EXERCISE SCIENCE

TREATMENT OF AN INJURYp. 73 - 79

Signs of an injuryFirst aid treatment

THE SHOULDER JOINTTHE KNEE JOINT

THE ANKLE JOINT

TREATMENT OF AN INJURY

Signs of an injury: SHARP• Swelling• Heat• Altered appearance and function• Red in colour• Painful

TREATMENT OF AN INJURY

First aid treatment immediately following an injury: PIER principle

• Pressure – applied with ice; left on 10 – 20 min, similar break time; repeat

• Ice – avoid heat during initial days of an injury (will promote swelling)

• Elevation during icing to help reduce swelling• Restricted (rested) using tensors and slings

THE SHOULDER JOINT

Glenohumeral joint – classified as synovial ball-and-socket joint

• the instability of this joint is what permits its excellent mobility

• the joint is held together by several ligaments and the tendon of the biceps brachii which helps to support the joint anteriorly

• very susceptible to injuries from overuse and from heavy physical contact

THE SHOULDER JOINT

Biceps Tendinitis• overuse injury from overworking or

overloading the joint (not enough rest given)• symptoms: pain on proximal end of the biceps

(pain during shoulder or elbow flexion)

THE SHOULDER JOINT

Shoulder Separation• occurs at the acromioclavicular joint (tearing of

the acromioclavicular ligament)• x-rays are used to determine the severity of the

tear• injury results from contact with another player

or fall on the shoulder• 3rd degree tears may require surgery; recovery

accelerated with physio

THE SHOULDER JOINT

Shoulder Dislocation• results when the head of the humerus pops out of the

glenoid fossa• this injury results from a hit or fall (tears to the

glenohumeral ligament and joint capsule)• attempts to relocate the shoulder may results in

permanent damage to numerous vital nerves and blood vessels

• should only be attempted by qualified personnel• surgery may be required for third-degree

dislocations

THE SHOULDER JOINT

Rotator Cuff Tears• 4 rotator cuff muscles: supraspinatus, infraspinatus,

teres minor, and subscapularis• tears may occur to one or all four of the muscles; 3

of the muscles share a common tendon attachment• causes difficulty and pain when abducting and

laterally or medially rotating the shoulder• apply PIER principle to speed up diagnosis and

healing

THE KNEE JOINT

• This joint is the articulation of the tibia and femur (not fibula)

• originally classified as synovial (modified hinge), but now classified as a modified ellipsoid joint because it is now known to slightly rotate medially and laterally

THE KNEE JOINT

Knee Ligament Tears• the most common tears result from blows to

the lateral side of the knee, which results in damage to the medial side

• the first tissue to tear is the joint capsule, and if severe enough, will damage the medial collateral ligament, medial meniscus, and anterior cruciate ligament, as well

THE KNEE JOINT

Knee Ligament Tears• women are more susceptible to ACL tears and other

knee injuries because of their wider Q-angle (quadriceps angle)

• the Q-angle is formed in the frontal plane; a line is drawn from:

• the centre of the patella to the anterior superior iliac spine

• the other is from the tibial tuberosity to the centre of the patella extending up the thigh

THE KNEE JOINT

Knee Ligament Tears• the width of the pelvis determines the size of

the Q angle• the greater angle in women, causes forces to

the concentrated on the ligament each time the knee twists

• proper stretching and strengthening will decrease the chance of injury

THE KNEE JOINT

OSGOOD-SCHLATTER Syndrome What is it? What causes it? • a result of osteochondritis (a disease of the

ossification centres in the bones of young children)

• growing pains for the child• in growing child, the growth plates of the tibial

tuberosities can become irritated or inflamed if overloaded or overused

THE KNEE JOINT

OSGOOD-SCHLATTER SYNDROME What tissues are affected? Who does it affect?• more prevalent in males• running & jumping stresses the patellar

tendon and ligament, causing inflammation of the cartilage layer in that growth plate

THE KNEE JOINT

OSGOOD-SCHLATTER SYNDROMEFuture implications & treatment• does not affect growth of child or damage

epiphyseal plate• must be diagnosed by physician• follow PIER

THE KNEE JOINT

PATELLOFEMORAL SYNDROME (PFS) What is it? What causes it? • gradual onset of anterior knee pain or pain

around the patella• the pain is a result of increased or misdirected

forces between the patella and femur• aggravated by sports (running, VB, BB...)

THE KNEE JOINT

PATELLOFEMORAL SYNDROME (PFS) What tissues are affected? Who does it affect?• usually affects adolescents or young adults,

more often women• debate/lack of concensus on factors• overuse, overloading, and misuse of

patellofemoral jt. are agreed (researchers)

THE KNEE JOINT

PATELLOFEMORAL SYNDROME (PFS) Future implications & treatment • treat with PIER• if pain persists, seek medical care

THE ANKLE JOINT

THE ANKLE JOINT• classified as modified hinge • comprised of tibia, fibula and talus

THE ANKLE JOINT

Inversion sprains• inversion sprains are common injuries (rolling over on ankle)• ankle is weakest when plantar flexed; thus when you jump and

land hard to change direction, the ankle plantar flexes with great force

• this injury can affect one or all of the lateral ligaments of ankle• the severity of the sprain dictates the amount of time needed for

healing• surgery is rare (even in 3rd degree)• sprains described as low or high; high involve damage to one or

both anterior and posterior tibiofibular ligaments• apply PIER

THE ANKLE JOINT

Eversion sprains• rare; a very strong deltoid ligament attaches the medial malleolus

to 3 bones of the foot, causing tip of medial malleolus to tear off• Pott’s Fracture – most severe eversion injury – the tip of the

medial malleolus is broken, as is the fibula• Cause: a force on the medial side of ankle, causing deltoid

ligament to rip off the tip of the medial malleolus and a break of the fibula

• Treatment: case 8 to 12 weeks, then intense physio• Future implications: not career-ending; won’t break in same spot

again; care and rehabilitation should be adhered to in order to prevent future weakness