessing current fitness levels,
medical history and conditions and previous
injuries related to exercise.
SKILL AND TECHNIQUE
Injuries can often result from poor
skill and technique
E.g. incorrect head positioning in a
tackle
PHYSICAL FITNESS
Being physically ready for sport reduces the
chance of being injured. General fitness should
be achieved before participating in most sports.
For more specificity, physical fitness should be
related to the sport, e.g. cardiovascular fitness
for cross country runners, muscular strength and
power for weightlifters, flexibility and muscular
endurance for gymnastics.
A lack of physical fitness places the athlete at risk
of injury, e.g. participating in gymnastics with a
lack of flexibility would increase the likelihood of
a muscle tear, participating in a marathon with
no cardiovascular fitness may result in a calf
strain or a rolled ankle.
WARM UP
An appropriate warm up should prepare
the body for physical activity. Warm up
routines need to be specific to the nature
of the sport. For example, a warm up for a
game of touch needs to include running
with changes of direction, forwards and
backwards running and ball passing. A
good warm up gradually prepares the
body for the demands that will be faced
during participation in the sport.
COOL DOWN
A cool down eases the body into
recovery and reduces the severity of
soreness. A cool down should not be
as intense as a warm up.
STRETCHING
Stretching is an essential part of
any warm up and cool down. For
warm ups, generally dynamic
stretching is more effective. It
gradually prepares the muscles
and joints for activity and ranges
of motion they may experience
in the sport. Failure to stretch in
a warm up may result in a
muscular tear or joint sprain by
forcing a joint beyond its range
of motion. For cool downs,
generally static stretching is
most effective. Failure to stretch
as part of a cool down will
increase the incidence of
soreness and affect further
participation.
SPORTS POLICY AND THE
SPORTS ENVIRONMENT
RULES OF SPORTS AND
ACTIVITIES
Rules assist the flow of play, create a safe
environment for participation and protect
from injury.
Where a dangerous practice is identified a
rule change may be able to reduce this
risk. E.g. Spear tackle in Rugby League
Appropriately accredited referees,
umpires, etc should enforce rules.
MODIFIED RULES FOR
CHILDREN
Such modifications protect children from injury
and ensure safety.
They make allowances for the size and strength
of young children.
They often remove elements of the adult game
that place participants at risk of injury.
Examples include: Rugby leagues, mini footy and
mod league. Minky Hockey, Roo Ball etc.
Modifications can include:Changes in size of playing field
Changes in size or weight of playing
equipment
Changes in timing of games
Changes in rules regarding numbers
of players or inter change
Others you can think of ???
MATCHING OF OPPONENTS
This means that sport can be equitable for
all participants and provisions may include
divisions such as:
– Weight
– Age
– Skill divisions
Or as per Rugby Union smaller players
may be able to weigh down a division
PROTECTIVE EQUIPMENT
In most sports some form of protective
equipment is used by players to ensure
their safety during the game.
Ground surrounds and equipment must
also be made safe. Sometimes this
involves use of protective equipment as
well. E.g. Goalpost pads
APPAREL AND PROTECTIVE
EQUIPMENT FOR HEAD AND NECK,
EYES, BODY, TEETH AND FEET
Some examples of these may include:
–
–
–
–
–
–
–
–
–
Neck braces
Goggles
Glasses
Arm guards
Gloves
Mouth guards
Sport-specific shoes
Headgear
Shoulder pads
SAFE GROUNDS AND
FACILITIES
Surfaces must be level and free from any
protruding objects that may cause harm
or injury
Barriers must be in place to maintain
spectators and separate the game from
the crowd.
If playing at night adequate lighting
should be provided
Any hard objects (goal posts, etc) should
be padded.
Others you can think of????
SAFE EQUIPMENT
Any equipment used must be safe and not
pose any hazard to any participants
All individual equipment must be kept in
good condition and checked before each
game.
Most sports make provisions for the use of
protective equipment. All protective equipment
must:
Adequately protect the wearer and
others
Allow freedom of movement
Allow airflow
Be comfortable
Be of acceptable quality
ENVIRONMENTAL
CONSIDERATIONS
THERMOREGULATION
Thermoregulation is the
process of maintaining
core body temp
TEMPERATURE REGULATION
Core body temp should be
maintained at 37.5 degrees Celsius.
It is controlled by hypothalamus in
the brain.
Hypothermia: abnormally LOW
body temp.
Hyperthermia: abnormally
HIGH body temp.
44 Upper limit of survival
42 Heat stroke – brain damage
40 Fever
37 Normal
36
Shivering and Co ordination
34
Violent Shivering
32
30
Semi – Consciousness
28
Body unable to regulate
26
Temperature
IT IS INTERESTING TO NOTE THAT OUR THERMAL DEATH POINT IS ONLY 7 DEGREES
EITHER SIDE OF OUR REFERENCE TEMPERATURE – 37 DEGREES C
Thermoregulation occurs in four
ways:
Convection: the transfer of heat away
from the body by moving air currents.
Radiation: the transfer of heat away from
the body to a cooler environment.
Conduction: the transfer of heat away
from the body to something else (e.g.
ice).
Evaporation: heat loss through sweat.
CLIMATIC CONDITIONS
Climatic conditions including temperature,
humidity, wind, rain, altitude and pollution need
to be considered prior to performance. The
combination of high temperature and high
humidity increase the level of risk of
hyperthermia, particularly in relation to
endurance performances. The combination of
cold weather and wind increase the likelihood of
hypothermia.
Think about wind chill factor, effect of different
climates, (dry heat vs humid) etc.
GUIDELINES FOR FLUID
INTAKE
Appropriate hydration is one of the
main issues regarding temperature
regulation and maintaining athletic
performance. Fluid replacement
before, during and after exercise is
extremely important as even a small
loss of fluid can affect an athlete's
performance.
LeagueSafe
DEHYDRATION
ALWAYS THINK
PREVENTABLE
Drink water …. cool
to cold.
Drink before …
during … after
training and playing.
Special care in
hot/hot humid
conditions.
Thirst is a poor indicator of the
need for fluid replacement
What type of drink is
the best ?
Alcohol - NO
High sugar/caffeine - NO
Sports Drinks - YES
WATER - YES, YES
WEIGH PLAYERS
FLUID REPLACEMENT
SAFE HYGIENIC PRACTICES ARE
ESSENTIAL WITH WATER
CONTAINERS AND THE DELIVERY OF
WATER TO PLAYERS – PROTOCOL?
DRINKS HIGH IN CAFFEINE AND
SUGAR?
(DISCUSS)
ACCLIMATISATION
Acclimatisation involves preparing
the body to perform in the climatic
conditions that will be experienced
during an event, e.g. heat, altitude,
cold. It is an important factor in
preparing for any event and
contributes to preventing injury.
TAPING AND BANDAGING
PREVENTATIVE TAPING
Refers to the application of adhesive or
non-adhesive strapping or bandages to a
joint area to protect, support or
strengthen the joint during movement.
In some sports that require high amounts
of explosive movements there is
considerable potential for injury.
Taping in this situation is called
PREVENTATIVE or PROPHYLACTIC
taping
TAPING FOR ISOLATION OF
INJURY
Taping is often required after an
injury and may be necessary during
the rehab process.
Injuries may be taped when
returning to play for physical and
psychological support.
A player may use this until their
body is fully accustomed to activity
again.
BANDAGING FOR IMMEDIATE
TREATMENT OF INJURY
Bandaging is more commonly used
for the treatment of soft tissue
injuries. Bandaging can help reduce
swelling, support a joint or muscle
and restrict movement. Generally,
elastic bandages or slings are used.
To be effective, the correct technique
and firmness need to be applied to
the injured area.
Taping Principles:
Non-elastic taped for support
Begin with anchors
Ensure evenness of tension
Overlap each application
Maintain even pressure
Reapply if circulation is cut
Avoid creases
Avoid continuous taping
Always tape in the direction to
tighten
Completely cover skin with no gaps
Finish with locks
Remove with blunt scissors
TAPING
ALWAYS THINK
EFFECTIVENESS
Give support without limiting function.
Does the player really need taping?
IF SO
Decide why.
Know the anatomy involved.
Decide how.
Know materials to use.
REMEMBER
Rehabilitation first – consult physiotherapist.
TAPING SHOULD ONLY BE APPLIED BY PERSONS
TRAINED TO USE TAPING TECHNIQUES!
Explore the following links for demonstrations on taping an
ankle, wrist and thumb.
Ankle
http://emedicine.medscape.com/article/86495-overview
http://www.elastoplastsport.com.au/Injury/TapingTechniqu
es.aspx
http://www.physioadvisor.com.au/11244150/ankle-tapingankle-strapping-physioadvisor.htm
Wrist
http://www.physioadvisor.com.au/11376450/wrist-tapingwrist-strapping-strap-wrist-phy.htm
Thumb
http://www.physioadvisor.com.au/12460050/thumbtaping-thumb-strapping-strap-thumb-phy.htm
HOW IS INJURY
REHABILITATION
MANAGED?
REHABILITATION PROCEDURES
PROGRESSIVE MOBILISATION
After treatment it is essential for
movement to be restored ASAP.
It involves gradually extending the
range of movement
May initially be passive until active
movement can be restored
GRADUATED EXERCISE
• STRETCHING
• CONDITIONING
• ACHIEVING TOTAL BODY FITNESS
STRETCHING
To reduce scarring, stretching is
important.
The most appropriate are proprioceptive
neuromuscular facilitation (PNF).
Initially, movement should be within
pain barriers and gradually increased
as strength increases
CONDITIONING
It involves adapting the body to a
range of strength, agility and power
skills to ensure full function
This is followed by exposure to noncompetitive situations where full
movement is required.
TOTAL BODY FITNESS
It is regaining pre-injury fitness
Must involve all principles of training, particularly
progressive overload.
Programs should involve all muscle groups and
energy systems.
Adaptations should include:
–
–
–
–
–
–
–
–
Hypertrophy of muscles (increased size)
Increased capillarisation and blood flow
Strengthening of ligaments and tendons
Increased elasticity of fibres
Increased joint mobility
Absence of pain
Full confidence in the injury
Fully restored balance and coordination
TRAINING
With total body fitness restored, full
training can commence.
The athlete will be expected to train fully
with no pain.
This involves warm up, conditioning, drills,
skills, development exercises, tactics and
cool down.
USE OF HEAT AND COLD
The application of heat and cold to an injured site
is important in the healing process. Cold is used
for the immediate treatment of injury as it
prevents swelling due to internal bleeding. It can
be applied by using ice packs, ice contained in
plastic and wrapped in a towel or cool water/ice
baths and immersion for short periods. Cold will
also be useful after exercise and training when
the injured area has been through a workout.
Heat should not be used in the early stages of
injury while bleeding at the injured site is still
occurring. It may help in promoting movement
and blood flow and relaxing the muscles through
rehabilitation.
RETURN TO PLAY
INDICATORS OF READINESS TO
RETURN TO PLAY
ELASTICITY: flexibility returned
STRENGTH: new tissue is strong and able
to support body in stressful movements
PAIN FREE: if there is no visible or
communicated pain, the athlete has
passed this condition of readiness to
return to play
MOBILITY: the joint where the injury was
sustained must have a suitable range of
movement and mobility to suit the playing
conditions
BALANCE: able to balance on injured limb
MONITORING PROGRESS
Pre test and post-test: the progress
of the athlete must be monitored
before and after a fitness test to
ensure that there is no damage or
harm done during the test which
may delay the return to play.
PSYCHOLOGICAL
READINESS
After an injury, an athlete may feel
quite anxious about returning to
play. Even if the athlete is physically
recovered from an injury, they may
not be psychologically ready to
return to elite competition. In this
case, a coach may play them in a
lower division until they are back to
their best
SPECIFIC WARM UP
PROCEDURES
After injuries, it is sometimes necessary to
have a specific warm up where the focus
is on preparing the injury site for the
proceeding impacts of play.
A specific warm up may include:
– Extra or varied stretches
– Strength work
– A more concentrated warm up
RETURN TO PLAY POLICIES
AND PROCEDURES
Individual sports will have their own
specific return to play policies and
procedures. The athlete's wellbeing
should be central to any return to
play policy. Contact sports usually
have a policy about returning to play
after a head injury.
ETHICAL CONSIDERATIONS
PRESSURE TO PARTICIPATE
Many coaches will put pressure on valuable
players to return early so that their playing roster
is bolstered.
The more professional the sport, the more
intense the pressure becomes.
This also carries risks, such as:
– Long term health problems
– Arthritis
– Early retirement
USE OF PAIN KILLERS
Some elite players have injuries heavily
strapped or painkillers injected so that
they can return ASAP.
Irrespective of financial gain, it is unwise
to return early
Pain indicates tissue damage and is a
warning that rehab is necessary.
Painkillers de-sensitize the area and leave
it susceptible to further injury, prolonging
the healing process and may lead to
permanent damage.