Injuries and the Healing Process Inflammation Injuries –Strain –Sprain –Contusion

Injuries and the Healing Process

Inflammation

• Injuries– Strain– Sprain– Contusion

Open Wounds

• Tissue is torn

• Capillaries are damaged

• Cells Die

• Interruption of Blood and 02 Supply

Response

• Specialized Cells Sent to Injured Area– Control Damage to the Area– Initiate Blood Clotting– Muscle Spasm Splint Area– Muscle Spasm to Reduce Blood Flow

Signs and Symptoms

• Pain– Increase Pressure on Nerve Endings– Cells Response to Lack of O2

• Swelling– Fluid Gathering in Damaged Area– Hemorrhage, Lymph and Synovial Fluid

– Increased Pressure on Nerve Endings– Gravity Increased Swelling if Not Elevated

• Note garden hose filled with water and hit it with a hammer

• Redness

• Healing Process Begins

• Increase in Blood Supply Providing Nutrients for Repair

• Note: Storm damage-remove debris (circulatory and lymph system

First Aid

• Role– Prevent Further Damage– Reduce Pain and Stabilize

• Untreated Injury During Inflammation– Prolonged Recovery Time

• Proper First Aid– Assist Body Protection of Further Injury– Reduce Risk of Further Injury

RICE

• Rest

• Ice

• Compression

• Elevation

Rest

• Rest the injury to decrease blood flow to the injured area

• Rest to reduce the chance of continual stress and re-injury to the injured area

• Rest to decrease the healing time

Ice Injury

• Stronger Stimulant than pain (override Pain)

• Reduce circulation

• Slow nerve conduction

• Reduces cells need of oxygen and metabolism

Compression

• Reduces blood flow to the injured area

• Start distally and wrap toward the heart

• Stretch the wrap about 70%

• Excess pressure does not reduce swelling

• Actually hampers the healing process

Elevation

• Elevate above the level of the heart

• Blood return to the heart is by venous pressure to overcome gravity

• This allows the body to work less and increase healing

Treatment

• Determined by athletes response to the injury

• Bleeding will occur from 1-72 Hours

• Hemorrhage will increase if– Stress on the injury– Reoccurrence of mechanism– Wrong form of treatment

Treatment

• If heating increases swelling or pain return to cold

• Heat to remove material waste from injured area

• Heat increases local circulation

• Brings nutrients to the area

• Absorbs the waste product

Do not heat if:

• Immediately after the injury

• Numbness or loss of sensation

• Over bones with metal pins

• Sensitive areas such as eyes or genitals

Cold Treatment Procedures

• Gel cold pack

• Instant cold pack

• Ice bag

• Ice massage

• Ice water immersion

• Cold whirlpool

Cold gel pack

• Do not apply directly to the skin

• Place ice on injury not injury on ice

• Treatment time 15 minutes

Instant cold packs

• Expensive

• Lack coldness

• Convenient

• Treatment time 15 minutes

Ice Bag

• Plastic bag

• Wet towel

• Inexpensive

• Availability

• Treatment time 15 minutes

Ice Massage

• Used most often with chronic injuries

• Move ice continuously to prevent frostbite

• Treatment time 3-15 minutes

Ice Water Immersion

• Temperature 32-40 Degrees

• Surrounds the injury

• Equal reduction in temperature of the body part

• Ice until numb

Cold whirlpool

• Temperature 55-65 degrees

• Provides cold as well as massage

• Treatment time 15-20 minutes

Hot treatment procedures

• Hydrocollator (Hot) Pack

• Hot whirlpool

• Massage

Hydrocollator Pack

• Use towels to insulate

• Temperature is 170 degrees

Hot Whirlpool

• Temperature 101-106 degrees for full body submersion

• Temperature can be 110 degrees for an extremity

• Massage by air jets

Massage

• Friction increases temperature and circulation

• Relaxes muscles

• When reducing swelling work toward the heart for Western Style and away from the heart for Oriental Style

Contrast Bath

• Combination of heat and cold treatment

• Start in cold end in cold

• Provides a pumping action through the constriction and dilation of the blood vessels

• Removes the waste product

Rehabilitation

• Goal– To return the athlete to competition as soon as

possible without further risk of injury– Return the athlete to pre-injury flexibility,

strength and endurance– Prevent deconditioning of the rest of the body

Common Athletic Injuries

• Sprains• Strains• Contusions• Open wounds• Laceration• Puncture

• Fractures• Stress Fractures• Dislocations• Subluxations

Sprains

• A joint is forced beyond its normal limits

• Joint forced in an abnormal direction– 1st Degree: Stretched– 2nd Degree: Stretched or slightly torn ligament– 3rd Degree: Ligament completely torn

• X-Ray to rule out fracture

• Rehab before returning

• Surgery for 3rd degree

Strain

• Causes– Overuse

– Overstretch

– Overload

– Strength imbalance between muscle groups

• 1st Degree stretch of the muscle– Little or no disability

– Little or no loss of function

– Little or no loss of ROM

Strain (Cont.)

• 2nd Degree stretch or slight tear of the muscle– Loss of Strength– Loss of function– Loss of ROM

• 3rd degree complete tear of the muscle– Total loss of function

Strain (Cont.)

• 2nd and 3rd degree strains should be examined by a Physician

Contusion

• A bruising of the soft tissue• Blood vessels broken- internal hemorrhage• Hemorrhage and leakage of cellular fluids• Swelling and internal pressure• Discoloration

– Untreated or unprotected=Myositis Ossificans

– Myositis ossificans calcium formation in the soft tissue

– RICE and donut pad

Open Wounds

• Abrasion

• Laceration

• Puncture

• Incision

Abrasion

• Friction burns and scrapes• Scrape skin from the body leaving an open

wound• Clean with soap and water• Remove all dirt and debris• Germicide to stop bleeding and prevent

infection• Watch for signs of infection

Laceration or Incision

• Stop bleeding by direct pressure and elevation

• Clean area of dirt and debris

• Determine if stitches are needed

• Watch for signs of infection

Puncture wounds

• Infection injected into the blood stream

• Seals in infection as they occur

• Clean area

• Watch for infection

• Tetanus shot

Fractures

• Pain and swelling

• Deformity

• Crepitation

• Open or closed (simple or compound)

Stress Fracture

• Overuse

• Develop slowly

• Do not always appear as a fracture

Dislocation

• Subluxation= a dislocation that resets itself

• Separation= separation of two immovable bones

• Separation of bones

• Stretch or tear of ligaments

• Fracture may be present

Signs of infection

• 2-7 days after injury

• Red swollen and tender

• Mild fever or head ache

• Swollen lymph gland (neck, arm pit, or groin)

• Red streaks in the veins