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Injuries Signs and Symptoms

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Injuries Signs and Symptoms Injuries Signs and Symptoms Pain Swelling Heat Redness Loss of function Depends on severity of injury Treatment R.I.C.E. and possible NSAIDs Range of Motion (Stretching!) Strength and Endurance Neuromuscular Control & Balance Functional and Sports Specific Progressions Maintain Cardio Fitness All depend on severity. Begin rehab as soon as possible. What are the two categories of acute muscle injuries? Contusions Strains How does one receive a contusion? Sudden traumatic blow to the body What is typical in cases of severe contusions? a. the athlete reports being struck by a hard blow b. the blow causes pain and a transitory paralysis caused by pressure on and shock to the motor and sensory nerves c. palpation often reveals a hard area, indurated because of internal hemorrhage d. ecchymosis, or tissue discoloration, may take place What is a strain? A stretch, tear, or rip in the muscle or adjacent tissue such as the fascia or muscle tendon How are strains most often produced? Abnormal muscular contraction What is the cause of abnormal muscular contraction? It is fault in the reciprocal coordination of the agonist and antagonist muscles take place. The cause of this fault or un-coordination is a mystery. However, possible explanations are that it may be related to: a mineral imbalance caused by profuse sweating to fatigue metabolites collected in the muscle itself to a strength imbalance between agonist and antagonist muscles. What is a grade 1 (or 1st degree or 1°) strain? Slight over-stretching to mild tearing (20%) of the muscle fibers. It is accompanied by local pain, which is increased by tension in the muscle, and a minor loss of strength. There is mild swelling, ecchymosis, and local tenderness. What is a grade 2 (or 2nd degree or 2°) strain? Moderate tearing (20% - 70%) of the muscle fibers. It is similar to a grade 1, but has moderate signs and symptoms (moderate loss of strength, moderate swelling, ecchymosis, and local tenderness). What is a grade 3 (or 3rd degree or 3°) strain? Has signs and symptoms that are severe (severe swelling, ecchymosis, and local tenderness) with a loss of muscle function and, commonly, a palpable defect in the muscle. What does a tendon attach? Muscle to bone What does a ligament attach? Bone to bone What is a cramp? A painful involuntary contraction of a skeletal muscle or muscle group. Cramps have been attributed to what? A lack of water or other electrolytes in relation to muscle fatigue. What is a spasm? A reflexive reaction caused by trauma of the musculoskeletal system List and define the two types of spasms or cramps: a. clonic – alternating involuntary muscular contraction and relaxation in quick succession b. tonic – rigid muscle contraction that lasts a period of time. What are the four specific indicators of possible overexertion? a. acute muscle soreness b. delayed muscle soreness c. muscle stiffness d. muscle cramping List and define the two types of muscle soreness: a. Acute-onset muscle soreness – which accompanies fatigue. This muscle pain is transient and occurs during and immediately after exercise. b. Delayed-onset muscle soreness (DOMS) – becomes most intense after 24 to 48 hours and then gradually subsides so that the muscle becomes symptom-free after 3 or 4 days. (This second type of pain is described as a syndrome of delayed muscle pain leading to increased muscle tension, swelling, stiffness, and resistance to stretch). What are the possible causes for delayed-onset muscle soreness? It may occur from very small tears in the muscle tissue, which seems to be more likely with eccentric or isometric contractions. It may also occur because of disruption of the connective tissue that hold muscle tendon fibers together. What is muscle stiffness? Muscle stiffness does not produce pain. It occurs when a group of muscles have been worked for a long period of time. The fluids that collect in the muscles during and after exercise are absorbed into the bloodstream at a slow rate. As a result, the muscle becomes swollen, shorter, and thicker and therefore resists stretch. What can be done to assist in reducing muscle stiffness? Light exercise Massage Passive mobilization What is muscle guarding? Following injury, the muscle that surrounds the injured area contract, in effect, splint that area, thus minimizing pain by limiting movement. (Quite often this splinting is incorrectly referred to as a muscle spasm) The suffix “itis” means inflammation: Myositis/Fasciitis - inflammation of the muscle tissue Tendinitis – inflammation of a tendon Tenosynovitis - Inflammation of the synovial sheath surrounding a tendon Bursitis – inflammation of the bursa Periostitis – inflammation of the bone covering What are the major acute injuries that happen to synovial joints? Sprains Subluxations Dislocations What is a sprain? Stretching or total tearing of the stabilizing connective tissues (ligaments) What is a grade 1 (or 1st degree or 1°) sprain? Slight over-stretching to mild tearing (20%) of the ligament. It is characterized by some pain, minimum loss of function, mild point tenderness, little or no swelling, and no abnormal motion when tested. What is a grade 2 (or 2nd degree or 2°) sprain? Moderate tearing (20% - 70%) of the ligament. There is pain, moderate loss of function, swelling, and in some cases slight to moderate instability. What is a grade 3 (or 3rd degree or 3°) sprain? It is extremely painful, with major loss of function, severe instability, tenderness, and swelling. What is a subluxation? Partial dislocations in which an incomplete separation between two articulating bones occurs. What is a dislocation (luxation)? Total disunion of bone apposition between articulating surfaces What are several factors that are important in recognizing and evaluating dislocations? Loss of limb function Deformity Swelling Point tenderness What is an acute bone fracture? A partial or complete interruption in a bone’s continuity What is a stress fracture? Rhythmic muscle action performed over a period of time at a sub-threshold level causes the stress-bearing capacity of a bone to be exceeded What are the typical causes of stress fractures in sports? Coming back into competition too soon after an injury or illness Going from one event to another without proper training in the second event Starting initial training too quickly Changing habits or the environment Strains Injury Mechanism of Injury (Etiology) Signs & Symptoms Treatment Groin Strain (Hip) Running, Jumping, Twisting (ER) Typical Typical, May need crutches, compression wrap during activity Quadriceps Strain (Thigh) Sudden stretch from knee flexion Typical Typical, May need crutches, compression wrap during activity Hamstring Strain (Thigh) Sudden stretch from knee extension Typical Typical, May need crutches, compression wrap during activity Gastrocnemius Strain (Leg) Quick starts & stops, jumping, Typical Typical, heel wedge, compression sudden knee extension. wrap during activity Achilles Tendon Strain (Ankle) Usually after ankle sprains or sudden Typical Typical, heel lift, compression wrap excessive ankle dorsiflexion. during activity Achilles Tendon Rupture (Ankle) Sudden pushing-off action of the Typical, hears a pop, indentation at RICE, X-ray to rule out fracture, forefoot with the knee being forced site, positive Thompson’s Test possible surgical repair, into complete extension. immobilization for 4 to 6 weeks, begin rehab. Heel lifts in both shoes Longitudinal Arch Strain Repetitive contact with a hard Typical Typical, Reduce weight bearing playing surface. It may appear activity, possible arch support taping suddenly or slowly over time. Metatarsal Arch Strain Excessive pronation and weak Typical Typical, orthotic or pad to elevate intertarsal ligaments will allow the the fallen arch. foot to abnormally spread resulting in a fallen arch Patellar Tendon Rupture Sudden powerful contraction of the Typical, Defect can be palpated, Typical, surgery quadriceps athlete cannot extend the knee, swelling, initial significant pain followed by a feeling that the injury is not serious Strains Injury Mechanism of Injury (Etiology) Signs & Symptoms Treatment Elbow strain Excessive resistive motion, repeated Typical Typical microtears Lumbar strain Sudden extension on an overloaded, Typical Typical unprepared, or underdeveloped spine, usually in combination with trunk rotation; chronic strain, commonly associated with faulty posture that involves excessive lumbar lordosis. Neck and Upper Back strain Turn the head suddenly or forced Typical, muscle guarding and Typical, possible soft cervical collar flexion, extension, or rotation reluctance to move the neck in any direction Cervical sprain (Whiplash) Turn the head suddenly or forced Typical, muscle guarding and Typical, X-rays to rule out fracture. flexion, extension, or rotation, but reluctance to move the neck in any and possible soft cervical much more violently than the direction; this pain may persist much cervical strain longer than that of the cervical strain. Sprains Injury Mechanism of Injury (Etiology) Signs & Symptoms Treatment Hip Sprain Sudden stretch from knee flexion Typical Typical, May need crutches MCL Sprain (Knee) Direct blow (valgus force), severe Typical, positive valgus stress test Typical, May need crutches outward twist LCL Sprain (Knee) Direct blow (varus force) Typical, positive varus stress test Typical, May need crutches ACL Sprain (Knee) Direct blow, rotation, hyperextension Typical, positive anterior drawer test, Typical,
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