Dr Aparajitha KrishnanSports PhysicianHospital Sungai Buloh

kinds of injuries that occur during sports or exercise. Due to :1) accidents2) poor training practices3) improper equipment,4) lack of conditioning,5) insufficient warm up/down

the term is viz.ly reserved for injuries that involve the MSK system i.e. :Muscles Bones Cartilage LigamentsTendons

H = historyO= observationP = palpationS = special testI = investigation T =treatment

History: Attitude, mental condition, and perceived physical state.Stated by the athlete.Primary ComplaintMechanism of InjuryCharacteristics of the SymptomsLimitationsPast History

Observation: General Appearance

Consciousness

Posture and Gait

Deformity, swelling, discoloration, scars, and general skin condition

Rule out # Skin temperature/ wettednessSwellingTendernessDeformityMuscle spasm

Caused by an interaction between an outside force and the body

Causing :-

An abrasion/laceration/blister

A sprain/strain

A subluxation/dislocation

A fracture

Enviromental factors causing

Heat injuriesexercise induced collapseheat crampsheat stroke

2) Cold injurieshypothermia

Mechanism of onset= application of force, such as scraping or friction to the outer layer of skin

Eg tackle on a dry, hard surface which causes the skin to be scraped off.

Treatment : gentle cleansing with flavin to prevent infection.

If laceration is >1cm wide or with active bleedingrefer to dr

If laceration is over lip or eyelid refer dr

An injury to a ligament results from overstretching

Severity =from tissue microtrauma to total disruption of the tissues.

Areas of the body most vulnerable to sprains are ankles, knees, and wrists.

Signs of a sprain include :a) tenderness b) bruisingc) inflammationd) swelling; e) inability to move a limb or jointf) joint laxity or instability.

when the ligaments have been stretched but not torn. Symptoms include: Mild pain Some swelling Mild joint stiffness Slight pain with functioning

is a partial tearing of the ligament. Symptoms include:Significant swelling Bruising Moderate pain Some loss of motion

Stressing the joint is painful,

The ligament has been torn completely. Symptoms include: Severe swelling Severe pain Instability of the joint Complete loss of function

Stressing the joint is less painful because the ligament is completely torn and is not being stretched,

Phase 1

immobilize the area

PRICEM for 24-72 hours.

move patient to a safe areaimmobilizebandagetape

1st 24-72hrs maintain area w/o unnessary activity2 types a)active restspecifically do not do activity aka absolute rest

b)Passive restdoing activities of daily living

The 1st 24 72 hrsMethod**For 15-20minWith 1-2 hr betw applicationsAim minimise swelling n pain

The way which ice is applied will vary according to the required effects.It may be applied in the following ways:Ice towelsIce packsImmersionIce cube massageIce sprayCold gel

Decrease metabolism of cell

Vasoconstrictionreduce heamatoma p substance entry is reduced

Delays inflammation

increases action potential of mast cells

reduces firing of nerves

Decrease muscle spasm by inhibiting stretch reflex

Raynauds phenomenaSLEVasculitisMultiple myelomaCold urticaria

Compressionlimits space of swellingDistribute localised edema ie available for reabsorption into circulationElevation increases venous flow

NSAIDsCox-2 inhibitorsOpioidsParacetamol

HeatHeat increases the bleeding at the injured site.Avoid hot baths and showers, saunas, hot water bottles, heat packs and liniments.

Alcohol increases bleeding and swelling at the injury site, and delays healing.

It can also mask the pain of the injury Underestimate severity so player wont seek treatment as early as they should.

as it cause further damage. should not resume exercise within 72 hours of an injury

MassageIncrease in bleeding and swellingshould be avoided in 1st 72 hours

Heat injury is 48-72 hours oldEarlier =worsens the bleeding and inflammation. Heat can be applied in the form of:

Deep heat creamsHeat padsHot water bottlesHeat lamps

Heat dilates the blood vessels so more blood to the area It eases pain and muscle spasms. Heat can burn the skin.

What is a Fracture? A fracture is a break, crack, or chip in the bone.A fracture is a loss of continuity in the bones surface. Treatment of a FractureDo not move the player.Immobilise the injured limb. Call an ambulance.Keep player warm. Monitor pr/bp/consciousnessSigns &Symptoms of a FractureThe player or others may have heard a crack. There will be localised pain Sometimes there can be a visible deformityLocalised swelling & bruising. The player may be unwilling or unable to move or put weight on the limb. Sometimes there can be numbness or tingling (pins & needles).

If athlete is experiencing any symptoms of heat illness, initiate action plan:

Heat Stress (Mild):S/S: Cramping Txm:Remove from sunDizziness / Light headed Remove clothing and Nausea/VomitingequipmentRapid BreathingEncourage athlete to drink fluidsApply ice towels to axilla/groin/head/neck

Monitor and record vitals every 3-5 minutes.

Heat Exhaustion (Moderate):S/S:Cramping Txm: Extreme Exhaustion Treatment same as Heat Stress +Dizziness/ light headed Cool with fans if availableMoist / Pale / Cool skin Elevate legsVisual Disturbancessponging w cold waterAltered mental stateIncreased body temp (>102)Monitor and record vitals every 3-5 minutesHeat Stroke (Severe):S/S:StaggeringTxm: Hot / Dry skinsame as heat exhaution + ice bathAltered mental stateSevere headache Increased body temp (>104)Weak pulseDecreased blood pressureMonitor and record vitals every 3-5 minutes

Causes:-Improper clothingUnfavourable weatherAged/infant

Cold induced bronchospasmS1 n S2 TxmMDI Sob warm drinkChest tightnesswheeze

Area is cold/numbSkin=red and swollen

Txm remove clothingimmerse area in water heated up to 39-42CWrap area to prevent recooling

Dehydration occurs when more fluid is lost from the body than is taken in.

This causes an imbalance of minerals, sodium, and potassium, which are all needed for muscle and nerve function.

There are many things that cause dehydration including: vomiting, diarrhea, blood loss, and failure to drink .

dry mouth, fatigue, chills, dry skin, dark colored urine, thirst.

racing pulse, difficulty breathing, muscle spasms, dim vision, confusion, unconsciousness death

Water hydrates better inexpensive, taste not appealingSports drinks taste better. additional electrolytes Juice nutritious, not a good thirst quencher (fruit sugar). Caffeinated soft drinks quick energy boost do not rehydrate coffee, tea, and alcohol diuretic

HOPSIT

rememberPRICEM

Hydration

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