Transcript Document

The Physiological and
Psychological
responses to sports
injuries
P3 & P4/ M2/ D1
Damaged Tissue and primary response:
INFLAMMATION
Inflammation is a protective attempt by the body to remove harm
and to initiate the healing process
It occurs within a few minutes to hours of injury
The 5 key characteristics of
inflammation are:
•Pain
•Redness
•Swelling
•Heat
•Immobility (loss of function)
THE INFLAMMATORY RESPONSE
Injury causes tissue damage
The damaged tissue releases chemicals
Blood vessels dilate (widen) allowing increased blood flow to the injured
area.
This causes;
HEAT
PAIN
REDNESS
BLEEDING
SWELLING
LOSS
OF
FUNCTION
THE CLOTTING MECHANISM
(COAGULATION)
Clotting, also known as “coagulation”, occurs almost immediately after injury to a blood vessel. It
is the process of blood changing from its usual liquid state to a solid form.
There are 3 stages:
•Formation of Prothrombinase
When liquid blood comes into contact with certain molecules (or foreign objects) it
stimulates the formation of an enzyme called Prothrombinase.
•Prothrombin is then converted to Thrombin
The enzyme Prothrominase converts Prothrombin into Thrombin (another enzyme)
•Fibrinogen is converted into Fibrin
Thrombin converts Fibrinogen into Fibrin which forms the tread-like scaffolding
structures that form a clot/ and eventual SCAB.
HERE
IS A LINKS TO A VIDEO ANIMATION OF
INFLAMMATION
&
COAGULATION WHICH MAY
HELP YOUR UNDERSTANDING!
A cartoon animation of the full
Clotting
detail including all the info you need
http://www.youtube.com/watch?v=9QVTHDM90io
process in
Scar Tissue and Remodelling process:
A scar is a result of the body's repair
mechanism after injury on many
tissues. Scar tissue replaces normal
tissue after it is damaged.
Scar tissue is the formation and laying
down of a protein called “collagen”. This
is a fibrous tissue that replaces the
tissue that has been damaged.
It is not as elastic and pliable as skin
and muscular tissue which makes it a
lower quality tissue and less effective
and efficient at doing its job.
SPRAINS AND STRAINS:
Sprains and Strains are overstretching or tearing of tissue. Sprains
involve ligamentous tissue and strains involve muscular tissue. Both
involve pain and discomfort , deformity, swelling, bruising, impaired
movement and loss of function.
STRAIN
A stretching or tearing of muscle/tendon
SPRAIN
A stretching, or tearing, of one or more ligaments.
Sprains and Strains can be classified as first, second and third
degree, depending on the amount of fibers involved.
GRADES OF INJURY:
LIGAMENT SPRAIN
MUSCLE STRAIN
Degree / Severity
Fibre Damage
Signs and Symptoms
Grade I (mild)
few fibres
Minimal discomfort swelling /
tenderness movement slightly
impaired / functional.
Grade II (moderate)
many fibres
Significant pain / discomfort /
noticeable swelling / tenderness /
impaired movement / function
impaired.
Grade III (severe)
total rupture
Pain / significant swelling /
bruising / tenderness / impaired
movement / joint unstable / loss
of function.
HAEMATOMAS (INTER/INTRA):
A haematoma, is a localized collection of blood outside the blood
vessels, usually caused by trauma (in this case a muscle). It is different
from a bruise, which is the spread of blood under the skin in a thin layer.
•There are 2 types of haematoma:
•Intramuscular
This injury only effects the muscle fibre tissue and therefore bleeding
is contained within the sheath that surrounds the muscle. Pressure
within the muscle builds up which can become very painful. The fluid
is unable to escape as the muscle sheath prevents it, acting like a
balloon. Healing takes longer as bleeding stays in one area and has to
be broken down.
You are less likely to see visible bruising.
•Intermuscular
This type of injury includes the muscle and also the muscle sheath and
therefore bleeding is not contained and can spread (for example with
gravity). Initial bleeding can last longer, however recovery is often
faster than intra muscular as the blood and fluids can flow away from
the site of injury.
You are more likely to see bruising.
Criteria P3 and P4 aim to address the issue of occurrence
of sports injuries and the resulting symptoms, both
physiologically and psychologically
Damaged tissue:
-
Primary damage response, healing response,
the clotting mechanism
Scar tissue:
-
The importance of scar tissue control in the remodelling process
If the explanation is sufficient enough
and related to the concept of sports
injury, then it is possible that
Specific to injury:
-
Sprain/strain (signs and symptoms of first,
second and third degree), haematomas
(inter/intra)
Response to injury
Anger, anxiety, depression, frustration, isolated
from team mates
Response to treatment and rehabilitation
Anxiety, frustration, need for motivation, use of
goal setting
grading criterion
M2 and D1
(analysis) may also be achieved.
To push for the Distinction go into
further detail and analyse what might
happen if a player ignored the
physiological and psychological signs
and symptoms of injury. Use examples
of professional athletes, with news
reports or newspaper articles if
possible.
What you guys can do…
O Design a leaflet that describes in a informative
manner the following points:
·
·
·
Damaged tissue- primary response (inflammation)
The Clotting Mechanism
Scar Tissue/ Re-modeling process
Signs and Symptoms a coach should look out for to identify;
o A sprain
o A strain
o Grading system (1st/ 2nd
• Haematoma
(Including severity and types of haematoma
AARON RAMSEY
In February, 2010, during an Arsenal
v Stoke match Aaron Ramsey
fractured both his right tibia and
fibula which required surgery. He
experienced one of the worst
possible injuries and faced months of
gruelling physio and rehab.
•Put yourself in his shoes….
•How do you think he felt?....
PSYCHOLOGICAL RESPONSES TO INJURY: ANGER,
ANXIETY, DEPRESSION & FRUSTRATION
After the initial shock and denial of receiving
the injury, Aaron would experience emotions of;
Anger – Aaron would have been very angry, maybe asking
“Why me?”
Anxiety – Feelings of anxiety would be present with Aaron asking
himself questions such as
“Will I recover from this?”
“Do I need surgery?”
“Will I ever get back to full fitness & play at the same level?”
Depression – Aaron will no longer be experiencing the adrenalin
rush and the feel good hormones of when playing football. This may cause
feelings of depression.
Frustration – Aaron may feel this out of boredom of rehab & being
restricted to a timescales e.g. wanting to progress to running but his
Physio/Surgeon not letting him until 3 months post injury
These emotions will vary depending on the individuals
personality, playing status & degree of injury
How would you as
the Physio combat
these negative
emotions?
PSYCHOLOGICAL RESPONSES TO INJURY:
Isolation from team mates…
Whilst completing physio sessions and rehab
you are removed from the normal training group.
This can result in you feeling isolated from the
group.
Having social interaction with
team mates and a support
network from within the club can
help reduce the stress of an injury
and maintain group cohesion.
PSYCHOLOGICAL RESPONSES TO
TREATMENT & REHAB:
Once the initial recovery from surgery was over Aaron faced the gruelling
task of physio. He had the prospect of long days, weeks and months in
rehab. He would have experienced emotions such as…
Anxiety – fear of re-injury, fear of future prognosis e.g. arthritis in the
future in he continue to play. Feelings of anxiety will be heightened if he
has Trait Anxiety is a Type A personality
Frustration – uncertainty of the timescale of return e.g. if his return
to training date keeps getting put back, watching his team mates play in
important games your missing out on
Drop in Motivation – this may be caused by the return date to
training seems so far away, he can’t see the light at the end of the tunnel.
It would be the responsibility of the Physio and back room staff to raise
his moral levels and keep him motivated. This could be helped by goal
setting.
PSYCHOLOGICAL RESPONSES TO
TREATMENT & REHAB: The Use of Goal Setting
Being told on day 1 that he
wouldn’t play a competitive game for 8 months, would have
been devastating for Aaron. His motivation for Physio and regaining his strength
would have started high but would more than likely have dropped after the initial phase of
physio.
A way to improve motivation and enthusiasm would be to set Aaron
goals &
SMART targets.
For example, rather than being told;
“lets work towards getting match fit in 8 months”
He may have been told;
“lets work towards weight bearing in 6 weeks”
Then, following that;
“lets work towards running in 3 months”
Having smaller, realistic and achievable goals would help boost
motivation. Achieving a goal every few weeks would give Aaron a
sense of accomplishment and boost his self confidence, giving him
more motivation to work hard in the next phase of rehab.
Criteria P3 and P4 aim to address the issue of occurrence
of sports injuries and the resulting symptoms, both
physiologically and psychologically
Damaged tissue:
-
Primary damage response, healing response,
the clotting mechanism
Scar tissue:
-
The importance of scar tissue control in the remodelling process
If the explanation is sufficient enough
and related to the concept of sports
injury, then it is possible that
Specific to injury:
-
Sprain/strain (signs and symptoms of first,
second and third degree), haematomas
(inter/intra)
Response to injury
Anger, anxiety, depression, frustration, isolated
from team mates
Response to treatment and rehabilitation
Anxiety, frustration, need for motivation, use of
goal setting
grading criterion
M2 and D1
(analysis) may also be achieved.
To push for the Distinction go into
further detail and analyse what might
happen if a player ignored the
physiological and psychological signs
and symptoms of injury. Use examples
of professional athletes, with news
reports or newspaper articles if
possible.
What you guys can do…
O
Think back to your last serious injury, if you have had one. If not, try to imagine a career
threatening injury; think about all the emotions you would experience.
O Write a diary for an injured player identifying all the psychological responses
that may occur. You could write multiple daily entries or create one weekly
entry. To make sure you cover the grading criteria, ensure you include
the following points:
Emotions experienced
o Anger
o Anxiety
o Depression
o Frustration
o Isolation from team mates
o Response to treatment:
- Drop in motivation
- Frustration
- Goal setting