O​PTION​ – S​PORTS​ M​EDICINE
CQ1: How are Sports Injuries Classified and Managed?
W​AYS​ ​TO​ C​LASSIFY​ S​PORTS​ I​NJURIES​ ​AND​ S​PECIFIC​ E​XAMPLES
Classificat
ion
Direct
Definition
o
o
Indirect
Soft
Tissue
Are caused by an
external force
applied to the
body, such as a
collision with a
person or object.
It injury at the
point of contact
Are caused by an
intrinsic force; a force
within the body.
Include damage to:
muscles, tendons,
ligaments, cartilage,
skin, blood vessels,
organs and nerves.
Are all other injuries
in the body OTHER
than bones and teeth.
Cause
External Object
Examples
Results in
●
Collision = A shoulder
dislocation caused by
a collision between
hockey players or
two players colliding
with each other in a
soccer or tackle
External Object = A
hockey stick hitting a
person in the shins.
o
o
o
o
Pulling a hamstring
during a rac
volleyball player
causing stress to the
ligaments in the knee
joint.
Excessive strain being
placed on muscles, tendons
and ligaments, causing
irritation and possible
damage to body structure.
Rolling ankle on poor
surface
Tearing Hamstring
after poor warm-up
Impact from Object
TWO TYPES;
Acute​ – occurs suddenly ie.
A sprain, strains,
dislocation, subluxation,
torn cartilage, contusion
and abrasion
●
Normally occur as a
result of inadequate
warm-up, ballistic
movements, excessive
movement, or fault in the
execution of a skill.
Intrinsic
●
●
●
●
●
Fracture
Dislocations
Sprains
Bruises.
Chronic/Prolonged​ –
include many of the same
types of injury but their
severity necessitates a long
rehabilitation. Most
common are tears and
contusions.
Hard
Tissue
Cause damage to the
Bones and teeth
Overuse
Occurs as a result of a
repeated force on
body parts.
●
Ie. In the bones,
tendons and
muscles
Frequently are more
serious than soft tissue
injures.
E.g. dislodging a tooth
and fracturing a bone.
o
o
Are caused by
overuse of specific
body regions over
long periods of time.
Often provoked by
repetitive, low
impact injuries such
as jogging or
stepping.
o
o
Anterior shin splints,
which are an
irritation to the front
portion of the shine
bone, and tendon it
is which is a irritation
of the tendons.
stress fracture from
continually running
on concrete.
Most common hard tissue
injury is a fracture
●
Fracture ​– is a break in
the bone.
Stress fractures​ – are small
incomplete bone fractures
caused by repeated
pounding, usually on hard
surfaces. Usually results in
local swelling and
tenderness.
S​OFT​ T​ISSUES​ I​NJURIES
Tears
o
o
A tear occurs when tissue is excessively stretched, severed or contracted quickly .
The two types of tears are SPRAINS and STRAINS
Sprains (Ligament)
o
o
o
o
Arise from the stretching or tearing OF A LIGAMENT.
Ligaments are strong rigid, inelastic tissues that
connect BONE TO BONE.
Sprains occur when​ LIGAMENTS are stretched or
torn, ​resulting in pain, swelling and the inability to
perform normal joint movements.
They are classified according to the severity of their
ligament damage.
⇒ First Degree: Stretched fibres, some pain but
there is normal range of motion
⇒ Second Degree: Considerable amount of damaged fibres that restricts rang of motion.
⇒ Third Degree: Complete ligament tear with excessive laxity and no firm end pint of motion.
Strains (Tendon and Muscle)
o
o
Muscle tear:​ referred to as a strain and occurs when all of
the muscle fibre fail to cope with the demands placed upon
them
Strains occur when a ​MUSCLE or TENDON​ is stretched or
torn
o
o
o
They cause considerable pain and bleeding may cause discolouration around the injury
Any movements result in sharp pain
There are 3 grades of Strains
⇒ First Degree: Little damage with some stretched fibres but no loss of strength
⇒ Second Degree: Moderate damage with more stretched fibres and some loss of strength.
⇒ Third Degree: Complete tear.
Contusions (Bruises)
o
o
o
o
o
Impact with a player or object causes contusions by crushing the soft tissue.
Is caused by a sudden blow to the body
It is bleeding into the soft tissue
Some are Superficial and close to the skin whilst others penetrate deeply and cause the bone to bruise.
Haematoma (blood tumour) forms as blood clots in the connective tissue membrane as internal bleeding into the
area may continue over a period of time
Skin Abrasions
o
o
o
o
o
Occurs when player falls on a dry, hard, surface (such as tennis and netball)
Injury causes pain and shallow bleeding as a result of scrapes.
Skin may be embedded with dirt and foreign materials.
Caused by scrapes and grazes
⇒ For example: falling on asphalt
They require thorough cleaning, sterilisation and dressings to prevent infection.
Lacerations
o
o
o
Occurs when shard objects slice through the skin, often resulting in more blood loss. Bleeding should be
controlled
Lacerations are wounds where the flesh has incurred an irregular tear
⇒ For example: Can occur to the scalp and mouth, especially the lips and tongue if the soft tissue has been
force against the teeth. This requires thorough cleaning with antiseptic soap, dried and a sterile gauze
pad applied. Pressure applied to stop bleeding.
Medical attention required if stiches are required.
Blisters
o
o
o
o
o
Are as a result of continued friction
Fluid builds below or within the epidermal layer of the skin giving rise to pain
Can contain liquid or even blood if vessels are ruptured
Blisters occur when:
⇒ New equipment is being worn or used
⇒ Equipment is being used for a long time (ie bats, gym bars, clubs)
⇒ The activity required sudden change of direction, causing friction in shoes.
Management requires rest for 24 hours if symptoms persist and fluid is still present it may need to be surgically
released. Needs to be washed with soap + water and antiseptic should be apply as well as a ointment (make sure
it is also dry)
Inflammatory Response
o
o
o
o
When soft tissue is injured it becomes inflamed and activates a self-healing process refereed to as the
inflammatory response
5 characteristics: Pain swelling, redness, heat, loss of function, loss of mobility
It is the body’s natural reaction to injury and infection
Involved vasodilation (widening of the blood vessels) allowing more blood to the area and more fluids to exit the
vessels into the surrounding tissue
o
Increase white blood cells (leucocytes) entering the area to clean up debris and fight infection (if the injury is
open)
Phase
Phase 1: The
Inflammatory
Stage/Acute
Phase 2: The
Repair and
Regenerative
Stage
Phase 3: The
Remodeling
Stage
Time
Symptoms
Inflammation (The
initial response)
48 – 72 hours
o
o
o
o
o
o
Pain, redness and swelling around the injured area
Loss of function and mobility reducing possible range of motion
Damage to cell and surrounding tissues
Increased blood flow to the area
Leakage of fluid causing swelling (oedema)
The formation of many blood vessels to promote healing
(lasting between 3-6
days
o
o
o
The elimination of debris
The formation of new fibres
The production of scar tissue
o
o
Increased production of scar tissue
Replacement tissue that strengthens and develops in direction force is
applied.
Varies according to the timing and degree of mobilization of the injury.
Excessive exercise too early causes more damage.
Too little exercise allows lots of scar tissue to form lacking strength and
flexibility
(Can last from 6
weeks to many
months)
●
●
M​ANAGE​ S​OFT​ T​ISSUE​ I​NJURES
o
Immediate treatment aims to reduce swelling, precent further damage and in long term the treatment aims to:
restore flexibly, regain function, precent reoccurrence
H​ARD​ T​ISSUE​ I​NJURIES
Fractures – Simple and Compound
o
o
o
o
o
o
o
Is a break in the bone
Simple Fractures
⇒ The bone breaks but remains underneath the skin
Compound Fractures
⇒ The bone breaks and protruded through the skin
Hairline Fracture and Stress Factures; small cracks in bone
There are many different types of fractures including:
⇒ Greenstick
⇒ Comminuted
⇒ Depressed
⇒ Oblique
⇒ Impacted
⇒ Longitudinal
⇒ Spiral
⇒ Transverse
⇒ Serrated
Management of Fractures:
⇒ DRSABCD
⇒ Controlling bleeding
⇒ Treating shock
⇒ Use of a splint and bandage to
IMMOBILISE area (to restrict
movement in the injured area)
⇒ Seek immediate medical assistance
Most suspected fracture injured require
medical attention if there is:
⇒ Obvious deformity
⇒ Uncontrolled bleeding
⇒ Causality is unable to complete TOTAPS regime
Dislocation
o
o
o
o
o
Is the displacement of a bone at a joint.
Cause pain and are apparent because of the deformity they cause.
Signs and symptoms include:
⇒ Deformity and swelling
⇒ Pain and Tenderness
⇒ Loss of function
Finger dislocations are very common in contact sports.
Treatment of Dislocations:
⇒ Securing with a split to fully IMMOBILISE the injury
o
o
⇒ Ice, elevation, and support using a bandage
⇒ Immediate medical attention
Follow these guidelines when treating a dislocation:
⇒ Never attempt to relocate the displaced bone as this might increase the damage
⇒ Seek medical attention
Subluxation
⇒ Is when a bone might momentarily “pop out” and quickly return to place
⇒ It stretches ligaments but does not cause additional damage
⇒ Joint will be vulnerable.
How to manage hard tissue injuries
o
o
Immobilisation
⇒ Using a supporting splint to immobilise the area (bandage or sling can also be used)
⇒ Ensure ties are on the outside of the limb
⇒ Splint should extent past the nearest joint
REFER TO MANAGEMENT for both fractures and dislocations
Assessment for Medical Attention:
o
o
o
Perform DRSABCD:
⇒ Danger: Look for danger
⇒ Response: COWS (can you hear me? Open your eyes? What’s your name? Squeeze my Hand.)
⇒ Airways: Clear airways
⇒ Breathing: Look, Listen, Feel
⇒ CPR
⇒ Defibrillator
Use this when a player comes off the field and has an injury. If athlete is conscious use TOTAPS:
⇒ Talk: ​Talk to the player and ask for what happened. Provides valuable info.
⇒ Observe: ​Look at the injury and see if there are obvious signs of SWELLING or DEFORMITY. Compare
swollen areas of the body.
⇒ Touch: ​Gently feel the injury for any sign of deformity or swelling. Try to pinpoint area of pain
⇒ Active Movement:​ Ask player to perform a range of movements ie. Flexion, extension, rotation, and
more. If done without pain = further
assessment.
⇒ Passive Movement: ​Physically
mobilises the joint (with flexion,
extension or rotation) to identify
painful areas and instability in joint
⇒ Skills Test: ​Ask player to perform a skill
required in game – e.g. a sidestep. If
they are able to perform it then player
can return to game.
Assessment can be stopped at any stage if
damage is apparent
A​SSESSMENT​ ​OF​ I​NJURIES
TOTAPS
T
TALK
-
ask what happened
what did you feel when it happened?
O
OBSERVE
T
TOUCH
A
ACTIVE
MOVEMENT
P
PASSIVE
MOVEMENT
S
SKILLS TEST
-
where does it hurt?
has this happened before?
-
athletes behavior and injury
deformity, swelling, pain
if fracture/dislocation obvious ​ ​assessment should stop and management begin
-
is the injury tender to touch?
is the injury hot to touch?
if fracture or dislocation ​ ​ start management
-
ask athlete to move injured part
if movement is hindered ​ ​ stop immediately and start management
-
sport first aider should move injured part through range of movement until pain
if pain or change in ROM ​ ​ start management
-
ask athlete to complete some basic movement skill suitable to their sport to see if
they can return to play
CQ2: How does Sports Medicine Address the demands of specific athletes?
C​HILDREN​ ​AND​ Y​OUNG​ A​THLETES​:
o
o
o
o
Have special needs that practitioners should be aware of
They do not have fully developed bodies
Main conditions are: Asthma, Diabetes (type 1 and 2), and Epilepsy
Sports Medicine personnel’s need to be aware of the management
Asthma (Medical Condition)
o
o
Asthma is a condition characterised by breathing difficult where there is a reduction in the width of the airways
leading to the lungs, resulting in less air being available to the. 2 million Australian suffer from it
Narrowing of the air passaged to the lung making it hard to breathe
Signs and Symptoms
Strategies
Management of Condition
o
o
o
o
o
o
o
o
o
o
Leads to:
⇒ Wheezing
⇒ Coughing
⇒ Difficulty Breathing
Narrowing of the air passaged to the lung
making it hard to breathe
Leads to:
⇒ Wheezing
⇒ Coughing
⇒ Difficulty Breathing
Exercise Induced asthma during running
Cannot partake in running/intense sports
May use it as an excuse to not play certain
sports
Many causes; ie. Dust, pollen, smoke, air
quality, cold & flu, exercise
Exercise induced asthma:
⇒ During this condition airways are
dilated during physical exercise
but constrict immediately activity
ceases (thus asthma attacks
occur)
⇒ The cause is related to cooling
process of nerve endings which is
more extreme during running
o
o
o
o
o
o
o
o
Swimming in warm water is
recommended.
Especially warm, moist
water/environments as they
are less likely to cause attacks.
Generally agreed exercise is
more benefit than none all
Activity should be preceded by
controlled breathing and
relaxation exercises
Gradual warm-up and
conclude with leisurely
warm-down
Exercise intensity should be
steady
Use medication before
exercise
Water consumption
Remove athlete from any
environmental triggers
If an attack occurs:
⇒ Sit person
comfortably up right.
⇒ Stay calm and
reassure person
⇒ Give 4 puffs of blue
puffer/inhaler. Best
given through a
spacer. Give ONE puff
every FOUR breathes,
holding breathe 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 000
immediately
Diabetes (Medical Condition)
o
o
Diabetes is a disease in which the body does not produce or properly use insulin
Insulin regulates the blood sugar levels in the body and is produced by the pancreas to metabolise carbohydrates. Can
lead to high blood glucose levels.
Type
Signs and Symptoms
Type 1 Diabetes
Is usually hereditary and the pancreas does NOT
PRODUCE insulin AT ALL.
Type 2 Diabetes
Is usually developmental and is usually the result
of a sedentary lifestyle and poor nutrition.
Obesity is a significant determinant for this and
treated with managed diet and lifestyle changes.
Is the bodies inability to produce SUFFICIENT
insulin or use it effectively
Management
It is treated with injected insulin
It is treated with injected insulin
Hypo-glycaemia
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Hyper-glycaemia
o
●
●
●
●
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Sugary Foods
●
●
●
Apply DRSABCD
Give nothing to eat or drink
Seek Medical Advice
Low glucose levels
Blood sugar below 3.0
Mild Cases: Dizziness, weakness, and
disorientations
Severe Cases: Convulsions,
Unconsciousness, Brain damage
High glucose levels
Blood sugar level over 10.0
Causes: lethargic, and thirst
Can cause coma or death if untreated
Management
⇒ Exercise is of considerable assistance in managing diabetes
⇒ The athlete must balance insulin by way of injection, food intake, and exercise if their physical
performance is optimal
⇒ Diet needs to be well balance with complex carbs
⇒ Require a pre-game meal to raise blood sugar levels and hourly glucose supplementation (e.g. A banana)
if exercise is protracted
⇒ Allowing adequate warm down and cool down
⇒ Always have supply of HYPO food
Epilepsy (Medical Condition)
o
Epilepsy is a disruption to brain function, causing a brief alteration to the level of consciousness and resulting in
seizures or fits.
o
Is a disorder of the brain, which is caused when electrical signals in the brain misfire and disrupts conversation
between neurons.
Signs and
Symptoms
●
●
May go
unnoticed
Rigid body
with jerking
movement
Strategies to Reduce Risk
Management
●
●
●
●
●
●
●
●
●
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If seizures occur often COLLISION SPORTS should be
avoided
If they only occur during sleep or are controlled with
medication ​ ​ it should NOT prevent them from doing
a wide range of sport.
Other players, parents or supervisors should be
present and know what to do if seizure’s occur
Swimming, scuba diving, and rock climbing should be
avoided as loss of control can lead to serious injury or
death
●
●
Protect from harm
Place something soft under head
Do not put anything in mouth
Do not retrain them
Place in recovery position
When seizure is stopped allow
athlete to rest
Reassure
Seek medical treatment
●
Overuse Injuries (stress fractures)
Definition
Common Causes
Management
●
●
●
●
●
●
●
●
●
●
Overuse injuries occur because of
repeated use of a part of a body,
causing tissue damage and
discomfort
Examples that commonly affect
young people:
⇒ Stress fractures
⇒ Tennis elbow
⇒ Achilles tendonitis
⇒ Swimmer’s shoulder
⇒ Runner’s knee
Children and young athletes more
susceptible because of different
growth rates and soft tissue
High training volume and intensity
High training frequency
Lack of warm-up
Lack of general fitness
Biomechanical problems leading
to stress on certain parts of body
Unsuitable equipment. E.g.
running shoes with no support
Poor technique or change in
technique leading to joint stress
Strength and flexibility imbalances
result in poor body alignments
●
●
●
●
Have days of non training
Monitor volume and intensity of
their exercise
Variety in sport e.g. different
stroke in swimming
(Stress fractures)
o
o
Stress fracture is one of the most common forms of overuse injury
Common is shin splints
Signs and Symptoms
●
●
Gradual onset of pain,
which tends to be localized
Pain increasing if it not
treated
Treatment
●
●
●
Immediate rest for 4-8 weeks depending on severity
Frequent use of ice to reduce inflammation
Use of anti-inflammatory medication
●
Local swelling and
tenderness
●
●
Maintain physical condition by activities that do not involve injured part
(ie. Swimming)
Use of corrective devices and exercises to improve body mechanics
Thermoregulation
o
o
o
o
o
Thermoregulation refers to the maintenance of a stable internal temperature independent of the temperature of
the temperature of the environment
Temperature control through balancing heat loss with heat gain is managed through thermoregulation
Children are at risk from environment stress
⇒ Less effectively to control their body temperature at 35.7
⇒ Have underdeveloped sweat glands for cooling
⇒ This is because their sweat glands release fluid MORE SLOWLY and are LESS RESPONSIVE to temp changes
⇒ Therefor rely more on RADIATION and CONVECTION to lose heat
Children’s ACCLIMATISATION to heat is also slower and thus they are at greater risk on hot, humid days and also:
⇒ Shorter tolerance in heat Increases possibility to dehydration
⇒ Have higher changes of hypothermia from exposure to cold
Management
⇒ Avoid extreme conditions
⇒ Have regular rests
⇒ Regular water breaks/Hydration
⇒ Wear loose and light coloured clothing
⇒ Warm clothes on cool days
⇒ Sun protection ​ ​ early in afternoon or in the morning
⇒ Training intensity ​ ​ short games, frequent rotations
Appropriateness of resistance training
o
o
o
o
o
Use of a safe program of low resistance training with high repetitions and the full range of motion is SUPPORTED
Strength training for children should be part of overall fitness and chill
Should not be competitive
Strength specialisation (ie. Focusing on power or absolute strength) should be avoided in under 16 year olds
because it can lead to:
⇒ Can lead to imbalances between muscles groups
⇒ Contributes to injury
⇒ Causes growth stunt
⇒ Can damage growth plates
Following guidelines should be followed:
A​DULT​ ​AND​ A​GED​ A​THLETES​:
o
o
o
o
Most obvious concern for adult and aged athletes is pre-existing health risks
Older people who do aerobic exercise are at less risk of suffering from obesity, hypertension, asthma, or
emphysema.
Heart conditions and bone and joint mobility problems have a significant effect on the options available to adults
and older people.
It is harder for older people to recovery
Heart Conditions
o
o
o
o
o
o
o
o
o
People with heart conditions include people who suffer from:
⇒ Suffer from high blood pressure
⇒ Have experienced a heart attack
⇒ Have other heart problems
⇒ Had bypass surgery (surgery where they remove fat from the coronary artery)
Prescribed exercise conveys considerable benefit with little risk to people in these groups.
⇒ Exercise reduced blood pressure in moderately hypertensive patients by an average of 11 systolic and 9
diastolic points
Exercise should be in conjunction with a balanced diet and low fat/salt intake
People with heart conditions should obtain medical clearance before undertaking exercise programs.
⇒ Some may require a stress test to determine level of intensity
⇒ Supervision is required in early stages
Best options are aerobic exercises such as
⇒ Walking, cycling, jogging and swimming
Begin with 30 mins of exercise per day 3 times a week
Each session must have a warm up and the progression has to be smooth and graded
Key principled for sports participation for people with heart conditions are:
⇒ Initially, they require medical clearance
⇒ Exercise must be aerobic
⇒ Progress must be gradual
⇒ Activity needs to be of moderate intensity
⇒ Should exercise at 65-75% of MHR ​ ​ if too high they get hypertension
⇒ Program should be tailored to individual tastes
⇒ Program must be sustainable as benefits accrue only after a period of months
Types of Exercise:
⇒ Bowls
⇒ Cycling
⇒ Golf
⇒ Light loads for strength training (heavy loads and pure isometrics can raise blood pressure to dangerous
levels = bad)
Fractures and Bone Density
o
o
o
Exercise programs reduced the risk of falls and subsequent fractures amongst people who have osteoporosis
⇒ Osteoporosis is a type of musculoskeletal condition in which there is deterioration in the bone structure.
The bones become thing and weak, leading to an increased risk of bone fracture.
Physical activity increases bone mass and makes bones stronger.
⇒ Important for old women as it delays post-menopausal bone density loss
Inactivity should be avoided as it leads to calcium discharge from bone making it weaker
o
o
o
o
o
o
⇒ Inactivity leads to muscle atrophy (muscle deteriorates)
Sport exercise programs need to be sage, beneficial and not cause pain
Should focus on
⇒ Physical fitness
⇒ Balance
⇒ Strength
⇒ Coordination
⇒ Aerobic capacity
⇒ Flexibility
Risk of fall should be noted and activity avoided is this concerned
Types of exercise:
⇒ Endurance activities such as; walking, cycling, swimming
⇒ Low impact balance activities such as aerobics
⇒ Low range strengthening exercise focusing on the limbs, trunk and back
High loads must be avoided and resistance developed gradually
Aim is to develop POSTURAL RESTRAINING; that is, to teach safe ways of performing movements such as lifting to
avoid further fractures
Flexibility/ Joint Mobility
o
o
o
o
o
Exercise has positive effects
Arthritis, aching joints and tight muscle’s, problems experiences by older people are helped by exercise programs
that focus on
⇒ Safe stretching
⇒ Improving the range of motion in joints
Programs should increase balance and stability to reduce fractures caused by falls
Programs need to:
⇒ Be low impact
⇒ Be specific to person’s limitations
⇒ Consider existing medical conditions that might limit movement
Types of exercise to do:
⇒ Walking
⇒ Cycling
⇒ Swimming
⇒ Flexibility classes
⇒ Aqua-aerobics
⇒ Tai Chai
Sport Participation options available for aged people with medical conditions
Exercises/Types
of Activity
Why they are safe
Walking.
o
o
Walking is a perfect way to start exercising.
It requires no special equipment, aside from a pair of comfortable walking shoes, and can be
done anywhere.
o
Keeps you motivated while also providing a source of fun, stress relief, and a place to meet
friends.
o
Working out in water is wonderful for seniors because water reduces stress and strain on the
body's joints.
Less chance of falling
Senior sports or
fitness classes.
Water aerobics
and water sports.
o
Yoga​.
Tai Chi and Qi
Gong​.
Strength training
o
Combines a series of poses with breathing. Moving through the poses works on strength,
flexibility and balance. Yoga can be adapted to any level.
o
Martial arts-inspired systems of movement that increase balance and strength
o
Use free weights (“dumbbells”) to do repetitive sets of lifting. Don’t have weights? Use anything
that is weighted and fits in your hand, like soup cans.
It strengthens their bones
o
Chair Exercise
o
o
Like toe taps, Sunshine arm circles, Seated Row, Tummy Twists, Hand Squeeze, Glute Squeeze,
Knee lifts.
Easy, convenient, no harm
F​EMALE​ A​THLETES
o
o
Have special dietary needs including:
⇒ Increased Iron
⇒ Increased calcium
requirements
Calcium is important in promoting
strong bone growth and sturdy
structure for muscle attachments.
Eating Disorders
o
o
o
o
o
Eating disorders are characterised by
behaviour such as purging, binge
eating, and starving. The most common eating disorders are anorexia nervosa and bulimia nervosa.
Affect more than ½ of athletes who complete events where low
body fat and specific physiques are required ie:
⇒ Gymnastics
⇒ Synchronised swimming
⇒ Diving
⇒ Dance
⇒ Running and Swimming (less degree)
It can lead to;
⇒ Malnutrition
⇒ Lack of physiological adaption
⇒ Slow recovery
⇒ Lethargy
For example; gymnasts and divers pressure to be ideal body size.
How to prevent, trainers and coaches should;
⇒
⇒
⇒
⇒
⇒
Expect athletes to do their best not just win
Detect signs of eating disorders
Use counsellors and experts on these areas
Observe training routines and practises
Invite parents to training sessions to see not too much pressure is placed
Iron deficiency
o
o
o
o
o
o
o
Iron deficiency causses Anaemia which is when haemoglobin
levels drop below 11 grams per 100mL of blood.
⇒ Anaemia is a condition in which there is low level of
haemoglobin, resulting in less oxygen being available
to
tissues
Caused by a combo of poor diet and menstruation
Mineral is crucial in the role of oxygen transporting
⇒ Without sufficient iron, number of red blood cells is
reduced, limiting oxygen-carrying capacity of blood thus affecting the degree to which the athlete is able
to participate in sport
Iron deficiency can lead to;
⇒ Fatigue
⇒ Loss of energy
⇒ Decreased aerobic capacity
⇒ Poor performance
⇒ Lethargic
⇒ Anaemia which leads to; reduced lactate clearance AND reduced energy production
⇒ Can stop menstruation (and lead to amenorrhea)
⇒ Poor recovery
⇒ Poor concentration levels
More prevalent amongst women because
⇒ They consume less red meat
⇒ They lose 5-40g of iron during MENSTRUATION (recommended daily intake is 15g)
Exercise-induced anaemia = result of intense training where iron reserves are heavily drained
Precautions; Supplementation, monitor levels, etc.
Bone Density
o
o
o
o
o
o
Bone density is a measure of bone strength. (Refers to thickness and strength)
Bones density is directly related to the quantity of calcium of the bones
⇒ Lack of calcium = weak bones = more susceptible to structural weakening and fractures
⇒ E.g. in spinal cord leading to hunch back
Overactive parathyroid glands result in calcium discharge from bone tissue to bloodstream, causing brittle bones
and CAUSING OSTEOPORSIS
Following menopause women lose calcium faster
Affect on sports participation;
⇒ Prone to fracture and injuries
⇒ Avoid high intensity and contact sport
⇒ Weight bearing and resistance exercise
⇒ Reduces strength levels of bones
Female athletes should start programs focus on safety ie.
⇒ Chose aerobic sports such as swimming, cycling, running and aerobics
⇒ Be aware of effect of age and menopause on bone density
⇒ Well balanced diet with calcium rich foods is recommended
⇒ People with osteo should warm-up, stretch and use ICE on inflamed areas post swelling
⇒ Do weight-baring exercises
Pregnancy
o
o
Mild-moderate exercise is good and recommended
Changes during Pregnancy
⇒ Careful overstretching (due to increased levels of relaxin in body)
o
o
o
⇒ Loss of balance as there is shift in centre of gravity
⇒ Haemoglobin levels rise ​ ​ greater oxygen transport
⇒ Require more nutrition
Benefits of exercise;
⇒ improves cardiovascular fitness/maintain
⇒ maintenance of fitness and general well-being
⇒ weight control in later stages of pregnancy
⇒ improved muscle tone
⇒ improved mood
Moderation is key to stop restricted placental blood flow
Precautions
⇒ Exercise at the cool of day
⇒ Avoid humid places
⇒ Consume adequate water to avoid thermal stress which can affect foetal development
⇒ Do not play contact sports in late pregnancy (hard blows may lead to baby blood + oxygen supply)
⇒ Avoid over heating and high intensity sports (baby needs temp regulation)
CQ3: What role do preventative actions play in enhancing the wellbeing
of the athlete?
P​HYSICAL​ P​REPARATION
o
o
o
Enables body to better cope with demands of the sport or activity
Sessions that stress physiological capacities = adaptations
May include; resistance training, interval training, and general conditioning
Pre-Screening
o
o
o
o
o
o
o
Assesses the health status of a person before they become involved in a training program in form of
questionnaire or assessment
Prior new program athlete needs to be pre-screened to see what risks
Age, gender, health status = Important
FOR EXAMPLE; person who is 40 and wants to begin program and has history of active involvement fun runs and
aerobic activities will not have same elements of risk as older, obese people.
Pre-screening is important for;
⇒ Males 40+
⇒ Females 50+
⇒ Asthmatics
⇒ Smokers, obese people, high blood pressure people
⇒ Family history of heart conditions
Tailored exercise programs can be devised to suit needs
Also took for people to begin and maintain using exercise prescription (species what we need to do to reach a
desired level of fitness = FITT)
Skill and Technique
o
o
o
o
o
Relate to efficiency with which we perform required activities
Skilful players have ease and precision and display high degree of
⇒ Temporal patterning – smaller parts of movement are execute in sequence
⇒ Pacing – precise and times
⇒ Control
Correct skill precents injury
For example; Footballer who is unsure of tackling technique is at risk every time they tackle
For Example; Wrestler who has inferiors falling technique will risk injury when they throw on canvas
Physical Fitness
o
o
o
o
o
Most important in enhancing well-being of athletes to ensure level of PF required is attained before competition
Depends on type of sport or activity
For Example; Rugby requires superior cardiorespiratory fitness with high levels of strength, power, speed,
endurance and agility.
For Example; Gymnastics requires less cardio fitness and more flexibility, co-ordination, balance and body
composition. No flexibility = muscle tear
Reduces injury.
⇒ If not fit not correct sport = major factor to injury if not achieved to adequate level
o
Adequate physical fitness fitted for sport are required to make sure body system meets demands of activity
Warm up, Stretching and Cool Down (ONE DOT POINT)
o
Important for enhancing performance and preventing injury
Warm up
o
o
o
o
o
Most important injury prevention
Needs to be geared with demands of sport
⇒ For example; Sprinters war, up for 45 mins before a 10 second event, 20-25 minutes for netballers/soccer
players
Sports that require EXPLOSIVE movements = longer warm up time
⇒ e.g. discuss, shot-put, gymnastics
⇒ Endurance ones don’t need so much
Purpose it to;
⇒ Redistribute blood flow
⇒ Aids in digestion and circulation
⇒ Higher muscle temps increases ability of muscle to stretch without tearing
⇒ It increases muscle ability to response to stimulus (reflexes)
⇒ Mental prep
Suggested phases:
Stretching
o
o
o
o
Sports people require unique and additional specific flexibility according to demands of sport.
Benefits;
⇒ Increases flexibility
⇒ Length of muscles around joint
⇒ Reduces injury
Muscles need to be stretched prior to sport and achieved through safe stretches such
as;
⇒ Static stretches: muscle group or one muscle is gradually stretched beyond
normal range and held for 30 seconds
⇒ Proprioceptive neuromuscular stretching (PNF) – Performed with partner.
Static stretch following by isometric contraction and relaxation phase in
lengthened position.
Muscle groups with greatest demand require more attention
o
For example; a high jumper will stretch all major muscle groups but give more attention to calf and thigh muscle
groups, as demand is greatest.
Cool Down
o
o
o
o
Is the recovery period following competition/exercise where body temp, circulation, and respiratory rates return
to pre-exercise state.
Cool down is essential to;
⇒ Maintain the stretch in muscle groups:​ For example; leg muscles of cyclist may shorten is legs do not
reach full extension during pedalling
⇒ Disperse Lactic Acid: ​exercise recovery results in more effective LA removal
⇒ Prevent blood pooling: ​Gradual reduction in HR reduces vasodilation (supply of blood to working muscles)
in muscles heavily worked
Adequate cool down might be stretching for 10 minutes, callisthenics, and finishing with a light jog or swim (gross
motor activity)
Emphasise stretching
❖ Analyse different sports in order to determine priority preventative strategies and how adequate preparation
may prevent injuries
S​PORTS​ P​OLICY​ ​AND​ T​HE​ S​PORTS​ E​NVIRONMENT
o
Sports policy, rules of the game and equipment may be subject of discussion and review to improve well-being of
athletes.
Rules of Sport and Activities
o
o
o
o
o
o
Rules of sport assist the flow of play and protect participants from injury
Types of rules;
⇒ How to move
⇒ Restriction of contact
⇒ Safety Equipment
⇒ Tackle
⇒ Staying in lanes on court
Rules enforced by referee of umpire to promote safety within a game
Compliance with rules in sporting helps ENHANCE SAFETY
Rule Infringements must be deal with using penalties
Examples;
o
⇒ Marathon runners are obliged to consume fluid during event to prevent heat stroke
⇒ Hockey goal keepers must wear protective gear before paying
⇒ Soft ballers must wear facemasks if they are catching.
In Rugby:
⇒ E.g. In collision sports such as rugby league and union there is injury and thus the potential for common
illegal movements such as head-high tackle are more likely to occur.
⇒ In this case, CODES and WELL-DEFINED rules are put into play and a range of serious penalties.
⇒ It is common for the National Rugby League Judiciary to take legal action against players who cause injury
to other players through violence of negligence
Modified Rules for Children
o
o
o
o
Have specific needs because of stature and limited capabilities
⇒ When suited to their needs ​ ​ adds potential to learn skills and enjoy sport
⇒ If they see themselves as failure ​ ​ the will not continue
Example of modifications to junior sport to accommodate to the needs of children include;
⇒ Decrease in size of the field/court:​ Using smaller field space in Little Athletics
⇒ Smaller and Safer Equipment;​ Lowering B-ball and netball hoops, T-ball stands in softball for ball contact
(increase chance of shooting and hitting ball)
⇒ Rule Changes to make them simpler;​ no tackling in Oz Tag, Kanga cricket, mini basketball, mini hockey
⇒ Games shortened; S​ horter soccer games to prevent fatigue
⇒ Awarding trophies and certificates for achievement
Changes encourage children to take part and continue in activity
Rules and environment need promote; enjoyment, involvement, continuity in the sport and safety
Matching of Opponents (e.g. Growth and Development, Skill Level)
o
o
o
o
o
To promote safety it is desirable to match children with others of comparable size
Size variations make difference in sports such as rugby, hockey and cricket whereby larger kids hit harder
Consideration given to different;
⇒ Age
⇒ Size
⇒ Gender
⇒ Strength
⇒ Psychological development
⇒ Level of skill
Competition even and skills matched = interest heightened and people want to play and enjoy competition for its
own sake not solely to win
For example;
⇒ Divisions in netball ie. U7’s DIV 4 is lower than U7’s DIV 1
⇒ Weight divisions in karate and weightlifting; heaver person lifts heavier weights and is against heaver
people
⇒ Grading in sports
Use of Protective Equipment
o
o
o
o
o
Protective equipment is essential and equipment/grounds also have to be safe
Many sports make provision for use of protective equipment
Purpose;
⇒ Spreads force of impact and puts less pressure on body
⇒ Absorb energy and decrease blow
⇒ Reduce chance of injury (not hinder performance)
Protective equipment must;
⇒ Protect the wearer and other players
⇒ Allow freedom of movement
⇒ Allow air flow as required
⇒ Be comfortable
Examples of protective equipment;
⇒
⇒
⇒
⇒
⇒
⇒
o
o
o
Mouth guards in basketball and football
Helmets in cricket and cycling
Face masks in baseball and softball
Padding for cricked, football and hockey
Wetsuits for surfing
Sun protection; sunglasses and hats from ultraviolet rays in cricked and hockey
Footwear is the most IMPORTANT piece of protective equipment and should be specific to sport.
⇒ Basketball places different demands on footwear and require more grip, Football news sidestepping on
grass so need for support to assist change in direction
Bad footwear can lead to blisters, calluses, sprains, strains and structural deformations
A cross trainer helps reduce injury when and is perfect when;
⇒ Its flexibility in the toes
⇒ A high heel to support Achilles tendon
⇒ Soft sturdy midsole to absorb impact
⇒ Support for the arch of the foot
⇒ Quality non-slip sole
Use of Safe Grounds, Equipment and Facilities
o
o
o
Player safety is paramount
Responsibility of organising group to ensure every effort is made
Safety Guidelines for Children in Sport and Recreation, b
​ y Sports Medicine Australia makes following
recommendations on grounds, equipment and facilities.
Safe Grounds
o
o
It is essential for the safety of participants that playing area is suitable for play.
Following issues need to be addressed before start of play
⇒ Surface in reasonable condition; without holes, sprinkler heads of hard patches
⇒ Clear away ALL rubbish; broken class, stones, lids from cans/bottles
⇒ Corner Posts and field posts cannot injury players
⇒ Padding permanents fixtures; such as goal posts
⇒ Unnecessary equipment and vehicle kept away from sidelines
⇒ Lighting is good
⇒ Matting where necessary; in gymnastics
Safe Equipment
o
Equipment should be checked each time before use. All equipment must;
⇒ Suited to the size and ability of the child (e.g. ball shouldn’t be too heavy, if hit, can cause potential
injury)
⇒ Regularly checked (maintenance)
⇒ Sufficient in number (e.g. enough long socks and shin pads for whole soccer team)
⇒ Padded appropriately
⇒ Stable or movable if necessary
Safe Facilities
o
o
o
The design of fields courts and playing facilities must contribute to player safety
For example; if goals are in or close to the field of play, they must be padded. Players who go beyond this field of
play through movements such as tackles must have enough room to stop safely
Sponsor signs, timing devices, false start equipment etc. should not interfere with player movements on or off the
field.
❖ Critically analyse sports policies, rules and equipment to determine to which degree they promote safe
participation e.g. heat rules, rugby union scrum rules
HEAT RULES
o
o
o
o
Enforced drink and rest breaks to avoid overexertion, dehydration and heat exhaustion.
Some games/trainings are cancelled if UV/temp forecasted too high.
Example: EXTREME HEAT POLICY – AUSTRALIAN OPEN:
⇒ The Australian open is the only major tournament in the world that has an extreme heat policy. If it
reaches a certain point where safety of the fans and their enjoyment and the lack of performance of the
players would be impacted we are able to close the roof of the arena or games will be
cancelled/postponed.
Example: Policy for Athletics
⇒ If track reaches above 40 degrees they wait until the temperature drops a bit lower
RUGBY UNION SCRUM RULES:
o
o
o
Rugby foul play rules encourage fair and safe play by introducing penalties if individuals breach the rules of the
game.
This prevents serious injury.
Particular rules include:
⇒ Obstructing or abusing opponents.
⇒ Tackling too early, too late, or above the shoulders, or when they are in the air.
E​NVIRONMENTAL​ C​ONSIDERATIONS
o
o
o
o
Some environmental conditions can place athlete at sick.
Should be necessary precautions
Appropriate hydration is key in the case of endurance work
Lack of fluid leads to impaired performance and health issues
Temperature regulation (Convection, Radiation, Conduction and Evaporation)
o
o
o
o
o
o
Temp regulation is body’s ability to regulate the internal environment in
comparison to extreme temperatures.
Normal body temp is 37 degrees because of heat produced by metabolism
The heat is DISPERSED through specialised heat mechanisms (transfer body
give and lose);
⇒ Convection
⇒ Radiation
⇒ Conduction
⇒ Evaporation
Hypothalamus reacts when body temp goes above and below
⇒ Small DROP of temp = causes body to shiver
In healthy people body temp is kept within small range
When the amount of heat produced is equal to amount of heat lost, the body is in heat balance.
heat to
Method/%
of Heat Loss
Conduction
3% of heat
loss
Definition
Heat is transferred from
the skin to an object or
from an object to the skin
through Contact. For
heat loss, an ice pack on
skin or for heat gain, skin
contact with clothes.
Example/Description
High Temp + High
Humidity
Cold, windy conditions
o
When playing tennis
our feet contact with
the surface conducts
heat during the
process
Loss occurs because
gradient exists
between the body
and the part of the
environment in
contact
When environ temp
is lower than body
temp heat flows
from body
o
o
o
Ice vest
Apply ice packs
Lie on colder
surfaces (ie.
Concrete/tiles)
o
o
Use a heat pack
Lie on a warmer surface
ie. After swimming lie on
the concrete
A runner loses heat
to the surrounding
air as he/she moves
through it
Heat loss, the wind
will be cooler than
the surface of the
body
o
To cool off you
would stand in
front of a fan
Avoid exercise
in high temp
and high
humidity
Remove extra
clothing to
promote wind
exposure
Poor water over
the body ​
water is also a
form of
convection
o
Put a heater on so that
the warm convection
warms you up
Put more clothing on to
prevent wind convection
from chilling you ​
windbreaker jacket
Cover your extremities
(ears and fingers) as
they lose heat the most
​ wear ear muffs and
beanies
Avoid standing
near the sun
and move to the
shade
Wear
light-colored
clothing to
avoid heat
absorption
(preferably
white as it
reflects it)
o
o
o
o
Convection
12% at rest
Is the transfer of heat
away from the skin by
moving fluid such as an
air current. For heat loss,
the wind will be cooler
than the surface of the
body. For heat gain, the
air movement must be
warmer than the body.
Water is also a fluid
o
o
o
o
o
o
o
o
Radiation
60% at rest
Refers to loss of heat in
the form of infra-red
rays. The transfer of heat
to and from the
atmosphere. For heat
loss, the surrounding
atmosphere would be
cooler than the body and
for heat gain, the
atmosphere would be
warmer than the body
o
o
During activity our
body loses heat and
considerable amount
if radiated to the
atmosphere
Bigger difference
between body’s heat
and environment =
greater radiated heat
loss
o
o
o
Stand in the sun
Wear dark clothing to
absorb sunlight
Evaporation
25% at rest
80% during
events and
extreme heat
Refers to heat loss
through sweating. Heat
is lost through
perspiration (sweating).
o
Process of cooling
only effective when
water evaporates
o
o
o
Drinks lots of
water
Poor water on
skin (first
convection then
evaporation)
o
o
Take wet clothes off ​
when you sweat and it
sits on you the wind will
hit you and you get
chilled
Dry your skin
Wear a windbreaker ​
heat stay within
Climatic Condition (Temperature, Humidity, Wind, Rain, Altitude, Pollution)
o
o
o
o
o
o
o
Affect of climatic conditions need to be understood as they have the potential to affect an athletes health and
well-being
Combination of high temp and high humidity increase risk of hyperthermia
Combination of cold weather and wind result in high risk of hypothermia
Dry heat
Hypothermia​ (TOO COLD) is a condition characterised by body heat loss that far exceeds body heat gain, resulting in
subnormal body temperature.
Hyperthermia (​ TOO HOT)​ i​s excessively high body temperature that is usually experienced in hot, humid conditions in
which evaporation is unable to take place.
Vasoconstriction​ is a decrease in blood vessel size, causing less blood to be supplied to the area that is serviced by that
blood vessel.
Climatic Condition
Temperature
Effect on Sport
o
o
Extreme temp environment may lead to hypothermia and
hyperthermia
Risk of dehydration
Heat:
o
o
o
o
Excessive heat make it difficult for body to core body temp of
37 degrees
Water requirement increases in heat
High temp can lead to stroke as blood volume becomes
devoted to heat transpiration rather than oxygen
Excessive sweat place strain
Strategies
o
o
o
o
o
o
o
Be aware of clothing
app for activity
Not overdress
Don’t swim in water
colder than 15
degrees
Increase fluid intake
Acclimatize
Take regular breaks
Stay in shade and
wear correct clothing
Cold:
o
o
o
Humidity
o
o
Wind
o
o
Skiing/surfing in cold can be as hazardous
Cause loss of body to heat to extent that ability to maintain
heat balance is jeopardized
Results in activation of heat conservation; shivering and
vasoconstriction (decrease vessel size)
Environmental warmth and humidity limit body’s ability to
dissipate heat
Prevents evaporation
Combined effort of convection and conduction lead to wind
chill
Burning sensation on skin can be accentuated by increased
cloud and humid
o
DO NOT/AVOID
exercising e at times
of high temp and
humidity
o
o
Warm up properly
Wear light clothing
that covers areas
Rain
o
o
At risk of lowering core temp and hypothermia
At risk of muscle strains and breathing difficulty
o
Might assist body temperature control during performances in
warm to hot conditions
Affect safety → visibility
Important in events (cycling) where the combination of speed,
lack of tractions and poor visibility → injury
Increase chance of injury
o
o
o
Altitude
o
o
o
o
o
Pollution
o
o
o
o
o
during running and
cycling
o
Postpone activities
where rain affects
safety
Altitude increase ability to perform work is affected (in
endurance a lot)
Oxygen in air is thinner
Reduction of 3-3.5% in air thinner
Solar radiation is stronger
The body makes more red-blood cells/hemoglobin
o
Should acclimatize in
training when
competition is in
altitude conditions
Use sun protection
Can affect breathing amongst people who suffer from asthma
and cardiorespiratory issues.
Increases airway resistance causing irritation
Carbon Monoxide binds to hemoglobin, thereby inhibiting
oxygen delivery to muscles
Ozone might cause health risk as it causes discomfort, nausea,
and eye irritations
Feelings of coughing, wheezing, watery eyes and that breathing
is restricted
o
o
o
o
Avoid cigarette
smoking
Avoid exercise during
rush hours in cities
Not exercise when
humidity, temp and
traffic pollution is
high
Guidelines for fluid intake
o
o
o
o
o
o
Role of water is crucial in temp regulation
Reduction in water reduces plasma levels and causes blood pressure to decrease
⇒ This results in less blood being available to the muscles and skin
⇒ Also affects bodies circulatory function
Even minimal fluid loss can affect endurance performance
For example; distance runners, their pace falls by 2% for every 1% of fluid loss
Progressive water loss procedures following symptoms;
⇒ 1% loss (700mL); Thirst
⇒ 5% loss; Considerable discomfort and decline in aerobic effort
⇒ 10% loss; breakdown in coordination with movements becoming difficult
⇒ 20% loss; Upper limit of dehydration before death
Sports Med Guidelines for water intake;
⇒ Before Competition; at least 500mL, 30 mins prior
⇒ During Competition; 150mL every 15 mins, more in hot conditions, replace 80% of fluid loss while still
continuing to exercise
⇒ Following Competition; Drink liberally, replenish water till urine is clear
⇒ What to drink: water, diluted electrolyte if exercise is more than one hour, non-carbonated, no alcohol,
Acclimatisation
o
o
o
o
o
o
Is a training technique where an athlete experiences different climatic stressor causing physiological adaptations
Where athletes need to compete in range of climates acclimatisation assists performance
For example; Footballers from northern Queensland have may have difficulty with breathing and skill execution
on cold evenings in Canberra, while Sydney footballers find the humidity energy sapping
Is about developing tolerance to conditions
Applied to heat, cold, humidity, wind and altitude
Is enhanced through exposure and training in that environment
o
o
o
Generally takes 5-7 days to heat and humidity, whereas altitude takes 2-3 weeks.
An example of heat acclimatisation was the Commonwealth Games held in India. India’s climate is much hotter
and more humid in Australia. Therefore, to combat the heat and humidity in India and the associated sweating,
loss of body fluid, and increase body temp most Australian athletes would experience a period of heat
acclimatisation (whether it be initial or during training) prior to the games when necessary.
For example; athletes would sit in heat rooms to regulate temperature and thus their body’s regulation would
process to the anticipated climatic conditions. This enables the body’s mechanisms to adjust and aid the athlete.
This is a well-proven and vital strategy to ensure maximised performance is not decreased through having
hyperthermia, dehydration and heat stroke from not adequately preparing for the climatic conditions.
❖ Evaluate Strategies an athlete could employ to support the body’s temperature regulation mechanisms
o
o
During competition, an athlete may produce 15-20 times the heat they normally produce at rest
Several actions can be taken by athletes to assist the body with thermoregulation
⇒ Adequate fitness:​ heat tolerance can be improved through excellent physical fitness and regular training
in warm and humid conditions
⇒ Hydration:​ substantial amounts of water are lost through sweating, and drinking water assists with the
sweating mechanism.
⇒ Appropriate ​clothing (cold weather): tight fitting, insulating clothing can reduce heat loss through
convection. Having a spare set of clothes to wear following intensive exercise is also important. If
sweating has been heavy, this is vital otherwise there will be a large drop in core body temp.
⇒ Modifying warm up:​ in hot conditions, warm-up duration and intensity should be reduced to ensure that
there is no significant increase in body temperature before an event begins
⇒ Acclimatisation:​ can assist the body’s thermoregulation mechanisms. An athlete acclimatised to hot
conditions is able to sweat more, allowing for increased heat loss through evaporation.
❖ Analyse the impact of climatic conditions on safe sports participation
T​APING​ ​AND​ B​ANDAGING
o
o
o
Important for safety measures
Can be used as preventative strapping or for injury rehabilitation
Increase safety and well-being of the athlete
Preventative Taping
o
o
o
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
Sports that require agility, speed, power, and strength can place stress on joints
⇒ Examples of sports are; basketball, football, soccer and netball
⇒ They require EXPLOSIVE movement and changes in direction ​ ​ joints periodic strain and high stress
Taping in such situations are
⇒ PREVENTATIVE or PROPHYLATIC measure
o
o
Prophylactic = aims at preventing
In this example ​ ​ taping is used to prevent inversion of sprain
⇒ Ankle rolls laterally causing strain to ligaments around lateral aspect,
⇒ Taping allows plantar and dorsi flexion ​ ​ and restricts rolling in (inversion) and eversion (rolling out)
TAPING PROCEDURE:
o
o
o
o
o
o
Positioning:
⇒ Stabilise ankle
⇒ Shave area to be taped
⇒ Set ankle in dorsi-flexion ​ ​ Achilles tendon fully stretched
⇒ Slightly evert foot
⇒ Adjust height
Anchor: 2
⇒ Attack first anchor 15cms above ankle joint
⇒ Begin at front foot and run obliquely around lower leg + overlap at
beginning
⇒ Second stirrup over first
Stirrups: 2
⇒ Begins with attachment to anchor on medial side
⇒ Take over back half of ankle bone
⇒ Take under arch of foot
⇒ Then join on later side
Extra Anchors: 2
⇒ Secure stirrups
Figure Sizes: 2- 3
⇒ Attach tape to anchor inside leg and pull down lower foot
⇒ Apply tape under sole of foot + upwards
⇒ Join with tape
Heel Locks:
⇒ Begin on inside of heel
⇒ Tape across top of foot and under heel
⇒ Come up medium side and extend BEHIND heel
⇒ Go across lateral bone and top of foot
⇒ Finish on medial side
o
Close Down:
⇒ Begin on lateral side of anchors
⇒ Wind tape around leg
Taping for Isolation of Injury
o
o
o
Required after injury has been sustained AND during rehabilitation process
FOR EXAMPLE; an ankle injury may be healed but requires testing in training. Support should be provided while
the injure area become accustomed to the demands of full activity
Taping also required so athletes can participate in conditioning ​ ​ maintain fitness during recuperation
Bandaging for immediate Treatment of Injury
o
o
o
o
o
When injury sustained it is required
Using RICER mean compression bandages are used to;
⇒ Restrict bleeding into area
Type of banding varies according to LOCATION and TYPE of injury sustained
Bandaging serves to LIMIT MOTION of the body part
⇒ Usually by securing it to another body part
For example; a sprained thumb may need to be strapped and supported by the wrist
Evaluate the role taping plays in both the prevention and treatment of injury
CQ4: How is Injury rehabilitation managed?
R​EHABILITATION​ P​ROCEDURES​:
Rehabilitation Procedures
o
o
o
o
o
o
Rehabilitation is the process of restoring the athlete to pre-injury level of physical fitness
It included MOBILSATION, STRETCHING, CONDITIONING, TAPING, TRAINING and TESTING as part of the
assessment process
Proper rehabilitation should be followed through the stages before competition is recommenced
Aim
⇒ Prevent re-injury
⇒ Restore to optimal function
⇒ Return athlete to competition quickly and safely
Time taken to complete recovery varies
FULL RECUPERATION HAS TO TAKE PLACE BEFORE SPORT
Progressive Mobilisation
o
o
o
o
Following RICER it is important movement is restored to injury ASAP
Involved gradually extending the range of movement through which the injured part can be manipulated and
continued until the part is fully functional
Can be achieved through
⇒ Active Movement
⇒ Passive Movement
FOR EXAMPLE: Ankle Injury
Graduated Exercise
o
Involves:
⇒ Stretching
⇒ Conditioning
⇒ Achieving total body fitness
Stretching - Graduated Exercise
o
o
o
o
Stretching injured area is important so it heals without scarring
Provides elasticity of muscle fibres
Scarring = shortens muscle + prone to further injury
Proprioceptive Neuromuscular Facilitation (PNF)
⇒ Most appropriate form of stretching
⇒ Muscle is stretching and strengthened during safe movements
⇒ PNF is when you push/stretch ​ ​ rest ​ ​ go a little bit further
o Benefits of stretching:
⇒ Reduce muscle tension
⇒ Increase Circulation
⇒ Increase Muscle and Tendon Length
Conditioning - Graduated Exercise
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Rehab programs need to be individualised to athlete because of difference in sex, age, genetics, existing chronic
conditions etc.
⇒ Overly Aggressive conditioning program bay do harm and lengthen recovery process
o CONDITIONING implies a build-up in fitness as a result of ADAPTATIONS to gradual increase in PHYSICAL STRESS.
⇒ Use a range of strength, agility and power skills to ensure full function
o OVERLOAD PRINCIPLE
⇒ To ensure that a greater than normal load is placed on body
⇒ Adherence also importance because it recognised optimal amount of overload
⇒ Periods of rest and recovery are followed by increasing periods of works
⇒ Ensure the Conditioning experience is pain free in the injured area
⇒ E.g. start of small and build up. Bicep Curl ​ ​ go from 1kg ​ ​ 2kg ​ ​ 3kg ​ ​ eventually to 5kg to build
strength
o PRINCIPLE OF SPEFICITY:
⇒ Conditioning regime needs to target general cardio fitness
⇒ In conjunction with increasing need for power and strength
⇒ Local Muscular Endurance around area
⇒ E.g. If it’s an ankle issue then all exercise focus on the foot/ankle region rather than the arm
Total Body Fitness - Graduated Exercise
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Is regaining the level of MENTAL and PHYSICAL fitness reached by the athlete before injury occurred.
Regaining pre-injury fitness
Must progressively and gradually overload muscle groups/energy systems that require adaptations BEFORE
competition is started again
There adaptations include;
⇒ Hypertrophy (increased size) of the muscles
⇒ Strengthening of the tendons and ligaments
⇒ Increased capillarisation and subsequent blood flow to the inured area
⇒ Increased elasticity of fibres
⇒ Increased joint mobility
⇒ Absence of all pain
⇒ Full confidence in knowing that injured area can handle match stress
⇒ Fully resorted balance and coordination
Training
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With total body fitness achieved, full training can resume (TRAINING NOT GAMES)
Expected to participate in full training program in a pain-free environment
Involves:
⇒ Warm-up
⇒ Conditioning
⇒ Drills
⇒ Skills Development
⇒ Tactics
⇒ Cool-Down
Use of heat and cold
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Cold (Cyrotherapy)
⇒ Cold can be applied for anything up to 4 DAYS following the injury and may be required following that to
reduce inflammation
⇒ Application of; ice massage, ice water immersion, vapocoolant sprays
⇒ Decreases; swelling, circulation, inflammation, pain + discomfort, muscle spasms, muscle spasms, tissue
immobilization
⇒ Use of RICER
⇒ Used in Acute phase of injury
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Heat (Thermotherapy)
⇒ Heat is NOT USED FOR 2 to 3 DAYS after injury, depending on the injury type and extent of damage.
⇒ Application of; moist heat packs, whirlpool baths, Contrast baths, Microwave diathermy, Ultrasound
therapy
⇒ Used when internal bleeding has stoped
⇒ Used to; increase elasticity to new fibres during stretching process, reduce pain, reduce stiffness, increase
blood flow, reduce inflammation
❖ Examine and Justify procedures for a range of Injures
R​ETURN​ T​O​ P​LAY
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Injured athletes should not return to play until injury is healed
In case of concussion, medical clearance is essential
Indicators for readiness of return to play (Pain free, degree of mobility)
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Effective treatment and rehabilitation ensure that the healing process has resulted in measureable improvements
to injured area. These Include;
⇒ Elasticity – New tissue has been stretched promoting elasticity, flexibility returned
⇒ Strength – New tissue is strong and able to support body in stressful movements
⇒ Mobility – athlete has gained full movement, they have agility, and ROM
⇒ Pain Free – Injury is pain free during light exercise and strenuous work
⇒ Balance – Injured person is able to balance body on injured limb
Monitoring Progress (Pre-test and Post-Test)
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To monitor progress compare
⇒ Pre-test – Before injury occurred
⇒ Post-test – After injuring was sustained
This established if athlete has lost fitness components (e.g. speed and agility)
Test need to incorporate sport specific movement
For example; if knee ligaments were damaged, and agility test such sa the Illinios test would be appropriate,
whilst a grip strength or power test would not be
Psychological readiness
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Psychological preparedness underpinned by confidence and positive outlook is essential
After injury athlete may feel anxious when returning to pay
⇒ On other hand some might want to go back even when not fully recovered
Even if they are physically active, they may not be psychologically ready to return to competition
Observed through discussion, observation and anxiety levels
Balance between;
⇒ Motivation
⇒ Self-assurance
⇒ Common sense is important
Specific Warm-up Procedures
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After injuries ​ ​ make sure fully warmed up and muscle groups are properly stretches before training or playing a
game
Warm up may need to be specific to injured area
For example; if a sprinter had a hamstring injury, stretching exercises to quads and hamstrings are needed to
ensure muscle groups have been extended in a safe environment beyond what will be demanded in the
competition
Other warm ups include; extra or varied, strength work, concentrated warm up
Return to play policies and procedures
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Individual sports will have own specific return to play policies and procedures/vary from sport to sport
Amateur sports
⇒ Individuals make decision with doctor, physio or trainer
Professional level
⇒ Policies and procedure followed to prove athlete is injury-free
Professional athlete protocol may involve; consultation, x-ray reviews, discussion for use of strapping, fitness
assessments, specific tests for ROM
Ethical Considerations: Pressure to participate AND Use of painkillers
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Pressure to participate comes from teammates and couches etc.
Some feel need to go back for $$$ reasons
Some athletes use pain killers to allow them to play
Ethical questions need to be explored as poor decisions = consequences impacting performance on the long term
Pressure to participate
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Coaches put pressure on valuable players to return early (especially in elite sports)
Some players have injures heavily strapped others given injections
For example; some coaches see players as commodity. They are part of contracts; need to be on field to play to
gain value for cost.
Unwise and dangerous to insist pressure on players before injury is healed
⇒ Leads to tissue damage, arthritis, early retirement
Use of painkillers
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Painkillers enable athletes to play important matches
Prescription painkillers is a concern
⇒ They mask pain that is normally present
⇒ Desensitize injured tissue leading to further damage (pain is natural response to organ damage)
⇒ They prolong healing process
⇒ Permanent mutilation of fibres may occur
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For example; key players in football and grand finals have been cited to use painkillers.
❖ Research and evaluate skill and other physical tests that could be used to indicate readiness to return to play