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Chapter 1 - Biomechanics of Musculoskeletal Injury
KNES 463
Why study the biomechanics of injuries? National Safety Council: Annual cost >
$435 million and 40% of hospital admissions
Unintentional injuries are the 5th leading cause of death in the U.S.
Potential life span for injures related deaths 36 years
What is the difference between an accident and injury? Accident: unexpected,
unavoidable and unintentional event
Some accidents involve injuries
What is an injury?
Damage caused by physical trauma sustained by tissues of the body
What is Biomechanics?
The applications of mechanical principles to biological problems.
Mechanism: Physical process responsible for a given action, reaction, or result.
Interdisciplinary approach (anatomy, physiology, mechanics, medicine, engineering, psychology)
Historical Perspective
Origins of mankind (prehistoric)
Treatment of injuries also as old as injuries
Surgical Instruments by Indian, Egyptians, Incas, and other cultures
Famous Contributors to the study of Injuries Hippocrates: Establish
foundations for the study of injury and medicine. Father of medicine.
Described many Orthopaedic conditions
Famous Contributors to the study of Injuries Galen: Roman
Physician (Gladiators) Basic anatomy,
treatment of spinal deformities, use of pressure bandages
Dark Ages after Roman Empire
Famous Contributors to the study of Injuries Andreas Vesalius:
Belgian Physician, provided detailed anatomical drawings of human dissections
Famous Contributors to the study of Injuries Leonardo DaVinci:
Role of joints, body senses (pain), trauma (impact), scientific drawings, similarities between man and machine.
Industrial Age and Technology
Technological advances Laser surgery Arthroscopy Artificial joints Microsurgery
Epidemiology
Study of incidence, distribution, and control of disease (can predispose a person to injury) and injury in a given population
Epidemiological Studies Descriptive: Analysis
of the frequency and distribution of an injury in a population
Categorization items:– Severity– Location (site)– Type of disability– Population subset– Activity
Analytical: Finds the cause and effect relationships in an injury
– More difficult, time consuming
– Must rule out all possible factors such as coincidence or mere correlation
Terminology
Incidence: Number of new injuries in fixed period of time by a group of people at risk.
Prevalence: Number of people with an injury/number of people at risk
Injury rate: Number of injury in population/reference measure (practice episodes, hours of exposure, innings played)
Relative risk: Likelihood of an injury happening to a group
Psychological Perspective
A person’s likelihood to injury depends on the task, environment, and the person’s psychological state
Psychological States
Psychological states predispose people to injuries– Stress
– Distraction
– Fatigue
Human Error
Inappropriate or undesirable human decision or behavior that has the potential for reducing effectiveness safety or performance
How can we reduce human error?
Selection of people with appropriate skills
Training Effective equipment,
procedures, and environment
Why do people suffer accidents?
Accident-proneness Accident-liability (situations) Capability-demand (increase demands) Adjustment-stress (increase stress levels) Arousal-alertness (boredom/anxiety) Goals-freedom-alertness (workers set own
goals injuries) CFAC (comprehensive multi-factor model)
Risk for Injury or death
Perception of risks– overestimation of
expertise or abilities
– overemphasizing situations
– It can’t happen to me! philosophy
Psychological factors in InjuryPreceeding factors Associated factors Factor after
Medical/Psychologicalhistory
Emotional distress Culpability
Somatotype Injury site Rehabilatationcompliance/effectiveness
Life Stress/or change Pain Pain/medication
Sports stress Timeliness Psychological status
Overtraining Unexpectedness Social Support
Sport related risk factors Personality conflicts
Fans & media
Litigation
How can we prevent injuries?
Injury Control programs– educate those at risk
– Legislation (seat belts)
– Automatic protection (airbags)
Automatic protection is the most effective
How can we prevent injuries?
Health & safety Education Programs– Least effective program– Greater the effort to adopt a safer behavior the
less likely the adoption of that behavior
Fitness Programs– Fit individual a less likely to be injured and
recover faster
Can injuries be eliminated?
No, but the severity and the incidence can be reduced