CH01_PPT - acasportsmedicine

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CH01_PPT - acasportsmedicine
Chapter 1
The Concept of Sports Injury
Sports Participation
In the United States, 6.7
million public high school
children are involved in
sports activities annually.
© Ilene MacDonald/Alamy Images
Title IX Education Assistance Act
of 1972
• Since its passing, female
sports participation increased
by 700%.
• It was believed that girls
weren’t tough enough to play
• Research indicates injuries
are sports specific, NOT
gender specific.
General Injury Data
According to a
Pennsylvania study,
rates of athletic injuries
among of high school
students were:
• Football – 46.7%
• Boys’ basketball –
• Wrestling – 9.68%
• Girls basketball –
General Injury Data (continued)
In a two-year study of a
community sports program,
children participating in
soccer had the highest rate
of injury, followed by
baseball, football, and
Contusions were the most
common injury.
Definition of Sports Injury
• There is no
universally acceptable
•The majority of
today’s definitions use
“time lost” criteria as
the major determinant.
NCAA Definition of Sports Injury
Sports Injury:
1. Occurs as a result of participation in
organized intercollegiate practice or
2. Requires medical attention by a team
athletic trainer or physician.
3. Results in restriction of athlete’s
participation for one or more days after
the injury.
Acute Injuries
Acute Injury – “characterized by rapid
onset, resulting from a traumatic event”
• Acute injuries typically involve
significant trauma followed by
pain, swelling, and loss of
Critical Force – “magnitude of a single
force for which the anatomical structure
of interest is damaged”
Chronic Injuries
Chronic Injury – “characterized by
a slow, insidious onset, implying
a gradual development of
structural damage”
• Chronic injuries develop over
time and are often associated
with repetitive, cyclic
activities, such as running.
• These injuries are commonly
called “overuse injuries.”
Common sites include the
Achilles tendon, patellar
tendon, and the rotator cuff.
Overuse Injuries
• Overuse injuries may be caused by:
1. Intrinsic Factors – immature cartilage, lack
of flexibility, lack of proper conditioning,
psychological factors.
2. Extrinsic Factors – excessive training, lack
of adequate recovery, incorrect technique,
playing on uneven or hard surfaces
Types of Tissues
Soft Tissues
Joint capsules
Blood vessels
Skeletal Tissue
Any bony
structure in the
Catastrophic Injury
Catastrophic Injuries:
• Involve damage to the brain
and/or spinal cord.
• Can be life threatening or
cause permanent damage.
• Can occur as a direct or indirect
result of sports participation.
• Which Sport has the most
Catastrophic injuries?
Girls' Most Dangerous Sport:
For high school girls and college women, cheerleading is far more dangerous
than any other sport, according to a new report that adds several previously
unreported cases of serious injuries to a growing list.
High school cheerleading accounted for 65.1 percent of all catastrophic sports
injuries among high school females over the past 25 years, according to an
annual report released Monday by the National Center for Catastrophic Sports
Injury Research.
The new estimate is up from 55 percent in last year's study. The researches say
the true number of cheerleading injuries appears to be higher than they had
previously thought. And these are not ankle sprains. The report counts fatal,
disabling and serious injuries.
Injury Classifications
Sprains are injuries to ligaments.
• First-degree: mild pain with little/no swelling
• Second-degree: ligament damage, pain,
moderate swelling, and dysfunction
• Third-degree: complete tear of ligament(s),
pain, swelling, dysfunction leading to a loss
of stability
Injury Classifications
Strains are injuries to tendons, muscles, or
musculotendinous junctions.
First-degree strain: mild with little/no swelling, pain
noticeable with use
• Second-degree strain: more extensive softtissue damage, pain, and moderate loss of
• Third-degree strain: complete rupture,significant
swelling, loss of function, and possible defect in
Injury Classifications
Contusions are commonly referred to as
• Result from direct blows to the body surface,
causing a compression of the underlying tissue
• Contusions are associated with pain, stiffness,
swelling, ecchymosis, and hematoma
• May result in myositis ossificans – a bonelike
formation within the muscle tissue
Skeletal Tissue Injuries
Fractures are breaks or cracks in a bone.
Types of Fractures
• Closed
• Open
• Stress
• Salter-Harris
Dislocation – “displacement of
contiguous surfaces or bones
comprising a joint”
Subluxation: partial
Luxation: complete
** All dislocations should be diagnosed and
treated by a physician.
Injury Recognition
Coach’s role:
• Coaches are most often the first to arrive
at the scene of an injury.
• Treat all possible injuries as such until
proven otherwise.
• Recognize and determine if the injury
requires medical referral.
**Schools or sponsoring agencies should make every effort to hire
a BOC-Certified Athletic Trainer.
• What is the difference between
anterior and posterior?
Epidemiology of Sports Injuries
• Epidemiology – “study of the distribution of
diseases, injuries, or other health states in
human populations for the purpose of
identifying and implementing measures to
prevent their development and spread”
• Scientific sports injury research is a
relatively recent trend.
Epidemiology of Sports Injuries
Sports injury epidemiology involves
determining risk factors that may play a
causative role in the injury.
• Hypotheses are developed to test for
statistical relationships between risk
factors and injury.
Classification of Sports
American Academy of Pediatrics has developed
categories of sports based on risk of injury.
• Contact/collision
• Limited contact/impact
• Non-contact
Extent of Injuries: Tackle Football
• 25.5 injuries for every 100 players with the
highest rate of injury occurring during games.
• Game injury rates were double the rates seen
in practice.
• Hip, thigh, and leg regions injured most often.
• 2.4% of injuries required surgery, and of
those 59.4% involved the knee.
Extent of Injuries: Tackle Football
• Contusions, strains, sprains, and fractures
are common injuries.
• Offensive players have higher risk than
defensive players.
• Older players have higher risk than younger
• Spinal cord and brain injuries are a major
Extent of Injuries: Basketball
• Ankle sprains are the
most common injury in
both sexes.
• Girls have higher risk of
knee injuries than boys
and are more likely to
require surgery.
• The rate of ACL injury
during games was 3 times
higher for women than
Extent of Injuries: Baseball
In 2004, over 450,000 high
school boys participated.
Nearly 12% sustained injuries.
• Forearm/wrist/hand or
shoulder/arm were often
Of these injuries, most were
strains or sprains.
Extent of Injuries: Baseball
• Children between the ages 5 and 14 have
increased vulnerability to chest impact
injuries from balls.
• Little League Elbow – Chronic elbow injuries
are a concern for adolescent pitchers.
-Sidearm pitching presents the greatest
risk for elbow problems.
Extent of Injuries: Wrestling
• In 2004, there were
over 240,000 high
school participants.
• About 27%
sustained injuries.
• Collisions with
opponents and mats,
and takedown and
escape maneuvers
resulted in various
© Digital Vision/Getty Images
Extent of Injuries: Wrestling
•Shoulder/arm, knee, and forearm/wrist/hand
were injured most often.
•Most of these injuries were strains &
•Friction burns, skin infections, weight
management, and “cauliflower ear” are also
common issues.
Extent of Injuries: Volleyball
• During 2004, nearly
400,000 high school girls
• Nearly 15% suffered
injury, mostly sprains.
• Ankle/foot region is most
often injured.
Extent of Injuries: Soccer
In the United States, there
are 14 million
participants under 18
years of age.
During the 2002 season
• 340,000 high school boys
• 300,000 high school girls
Extent of Injuries: Soccer (cont.)
• Contusions are the most common injury.
• The majority of injuries are in the lower
extremity – accounting for about 60% of total
• Female athletes have a higher ratio of knee,
specifically ACL, injuries than male athletes.
• Research has shown that the majority of
head injuries result from collisions not
intentional heading.
• Improperly constructed, movable soccer
goals have been involved in a number of
severe injuries and deaths.
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