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

    C l i

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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