KNES 372

Standard reference position --> dorsiflexion, palms forward, etc,

down

divide left and right equally (in the middle)

anywhere but middle (flexion and extension)

divide back and front (adduction and abduction)

divide top and bottom (rotation)

Posterior = behind

Anterior = in front

*divided by frontal plane

relative to something

*divided by transverse plane

Medial = towards center

Lateral = away from center

*divided by median plane

often related to limbs

- relative

Inwards vs. outwards

"bow leg"

"knock knee"

Lumbar - 5

Thoracic - 12

Cervical - 7

Sacral - 1

Coccyx - 1

Excessive curve of the lumbar region

a dorsqally excessive thoracic curve

Flexion

Abduction

Occurs only in one plane (e.g. supination vs. pronation) e.g. head

multiple planes

flexed foot

pointed foot

toward midline

away from midline

NO

Combination of inversion (frontal plane), adduction (horizontal plane), plantarflexion (sagittal plane)

*Sickle foot

Combination of eversion (frontal plane), abduction (horizontal plane), dorsiflexion (sagittal plane)

*Sickle foot

B

A

Rotation: a kind of movement around a single point, away or towards midline

Circumduction: combination of movement to make circular movement

No, but mostly (e.g. ankle)

AKA: integrated support team (IST)

• Multi-disciplinary team of sport science, sport medicine and sport performance professionals.

• The goal is to ensure that athletes are healthy, fit and mentally ready for optimal performance.

- Physician, Therapist, Strength and conditioning coach, Exercise physiologist, Sport psychologist, Biomechanist, Nutritionist, etc.

Diagnosing the athletes condition and prescribing the treatment

prevention, management, treatment and rehabilitation of injuries

Rehabilitation of more serious injuries/rehabilitation after surgery

Establishing and maintaining a strength and conditioning program

exercise prescription and testing

helping athletes to cope with competitive fears, mental skills, preparing for RTS, how to handle emotions after setbacks, etc.

biomechanical assessments to enhance performance and prevent injury

education of athletes and support staff on how nutrition can enhance performance, recovery and health

the scope of practice and standard of care.

describes the services that a qualified healthcare professional is deemed competent to perform and permitted to undertake

– in keeping with the terms of their professional license.

Medical treatment guideline.

It specifies appropriate treatment based on scientific evidence and collaboration between medical and/or psychological professionals involved in the treatment of a given condition.

Teamwork!

Communication between athlete and coach is extremely important

- 1st part of injury prevention lies with the coach

- coach is influenced by money, winning, etc. (must communicate well for mutual benefit)

SEM team should be there for the player's health and safety, but will also have a secondary goal of winning (NEVER at the athlete's expense)

- Injury/re-injury

- reduced team or individual performance

- career loss (player and staff)

- interpersonal conflicts

- broken trust (athlete or coach)

- mental health issues

- set-back in rehab

- medical-legal

- much less people apart of the team: parents, student volunteers, coaches

- if injured = parent/athlete are in charge of themselves

- go to your own physio/doctor (money barriers)

- much less communication

- everyone is involved even in minor injuries

- intense injuries require much more mental health support through fear of returning/contact (that is possible)

The process of identifying risks (assessment, evaluation, control)

1. Within/across sport: policies

2. Club/team level: train for risk prevention, equipment, training safety

3. Individual level: train to treat injuries

is a process of measurement/estimation of risks to teams and athletes

involves determining the significance and acceptability of the risks

is a process of identifying and implementing methods to control the risks and the consequences

- Injury surveillance

- Pre-season screening

- Monitor "at risk" team members

- Education

- Emergency Action Plan (EAP)

1. environment

2. equipment

3. athlete

- Field and surroundings

- Weather conditions

- EAP

- protective equipment

- special training equipment

- first aid kit

- AED

- medical issues

- previous injuries

- training history

- age

- sex

describe a possible change in behavior in an athlete when they use protective equipment.

- The theory is that the person will assess the level of risk, and if they assess that the protective equipment reduces that risk, they will simply undertake more extreme activities to return the risk to a level they are comfortable with.

- BE PREPARED!

- Emergency action plan is critical to facilitate a rapid and effect response to an emergency

- EAP should be prepared for practice and competition sites

• Charge person (designated for action and can ask for help = most capable for injuries)

• Call person

• Cell phone - Important phone numbers (EMS, facilitymanager)

- Instructions to EMS how to reach thefacility

• First Aid Kit

• Automated External Defibrillator (AED)

• Ambulation aid (crutches, wheelchair, spineboard)

1. Communication sheet (plasticized)

• Important phone numbers

• Address of facility, access(directions/map)

• Nearest hospital directions

2. Information where AED, spine board, etc. are located

3. Player/staff medical profile cards

• Name and emergency contact information

• Medical profile (e.g.,asthma, allergies)

• Is not breathing

• Does not have a pulse

• Is bleeding profusely

• Has impaired consciousness

• Has injured the back, neck or head

• Has a visible major trauma

• Cannot move arms or legs (or has lost feeling in them)

- EAP coordinator (charge person)

- Immediate AED access

- Trained personnel and annual practice

- Communication system

- Venue-specific EAP

- Medical timeout before each competition (between home and visiting team)

- Maintenance and monthly checks of AEDs (and document it! = prevent medical lawsuit)

Kinesiology A

• Main, Floor, across from Client Services Desk

• Main Floor, Aquatic Centre, next to change rooms

Kinesiology B

• Basement floor, Jack Simpson Gym entrance, next to emergency help phone

• 2nd floor, Jack Simpson Gym entrance, beside west elevator

• Main floor, near east main fire panel, MacEwan Hall link entrance

• Main floor, across from Sports Medicine

• Main floor, Racquet Centre, next to emergency help button

• Main floor, Human Performance Lab, outside B103

• 2nd floor, Human Performance Lab, outside B2225

Method of documentation

- standardized way to store medical info.

S (subjective information/history) = what player told you

O (objective information) = what you see, measurable

A (assessment) = what you conclude

P (plan) = what you do about it

*prevents medical lawsuits and helps SEM team

- happier

- play more

- common in sports = best you can

- burden on the healthcare system

17, 655

• 1 in every 3 youth (aged 11-18) in Canada seek medical attention for a sport-related injury every year

• Lower extremity injuries (60%) and concussions (20%)

- LE injuries: 60% knee and ankle

- Concussions: Hockey and rugby over 50%

• Highest burden –> hockey (10%), basketball (10%), soccer (10%)

• Participation in S&R (decrease)

• School/work attendance (decrease)

• Physical activity (decrease)

• Overweight/obesity + other health implications (increase)

• Osteoarthritis (ankle & knee joint injuries) (increase)

• Psychosocial consequences

• Health care and indirect costs are high

- Primary physio/doc appointment

- referral to sports med doc.

- imaging

- surgical consult

- pre-surgical physio

- surgery

- etc.

• Sport mastery and associated opportunities (U Sports, NCAA, Pro)

- 65% with ACL reconstruction for a total rupture played at the same level 3 years after (*in professional male Soccer).

- In elite athletes, at 2 years after ACLR surgery, 79.6% were still playing, 51% at the same level

Intrinsic: physical characteristics, skill level, risk level

Extrinsic: exposure, training, opponents, environment, equipment, etc.

Modifiable risk factors

• E.g., equipment, training, body weight, flexibility

Non-modifiable risk factors

• E.g., weather, growth, age, sex, previous injury

prevent injury before it even starts to occur (decrease injury chance)

detecting injury in early stages to prevent worsening

arresting the progression of injury and addressing the issues

• Training strategies

• Rule modification

• Equipment

• Training programs to improve fitness/movement quality (n=64)

• New or modified sport equipment (n=33)

• New or modified rules (n=19)

• Education (n=14)

• Training programs to improve psychological and/or cognitive skills (n=6)

• Policy change (n=5)

• Multi-component/multiple interventions (n=14)

Training programs to improve fitness/movement quality

- prevent injury

- improve skills, coordination and control

- increase reaction speed and power

- increase joint stability

- foundational movement

- warm up

- e.g. ACL is not fatigued based = neuromuscular

Regular neuromuscular training (NMT) can reduce injury rates up to 70%

Tissue loading = don't want to overload joints/ligaments = want to use proper muscles

Valgus, external rotation

- includes meniscus, MCL injury

- slow down in direction change

- bend knees for direction change

- avoid valgus position (use abductors/glutes)

- knees above toes = joint safety

- straight spine

- heels on ground

- head directly forward

- 90 degree angle

- slow lower

- maintain straight line (no pronation, no valgus)

Associations between injuries and:

• Rapid increases in training loads

• Insufficient practice vs. competition

• Too little variation in training load (monotony)

• Spikes in training load

*don't increase too quickly

*periodization = phases of training

External: work performed (quantifiable: intensity, duration, and frequency of exercise)

Internal: body's response (specific to the exercise type)

Sum of movement and structure specific loads (e.g. step, throw, jump, direction change)

- different between individuals

- strength capacity, injury history, biomechanics, size/weight

- Better to be multisport

- DONT early specialize

- increasing chance of injury

Athletes are classified as

• Low (score = 0-1)

• Moderate (score = 2), or : 2.61

• High (score = 3) specialization. :4.74

• Tissue damage / derangement of normal physical function

• Generally due to external forces (transfer of kinetic energy)

• Sport injury can apply to all tissues - Vessels, muscle, ligament, cartilage, nerve, etc.

Injury may result from a clear acute mechanism (acute injury), clear repetitive mechanism (overuse injury), or from a combination of both mechanism.

• Acute injury → Sudden onset (single event)

• Overuse injury → Gradual onset (repetitive)

• Overuse injury → Sudden onset (single event / repetitive)

• Contact with another athlete

• Contact with an object