1.2c injury prevention

• acute injuries

  occur at a specific moment in time, when there is a sudden injury associated with a traumatic event, such as a fracture of a bone in a boxer's jaw or a knee ligament tear after a bad tackle in football. common causes of acute injuries are a collision between two players, a fall or excessive impact from an object e.g., a football
• chronic injuries

  occur over a period of time. a chronic injury is a slowly developed injury associated with repeated or continuous stress or overuse, such as pain in a tennis player's elbow or a runner's heels. common causes of chronic injuries are a sudden increase in the intensity, frequency or duration of activity, reduction in recovery, inadequate equipment or technique, poor range of motion, and an inadequate warm up or cool down
• hard tissue injuries

  involve damage to the bone, joint or cartilage and include fractures and dislocations. hard tissue injuries can result in internal bleeding, circulatory problems and joint instability and usually require hospital treatment
• soft tissue injuries

  are the most common in sport and involve strains and sprains of the muscles, tendons or ligaments. soft tissue injuries result in inflammation and bruising (internal bleeding) and require immediate attention to minimise recovery times
• fractures- acute hard tissue injury

  a fracture is a partial or complete break in a bone due to an excessive force that overcomes the bone's potential to flex. the fracture usually comes from a direct force (collision or object) or indirect force (falling or poor technique). common indications are pain at the fracture site, inability to move or unnatural movement of the injured area, deformity, swelling and dislocation. all fractures are serious but the sigs, symptoms and length and type of treatment will depend on the type of fracture
• types of fracture

  • compound (open): fracture breaks skin, creating open wound + high risk of infection
  • simple (closed): skin unbroken, little bone movement, little soft tissue damage
  • incomplete: partial crack, not fully separated
  • complete: total break, separating into fragments
  • greenstick: partial break from bending action
  • transverse, oblique and spiral: perpendicular, diagonal or twisting crack across whole bone
  • comminuted: many fragments, long recovery process
  • impacted: ends of bones being compressed together
  • avulsion: bone fragment detached at site of connective tissue attachment
• dislocation- acute hard tissue injury

  occurs when one bone is displaced from another, moving them out of their original position. usually occurs from direct force (collision or object) or indirect force (a fall) pushing the joint past its extreme range of motion. common indications are severe pain at the injury site, loss of movement, deformity, swelling or a "pop" feeling. all dislocations require treatment by a medical practitioner to ensure the bones are replaced in the correct alignment without causing further damage to the joint
• subluxation- acute hard tissue injury


  an incomplete or partial dislocation. often causes damage to the ligaments that causes damage to the ligaments that connect bone to bone. when overstretched, ligaments can permanently lengthen, which decreases the joint stability and increases the likelihood of recurrent dislocation. this mat result in surgeries and compromise a long-term playing career
• contusion and haematoma- acute soft tissue injuries

  contusion (bruise)- an area of skin or tissue where blood vessels are ruptured. most are minor (heal rapidly without break in play or training). severe cause deep tissue damage, preventing participation for months. caused by a fall or direct impact from player or object

  damaged tissue leads to haematoma: localised congealed bleeding from ruptured blood vessels, totally or relatively confined to a tissue (e.g., a muscle). range from small bruises to deep bleeds seeping into surrounding tissue. signs include swelling and discolouration
• rupture

  a complete tear of a muscle, tendon or ligament
• sprain- acute soft tissue injury

  overstretch or tear to the ligaments which connect bone to bone and support a joint. usually caused by a sudden twist, impact or fall forcing the joint past its extreme ROM. commonly occur in ankles of games players and athletes

  signs and symptoms include pain, swelling, bruising, inability to bear weight and possible dislocation. severity can range from overstretch of a few ligaments to a partial tear to a total rupture or detachment of a ligament from the bone
• strain- acute soft tissue injury

  overstretch or tear to muscle fibres or tendons connecting muscle to bone. usually caused by overstretching or contracting muscle fibres too quickly, causing overstretch and partial or complete rupture of muscle fibres or tendons. occur in sports with explosive movements e.g., returning from a lunging position in badminton.

  signs and symptoms: pain on movement, swelling, discolouration or bruising. severity ranges from minor damage to fibres to more extensive damage but not completely ruptured to completely ruptured and requires surgery and rehabilitation
• abrasion- acute soft tissue injury

  superficial damage to the skin caused by a scraping action against a playing surface, such as falling on the tracks, or clothes rubbing on the body, such as chafing. if the abrasion causes an open wound, it may contain dirt and require cleaning. if laceration (cut) is caused, medical attention may be required for suturing (stiches)

  most sports have rules requiring the player to leave the game until bleeding stops, regardless of size of injury
• blisters- acute soft tissue injury

  the separation of layers of skin where a pocket of fluid occurs due to friction. although painful, they many not stop participation with treatment and they are preventable with the correct equipment, footwear and training load
• concussion- acute injury

  traumatic brain injury resulting in disturbance of brain function, such as headaches, dizziness, balance problems and even loss of consciousness. can be caused by direct blows to the head or other parts to the body, causing rapid head movement and so is common in rugby, boxing, football ect

  the brain floats in cerebrospinal fluid in the skull. on impact, the head accelerates the brain against the rough inner skull wall, then rebounds it to the other side, causing swelling and disruption to neurones
• symptoms and signs of concussion

  clear indication

  • post-traumatic seizure
  • loss of consciousness
  • balance problems
  • disorientation and confusion
  • dazed or blank expression

  may indicate

  • lying motionless, slow to get up, grabbing or clutching head, headache, dizziness, visual problems, nausea or vomiting, fatigue, light sensitivity
• osteoarthritis

  degeneration of articular cartilage from the bone surfaces within a joint, causing pain and restricted movement
• stress fracture- chronic hard tissue injury

  tiny crack in the surface of the bone, usually caused by fatigued muscles transferring stress overload to bone tissue. overuse injury, sometimes referred to as fatigue or insufficiency fracture. specific spots of pain during physical activity may be an indication, but pain subsides with rest and is hard to spot on an X-ray

  common where the repetitive stress of the foot on the ground without enough rest periods can cause trauma. overtraining, intensity overload, unfamiliar surfaces and inappropriate equipment all contribute
• bone spurs

  outgrowths of bone into a joint, causing pain and restricted movement
• shin splints- chronic soft tissue injury

  chronic shin pain, due to repeated overuse of tibialis anterior (anterior shin splints) and tibialis posterior (posterior shin splints) can become injured through excessive loading stress, resulting in tenderness and inflammation. tendons connecting muscle to the shin bone attach on the outer casing of the bone known as periosteum. in most cases of shin splints, connection between the tendon and periosteum becomes inflamed, leading to pain in certain areas. there are related conditions affecting muscles such as medial tibial stress syndrome (MTSS)
• MTSS has been frequently reported by distance runners, dancer, football players and gymnasts. largely caused by overuse and overtraining on hard or uneven surfaces. runners often suffer shin splints at the beginning of training by overloading too soon, or quickly changing running routines. being overweight, wearing inadequate footwear and poor leg biomechanics can also lead t shin splints
• tendinosis- chronic soft tissue injury

  deterioration of a tendon's collagen in response to chronic overuse. repetitive strain causes small-scale injuries that are not given enough time to heal and so accumulate, resulting in a chronic injury. signs and symptoms include burning, stinging, aching, tenderness and stiffness common in the wrists, elbows, forearms, shoulders, knees or heels e.g., achilleas tendon and tennis elbow
• Achilles tendon

  pain, tightness and deterioration in the tendon behind the ankle common in distance runners; a slow progression of pain which will lead to difficulty climbing stairs or running
• tennis elbow

  (lateral epicondylitis) strenuous overuse of the tendons in the forearm during repeated twisting actions can lead to microscopic tears, tightness and pain that limit movement, common in athletes who overstrain in racket sports or throwing activities
• injury risk factors

  intrinsic risk factors:

  • individual variables e.g., previous injury
  • training effects e.g., poor preparation

  extrinsic risk factors:

  • poor technique and training
  • incorrect equipment and clothing
  • inappropriate intensity, duration and frequency of training
• intrinsic risk factors- individual variables

  • previous injury
  • posture and alignment issues
  • age increases injury risk as bone tissues lose strength as connective tissues suffer overuse, wear and tear, becoming more prone to injury
  • nutrition for injury prevention and recovery
• intrinsic risk factors- training effects

  • poor preparation will increase the risk of injury
  • inadequate fitness levels can lead to injury if the intensity, duration or frequency or ability of the opponents is too high
  • inappropriate flexibility level can lead to poor joint stability as there is a limited range of motion
• extrinsic risk factors- poor technique and training

  overuse injuries are largely caused by performing repetitive actions with poor technique. excessive stress will be placed on muscles, tendons and ligaments which will deteriorate over time
• extrinsic risk factors- incorrect clothing and equipment

  • can wear protective equipment to minimise risk of injury to certain parts of the body. should be age and size appropriate and follow sports regulations and be checked for damage regularly
  • wear sports specific clothing which maximises performance while minimising risk of injury
  • use correct equipment and footwear specific to sports needs
• extrinsic risk factors- inappropriate intensity, duration or frequency of activity

  the principles of training must be followed to ensure risk of injury is minimised

  • if intensity is too high, acute injuries may occur as the forces placed on the connective tissues and joints may be excessive
  • if frequency or duration is too great, acute inflammatory injuries may occur such as tendonitis, or chronic overuse injuries such as stress fractures may develop
  • if training methods aren't varied, repetitive strain and overuse injuries may develop
• warm up

  raise body temperature and prepare athlete physiologically and psychologically for activity, to reduce risk of injury and maximise performance

  • 20-45 mins
  • gradually increase in intensity

  1. HR raising activity to increase temperature, blood flow, HR, breathing frequency and O2 delivery to muscles
  2. stretching and mobility exercises to lubricate and mobilise joints increasing elasticity in connective tissues
  3. sport specific drill to activate neural pathways and rehearse movement patterns
• static stretching in warm ups

  research suggests:

  • has no effect on injury prevention
  • may reduce the peak force produced in the achilles tendon by 8%
  • deteriorates antagonistic coordination, hindering explosive movements
  • reduces eccentric strength, decreasing the ability to change direction at speed
  • reduces muscles ability to consume O2 by 50%

  and so dynamic stretching is more effective in a warm up
• cool down

  active recovery is performed to maintain heart rate, blood flow and metabolic activity to flush the muscle tissue with oxygenated blood, removing waste products starting the healing process:

  • 20-30 minutes
  • gradually decreases in intensity
  • moderate intensity activity to maintain HR, venous return mechanisms and blood flow to remove waste products from the muscle tissue
  • stretching exercises to reduce muscle tension, increase muscle relaxation and gradually lower the muscle temperature
• SALTAPS

  protocol for the assessment of a sporting injury: stop, ask, look, touch, active movement, passive movement and strength testing
• SALTAPS- stop

  stop the game if a player is injured and observe the injury
• SALTAPS- ask

  ask questions about the injury such as where does it hurt, what type of pain is it, which way did you fall
• SALTAPS- look

  search for specific signs such as bruising, swelling, broken skin, bleeding or foreign objects
• SALTAPS- touch

  gently palpate the injured area to identify painful regions and inflammation
• SALTAPS- active movement

  ask the player whether they can move the injured area without your assistance
• SALTAPS- passive movement

  if there is active movement, gently move the injured area through its full range of motion