Transcript Injuries & the Healing Process

Chapter 3
Understand:
 Inflammation process in healing
 Treatment rationale of ice vs. heat
Identify:
 Principles of physical rehabilitation and range
of motion
 More common musculoskeletal disorders
 Athlete’s vital signs
 Distinguish between acute and chronic injury
management
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Injury (strain, sprain, contusion, open
wound): the body immediately begins the
process of healing.
Healing: the process where the body repairs
damage tissue.
Inflammation: one component of the healing
process, where the body begins to repair
itself.
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Acute Injury: muscle strain or ligament sprain,
tissue is torn, capillaries are damaged, and cells
die, interference in blood and oxygen supply.
Bodies Reaction: sending specialized cells to the
injured site attempting to limit damage and
begin healing (blood clotting, contracting
muscles, which splints the area to restrict further
movement, and reduce blood flow.)
Bodies Reaction: pain, swelling, redness, heat,
and loss of function. Hey guys
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Pain: pressure on nerve endings from internal
hemorrhage and cellular response to lack of
oxygen.
Swelling: (edema) accumulation of fluids in the
damage area.
◦ Hemorrhage, lymph fluid, and synovial fluid contributes
to swelling and pressure.
◦ Gravity also increases swelling.
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Redness: increased blood supply (the body
provides the site with nutrients for repair).
Three Phases of the Healing Process:
1. Inflammation- redness and swelling (2-4
days)
2. Initial repair- (tissue repair) scare tissue is
the first tissue the body generates. (2-4
weeks)
3. Regeneration-replace all damaged tissue
with new and healthy tissue. (1 year)
Vital Signs: measures that monitor life
(heart rate, breathing, pulse)
Pulse: Adult 60-80 beats/minute;
child 80-100 beats/minute
 Rapid, but weak pulse-shock, bleeding, diabetic
coma, and/or heat exhaustion.
 Rapid, but strong pulse-heat stroke and/or severe
fright.
 Strong, but slow pulse-skull fracture and/or stroke.
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No pulse -cardiac arrest and/or death.
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Take pulse neck (carotid artery) and wrist (radial
artery)
Respiration-adult 12-20 breaths/minute, child
20-25 breaths/minute
 Shallow breathing-shock
 Irregular/gasping-cardiac related
 Frothy blood from the mouth-chest fracture
(rib fracture) in upper lateral portion of chest
(arm pit).
Watch, feel, and count (rise and fall of chest)
Temperature-oral 98.6 degrees
 Hot, dry skin-disease, infection, and/or overexposure to environmental heat.
 Cool, clammy skin-trauma, shock, and/or
heat exhaustion.
 Cool and/or dry skin-over-exposure to cold.
Skin Color
 Red Skin-heat stroke, diabetic coma, and/or
high blood pressure.
 White(pale)-insufficient circulation, shock,
fright, hemorrhage, heat exhaustion, and/or
insulin shock.
 Blue-blood is poorly oxygenated.
 Non-white athlete-examine inner lip, gum,
fingernail beds. (they still exhibit a paling of
skin)
Pupils:
 Constricted (sunlight)-during traumatic situation:
central nervous system and/or intake of
depressant drug.
 Dilated (dark room) or unequal-during traumatic
situation: head injury, shock, heat stroke,
hemorrhage, and/or intake of stimulant drug.
 Pupils fail-brain injury, intake of alcohol, or drug
poisoning.
PEARL-Pupils Equal And Reactive to Light
(examination of the eyes)
State of Consciousness:
Level of Consciousness (LOC)
1. Mental awareness
2. Memory and ability to recall
3. Response to commands, directions, events,
etc.
AVPU-alert, verbal, responds to pain, and
unresponsive.
Movement (Four Patterns):
1. Active (athlete provides movement)
2. Passive (trainer moves body part)
3. Assistive (trainer assists the athlete with
movement)
4. Resistive (trainer provides resistance to
oppose the movement of the body part)
Abnormal Nerve Stimulation:
1. Motor (movement)-athlete contracts affected
muscle
2. Sensory (feeling)-athlete touch (i.e. sharp vs.
soft)
Blood Pressure Adult: 120(systolic)/80(diastolic)
 Heart contracts(blood out), systolic pressure
can be determined, as heart relaxes(blood in),
diastolic pressure is determined.
ICE vs. HEAT
 Ice-first 48-72 hours-Reevaluate and if swelling,
pain, redness still present continue with ice.
Reduces: swelling, blood flow, pain
1. Ice packs-15 minutes-no directly to skin
2. Ice message-5-10 minutes-move ice
continuously
3. Whirlpool-15 minutes-perform rehab
movements-downfall, not elevated.
4. Cold spray-no longer then 10 seconds-damage
to skin, only cools surface.
Heat- increased blood flow, reduced muscle
stiffness, muscular relaxation.
 Hot packs-towels to protect skin.
 Hot whirlpool-follow-up treatment, rehab
movements.
Contrast bath-follow-up treatment (hot/cold
water immersion) heat pack and ice packs
EXERCISE- movement of the body (muscles)
 increases circulation at a deeper level.
 Strength
 Regain lost range of motion
Therapeutic Modalities: decrease pain, swelling, muscle
spasm (utilized with exercise)
 Electrical -currents
 Heat-short wave and microwave
 Light-ultraviolet
 Cold
 Air
 Water
 Message
 Laser
Acute vs. chronic:
1. Acute-quick onset, short duration (PRICES)
2. Chronic-Long duration, repeating.
Continued PRICES, but is coupled with
exercise, therapeutic modalities, heat, and
contrast treatments.
GOAL- return injured athlete to pre-injury level
of strength, power, endurance, flexibility, and
confidence as quickly and safely as possible.
 Arranged by Athletic Trainer upon physicians
protocol.
 Pain-should be avoided
 Athlete follows the program.
Five Phases designing a Program:
1. Post-surgical/acute injury
2. Early exercise
3. Intermediate exercise
4. Advanced exercise
5. Initial sports re-entry
Various rates of recovery should be expected.
Athlete needs to return:
1. Joint range of motion (ROM)-normal movement
of a joint
2. Muscle Flexibility
3. Muscular Strength
4. Muscular Power
5. Endurance
6. Balance
7. Proprioception
8. Kinesthetic awareness
9. Cardiovascular Fitness (total body conditioning)
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Arthritis: inflammation of a joint
Atrophy: decreasing in size of organ or tissue due to
degeneration of cells
Bursitis: inflammation of bursa sac
Contracture: fibrosis of muscle tissue producing
shortening of the muscle (doesn’t generate strength)
Contusion: a bruise, skin is not broken, direct blow
Dislocation: displacement of one or more bones or a
joint or organ from original position
Epicondylitis: (pitchers elbow, tennis elbow)
inflammation of the epicondyle and the tissues
adjoining them to the humerus
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Fasciitis: inflammation of a fascia
Myositis: inflammation of muscle tissue
Myositis Ossificans: inflammation of muscle,
with formation of bone
Sprain:
◦ stretching or tearing of joint structure (ligaments
and joint capsules)
◦ Strains stretching or tearing of muscle and tendons
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Subluxation: partial or incomplete dislocation
Tendinitis: Inflammation of the tendon