SPORTS MEDICINE How are sports injuries classified and managed?

Ways to classify sports injuries Direct and Indirect Direct injuries are caused by direct forces generated from outside the body, result in fractures, dislocations, sprains and bruises. E.g. a dislocated shoulder caused by a tackle in rugby league. Indirect Injuries are caused by an intrinsic force (a force within the body). They are caused by indirect warm up, ballistic movements, excessive movement or a mistake in execution of a skill. Result from excessive strain placed on muscles, tendons and ligaments. May cause damage to body structures. E.g. a sprinter tearing a hamstring during a race. Soft and Hard Tissue Soft tissue injuries include damage to muscle, tendons, ligaments, cartilage, blood vessels, skin, organs and nerves. Either acute or chronic. Acute injuries occur suddenly examples include sprains, strains, dislocations, abrasions, etc. Chronic injuries which are prolonged include the same types of injuries but their severity means long rehabilitation is necessary. Hard tissue injuries cause damage to bones and teeth. Often more serious than soft tissue injuries. Examples include dislodged teeth and broken bones. Fractures are most common. Overuse Overuse injuries are caused by overuse of specific body regions over long periods of time. E.g. shin splints, tendonitis. Contribute to stress fractures.

Soft tissue injuries Tears, sprains, contusions A tear occurs when a tissue is excessively stretched or severed. Two types of tear *sprains * strains. A sprain arises from the stretching or tearing or a ligament (connect bone to bone). 3 degrees of sprain. 1st degree = little damage, 2nd degree = moderate damage, 3rd degree = extensive damage. Strains occur when a muscle or tendon is stretched or torn, same levels as sprain (1st, 2nd, 3rd degrees). Contusions are caused by a sudden blow to the body e.g. a bruise. May be close to the skin or penetrate deeply causing bone to bruise. Skin abrasions, lacerations, blisters All are forms of skin trauma. Skin abrasions occur when the player may fall on a dry hard surface. The injury causes pain and shallow bleeding because of the skin being scraped. Treatment requires gentle cleansing and sterilisation top prevent infection. Lacerations are wounds where the flesh has incurred an irregular tear. Care must be taken to prevent infection, must refer to doctor if longer than 1cm. Blisters are caused by a collection of fluid below or within the epidermal layer of the skin, incur intense pain. Caused by new equipment being worn or used, using equipment for a long time and movement with sudden movement causes friction in sport shoe. Inflammatory response when soft tissue is injured it becomes inflamed but responds by activating a self-healing response. This is the inflammatory response, may last up to 3 or 4 days after injury. The injury progresses through phases. Phase 1 Inflammatory stage Pain, redness and swelling of area, loss of mobility, damage to cells, increased blood flow to area, formation of blood vessels to promote healing.

Phase 2 Repair and regenerative stage Elimination of debris, formation of new fibres, production of scar tissue Phase 3 Remodelling stage Increased production of scar tissue and replacement tissue Hard tissue injuries Fractures Either simple or compound. Simple (closed) fractures are when the bone breaks but remains under the skin. Compound (open) fractures are when the bone breaks and protrudes through the skin. Types include greenstick (like a crack), comminuted (broken into parts), depressed (dent of the skull) and oblique (one break). Dislocation Is the displacement of a bone at a joint. Cause deformity, technically a soft tissue injury as the bone although displaced is not damaged. Bone has to be physically reinserted into joint. Symptoms include deformity, swelling, pain, loss of function.