PDHPE HSC Enrichment Day 2012 - 59

PDHPE

Sports Medicine

Focus Question 1

What are the signs and symptoms and

management of hard tissue injuries?

Students learn about:

• Hard tissue injuries

• fractures

• dislocation

Students learn to:

• Manage hard tissue injuries

• assessment for medical attention

• immobilisation

What is Hard Tissue?

The two common hard tissue injuries are fractures and dislocations.

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Fractures can be classified into three categories:

Simple - ........................................................................................

Compound - ...............................................................................

Complicated - ............................................................................

Signs and symptoms of a fracture may include:

• Loss of function

• Swelling

• Deformity

• Signs of shock

• Pain and tenderness

• The affected area moving too freely

• Visible signs of bone

• The sound of a snap at the time of the injury (Sports Medicine Australia)

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A dislocation is:

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Signs and symptoms of a dislocation may include:

• Loss of function

• Swelling

• Deformity

• Pain and tenderness

(Sports Medicine Australia)

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How Are Hard Tissue Injuries Managed?

Primary Assessment

1. DRABCD

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2. STOP- conducted only after life-threatening problems have been managed.

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Focus Question 2

Assess the effectiveness of taping and bandaging in enhancing the well-being of

athletes.

Students learn about:

taping and bandaging

preventative taping

taping for isolation of injury

bandaging for immediate

treatment of injury

Students learn to:

evaluate the role taping plays in both the prevention and

treatment of injury

PDHPE HSC Enrichment Day 2012 - 63

Bandaging for Immediate Treatment of Injury Preventative Taping

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Taping for Isolation of Injury

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Bandaging For Immediate Treatment of Injury

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PDHPE HSC Enrichment Day 2012 - 65

Take Home Activities

The following activities can be done at home as part of your study in preparation for

the HSC:

Activity 1:

Label the following x rays as being simple, compound or complicated fractures or a

dislocation.

a) b) c)

d) e) f)

g)

a) .................................................................................

b) .................................................................................

c) .................................................................................

d) .................................................................................

e) .................................................................................

f) ..................................................................................

g) .................................................................................

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Activity 2:

Broncos beat Rabbitohs but set to lose Jharal Yow Yeh for season

with broken leg

BRONCOS teammates Sam Thaiday and Justin Hodges reassured teammate Jharal Yow

Yeh that his career was not finished as he lay on the ground with a broken bone sticking

out of his right ankle during last night's match in Perth.

Thaiday and Hodges also begged the team

doctor to administer painkillers to the stricken

youngster as the game against Souths was

held up for several minutes before Yow Yeh

could be taken from the field on a stretcher.

The Test and Queensland State of Origin

winger suffered a compound fracture of the

right leg as he landed awkwardly after leaping

for a high ball in the 24th minute.

Brisbane won 20-12 in an amazing show of fortitude, with centre Jack Reed sin-binned

in the first half after which Souths leding 12-4.

Yow Yeh will spend at least two nights in Royal Perth Hospital, his teammates leaving

Perth at midnight on the infamous red eye flight.

"Jharal was laying there with his bone sticking out of his boot. He was in a lot of pain,"

skipper Thaiday said of the incident.

"Hodgo and I were trying to encourage him as much as we could. The first thing that

goes through your head when you get injured is your footy, your season and your

career (over).

Steve Ricketts

From: The Courier-Mail March 24, 201212:00AM

As you can see in the picture above, a Sports Trainer comes onto the field to assist

Jharal Yow Yeh.

Outline the management of this injury from the time it happened on the field until he

arrives at the Royal Perth Hospital.

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Activity 3:

After reading the two following articles explain in your own words how Kinesio taping

could be used to both prevent and treat an injury.

'I am in the yellow jersey, I am going to race here' - Evans fights to the end

Rupert Guinness

Sydney Morning Herald July 5, 2010

SAINT JEAN DE MAURIENNE: The X-ray results arrive. For Cadel Evans, it is the worst news

to receive one day after claiming the Tour de France leader's yellow jersey. His left

elbow is fractured. His dream of winning the race is probably over and all before he

had a chance to defend his lead. It is kept secret. Evans (BMC) is facing the challenge

of defending the Tour lead when racked with the pain from injuries.

In 2008, his five-day reign in the yellow jersey began the day after he crashed in stage

nine. This time, his injuries - including severe bruising, abrasions and cuts to his shoulder

and wrist, as well as a fractured elbow - have come in stage eight when he crashed

after seven kilometres.

''We weren't so worried about the shoulder and wrist, but the elbow looked like it had a

fracture of the radial head,'' BMC doctor Massimo Testa says.

Suspecting fracture, Evans at least knows there is a rest day to trial his pain threshold

before facing the destiny that those X-rays indicate awaits him. He sets out for a training

ride but returns early. He still feels pain and Testa recommends he has X-rays at the local

clinic. Fewer than five people are told of the fracture.

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''I don't want to say who knew, but it was a small group - not the riders. There were less

than five,'' BMC team co-owner and president Jim Ochowicz says. Testa, a long-time

confidant of Ochowicz, adds: ''We didn't want anybody to know because of the

morale of the team.''

Was the prospect of the ''inevitable'' for Evans - withdrawing - ever discussed? ''He didn't

want to talk about that. He said, 'I am in the yellow jersey, I am going to race here'. With

a fracture, two fractures, three fractures … That's Cadel,'' Testa says.

Testa is amazed Evans still went through it - a 204.5-kilometre ninth stage from Mourzine-

Avoriaz to Saint Jean de Maurienne over five Alpine passes. ''If you ride a bike six hours

up and down and you have a broken elbow, this is as much I think as any human can

do,'' Testa says.

That much was painfully clear as Evans was dropped from the main group of overall

contenders. The first sign was when Kazak Alexandre Vinokourov accelerated from the

group with 51km to go. It was on the 25km-long Col de la Madeleine, the last of five

mountains. Evans was near the front, but suddenly dropped back one bike length, then

two, then three. Then came the moment: he was adrift of a bunch of about 45 riders.

Until that moment, his Tour dream was still alive. ''He went way above what everybody

would have expected,'' Testa said.

Later, after more than 5½ hours of racing through the Alps, Evans crosses the finish line in

42nd place at 8 minutes, 9 seconds to the French stage winner, Sandy Casar (FDJ). So

exhausted is Evans when he stops after honouring the yellow jersey so well leading his

eight-strong group to the finish, he hugs the last teammate who rode more than 30km

with him, Italian Mauro Santambrogio. He then drops his head and cries. Even then, the

cycling world is yet to know the extent of his pain.

''I'm not at my normal level. When you're in the yellow jersey at the Tour, you have to be

there whether you're good or not,'' Evans says after the stage. ''The team was just

fantastic. I am the one who had the crash two days ago. I am the one who is wearing

the jersey. I am the one who is vulnerable. It's not my normal self to be dropped by a

group like that. Normally, today is a stage when I might have a chance for a stage win

and it wouldn't have an effect on [general classification]. For the win for the Tour, I

haven't seen the results yet, but I'm pretty sure it's all over.''

Only after Evans steps into the bus is the extent of his suffering revealed. Ochowicz

explains how the injury was kept secret to avoid BMC's rivals from attacking Evans early

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and to ensure that the Victorian's teammates would not lose their motivation to work

hard for him because of such uncertainty.

Ochowicz also explains the difficulties that Evans had in getting on the bike to race.

''He doesn't have full mobility,'' he says. ''We tried to relieve some of the pressure [with

Kinesio tape]. But he was having more trouble in the downhills than the uphills. [On the

rest day], he rode with the guys in the morning … Then our doctor [Testa] thought it

would be best if he went to the clinic and had the X-ray. Then they saw the fracture.''

Kinesio Tape – The Elastic Tape - Written by David Coombs

An increasing trend by runners is the use of elastic strapping tape to

manage injury and reduce pain. If you have seen this tape and

wondered what it does – read on.

Most people will now be familiar with runners and other athletes

sporting multi-coloured strips of tape, following the contours of the body in flamboyant

patterns. We invited physiotherapist David Coombs to give an insight into what the

tape does, how it works and what advantages it can provide.

Taping has been used for decades by physiotherapists, coaches and athletes to help

manage injury. Traditionally rigid flesh-coloured tape is used to stabilise a joint, for

example supporting the ankle joint after an inversion (rolling) injury. Support is provided

either short-term (to prevent further injury to a damaged structure, such as a ligament)

or long-term (to prevent recurrence of the same injury after healing has occurred). One

of the principal advantages of rigid tape is that it does not stretch and therefore is

perfectly suited to the former application where maximum stability is required. However,

the same rigidity can become a disadvantage when used long-term as some restriction

of normal movement inevitably occurs. For example, when taping the ankle to prevent

over-inversion, some restriction of ankle dorsiflexion and plantarflexion will occur,

potentially leading to altered running mechanics and further injury elsewhere in the

body. One possible solution to this problem is elastic strapping tape.

First developed in Japan in the 1970s elastic strapping tape, also known as Kinesio Tape,

Dynamic Tape, or Spidertech Kinesiology Tape, is fast gaining popularity and is now

available through a range of manufacturers, and in a variety of styles and colours to

suit all types of athletes and fashion aficionados. The tape can be purchased in rolls

that can be cut and customised to suit the individual, or in pre-cut strips and patterns

suitable for use on specific body areas or for specific injuries. The tape is designed to be

PDHPE HSC Enrichment Day 2012 - 71

worn for up to 5 days, can be worn during vigorous exercise – including running – and is

safe to get wet. There are a number of proposed benefits of using elastic tape and

these will be examined below.

Postural Management

By providing moderate restriction to unwanted

movement, your neuromuscular system is assisted with

maintaining muscles at the correct tension and joints at

their optimal alignment. Unlike rigid tape that completely

blocks unwanted movement, elastic tape encourages

correct movement. For example, when using

conventional rigid tape to support the ankle joint the goal

is to restrict movement to the extent that it is impossible to roll the ankle too far, thus

preventing injury to the lateral ligaments (see Figure 1).

In healthy individuals our peroneal muscles (positioned on the outside of the ankle and

extending up the lateral side of the calf) act as

active stabilisers of the ankle, contracting strongly to

maintain ankle alignment and prevent the excess

inversion that may lead to lateral ligament injury. In

other words, a healthy ankle does not need tape

because the alignment of the joint is maintained by

the muscles. It has been shown that repeated

inversion injury leads to inhibition of these muscles

and increased risk of further injury. Rehabilitation aims

to restore function of these muscles and reduce the

likelihood of re-injury. Elastic tape applied to the

lateral aspect of the lower leg (see Figure 2) can be

a useful adjunct to conventional exercise therapy, providing dynamic support for the

ankle, encouraging activation of the peroneal muscles, whilst allowing full active range

of motion. The combined effect is improved postural awareness and facilitation of

desirable muscle recruitment patterns leading to reduced injury risk and improved

rehabilitation outcomes.

Examples of conditions that can benefit from the use of elastic tape in this way are

muscle tears (eg groin, hamstring, quad or calf), tendonosis (eg Achilles or tibialis

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posterior), over-pronation of the foot/ankle, patello-femoral knee pain and upper limb

disorders such as tennis elbow and rotator cuff injury.

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