THE INJURY PROCESS

1
THE INJURY PROCESS
2
The Physics of Sports Injury

• Connective Tissues
• Ligaments Retinaculums
• Joint Capsules Bone
• Cartilage Fascia
• Tendons
• Others
• Epithelial Muscular
• Nervous

3
RELATED INJURIES IN THE ADOLESCENT

• Epiphysis cartilage near the end of bones in
  adolescents that are commonly referred to as the
  growth plate.
• Ligaments, capsules, and tendons are often
  stronger than the epiphysis. What might be a
  strain or sprain in an adult could be a growth
  plate injury in a child.
• Apophysis cartilage near the ends of bones were
  tendons attach commonly referred to as traction
  plates.

4
The Mechanical Forces of Injury

• Compressive
• Tensile
• Shear
• Critical Forces (limits)
• Ligaments Tendons resist tensile, less
  effective w/shear and compression
• Bone resists compression, less effective
  w/tensile and shear.

TISSUE
TISSUE
TISSUE
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The Inflammatory Process

• Physiologic response to trauma
• Swelling, pain, reddening of the area
• Phases
• Acute (3-4 days)
• Secondary Hypoxic Injury
• Resolution (healing) Phase
• Regeneration Repair
• Scar Tissue (30 - 95)

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Injury Process
Primary Injury
Primary Injury
Vasoconstriction
Vasoconstriction
ICE
SWELLING (Vasodilation)
Decreased SWELLING (Vasodilation)
cell
Hypoxia Secondary Injury
cell
Decreased Hypoxia and Secondary Injury
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Pain and Acute Injury

• Pain occurs when homeostasis is altered that
  triggers pain resulting in sensory nerve
  receptors transmit impulses to the CNS.
• When pain is the result of ext. forces, impulses
  travel relatively slow (Nocioceptive C Fibers).
• Slower because they are smaller and less
  mylinated.
• Gait control theory of pain (get hit on the head
  and your first move is to rub it).

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Intervention Procedures

• Why do we do what we do?
• Cryotherapy
• Method
• Frequency
• Physiologic Response to Cold
• Thermotherapy
• Method
• Frequency
• Physiologic Response to Heat

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Pharmacologic Agents

• Steroidal Anti-inflammatory Drugs
• Action not fully understood
• Cortisone, hydrocortisone, prednisone,
  dexamethosone
• Can negatively affect collagen formation
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
• Does not usually affect collagen formation
• Acetylsalicylic acid, ibuprofen, naproxen,
  naproxen sodium, indomethacin.
• Aspirin antiyretic, contraindicated for
  adeloscents.

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The Role of Exercise Rehabilitation

• Exercise is essential for increasing blood flow
  as well as guiding collagen tissue.
• Davies and Wolfes Law tissues heal according
  to the stresses applied to it
• Phases PROM, AROM, AAROM, RROM
• Progression Bilateral Support. Unilateral
  Support, Bilateral Non-support, Unilateral
  Non-support, Sport Specific.
• Closed vs. Open skills
• Closed vs. Open Kinetic Chain Exercises