dave berg sports injuries
TRANSCRIPT
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ERINDANLE COLLEGE SPORTS INJURIES TALK
• DAVE BERG, PHYSIO
• BERG PHYSIOTHERAPY AND SPORTS INJURY CENTRE AT ERINDALE MEDICAL CENTRE
• 6231 1155
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Sport should be fun
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ROLE OF PHYSIOTHERAPIST
• MANAGEMENT OF MUSCULOSKELTAL INURIES IN PRACTICE
• ON FIELD MANAGEMENT AND ASSESSMENT OF INJURIES
• SCREENING FOR THE PREVENTION OF INJURIES
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MUSCULOSKELETAL INJURIES
• BONE – BREAKS, SPINAL INJURIES
• MUSCLE STRAINS– TEARS, CORKS
• TENDONS – IRRITATIONS, TEARS
• LIGAMENTS – TEARS, SPRAINS
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Musculoskeletal Injuries Cont
• JOINT– MENISCAL, OSTEOCHONDRAL– DISLOCATIONS
• OTHER SOFT TISSUE INJURIES
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“OTHER”
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“OTHER CONT”
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BONE INJURIES
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Bone Injuries
• Usually high energy injuries
• Immediate pain, usually associated with an audible crack
• Deformity, Swelling, Pain to palpate, Pain to axially load.
• Types of breaks– stress fracture, spiral fracture, transverse break
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Stress Fractures
• Begin as pain with activity
• Progress to pain with activity and constant pain
• Most commonly affected areas are the foot, shin and low back
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Fracture Management
• Fingers. Sign if not obvious is to press through length of bone.
• Xray is gold standard test.• Surgery if displaced or rotated• four to six weeks if no surgery• Other breaks follow similar principles.
Immobilisation or surgery depending on displacement.
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Traumatic breaks
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Muscle Injuries
• Muscle Injuries are direct (corks), or indirect (tears).
• Muscle tears are known as strains, and are classed one to three
• Most commonly injured muscles are hamstring, calf, and quadriceps.
• Muscle Tears have a very high recurrence rate.
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Muscle Tears
• Grade One Tear: 7-10 days
• Grade Two Tear: 4-7 weeks
• Grade Three Tears: >six weeks
• Rehab of the muscle tear very important. Regaining strength, length and power.
• Pain is not the guide. Tensile strength (ability to contract under load) does not recover till several weeks
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Muscle Corks
• Impact injuries• Usually poorly
managed.• Immediate
management should be ice with full stretch.
• Definitely should not consume alcohol.
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Ligament Injuries
• Can be contact or non contact injuries.
• Involve the joint being moved in a direction it does not want to go.
• Pain is immediate• Ligament in ankle and
knee are most commonly torn
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Ligament Injuries Cont.
• Injuries are graded one to three
• Grade three injuries are full thickness tears and usually require surgery.
• Grade two tears can generally be managed conservatively. >four weeks
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Ankle Ligaments
• Most commonly torn are the Lateral ligament and the syndesmosis)
• Mechanism is usually rolling over the ankle, twisting on a fixed foot (syndesmosis), or falling over the heel usually from a height
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Management of Ankle Injuries
• Brace for four weeks if laxity present
• Strength training to improve peroneal and gastroc muscle strength
• Stretching to restore range of movement, particularly dorsiflexion
• Balance or proprioception retraining.
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Knee Ligaments
• Most Commonly torn are the ACL and Medial Ligament.
• ACL requires surgery. Is a non contact injury. Happens when stepping or cutting.
• Medial ligament is usually a contact injury. Managed conservatively with a brace for four to six weeks.
• Posterior Cruciate Ligament rarer. Hardly ever managed surgically even if fully torn.
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Head Injuries
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Head Injuries
• Usually involve head contacting something solid eg another head or knee
• If player is knocked out they should definitely not continue to play.
• Aggression, twitching, vomiting, severe headache, amnesia, and blurred vision are all bad signs
• Mandatory three weeks out if knocked out
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Head Injuries
• Three concussion episodes in one year should sit out the whole year.
• Two impacts in rapid succession can result in death.
• Should not consume alcohol, risk death
• If knocked out should not drive home, should be monitored and should not sleep till that night.
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Eye Injuries
• Involves foreign object into eye socket.
• Can result in loss of vision or eye.
• Immediate hospital referral.
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Joint Dislocations
• Occurs when a joint is taken out its socket
• Most commonly affected are the fingers shoulder, AC joint, and patella femoral joint. Ankles are uncommon
• Knee and hip dislocations are rare and VERY serious
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DISLOCATIONS CONT
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Shoulder disclocations
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SHOULDERS CONT
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Shoulder dislocations
• Mechanism outstretched arm forced backwards
• In someone under 25 years, greater than 90 percent chance of doing it again
• Once dislocated three times need surgery
• Surgery follows six to nine month rehab period
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Shoulder dislocations
• Conservative approach after first dislocation MIGHT prevent subsequent episodes and therefore surgery.
• Four to eight weeks off.• Strengthening of back and rotator cuff
muscles.• Improved proprioception in shoulder. • Improved thoracic movement.
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Other dislocations
• Knee and hip dislocations require immediate hospital review. Person can lose their limb
• Patellofemoral and AC dislocations are not surgical. Tend to respond very well to conservative treatment.
• Finger dislocations can be surgical depending on direction of dislocation
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Finger dislocations
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Hip dislocation
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Other joint injuries
• Other intra articular structures can be damaged. These include bone cartilage interface, called osteochondral injuries, meniscus injuries.
• Osteochondral injuries require prolonged rest or surgery.
• Meniscal tears can settle with rest but often need surgery, especially if knee is locking
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Tendon Injuries
• Usually occur in older athletes when blood supply starts to lessen.
• Can occur in younger athletes in high energy injuries.
• Tendons most commonly torn are rotator cuff, achillies, patella.
• These are usually surgical injuries.
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Groin injuries.
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Tendon Injuries Cont.
• More common than tears are inflammations
• Tendonitis starts as pain with activity and progresses to pain after activity.
• Very difficult to manage once established due to the poor blood supply of tendons.
• Best managed early with rest, anti inflams, and stretching and strengthening.
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Back injuries
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Back Injuries
• Can be traumatic or due to overuse.
• Stress Fractures can occur in sports where athletes bend backward a lot (gymnastics)
• Any number of structures can be damaged, and exact diagnosis is much more difficult.
• Back and neck injuries that occur on a football field or with high energy mechanism need to be taken very seriously
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Many injuries can be prevented, but sometimes its just plain
luck...
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But don’t worry too much. After all, sport shouldn’t be taken too
seriously, have fun!
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AND BESIDES, INJURIES CAN HAPPEN ANYWHERE,
ANYTIME.