Unit 1 – The Human Body in Motion...2019/02/04  · Reduce the pain and the risk of further injury by supporting and immobilisingthe injured area. ... joint pain stiffness swelling

Unit 1 – The Human Body in Motion

AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT?

Acute and Chronic Injuries of the Musculoskeletal System

AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT?

Musculoskeletal Sports Injuries

Sports injuries are trauma or overuse injuries that occur due to participation in sport or exercise.

They can be the result of:- an accident

poor fitness and training

poor technique

improper equipment or facilities

inadequate warm up

overuse

The immediate and long term cost of sports related injuries include:- health care costs for treatment time lost to employment, school and

home activities time lost to future sporting activities physical, psychological or emotional

damage equipment and program costs for

rehabilitation and prevention

According to the Australian Injury Hospitalisations 2011-12 report the sports that account for the largest number of cases are:- 1. Australian Rules Football 2. Soccer 3. Cycling 4. Wheeled motor sports 5. Water sports 6. Rugby 7. Roller sports 8. Equestrian activities 9. Basketball 10. Netball

Musculoskeletal Sports Injuries

Nature of Musculoskeletal Injuries

0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000

Fracture

Soft Tissue Injury

Dislocation

Open Wound

Intracranial

Internal Organ

Nature of Musculoskeletal Injuries

Incidence in ‘000 Australian Sports Injuries Hospitalisations 2011-12 -Australian Institute of Health and Welfare 2014

0 2,000 4,000 6,000 8,000 10,000 12,000

Knee and Lower LegHead

Wrist and HandElbow and Forearm

Shoulder and Upper ArmTrunk

Ankle and FootNeck

Hip and Thigh

Location of Musculoskeletal Injuries

Location of Musculoskeletal Injuries

Incidence in ‘000 Australian Sports Injuries Hospitalisations 2011-12- Australian Institute of Health and Welfare 2014

0 2,000 4,000 6,000 8,000 10,000 12,000

Fall

Unspecified

Contact wirh Another Person

Overexertion

Contact with Sports Equipment

Cause of Musculoskeletal Injuries

Cause of Musculoskeletal Injuries

Incidence in ‘000 Australian Sports Injuries Hospitalisations 2011-12 -Australian Institute of Health and Welfare 2014

Types of Sports Injuries - Acute

Acute injuries occur suddenly during physical activity. e.g. torn hamstring / rolled ankle / corked

thigh. Signs of acute injury include:-

severe pain and tenderness swelling possible disfiguration restricted movement inability to bear weight obvious bleeding or bruising

Types of Sports Injuries - Direct

Direct injuries are caused by external force such as:- players playing surface sticks balls

Direct injuries can include:- dislocations concussions bruises fractures cuts

Types of Sports Injuries - Indirect

Indirect injuries are caused by un-natural muscle actions and extreme forces on joints. For example:- overstretching sudden change in intensity sudden change in direction

Indirect injuries can include:- muscle tendon strains ligament sprains

Types of Sports Injuries - Overuse

Overuse injuries are caused by repetitive or unaccustomed use of muscle, tendon or bone. For example:- too much repetition sudden increase in training loads insufficient recovery times poor footwear / hard surfaces

Overuse injuries can result in:- tendonitis stress fractures

Acute Injuries - Strains

Strains – overstretching or tearing a muscle or tendon.

Caused by:- sudden contraction sudden overstretch muscle imbalance poor warm up poor flexibility poor technique

Acute Injuries - Sprains

Sprains – joint injury where a ligament is overstretched or torn.

Caused by:- twist fall unbalanced landing direct blow

Acute Injuries - Bruise

Bruise or “Cork” – a haematomathat is the result of direct contact.

Caused by collision with:- opponent stick ball playing surface

Treatment of Soft Tissue Injuries

Acute injuries are graded according to severity and include:- Grade I – some fibres are torn and the

site is moderately painful and swollen, but function and strength are mostly unaffected.

Grade II – many fibres are torn and the site is painful and swollen, with some loss of function and strength.

Grade III – the soft tissue is totally torn, with considerable loss of function and strength. Grade III injuries often need surgical repair.

Immediate treatment of acute sprains and strains:-

RICER protocol – rest, ice, compression, elevation and referral. RICE protocol should be followed for 48–72 hours.

The aim is to reduce the bleeding and damage within the joint.

The No HARM protocol should also be applied – no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.

Acute Injuries - Fracture

Fracture – a cracked or broken bone. Caused by excessive external or

internal force : twist fall direct blow sudden contraction

Acute Injuries - Dislocation

Dislocation – when a joint is forced beyond its limits and the bones are separated.

Usually involves accompanying ligament damage.

Caused by excessive force : twist fall direct blow

Treatment of Fractures and Dislocations

A fracture is termed:- closed where there is no break of the

skin open where the bone end has broken

the skin or a wound is present with the fracture.

The fractured or dislocated part should not be moved and first aid should be confined to providing soft padding and support in the position chosen by the patient.

Treatment of fractures and dislocations:- 1. Control any bleeding

Apply pressure

Apply padding around wound

2. Immobilise the injured part Reduce the pain and the risk of further injury by

supporting and immobilising the injured area.

Apply RICER protocol

3. Make the patient comfortable Help the patient into the position of greatest

comfort without any unnecessary movement.

4. Seek medical assistance

Chronic Injuries

Chronic Injuries occur slowly due to a period of prolonged overuse.

Examples of chronic injuries are:- tendonitis osteitis pubis shin splints stress fractures

Signs of chronic injuries include:- pain when exercising Inflammation dull ache at rest

Chronic Injuries - Tendonitis

Tendonitis – is inflammation of a tendon. Tendonitis can be caused by:-

repetitive joint actions insufficient recovery times poor technique inadequate strength inadequate flexibility poor equipment / facilities

Achilles tendonitis

Chronic Injuries – Osteitis Pubis

Osteitis Pubis – inflammation of the pubic symphisis due to excessive muscle pull on the pubic bone.

Osteitis pubis can be caused by:- excessive groin strain excessive training loads poor running technique poor footwear inadequate flexibility muscle imbalance (hip adductors &

abdominals)Osteitis pubis

Chronic Injuries – Shin Splints

Shin Splints – inflammation and pain along the shin area.

Shin splints can be caused by:- large running loads insufficient recovery times poor running technique poor footwear running on hard surfaces flat feet muscle imbalance (anterior & posterior

muscles of the leg)

Shin Splints

Chronic Injuries – Stress Fractures

Stress Fractures – occurs when a bone is subjected to repeated or heavy training loads causing tiny cracks or fractures.

More than 50% of stress fractures are in the lower leg.

Stress fractures can be caused by:- hard surfaces poor equipment (runners) sudden increase in training poor nutrition

Shins

Feet

Chronic Injuries – Plantar Fasciitis

Plantar Fasciitis – is inflammation of the plantar fascia - a thick, fibrous ligament that runs under the foot from the heel bone to the toes.

The plantar fascia is very limited in its capacity to stretch and when too much traction is placed on it micro-tearing will occur, resulting in irritation, inflammation and pain.

The main causes of plantar fasciitis include:- overuse unsupportive footwear over pronation Heel pain is a common

symptom of Plantar Fasciitis.

Chronic Injuries – Compartment Syndrome

Compartment Syndrome – is a condition in which pressure increases within a muscle "compartment" of the lower leg, cutting off blood supply to the area and causing swelling and pain.

The condition is aggravated through running as there is no room for expansion to accommodate the increased blood supply to the lower leg and the resultant lack of oxygen produces pain and forces the runner to stop.

In runners, compartment syndrome is due to overuse and the result of repetitive stress.

The lower leg is divided into compartments surrounded by tight

fibrous fascia.

Chronic Back Pain

Chronic Back Pain – damage or irritation to the complex network of spinal muscles, nerves, bones, discs or tendons can result in acute pain or referred pain.

Causes of chronic back pain include:- repetitive impact (e.g. running) a twisting motion (e.g. golf) a weight loading at the end of a range-of-motion

(e.g. weightlifting)

Up to 20% of all injuries that occur in sports

involve an injury to the lower back.

Treatments for over use injuries include:- cutting back the intensity, duration, and

frequency of an activity

adopting a hard/easy workout schedule and cross-training with other activities to maintain fitness levels

learning about proper training and technique from a coach or athletic trainer

performing proper warm-up activities before and after

using ice after an activity for minor aches and pain

using anti-inflammatory medications as necessary

If symptoms persist, a sports medicine specialist should be consulted.

A sports medicine specialist will:-

conduct a review of the training program and loads.

evaluate any predisposing factors. suggest a structured treatment plan that

could include:- physiotherapy and joint manipulation

anti-inflammatory injections

accupuncture

trigger-point massage

rest

Chronic Injuries – Treatment

Arthritis - Types

Rheumatoid Arthritis - occurs when the body’s immune system attacks the synovium ( a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints ) leading to destruction of bone and cartilage.

Osteo Arthritis - caused by a reduction in the normal amount of cartilage tissue as a result of wear and tear, injury or infection.

Arthritis – Symptoms and Treatment

Symptoms of arthritis include:- joint pain stiffness swelling reduced range of motion severe rheumatoid arthritis can cause joint

deformity

Treatment options include:- medication analgesics - effective for pain management nonsteroidal anti-inflammatory drugs help

control pain and inflammation joint replacement joint fusion physical therapy involving exercises that

help strengthen the muscles around the affected joint is a core component of arthritis treatment.

Osteoporosis

Osteoporosis – is a progressive bone disease that reduces bone density, weakening bone structure and increasing the incidence of bone damage.

Causes of osteoporosis include:- ageing lack of calcium in diet physical inactivity hormone imbalance long-term use of corticosteroid medications

Osteoporosis - Prevention

Steps both men and women can take from a young age to prevent osteoporosis include : an adequate intake of calcium in the diet appropriate levels of vitamin D absorption and

intake participation in weight bearing exercise – can

increase bone mineral density Treatment options include:-

undertaking activities that promote muscle strength, balance and coordination to reduce fall risk

medications to improve calcium absorption, balance hormone levels or slow down bone degeneration

Physiological Strategies to Prevent Injuries of the Musculoskeletal System

AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT

Physiological Strategies to Prevent Injuries –Physical Preparation

To be physically prepared for competition an athlete’s physical fitness needs to be at a level that can manage the demands of the competition.

Physical fitness helps reduce injuries in sport and is specific to the sport.

A reduction in the incidence of musculoskeletal injuries can achieved through incorporating the following training methods:- Core stability training

promotes the use of proper form and mechanics

promotes proper coordination of the key muscles used to support the spinal column.

Resistance training reduces the risk for musculoskeletal injuries

reduces the severity of such injury

Physiological adaptations achieved as a result of resistance training on the following enhances protection against injury:- effect on bone - resistance training is beneficial for

increasing bone strength and has a positive influence on bone mineral content.

effect on muscle – maintains or improves functional capacity of muscles and reduces the risks related to muscle imbalance.

effect on connective tissue - increases in muscle mass result in increases in the size and strength of the connective tissue resulting in greater body stability.

Physiological Strategies to Prevent Injuries –Physical Preparation

Flexibility training improved flexibility decreases the risk of activity based

injuries through:- helping joints move through their full range of motion

allowing muscles to work most effectively

reducing muscle imbalances

Physiological Strategies to Prevent Injuries –Physical Preparation

Physiological Strategies to Prevent Injuries -Warm Up – Cool Down

Warm ups reduce injury risk through:- increased circulation raised body temperature increased range of motion simulating of sporting movements providing psychological readiness

Cool downs will aid recovery by:- removing waste products replenishing fuels preventing blood pooling limiting stiffness

Physiological Strategies to Prevent Injuries -Hydration

Small amounts of dehydration will reduce sporting performance and increase injury risks.

Heat and hydration policies should be implemented by all sporting organisations.

Athletes need to : be adequately hydrated prior drink during participation rehydrate after performance

Physical Aids to Prevent Injuries of the Musculoskeletal System

AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT

Physical Aids to Prevent Injury –Protective Equipment

Protective equipment must be worn when mandated or deemed appropriate.

Protective equipment must:- fit correctly be worn properly be checked regularly and maintained be replaced when necessary

Examples of protective equipment include:- helmets mouthguards pads / protectors

Physical Aids to Prevent Injury –Taping and Braces

The taping of joints or the wearing of sports braces will provide:- extra support added stability minimise the effects of an injury

Physical Aids to Prevent Injury –Footwear and Clothing

Footwear needs to:- fit correctly provide adequate support provide adequate cushioning provide adequate grip

Clothing needs to:- fit properly protect from the environment (heat/sun/cold/wind)

Preventative Measures –Physical Environment

To ensure the physical environment is safe the following should be considered:- provision of padding and mats establish safety of environment prior to training or

competition report and remove hazards check weather conditions complete grounds report

Revision Questions

Explain how the following PHYSIOLOGICAL STRATEGIES can help reduce the risks of sporting injuries :

Warm up –Prepare the athlete physically and mentally and by introducing movement patterns, intensities and sporting actions prior to training or competition the body is better prepared for the upcoming loads. An increase in muscle temp. also allows effective muscle elasticity, joint motion and muscle contractions to occur with less risk of injury. Cool down –Reduce DOMS, dissipate wastes, restore the body to rest, allow improved recovery so that the athlete is in good shape for ongoing training loads. An active cool down also promotes improved flexibility.

Why is it important to allow adequate recovery times when trying to minimise the chance of an overuse injury ?

Adequate recovery times limit the risk of injury by permitting the body to recover from exercise intensities and loads and by allowing the body to adapt physiologically without the presence of

ongoing stress or load. During recovery the body strengthens bone, ligaments and muscle. If training sessions are too close together the physiological adaptations cannot occur properly and the new exercise loads will increase the risk of overuse injuries. What is osteoporosis ?

Loss of bone density and therefore bone strength. How can osteoporosis be prevented ?

Regular weight bearing activity, resistance training, calcium intake, vitamin D, no smoking.