Download - Sport Injury Management for Coaches
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SPORT INJURY MANAGEMENTFOR COACHES / PE
INSTRUCTORS
(THE CONCEPT)
BY :
NUR IZURA BT. MOHD SAAD
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What is Sport Injuries??
Caused by participation in a sporting event; maybe overuse injuries or caused by a hard contact
with something
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Objective
The participants will have a knowledge of:- Injury prevention
Injury cycle
The participants will be able to:- Systematically approach an injury situation
Provide appropriate initial management
Able to reduce the likelihood of further damage
Referral if necessary
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TYPE OF INJURY ACUTE
CHRONIC
CAUSES
INTRINSIC EXTRINSIC Body Composition Training Method Age Surface Muscle Weakness Equipment Poor Flexibility Environment Injury
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Causes of injury
Overload High intensity
Improper safety
Impropriate warm up & cooling down Others
Injury occurs- Hard & soft tissue
(due to intrinsic & extrinsic factors)
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COMMON SPORT INJURIES
Nerve JointMuscle
Bone Ligament
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Soft tissue
Refers to injuries to muscles, tendon, ligament,fascia & skin
Common / type of injuries
1. Sprain2. Strain
3. Open wound
4. Deep bruising (haematoma)5. Muscle soreness
6. Muscle cramp
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Management of soft tissue
injuryWhy need early management?
To facilitate rapid healing
To prevent edemaTo reduce risk of recurrent
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Factors to be consider
within(48-72 hours) To reduce local temperature To manage pain
Minimize inflammation Protect damage tissue from further injury
Aid collagen fiber growth (realignment)
Maintain cardiorespiratory & muscular fitness
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Prevention
Incident phase
PreventionOf
Recurrence
Acute phaseDefinitive care
Rehabilitation
Injury Cycle
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INJURY PHASE DESCRIPTION APPROACH USED
PREVENTION To stop injuryoccurring
Preventionstrategies
INCIDENTPHASE
The first fewseconds
Ensure no danger orno life-threatening(DRABC)
ACUTE PHASE 48 72 hours after
injury
STOP, TOTAPS,
RICER, NO HARMSFractureManagement
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INJURY ASSESSMENT
Primary Survey (DRABC)
Secondary Survey (TOTAPS)
3 St t t
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3 Steps n t e management o anincident
DRABC Danger, Response, Airway, Breathing, Circulation(could this incident have been prevented?)
STOP a fast on-field assessment.
Stop, talk, observe, prevent further injury
Determine - is there an injury
- can the athlete continue to play
- is the injury major/ minor
- should the athlete be removed
TOTAPS to make a full assessment on or off the field
Use it to:
specifically assess the injury
outline the basis of your management plan
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WHAT IS PRIMARY SURVEY ?
When an athlete goes down with an injury, you shoulddo as follow :
Determine whether the athlete is conscious/unconscious
If unconscious, check the athletes ABCs :
* airway used head tilt/chin lift/chin lift only
* breathing look, listen & feel for breathing- if none, give 2 full breaths
* circulation check carotid (neck) pulse
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If the athlete is conscious & able to talk, check these
function :* breathing for irregularities
* pulse for heart / circulation problems
If both breathing & pulse are normal, begin thesecondary survey to locate & check the extent of the
injury
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Performed after life threatening injuries have been ruled out
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TALK ask the player what happen ?- where does it hurt ?
- what kind of pain ?
OBSERVE look at the offered area forREDNESS/SWELLING
- is the injured side different fromother side ?
TOUCH touch will indicate warmth forinflammation
- touch also assesses pain
TOTAPS
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ACTIVE MOVEMENT
- ask the injured athlete to move the injuredpart without any help
PASSIVE MOVEMENT
- if the player can move the injured part, carefullytry to move it yourself through its full range of
motion
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SKILL TEST
- did the active & passive movement produce pain?
- If no, can the player stand & demonstrate some of
the skills from the game carefully?- If an injury is identified, remove the player from the
activity immediately.
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STOP stop the athlete from participating /
- stop the game if necessary
TALK talk to the injured athlete :
* what happened?* how did it happen?
* what did you feel?
* where does it hurt?* can you play on?
* if no, arrange appropriate transport
STOP
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OBSERVE observe whilst talking to the athlete:
* GENERAL : is the athlete distressed?
: is the athlete lying in anunusual position/posture?
* INJURED SITE
: is there any swelling, deformity /discoloration?
: can the athlete remove the injured part?
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PREVENT FURTHER INJURY by:
- ensuring a detailed assessment using
TOTAPS
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IMMEDIATE ASSESSMENT
(on the field)
R : Rest
I : Ice
C : CompressionE : Elevation
R : ReferralFurther Management?
Rehabilitation
NOH - HEAT
A - ALCOHOL
R - RUNNING
M -MASSAGE
R t i i j d li b
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Rest- stop using injured limb
How - should lying down, immobised & supported
Why - activity will promote bleeding
Ice- crushed ice in wet towel/ plastic bag, cold water
immersion in ice water, commercial cold packs
Why - ice reduces swelling, pain, muscle spasm
Compression- apply a firm wide
compression bandage (not to rigid)
Why - it reduces swelling, bleeding & providesupport
Elevation- Raise the injured area above the level of Heart
Why - reduce bleeding, swelling & pain
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The RICER regime must be continued & NO HARMfactors for the first 48 72 hours after the injury to
reduce :
The severity of further injury, haematoma & tissueswelling
The amount of tissue damage
The recovery time
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RICERessential elements for a quick recoveryfrom injury
REST rest reduces further damage
- avoid such as movement as possible to limitfurther damage
- dont put any weight on the injured part of thebody
ICE apply a hot/cold pack to the injury for
20 minutes every 2 hours
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COMPRESSION
- apply Elastoplasts Sport Elastic Adhesive
bandage or a non-elastic compression covering theinjured area as well as the areas
above & below
- compression reduces bleeding & swelling
- check bandage is not too tight
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ELEVATION elevate the injured area to stop
bleeding & swelling
- place the injured area on apillow for support
REFERRAL refer the injured person to a
qualified professional such as a
doctor for definitive diagnosis &
continuing management
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NO HARM HEAT - such as sauna, spa hot water bottle,
hot shower, rubs- increase bleeding
ALCOHOL increase swelling
RUNNING or exercise too soon can makeinjury worse
MASSAGE in the first 48-72 hours increase
bleeding & swelling
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INJURY PREVENTION
Conditioning Nutrition
- Warming Down Skills &Knowledge
- Warming Up Others
EnvironmentProtective Equipment
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Handling Minor Injuries
1. Evaluate the injury
2. Administer first aid
3. Remove from game (if necessary)4. Contact the coaches or parents
5. Suggest to see the doctor
6. Injury report
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Handling Serious Injury
1. Check level of consciousness (AVPU)2. Activate Emergency Medical (ERP)
3. Wait for rescue team
4. Assess the injury5. Administer the first aid
6. Assist for transportation
7. Accompany to hospital8. Complete injury report
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Cares for bleeding Could be open wound
Could lead to shock
1. Alert EMS system
2. Provide an open airways (monitor pulse)
3. Keep at rest (emotional support)4. Treat for shock
5. Loosen restrictive clothing
6. Nothing to the mouth7. Splint (for fractures)
8. Constantly monitor vital signs
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Moving an injured athlete
Moving critical injured
- keep the athlete still unless you cannot
establish airway or CPR
Non critically injured
- can be more readily move
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Management of soft tissue
injuries
(strain, sprain, soreness, contusion)
Early, aggressive & proper use of RICERregime and NO HARM factors is very
essential. (usually within 72 hours)
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Summary managing injured athlete
Once it happened. .
Step 1 Danger control danger then assess
Step 2 Life threat Use DRABC
Step 3 Initial injury assessment Use STOP
Step 4 Detailed injury assessment Use TOTAPS
Step 5 Initial management Manage appropriate
Referral
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Stages of managing injury
1. First Aid measures
2. RICE
3. Early management make a diagnosis withappropriate investigation
4. Formulate a treatment plan
5. Maintain cardiorespiratory fitness
6. Stretching & strengthening exercise
7. Sport specific fitness
8. Attention to technique & equipment
9. Competition staged return
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Other therapy
Corticosteroid injection
Inflammatory gels Vitamins
Dietary supplementation
- Glucosamine
- Chondroitin sulphate?
Traction
Electrotherapy
Sports massage
Surgery
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The use of special exercises and modifiedtraining methods to help an athlete recoveryfrom an injury
Is required to return the athlete to theprevious level & enable the athlete to returnto sport will function in the shortest possibletime
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OBJECTIVE OF REHAB :
Is enable the athlete to return to sport with fullfunction in the possible time
Also minimize the undesirable effects of
immobilization on the injured area; encourageproper healing, maintain all around conditioning(allowing for restrictions because of the injury) *restore sport specific function
Also can break an athletes injury or re-injurycycle
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Future of sports medicine
The risk of injury will never be entirely eliminatedbut modifications in training techniques,equipments, sports venue and rules based on
meaningful research have shown that risks can belowered.
(The Director of Institute of Preventive Medicine - Michigan)
Further Reading
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Further Reading1. Flegel, Melinda J (2004)
Sport First Aid, Human Kinetic
2. Griffith H. W. (1999)
Complete guide to Sports Injuries
Mc Graw Hill
3. Prentice, William E. (1999)
Rehabilitation techniques in Sports Medicine
Mc Graw Hill
4. BMJ, 1994, 308: 1356-9
ABC of Sports Medicine Nature, Prevention
& Management of Injury in Sport
. htt ://www.merck.com
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Conclusion
1. Injuries in sport usually either acute traumatic or
chronic (overuse) injuries
2. History to establish causes(s) of injury and thusmake correct diagnosis and prevent recurrence
3. Diagnosis for correct treatment
4. Treatment appropriate to injury
- Rest- DRUGS
- PHYSIOTHERAPY
- SURGERY
(cont ) Conclusion
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(cont.) Conclusion. .
5. Maintenance of general Fitness
6. Correction of poor training programmed
7. Rehabilitation gradual, structured regimen
8. Emphasis of importance of warm up, stretchingand exercise
9. Lets think common sense, dont panic andapproach with professional manner
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THANK YOU