Tissue Injuries in Sports

Cell Tissue

• Cell: smallest structural unit of living matter capable of functioning independently

• Tissue: A collection of cells in an organism that have similar structure and function

• Cell->Tissue->Organ->Organ System ->Organism

Layers of Skin

The Two Main Layers of Skin

• The upper barrier layer (epidermis)– The epidermal layers provide the barrier layer, which resists

bacterial entry and prevents fluid and electrolyte loss.

• The lower, much thicker, dermis. • The dermis is well vascularized (veins, arteries, and

capillaries) and also contains receptors for touch, temperature and pain.

Sports and soft tissue injuries:

• About 95 percent of sports injuries are due to minor trauma involving soft tissue injuries -- bruises, muscle pulls, sprains, strains, and cuts or abrasions.

Soft Tissue Injuries

Puncture Wound

How are puncture wounds different?

• There are two risks with puncture wounds.

• First, a wound infection can occur because of dirt pushed deep into the skin by the object (typically a nail) puncturing the tissue.

Puncture Wounds

• The second problem that can occur is an infection of the bone.

• If a nail penetrates deep into the foot, it can hit a bone and introduce bacteria into the bone.

Puncture Wound

• This risk is especially great if the nail has gone through a pair of tennis shoes.

• The foam in tennis shoes can harbor a bacteria (Pseudomonas) that can lead to serious infection in the tissues.

Puncture Wound

Laceration Vs. Puncture Wound

Laceration

• Laceration: A cut.

Incision

• A surgical cut.

Abrasion

• is a wearing away of the upper layer of skin as a result of applied friction force.

• In dentistry an "abrasion" is the wearing away of the tooth substance.

Abrasion

• An open wound, road burn, or rug burn in which the outer layer of skin has been scraped off.

Corneal Abrasion

Blister

• A bubble like collection of fluid beneath or within the epidermis of the skin.

Callus

• 1. A localized firm thickening of the upper layer of skin as a result of repetitive friction.

• 2. The hard new bone substance that forms in an area of bone fracture. Bony callus is part of the bone repair process.

Callus

Callus of the Bone

Sprains

• About one-third of all sports injuries are classified as sprains, a partial or complete a partial or complete tear of a tear of a ligamentligament – –

• Ligament- a tough band of fibrous connective tissue that connects the ends of bones and stabilizes the joint.

Tendon vs. Ligament

Signs and Symptoms of a Sprain

• a feeling that a joint is "loose" or unstable

• inability to bear weight because of pain

• loss of motion

• the sound or feeling of a "pop" or "snap" when the injury occurred

• swelling (edema)

• Sometimes ecchymosis will appear several days later.

Sprain

Sprain

Strains

• A strain is a partial or complete tear of a muscle or tendon.

• Muscle tissue is made up of cells that contract and make the body move.

• A tendon consists of tough connective tissue that attaches muscles to bones

Strain

Contusions -

• The most common sports injury is a contusion, or bruise –

• a result of a blunt injury causes underlying bleeding in a muscle or other soft tissues.

Contusion

Using a donut pad

Hematoma

• Chicago defenseman Sami Lepisto

Chicago defenseman Sami Lepisto: blocked slapshot.

Treatment

• Treatment for soft tissue injuries usually consists of R.I.C.E.

• Rest, Ice, Compression (wrapping with elastic bandages), and Elevation of the injured arm, hand, leg or foot.

• P.R.I.C.E.S. –Protection….Support

Sports and Skeletal injuries:

• A sudden, violent collision with another player, an accident with sports equipment, or a severe fall can cause skeletal injuries in the athlete, including fractures.

• Fractures constitute a low 5 to 6 percent of all sports injuries. Most of these breaks occur in the arms and legs. Rarely are the spine and skull fractured.

Dislocation

Dislocation

• A dislocation is a separation of two bones where they meet at a joint.

• A dislocated bone is no longer in its normal position.

• A dislocation may also cause ligament or nerve damage or blood vessel damage.

Dislocation

Subluxation

• Subluxation: Partial dislocation of a joint. A complete dislocation is a luxation.

Bone Fracture

• bone fracture is a medical condition in which a bone is cracked or broken.

Forearm Fracture

Skeletal Fracture

Bony Callus Formation

• 1. Hematoma forms at break

• 2. Fibrocartilaginous callus will fill the space

• 3. Bony callus formed by osteoblasts.

• 4. Osteoblasts build new compact bone and osteoclasts create new medullary cavity.

Fractures

Reduction

• Returning displaced or dislocated bones to their normal location

SHOULDER REDUCTION

• Sedation• Apply traction and counter

traction• Lift humeral head into the

glenoid• THIS IS DONE BY

TRAINED PROFESSIONALS ONLY!

Stress Fracture

• Stress fractures occur frequently because of continuing overuse of a joint.

• The main symptom of a stress fracture is pain.

• The most frequent places stress fractures occur are the tibia (the larger leg bone below the knee), fibula (the outer and thinner leg bone below the knee), and foot.

Stress Fracture

Grades of Injury

• A first degree sprain is a tear of a minimum number of fibers of the ligament.

• A second degree sprain is a partial rupture and a disruption of more fibers but with some instability.

• A total rupture is a complete disruption of the ligament resulting in joint instability. It is a very severe injury and is also referred to a third degree sprain.       

Grades

•  The varying grades of sprain can be compared to a stretch of a thick rubber band that is put on a sustained or increasing stretch.

• Starting with the tear of a few individual fibers more and more fibers give way, till the rubber band tears across totally.

First Degree Sprain

Second Degree Sprain

Third Degree Sprain

Grade I Ankle Sprain

Grade 2

Grade 3

ACL Tear

SPORTS INJURIES

Chronic and Acute

• Chronic injuries are caused by continuous stress over a long period of time

• i.e. Golfers elbow, tennis elbow, shin splints

• Acute are caused by sudden stress• i.e. Fractures, strains, sprains, concussion

How to prevent injuries

• Use correct equipment / clothing

• Environment

• Correct technique

• Rules / officials

• Warm up / cool down

• Equal opponents

Soft Tissue

• OPEN or CLOSED

• Open – skin damaged i.e. Cuts, blisters, grazes

• Closed – no external bleeding i.e. Bruises, strains, sprains, dislocations, cartilage damage

Hard Tissue

• Bone damage• OPEN (compound) or

CLOSED (simple)• Usually accompanied

by bruising and swelling (vessel damage)

• Lots of pain (damaged nerves)

Stress Fractures

• Most bone injuries are acute

• Stress fracture is Chronic and is a crack along the length of the bone

• Shin splints are a form of stress fractures.

Categories of injuries

• SOFT TISSUE / HARD TISSUE• OPEN / CLOSED• ACUTE / CHRONICExamplesA closed hard tissue injury…An open soft tissue injury…A closed soft tissue injury…An acute soft tissue injury…A chronic hard tissue injury…

Treatment – soft tissue

• Rest – stop immediately

• Ice – blood vessels contract to stop further swelling

• Compression – reduce swelling (not too tight)

• Elevation – blood flow reduced as working against gravity

Prevention Procedures for Blood-Borne Pathogens

Hepatitis B Virus Immunization

All persons with potential exposure to blood-borne pathogens

Protective Equipment

Gloves

Eye guards

Masks

Gowns

Resuscitation devices

Personal Hygiene

Hand washing

Towelettes

No application of cosmetics

Disinfection

Disinfect all surfaces

Biohazardous containers

Sharps

Linen

Disposable

No eating at work stations

For the Following Pictures:

• Identify the following:– SOFT TISSUE / HARD TISSUE

– OPEN / CLOSED

– ACUTE / CHRONIC

– LOCATION ON BODY: A/P,M/L,etc

– STRUCTURES: BONES,LIGAMENTS, etc.

What is this a picture of?

What is this a picture of?

What is this a picture of?

What is this a picture of