Sports injuries
Objectives
By the end of the session you should be
able to:
• List the physiological responses common to most sports injuries
• Describe the physiological responses common to most sports
injuries
Video link
Watch the video and identify 5 different types of
sporting injury, listing what you think the injury is
and write a sentence on how and why you think it
occurred
• Sports Injuries
Primary and secondary
damage
• Primary damage:
Is tissue destruction caused by an injury
• Secondary damage:
Occurs as cells at the injury site die due to hypoxia due to the
damaged and blocked blood vessels at the site which are
unable to deliver oxygen
Physiological Responses
Injury response cycle for any tissue
• Primary and secondary damage
1. Inflammatory response
2. Blood Clotting
3. Fibroblastic repair
4. Maturation remodelling
1. Inflammatory response
• Stage 1 / Swelling
• This inflammatory response represents the body's
attempt to dispose of blood (from torn tissue) and
damaged cells before starting to repair the damage
done.
• This initial inflammatory phase lasts about 2 to 4 days
and is followed by scar formation and repair.
1. Inflammatory response
• This is the beginning of the healing process
• Oedema helps to transport proteins and fibrinogen to the area
• Chemicals then irritate neuroreceptors which reduces pain
• The swelling restricts the movement of the body part preventing
further injury
• Leucocytes and Phagocytes are delivered to the injured area
to dispose of the damaged cells
2. Blood clotting
• Starts approximately 48 hours after injury
• Increase in the formation of extra cellular matrix
(collagen).
• Tissue cells reproduce to form new blood vessels
• Collagen is crossed linked but is generally haphazard
with no real tensile strength.
• This phase can last up to six weeks or more.
2. Blood clotting
• Haemostasis: damaged blood cells are blocked with
a clot which is then removed when tissue is repaired
• Platelets activated by Thrombin converge on the
injury site
• Fibrinogen causes the platelets to bind with
collagen that form a plug
• Once repaired Plasmin dissolves the clot
3. Fibroblastic repair
• Is the formation of scar tissue to repair injured tissue
• Starts to rebuild the capillary network ensuring blood
supply and nutrients to the damaged area
• Collagen is randomly deposited at this stage to
strengthen the wounded area
Collagen
• About one quarter of all of the protein in your body is collagen.
• Skin damage often destroys the weave-like structure of
collagen.
• Evolutionary legacy means the body acts in haste.
• The body creates a quick fix.
• When skin cells grow on this, they produce the pale, less flexible
material we know as scar tissue, rather than normal skin.
4. Remodelling
• Initiated after approximately 14 days of injury.
• Collagen fibres are realigned or remodelled along
lines of mechanical force forming a scar.
• Scar tissue reabsorbed – type III collagen is replaced
by type I collagen to increase strength.
• This phase can last up to a year.
4. Remodelling
• The re-modelling phase is initiated after a few weeks
but can take several months or even years to be
completed.
• Depending on the site and severity of the injury. The
re-modelling process is helped considerably by
rehabilitation exercises.
• Correct diagnosis, treatment and rehabilitation is
important at this stage.
The healing process
• In pairs decide how long (typically) it takes for these
types of tissue to heal, decide why they take that
long and think about the healing process
Skin
2-3 weeks
Muscle
4-6 weeks
Tendon
6-8 weeks
Ligament
6-8 weeks
Bone
12-16 weeks
Nerve
12-18 months
Task
• In your own words write down the four
stages of healing
Muscle healing
• Your muscles, do not actually heal with muscle
tissue, but with "foreign" substances including
collagen.
• The resulting scar tissue is weaker, less elastic,
and highly prone to re-injury.
• Once a muscle is damaged, it can become the
source of a great deal of pain.
Tendon and ligament healing
• Follow a similar healing process to that of muscle injury
healing.
• Inflammation peaks after 4 days and continues until 10
days post injury.
• Anti-inflammatory drugs can prevent adhesions but can
also delay repair and result in weaker healed tendons
Bone healing
• If you fracture a bone, as long as it is set and fixed
in place properly.
• A healed bone can be stronger than it was before
the fracture.
• Bone tissue heals with calcium and other minerals.
• Osteoblasts and Osteoclasts.
Cartilage healing
• Injuries which do not involve the underlying bone heal
poorly, if at all.
• No inflammation, bleeding, clots or granulation of
collagen matrix occurs in purely cartilaginous injuries,
because it doesn’t have a direct blood supply.
• Some healing may occur if underlying bone is
damaged.
Key words
• Hypoxia – starving of oxygen
• Oedema – accumulation of fluid and swelling
• Leukocytes – blood cells which devour
damaged or bad cells
• Haemostasis: is when damaged blood cells
are blocked with a clot which is then removed
when the tissue is repaired
• Platelets – blood cells which produce clotting
• Collagen – a protein that helps repair injured
tissue
• Fibrinogen - a protein used in repairing
tissue
• Plasmin – enzyme that degrades blood