Injuries & the Healing Process

Injuries & the Healing Process

Chapter 3

Understand: Inflammation process in healing Treatment rationale of ice vs. heat

Identify: Principles of physical rehabilitation and

range of motion More common musculoskeletal disorders Athlete’s vital signs Distinguish between acute and chronic

injury management

Objectives

Injury (strain, sprain, contusion, open wound): the body immediately begins the process of healing.

Healing: the process where the body

repairs damage tissue.

Inflammation: one component of the healing process, where the body begins to repair itself.

The Inflammation Process

Acute Injury: muscle strain or ligament sprain, tissue is torn, capillaries are damaged, and cells die, interference in blood and oxygen supply.

Bodies Reaction: sending specialized cells to the injured site attempting to limit damage and begin healing (blood clotting, contracting muscles, which splints the area to restrict further movement, and reduce blood flow.)

Bodies Reaction: pain, swelling, redness, heat, and loss of function. Hey guys

The Inflammation Process

Pain: pressure on nerve endings from internal hemorrhage and cellular response to lack of oxygen.

Swelling: (edema) accumulation of fluids in the damage area.◦ Hemorrhage, lymph fluid, and synovial fluid contributes to

swelling and pressure. ◦ Gravity also increases swelling.

Redness: increased blood supply (the body provides the site with nutrients for repair).

Acute Injury & Healing Process

Three Phases of the Healing Process:1. Inflammation- redness and swelling (2-4

days)2. Initial repair- (tissue repair) scare tissue

is the first tissue the body generates. (2-4 weeks)

3. Regeneration-replace all damaged tissue with new and healthy tissue. (1 year)

Healing Process

Vital Signs: measures that monitor life (heart rate, breathing, pulse)

Pulse: Adult 60-80 beats/minute; child 80-100 beats/minute

Rapid, but weak pulse-shock, bleeding, diabetic coma, and/or heat exhaustion.

Rapid, but strong pulse-heat stroke and/or severe fright. Strong, but slow pulse-skull fracture and/or stroke.

No pulse -cardiac arrest and/or death.

Take pulse neck (carotid artery) and wrist (radial artery)

Vital Signs

Respiration-adult 12-20 breaths/minute, child 20-25 breaths/minute Shallow breathing-shock Irregular/gasping-cardiac related Frothy blood from the mouth-chest fracture

(rib fracture) in upper lateral portion of chest (arm pit).

Watch, feel, and count (rise and fall of chest)

Vital Signs

Temperature-oral 98.6 degrees Hot, dry skin-disease, infection, and/or over-

exposure to environmental heat. Cool, clammy skin-trauma, shock, and/or

heat exhaustion. Cool and/or dry skin-over-exposure to cold.

Vital Signs

Skin Color Red Skin-heat stroke, diabetic coma, and/or

high blood pressure. White(pale)-insufficient circulation, shock,

fright, hemorrhage, heat exhaustion, and/or insulin shock.

Blue-blood is poorly oxygenated. Non-white athlete-examine inner lip, gum,

fingernail beds. (they still exhibit a paling of skin)

Vital signs

Pupils: Constricted (sunlight)-during traumatic situation:

central nervous system and/or intake of depressant drug.

Dilated (dark room) or unequal-during traumatic situation: head injury, shock, heat stroke, hemorrhage, and/or intake of stimulant drug.

Pupils fail-brain injury, intake of alcohol, or drug poisoning.

PEARL-Pupils Equal And Reactive to Light(examination of the eyes)

Vital Signs

State of Consciousness:Level of Consciousness (LOC)1. Mental awareness2. Memory and ability to recall3. Response to commands, directions, events,

etc.

AVPU-alert, verbal, responds to pain, and

unresponsive.

Vital Signs

Movement (Four Patterns):1. Active (athlete provides movement)2. Passive (trainer moves body part)3. Assistive (trainer assists the athlete with

movement)4. Resistive (trainer provides resistance to

oppose the movement of the body part)

Vital Signs

Abnormal Nerve Stimulation:1. Motor (movement)-athlete contracts

affected muscle2. Sensory (feeling)-athlete touch (i.e. sharp

vs. soft)Blood Pressure Adult: 120(systolic)/80(diastolic) Heart contracts(blood out), systolic pressure

can be determined, as heart relaxes(blood in), diastolic pressure is determined.

Vital Signs

ICE vs. HEAT Ice-first 48-72 hours-Reevaluate and if swelling,

pain, redness still present continue with ice. Reduces: swelling, blood flow, pain

1. Ice packs-15 minutes-no directly to skin2. Ice message-5-10 minutes-move ice

continuously3. Whirlpool-15 minutes-perform rehab

movements-downfall, not elevated.4. Cold spray-no longer then 10 seconds-damage

to skin, only cools surface.

Treatment

Heat- increased blood flow, reduced muscle stiffness, muscular relaxation. Hot packs-towels to protect skin. Hot whirlpool-follow-up treatment, rehab

movements.Contrast bath-follow-up treatment (hot/cold water immersion) heat pack and ice packs

Treatment

EXERCISE- movement of the body (muscles) increases circulation at a deeper level. Strength Regain lost range of motion

Therapeutic Modalities: decrease pain, swelling, muscle spasm (utilized with exercise) Electrical -currents Heat-short wave and microwave Light-ultraviolet Cold Air Water Message Laser

Treatment

Acute vs. chronic:1. Acute-quick onset, short duration (PRICES)2. Chronic-Long duration, repeating.

Continued PRICES, but is coupled with exercise, therapeutic modalities, heat, and contrast treatments.

Injury Management

GOAL- return injured athlete to pre-injury level of strength, power, endurance, flexibility, and confidence as quickly and safely as possible. Arranged by Athletic Trainer upon

physicians protocol. Pain-should be avoided Athlete follows the program.

Physical Rehabilitation

Five Phases designing a Program:1. Post-surgical/acute injury2. Early exercise3. Intermediate exercise4. Advanced exercise5. Initial sports re-entry

Various rates of recovery should be expected.

Physical Rehabilitation

Athlete needs to return:1. Joint range of motion (ROM)-normal movement

of a joint2. Muscle Flexibility3. Muscular Strength4. Muscular Power5. Endurance6. Balance7. Proprioception8. Kinesthetic awareness9. Cardiovascular Fitness (total body conditioning)

Physical Rehabilitation

Arthritis: inflammation of a joint Atrophy: decreasing in size of organ or tissue due to

degeneration of cells Bursitis: inflammation of bursa sac Contracture: fibrosis of muscle tissue producing

shortening of the muscle (doesn’t generate strength) Contusion: a bruise, skin is not broken, direct blow Dislocation: displacement of one or more bones or

a joint or organ from original position Epicondylitis: (pitchers elbow, tennis elbow)

inflammation of the epicondyle and the tissues adjoining them to the humerus

General Musculoskeletal Disorders

Fasciitis: inflammation of a fascia Myositis: inflammation of muscle tissue Myositis Ossificans: inflammation of muscle,

with formation of bone Sprain:

◦ stretching or tearing of joint structure (ligaments and joint capsules)

◦ Strains stretching or tearing of muscle and tendons Subluxation: partial or incomplete dislocation Tendinitis: Inflammation of the tendon

Disorders Continued