SPORTS MEDICINE 20REC 1020:

Injury Management 1

Definition of Sports MedicineAn area of health & special services that

applies medical and scientific knowledge to:

PreventRecognizeManage RehabilitateInjuries and illnesses related to sport,

exercise or recreation activity

Members of a Sports Medicine Team Physicians & Athletic Trainers primarily

responsible for the health and safety of sports participants

Essential to the prevention & care of sports injuries

Educate & counsel sport participants to prevent chronic injuries

Code of Ethics of an Athletic Therapist

Respect the rights, welfare & dignity of all

individuals

Comply with local, provincial and federal &

institutional guidelines

Maintain & promote high standards in the

provision of their services

Do not engage in conduct that could be

construed as a conflict of interest

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Why is this code so important to follow as an Athletic Trainer? Give 3 reasons.

Observing as a Fan or Athletic Trainer?

Fans enjoy the excitement of the game They can enjoy the collisions, speed and

complexity of the game from a purely entertainment point of view

Athletic Trainers must observe the game from a more clinical approach Anticipating collisions Looking for potentially dangerous situations

that arise Mechanism of injury is very important in

determining what has happened to an athlete

Liability Issues for Athletic Trainers Informed consent & participant risks Duty to properly assess the athlete’s

condition Duty to properly provide or refer the

athlete for medical treatment Duty to ensure that there has been proper

clearance for the athlete to participate or to return to participation and that the athlete has been properly advised of any risks of participation

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What are the consequences of not paying attention to Liability Issues as an Athletic Trainer? Provide at least 2 consequences.

Outline the severity of each consequence.

Pre Participation Medical Info Form Having a medical completed by athletes reveals

any major concerns with health that an athlete may have before starting Football Medicals provide our training staff vital info

about an ahtletes’ medical states before competition Having Par Q forms helps inform Athletic

Therapists about pre existing conditions that participants may have by completing a Questionnaire The Par Q form you all filled out give Oluchi an idea of

your history. It also helps with Liability Issues

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What do we do at Salisbury to cover this area? Think Wellness Center as well as any other

participation class.

Safety of playing areasEnsure that: the playing area is level, firm and free from

obstructions (for example, holes or exposed sprinkler heads)

permanent fixtures such as goal posts are padded, flexible and highly visible

there is adequate lighting if playing at night perimeter fences are well back from the playing

area spectators are kept well away from the playing

area.

Facility Assessment

Use the information from the previous slide to assess the following facilities in the school and area. Wellness Center Large Gym Football Field or Baseball Diamond

Check that protective equipment:

is worn by participants during training and competition

fits the participant correctly is regularly checked and maintained is specific and appropriate for the sport, size

and age of the participant is being used according to the manufacturer’s

guidelines and the recommendations of the governing sporting body.

What do we do at Salisbury with our Equipment?

Factors affecting athletes

An athletic therapist must know how the following factors affect athletes: Weather Hypothermia Hyperthermia Clothing protection Rinks/ pools

In hot or humid conditions:

Encourage participants to wear loose, lightweight, light-coloured clothing made from a natural fibre

Avoid intense activity in hot or humid conditions and monitor participants carefully for signs of heat illness.

Help participants avoid sunburn by encouraging them to slip on a t-shirt, slop on some sunscreen and slap on a hat.

Encourage participants to drink plenty of fluid before the activity begins and schedule regular drink breaks during the activity.

In cold and/or wet conditions:

Encourage participants to wear clothing appropriate for cold conditions (for example, dress in layers to trap heat, wear gloves and a hat to reduce heat loss).

Avoid participants standing exposed to the cold for long periods.

Encourage participants to change wet clothing as soon as practicable.

Alternative venues (for example, indoors) should also be considered, to ensure the safety and wellbeing of participants.

For example: Cool wet weather (hypothermia) Warm humid weather (hyperthermia) Lightning or tornados Carbon monoxide poisoning (rinks) Chlorine leakage (pools) Sunburn Other examples????

What do we do at Salisbury with regard to some of these environmental issues?

The environment can lead to injury

What is normal?

Normal body temperature is 37.5 C Any variation of the norm can be

extremely dangerous and can result in death!

Hyperthermia and hypothermia are two conditions an Athletic Therapist must be aware of.

Stages of Hyperthermia

There are 3 categories of increasing severity: Heat illness Heat exhaustion Heat Stroke

Causes of heat emergencies

High temperatures or humidity Prolonged or excessive exercise Medications/ alcohol use Track and field/ football/ fun runs Playing with a fever Dehydration Excessive clothing CV disease/ sweat gland

dysfunction Whirlpools/ saunas

Heat Illness (early stage)

signs and symptoms Profuse sweating Fatigue Thirst Muscle cramps

Heat Exhaustion (late stage)

signs and symptoms Headache Dizziness Light headedness Weakness Nausea Vomiting Cool moist skin Dark urine

Heat Stroke (good luck stage)signs and symptoms Fever Irrational behavior Extreme confusion Dry hot red skin Rapid shallow breathing Rapid weak pulse Seizures unconsciousness

What to do in case of Emergency How should an Athletic Therapist handle

these situations?

•Water (1/2 cups per 15 Water (1/2 cups per 15 min)min)•GatoradeGatorade•Salty drink (1 tsp salt per Salty drink (1 tsp salt per quart of waterquart of water

Handling Emergencies (con’t) For cramps – massage gently, but firmly

until they relax If signs of shock/ cyanosis/ decreased

alertness, confused/ seizures/ loss of consciousness/ or person does not improve or gets worse--- All 911 immediately!

Some DO NOT’s

DO NOT underestimate the seriousness of heat illness especially if the person is a child, elderly or injured.

DO NOT give the person medications to treat fever (aspirin, acetaminophen) which may actually cause harm.

DO NOT give person salt tablets/ alcohol/ caffeine

DO NOT give anything by mouth if person is vomiting or loss of consciousness

Hypothermia

Hypothermia is dangerously low body temperature (below 35 C)

It occurs when body loses more heat than it can generate

Can be FATAL!

Cause of Cold Emergencies

Being outside without enough protective clothing in the winter

Wearing wet clothing in windy or cold weather

Swimming pools or ocean/ falling overboard from boat into cold water

Heavy exertion, not drinking enough fluids, not eating enough in cold weather

Cross country or downhill skiing/ hockey Soccer/ rugby (wet/ windy sidelines) Does not have to be cold weather

Signs and Symptoms

Drowsiness Weakness Loss of coordination Confusion Pale and cold skin Slowed breathing/ heart rate Uncontrollable shivering (shivering may

stop at extremely low body temperatures)

What to do in case of Emergency If any symptoms are present, especially

unconsciousness, confusion or changes in mental status, immediately call 911 and perform the ABC’s (airways, breathing, and circulation)

Take person inside to room temperature and insulate them with warm blankets, if outdoors insulate from ground and cover head and neck to retain heat.

What to do… (con’t)

Remove wet or constricting clothing and replace with dry clothing

Warm person – use warm compresses to neck, chest wall, groin, if necessary use your own body heat to warm person

If alert and can swallow, have them sip warm sweetened fluids

Some DO NOTS…

DO NOT assume that someone found motionless in the cold is already dead

DO NOT use direct heat (hot water, heating pad, heat lamp) to warm person

DO NOT give the person alcohol

Frostbite

Frostbite

Frostbite is damage to the skin and underlying tissues caused by extreme cold over a period of time

A person with frostbite may also be subject to hypothermia

Check for hypothermia and treat that first

Frostbite Signs & Symptoms

Hands, feet, nose and ears are most vulnerable

Hard pale and cold quality of skin exposed to cold for length of time

Area lacks sensitivity to touch, although there may be aching pain

As area thaws, flesh becomes red and very painful, tingling, burning

Some DO NOT’s …

DO NOT thaw an area if it cannot be kept thawed Re-freeze may make damage worse

DO NOT use direct heat (radiator, campfire, heating pad, hair dryer) to thaw area

DO NOT rub or massage affected area DO NOT disturb blisters on skin DO NOT smoke or drink alcohol during

recovery

Frostbite Treatment

Warm the affected area with body heat, but avoid rubbing the area—it can damage tissue.

Don’t use hot water or other external heat sources, which could cause burns.

Wrap with warm, dry clothing. Get to a warm shelter. Drink hot liquids. Get medical attention.

Emergency Action Plan

A plan that is in place in case EMS has to be activated Each Plan should have a designated way for EMS

to access the injured athlete [A map can be helpful]

Each plan should have someone designated as a CALL PERSON The CALL PERSON calls EMS & Waits at the EMS

meeting point to guide EMS to the injured athlete Each plan should have someone designated as a

CHARGE PERSON The CHARGE PERSON waits with the injured athlete,

taking charge of the injured athlete and providing ongoing care for the athlete

Injury Categories

Life Threatening Activate EMS Activate Emergency Action Plan Provide immediate emergency first aid

Continue until EMS arrives Serious

Provide immediate emergency first aid Non Life Threatening

Evaluate and treat as time allows

Evaluate Injury Scenarios

Differentiate between injury categories Life Threatening

Provide 2 examples of what kind of injuries these might be Serious

Provide 2 examples of what kind of injuries these might be Non Life Threatening

Provide 2 examples of what kind of injuries these might be

WHEN WOULD MEDICAL REFERRAL BECOME NECESSAY?

Injury Categories Acute

Occur suddenly during activity Examples include: Ankle Sprains, Bone Fracture, etc

Chronic Occur as a result of overusing an area Often an athlete will ignore signs the body is giving

them telling them something is wrong Often athletes will play through minor injuries without

getting treatment on them after resulting in a chronic injury

Recurrent Injury re occurs after an athlete recovers from the injury

Usually the athlete did not completely finished treatment

Examples of different Injuries Provide one example of each of the

following injuries: Acute Injury Chronic Injury Recurrent Injury

Mechanisms of Injury Direct Blow

A Force is applied to a part of the body Causes beaks and contusions (Internal Bleeding)

Torsion Load application with axial rotation

Force onto twisting Shearing

One part of the body is going one way overtop of another part of the body going the other way ACL injuries are quite often shearing Brain injuries are quite often shearing

Bending & Twisting of Bones An Athlete gets bent over and something gives

Examples of Mechanisms of Injuries Give two examples of each of the 4

Mechanisms of injury: Direct Blow Torsion Shearing Bending and Twisting of bones

Phases of the Injury Cycle Inflammatory Phase

SHARP accronym: Swelling-Heat-Altered Fucntion-Redness-Pain Natural response of the body to protect the injury site

Repair & Regeneration Phase Body starts to grow new tissue and repairs

damaged tissue New tissue is easily reinjured

Remodelling Phase Retraining the injured part through controlled full

movements New tissue needs to be trained Scar tissue needs to released

Roles & Responsibilities of Athletic First Aider

Prevent Assessment of athletes strengths &

weaknesses Program design to prevent injury

Recognize Recognize injuries

Correct diagnosis Manage

Take care of immediate injury situations Rehabilitate

Follow through with care after initial diagnosis and management of injury Plan for a healthy recovery of athlete

from injury

Bones of the Ankle

Anatomy of an Inversion Ankle Sprain

Bones of the Wrist/Hand