Unit 1 The Human Body in Motion AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT?

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1 Unit 1 The Human Body in Motion AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT?

2 Acute and Chronic Injuries of the Musculoskeletal System AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT?

3 Musculoskeletal Sports Injuries Sports injuries are trauma or overuse injuries that occur due to participation in sport or exercise. They can be the result of: an accident poor fitness and training poor technique improper equipment or facilities inadequate warm up overuse

4 Musculoskeletal Sports Injuries The immediate and long term cost of sports related injuries include:- health care costs for treatment time lost to employment, school and home activities time lost to future sporting activities According to the Australian Injury Hospitalisations report the sports that account for the largest number of cases are:- 1. Australian Rules Football 2. Soccer 3. Cycling 4. Wheeled motor sports physical, psychological or emotional damage 5. Water sports 6. Rugby equipment and program costs for rehabilitation and prevention 7. Roller sports 8. Equestrian activities 9. Basketball 10. Netball

5 Nature of Musculoskeletal Injuries Internal Organ Intracranial Open Wound Dislocation Soft Tissue Injury Fracture Nature of Musculoskeletal Injuries 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000 Incidence in 000 Australian Sports Injuries Hospitalisations Australian Institute of Health and Welfare 2014

6 Location of Musculoskeletal Injuries Hip and Thigh Neck Ankle and Foot Trunk Shoulder and Upper Arm Elbow and Forearm Wrist and Hand Head Knee and Lower Leg Location of Musculoskeletal Injuries 0 2,000 4,000 6,000 8,000 10,000 12,000 Incidence in 000 Australian Sports Injuries Hospitalisations Australian Institute of Health and Welfare 2014

7 Cause of Musculoskeletal Injuries Contact with Sports Equipment Overexertion Contact wirh Another Person Unspecified Fall Cause of Musculoskeletal Injuries 0 2,000 4,000 6,000 8,000 10,000 12,000 Incidence in 000 Australian Sports Injuries Hospitalisations Australian Institute of Health and Welfare 2014

8 Types of Sports Injuries - Acute Acute injuries occur suddenly during physical activity. e.g. torn hamstring / rolled ankle / corked thigh. Signs of acute injury include:- severe pain and tenderness swelling possible disfiguration restricted movement inability to bear weight obvious bleeding or bruising

$playing surface sticks balls Direct injuries can include:- dislocations concussions bruises fractures$

9 Types of Sports Injuries - Direct Direct injuries are caused by external force such as:- players playing surface sticks balls Direct injuries can include:- dislocations concussions bruises fractures cuts

10 Types of Sports Injuries - Indirect Indirect injuries are caused by unnatural muscle actions and extreme forces on joints. For example:- overstretching sudden change in intensity sudden change in direction Indirect injuries can include:- muscle tendon strains ligament sprains

11 Types of Sports Injuries - Overuse Overuse injuries are caused by repetitive or unaccustomed use of muscle, tendon or bone. For example:- too much repetition sudden increase in training loads insufficient recovery times poor footwear / hard surfaces Overuse injuries can result in:- tendonitis stress fractures

12 Acute Injuries - Strains Strains overstretching or tearing a muscle or tendon. Caused by:- sudden contraction sudden overstretch muscle imbalance poor warm up poor flexibility poor technique

13 Acute Injuries - Sprains Sprains joint injury where a ligament is overstretched or torn. Caused by: twist fall unbalanced landing direct blow

14 Acute Injuries - Bruise Bruise or Cork a haematoma that is the result of direct contact. Caused by collision with:- opponent stick ball playing surface

15 Treatment of Soft Tissue Injuries Acute injuries are graded according to severity and include:- Immediate treatment of acute sprains and strains:- Grade I some fibres are torn and the site is moderately painful and swollen, but function and strength are mostly unaffected. RICER protocol rest, ice, compression, elevation and referral. RICE protocol should be followed for hours. Grade II many fibres are torn and the site is painful and swollen, with some loss of function and strength. Grade III the soft tissue is totally torn, with considerable loss of function and strength. Grade III injuries often need surgical repair. The aim is to reduce the bleeding and damage within the joint. The No HARM protocol should also be applied no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.

16 Acute Injuries - Fracture Fracture a cracked or broken bone. Caused by excessive external or internal force : twist fall direct blow sudden contraction

17 Acute Injuries - Dislocation Dislocation when a joint is forced beyond its limits and the bones are separated. Usually involves accompanying ligament damage. Caused by excessive force : twist fall direct blow

18 Treatment of Fractures and Dislocations A fracture is termed:- Treatment of fractures and dislocations:- closed where there is no break of the skin open where the bone end has broken the skin or a wound is present with the fracture. 1. Control any bleeding Apply pressure Apply padding around wound 2. Immobilise the injured part The fractured or dislocated part should not be moved and first aid should be confined to providing soft padding and support in the position chosen by the patient. Reduce the pain and the risk of further injury by supporting and immobilising the injured area. Apply RICER protocol 3. Make the patient comfortable Help the patient into the position of greatest comfort without any unnecessary movement. 4. Seek medical assistance

19 Chronic Injuries Chronic Injuries occur slowly due to a period of prolonged overuse. Examples of chronic injuries are:- tendonitis osteitis pubis shin splints stress fractures Signs of chronic injuries include: pain when exercising Inflammation dull ache at rest

20 Chronic Injuries - Tendonitis Tendonitis is inflammation of a tendon. Tendonitis can be caused by:- repetitive joint actions insufficient recovery times poor technique inadequate strength inadequate flexibility poor equipment / facilities Achilles tendonitis

21 Chronic Injuries Osteitis Pubis Osteitis Pubis inflammation of the pubic symphisis due to excessive muscle pull on the pubic bone. Osteitis pubis can be caused by:- excessive groin strain excessive training loads poor running technique poor footwear inadequate flexibility muscle imbalance (hip adductors & abdominals) Osteitis pubis

22 Chronic Injuries Shin Splints Shin Splints inflammation and pain along the shin area. Shin splints can be caused by:- large running loads insufficient recovery times poor running technique poor footwear running on hard surfaces flat feet muscle imbalance (anterior & posterior muscles of the leg) Shin Splints

$to repeated or heavy training loads causing tiny cracks or fractures.$ $More than 50% of stress fractures are in the lower leg.$

23 Chronic Injuries Stress Fractures Stress Fractures occurs when a bone is subjected to repeated or heavy training loads causing tiny cracks or fractures. More than 50% of stress fractures are in the lower leg. Stress fractures can be caused by:- hard surfaces poor equipment (runners) sudden increase in training poor nutrition Feet Shins

Chronic Injuries Plantar Fasciitis Plantar Fasciitis is inflammation of the plantar fascia - a thick, fibrous ligament that runs under the foot from the heel bone to the toes.

24 Chronic Injuries Plantar Fasciitis Plantar Fasciitis is inflammation of the plantar fascia - a thick, fibrous ligament that runs under the foot from the heel bone to the toes. The plantar fascia is very limited in its capacity to stretch and when too much traction is placed on it micro-tearing will occur, resulting in irritation, inflammation and pain. The main causes of plantar fasciitis include:- overuse unsupportive footwear over pronation Heel pain is a common symptom of Plantar Fasciitis.

Chronic Injuries Compartment Syndrome Compartment Syndrome is a condition in which pressure increases within a muscle "compartment" of the lower leg, cutting off blood supply to the area and causing

25 Chronic Injuries Compartment Syndrome Compartment Syndrome is a condition in which pressure increases within a muscle "compartment" of the lower leg, cutting off blood supply to the area and causing swelling and pain. The condition is aggravated through running as there is no room for expansion to accommodate the increased blood supply to the lower leg and the resultant lack of oxygen produces pain and forces the runner to stop. In runners, compartment syndrome is due to overuse and the result of repetitive stress. The lower leg is divided into compartments surrounded by tight fibrous fascia.

Chronic Back Pain Chronic Back Pain damage or irritation to the complex network of spinal muscles, nerves, bones, discs or tendons can result in acute pain or referred pain.

26 Chronic Back Pain Chronic Back Pain damage or irritation to the complex network of spinal muscles, nerves, bones, discs or tendons can result in acute pain or referred pain. Causes of chronic back pain include: repetitive impact (e.g. running) a twisting motion (e.g. golf) a weight loading at the end of a range-of-motion (e.g. weightlifting) Up to 20% of all injuries that occur in sports involve an injury to the lower back.

27 Chronic Injuries Treatment Treatments for over use injuries include:- cutting back the intensity, duration, and frequency of an activity If symptoms persist, a sports medicine specialist should be consulted. A sports medicine specialist will:- adopting a hard/easy workout schedule and cross-training with other activities to maintain fitness levels learning about proper training and technique from a coach or athletic trainer performing proper warm-up activities before and after using ice after an activity for minor aches and pain conduct a review of the training program and loads. evaluate any predisposing factors. suggest a structured treatment plan that could include:- physiotherapy and joint manipulation anti-inflammatory injections accupuncture using anti-inflammatory medications as necessary trigger-point massage rest

Arthritis - Types Osteo Arthritis - caused by a reduction in the normal amount of cartilage tissue as a result of wear and tear, injury or infection.

28 Arthritis - Types Osteo Arthritis - caused by a reduction in the normal amount of cartilage tissue as a result of wear and tear, injury or infection. Rheumatoid Arthritis - occurs when the body s immune system attacks the synovium ( a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints ) leading to destruction of bone and cartilage.

29 Arthritis Symptoms and Treatment Symptoms of arthritis include:- joint pain stiffness swelling reduced range of motion Treatment options include:- medication analgesics - effective for pain management nonsteroidal anti-inflammatory drugs help control pain and inflammation severe rheumatoid arthritis can cause joint deformity joint replacement joint fusion physical therapy involving exercises that help strengthen the muscles around the affected joint is a core component of arthritis treatment.

Osteoporosis Osteoporosis is a progressive bone disease that reduces bone density, weakening bone structure and increasing the incidence of bone

30 Osteoporosis Osteoporosis is a progressive bone disease that reduces bone density, weakening bone structure and increasing the incidence of bone damage. Causes of osteoporosis include:- ageing lack of calcium in diet physical inactivity hormone imbalance long-term use of corticosteroid medications

Osteoporosis - Prevention Steps both men and women can take from a young age to prevent osteoporosis include : an adequate intake of calcium in the diet appropriate levels of vitamin D absorption and

31 Osteoporosis - Prevention Steps both men and women can take from a young age to prevent osteoporosis include : an adequate intake of calcium in the diet appropriate levels of vitamin D absorption and intake participation in weight bearing exercise can increase bone mineral density Treatment options include:- undertaking activities that promote muscle strength, balance and coordination to reduce fall risk medications to improve calcium absorption, balance hormone levels or slow down bone degeneration

32 Physiological Strategies to Prevent Injuries of the Musculoskeletal System AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT

Physiological Strategies to Prevent Injuries Physical Preparation To be physically prepared for competition an athlete s physical fitness needs to be at a level that can manage the demands of the

33 Physiological Strategies to Prevent Injuries Physical Preparation To be physically prepared for competition an athlete s physical fitness needs to be at a level that can manage the demands of the competition. Physical fitness helps reduce injuries in sport and is specific to the sport. A reduction in the incidence of musculoskeletal injuries can achieved through incorporating the following training methods:- Core stability training promotes the use of proper form and mechanics promotes proper coordination of the key muscles used to support the spinal column.

Physiological Strategies to Prevent Injuries Physical Preparation Resistance training reduces the risk for musculoskeletal injuries reduces the severity of such injury Physiological adaptations

34 Physiological Strategies to Prevent Injuries Physical Preparation Resistance training reduces the risk for musculoskeletal injuries reduces the severity of such injury Physiological adaptations achieved as a result of resistance training on the following enhances protection against injury:- effect on bone - resistance training is beneficial for increasing bone strength and has a positive influence on bone mineral content. effect on muscle maintains or improves functional capacity of muscles and reduces the risks related to muscle imbalance. effect on connective tissue - increases in muscle mass result in increases in the size and strength of the connective tissue resulting in greater body stability.

Physiological Strategies to Prevent Injuries Physical Preparation Flexibility training improved flexibility decreases the risk of activity

35 Physiological Strategies to Prevent Injuries Physical Preparation Flexibility training improved flexibility decreases the risk of activity based injuries through:- helping joints move through their full range of motion allowing muscles to work most effectively reducing muscle imbalances

Physiological Strategies to Prevent Injuries - Warm Up Cool Down Warm ups reduce injury risk through:- increased circulation raised body temperature increased range of motion

36 Physiological Strategies to Prevent Injuries - Warm Up Cool Down Warm ups reduce injury risk through:- increased circulation raised body temperature increased range of motion simulating of sporting movements providing psychological readiness Cool downs will aid recovery by:- removing waste products replenishing fuels preventing blood pooling limiting stiffness

Physiological Strategies to Prevent Injuries Hydration Small amounts of dehydration will reduce sporting performance and increase injury risks.

37 Physiological Strategies to Prevent Injuries Hydration Small amounts of dehydration will reduce sporting performance and increase injury risks. Heat and hydration policies should be implemented by all sporting organisations. Athletes need to : be adequately hydrated prior drink during participation rehydrate after performance

38 Physical Aids to Prevent Injuries of the Musculoskeletal System AREA OF STUDY 1 - HOW DOES THE MUSCULOSKELETAL SYSTEM WORK TO PRODUCE MOVEMENT

39 Physical Aids to Prevent Injury Protective Equipment Protective equipment must be worn when mandated or deemed appropriate. Protective equipment must:- fit correctly be worn properly be checked regularly and maintained be replaced when necessary Examples of protective equipment include:- helmets mouthguards pads / protectors

40 Physical Aids to Prevent Injury Taping and Braces The taping of joints or the wearing of sports braces will provide:- extra support added stability minimise the effects of an injury

41 Physical Aids to Prevent Injury Footwear and Clothing Footwear needs to:- fit correctly provide adequate support provide adequate cushioning provide adequate grip Clothing needs to:- fit properly protect from the environment (heat/sun/cold/wind)

Preventative Measures Physical Environment To ensure the physical environment is safe the following should be considered:- provision of padding

42 Preventative Measures Physical Environment To ensure the physical environment is safe the following should be considered:- provision of padding and mats establish safety of environment prior to training or competition report and remove hazards check weather conditions complete grounds report

43 Revision Questions Explain how the following PHYSIOLOGICAL STRATEGIES can help reduce the risks of sporting injuries : Warm up Prepare the athlete physically and mentally and by introducing movement patterns, intensities and sporting actions prior to training or competition the body is better prepared for the upcoming loads. An increase in muscle temp. also allows effective muscle elasticity, joint motion and muscle contractions to occur with less risk of injury. Cool down Reduce DOMS, dissipate wastes, restore the body to rest, allow improved recovery so that the athlete is in good shape for ongoing training loads. An active cool down also promotes improved flexibility. Why is it important to allow adequate recovery times when trying to minimise the chance of an overuse injury? Adequate recovery times limit the risk of injury by permitting the body to recover from exercise intensities and loads and by allowing the body to adapt physiologically without the presence of ongoing stress or load. During recovery the body strengthens bone, ligaments and muscle. If training sessions are too close together the physiological adaptations cannot occur properly and the new exercise loads will increase the risk of overuse injuries. What is osteoporosis? Loss of bone density and therefore bone strength. How can osteoporosis be prevented? Regular weight bearing activity, resistance training, calcium intake, vitamin D, no smoking.

UNIT 2.- SPORT INJURIES: SYMPTOMS AND TREATMENT

UNIT 2.- SPORT INJURIES: SYMPTOMS AND TREATMENT Every year, millions of teenagers participate in high school sports. An injury to a high school athlete can be a significant disappointment for the teen,