Injury Prevention Exam #3

Front 1

Athlete’s Psyche:

Back 1

Front 2

Athlete’s Response To Injury:

Back 2

-Not textbook
-Response
-Disastrous
-Courage
-Embarrassment due to thinking only the "weak" get hurt.
-Escape because they don't want to play their sport any more.

Front 3

Injury Classification:

Back 3

-Short Term: 4 weeks or less.

-Long Term: 4 weeks or more.

-Chronic: lingering ex. tendinitis.

Termination: career ending.

Front 4

Short Term:

Back 4

-Reaction to Injury: Shock, Relief
-Reaction to Rehabilitation:
Impatient, Optimistic
-Reaction to Return: Eager

Front 5

Long Term:

Back 5

-Reaction to Injury: Fear, Anger
-Reaction to Rehabilitation: Loss of Vigor, alienation from their team.
-Reaction to Return: Acknowledgment typically after their 1st play.

Front 6

Chronic:

Back 6

-Reaction to Injury: Anger, Frustration
-Reaction to Rehabilitation:
Dependent/Independent from therapist during rehab, apprehension
-Reaction to Return: Confident (dependent player), Skeptical (independent player)

Front 7

Stress and Injury

Back 7

Front 8

Terminating: Athlete is DQ'd (disqualified)

Back 8

-Reaction to Injury: Isolation, Depression. Send to a psychologist to help. Athlete must go through the grief process.
-Reaction to Rehabilitation:
Loss of athletic identity
-Reaction to Return: There is no return to the sport. Closure, Renewal

Front 9

Factors that Impact Response:

Back 9

-Coping Skills: how they react to a crisis.
-PMH: previous medical history.
-Social Support: family, friends, team mates.
-Personality Traits: happy & optimistic vs. depressed.

Front 10

Injury-Prone Athlete:

Back 10

-Risk Takers
-Reserved, detached, tender-minded
-Apprehensive: muscle guarding, tense.
-Overprotective parents.
-Distracted: mind elsewhere not on their sport.
-Angry

Front 11

Stressors:

Back 11

-Stressors: playing sport, time commitments, coach, parents, team mates, rank.
-Personal: relationships, finance, goals, parents, health job.
-School: grades, time work load.
-Work: time, schedule, $, some sports won't let you work.

Eustress: positive stress and typically this type of athlete is not likely to get injured.
Stress leads to lack of focus and can result in injuries such as fractures, concussions.
It's important to recognize and deal with stress.

Front 12

Overtraining

Back 12

Front 13

Staleness:

Back 13

-Common @ the end of training
-Training increases or stays the same.
-Not enough rest
-Due to: emotional problems
-Anxiety
-Sx: palpitations, sweaty palms, headache approaching migraine status
SX: dec performance, fatigue, apathy, weight loss, irritable, restless, boredom

Front 14

Burnout:

Back 14

-Physical and Emotional Limits Reached
-Negative attitude. Ex. Don't wanna make play-offs.
-Loss of concern for themselves & their teammates.
-Sx: headache approaching migraine status, GI, sleep, fatigue, cynicism, depression approaching clinical aspect.

Front 15

Goal Setting:

Back 15

-Specific, attainable, achievable.
-Measured: measurable.
-Positive aspect
-Short vs. Long
-Achievable
-Satisfying, helps them achieve.
-Monitor and evaluate
-Improved compliance will result from goal setting.

Front 16

Social Support:

Back 16

-Listen, make eye contact
-Body language
-Care, show you care
-Explain and Manage: in detail
-Involvement with team
-Returning to Play: tell them when so they have something to look forward to.

Front 17

Return to Competition:

Back 17

-Physically: 95% strength, ROM & proprioception and Psychologically (Tiger Woods ended sports psych. stigma)
-Confident (good) vs. Fearless (stupid)
-Body Awareness: understand body changes.
-Refer When Necessary: there are some things that are out of scope of training.

Front 18

Disordered Eating:

Back 18

What to look for: changes.
-Isolation, decreased -confidence, eating behavior, obsession, patterns of activity.
-Bulimia Nervosa:
-Binge and Purge
-12-18 years old
-Perfectionist, obedient, motivated, successful
-Resulting Effects: stomach rupture, heart rhythm abnormal, liver damage, tooth decay, cuts on knuckles (Rolf's signs)

Front 19

Disordered Eating:

Back 19

-Anorexia Nervosa:
-15-21% will die.
-Body Image disorder
-Early Detection is key
-Resulting Effects: Thinning hair, heart palpitations, heart failure, kidney stones, kidney failure, amenorrhea (loss of menstruation)

Front 20

Female Triad

Back 20

Hint 20

Fix disordered eating and naturally amenorrhea & osteoporosis.
3 menstrual cycles a year is necessary to prevent osteoporosis.

Front 21

Philosophy

Back 21

Aggressive: depends on where in season, role on team, Dr.'s orders, athlete's mentality,
Short seasons
Too protective v. too aggressive: depends on the conservative or aggressive perception of the athletic trainer
Coaches role not to design rehab
First Aid on field.
Rehab program: end of rehab strength programming for sport & position specific training. They perform no actions, only provide functional input for sport & position specific improvements.

Front 22

Inactivity & Immobilization

Back 22

Inactivity: for the 1st 24 hours.
Rapid loss of physical fitness: after 48 hours.
Immobilization
Muscle, joint, ligaments, bone, neuromuscular control
Atrophy: muscle size decreases
Decrease lubrication
Decrease neuro-muscular control
Decrease flexibility
Decrease ROM

Front 23

Goals of Rehab

Back 23

First Aid: limit swelling #1 goal
Decrease Pain
Full ROM
Increase strength, power, endurance
Neuromuscular control
Improve balance
Cardio: maintain cardiovascular endurance & limit loss of cardio endurance.
Functional: sport & position specific.

Front 24

Rehab Goals

Back 24

First Aid
PRICE
Coach is allowed to perform
Control Pain
Modalities: ex. e-stem.
Meds: needs to know athletes previous medical history & ALL current medications they are taking.

Front 25

Rehab Goals

Back 25

ROM: static, dynamic, balistic
Due to muscular resistance, or contracture of ligaments or capsule
Stretching to regain
Joint Mobilizations
Traction: pulling apart boney ends at the joint.
Physiological v. Accessory: role, spin & guide, needed for full ROM.

Front 26

Rehab Goals

Back 26

Strength, power, endurance
Isometric: concentric & eccentric
While immobilized, beginning stages
Isokinetic: constant speed, various resistance.
Important for testing because it tells you how strong you are at different ROM.
Plyometric: mimics functional movement.
functional at the end of rehab.
Open v. closed chain: Open = non-weight bearing, good for muscle isolation. Closed = weight bearing, more functional.

Front 27

Rehab Goals

Back 27

Neuromuscular control
CNS: reestablish communication from brain to movement.
Postural sway
Balance/propioception
progression

Front 28

Rehab Goals

Back 28

Cardio: only do what they can do!
Alternative exercises: increase days
Maintain: 3x/wk
Water: don't ignore or forget!

Front 29

Rehab Goals

Back 29

Functional Progression
Restore normal function for sport: full play.
Functional tests should be sport & position specific.
Agility runs
Carioca
Vertical jumps
Rebounding
Hitting

Front 30

Modalities

Back 30

Ice
Bags, bath, cup
20 minutes on, 40-60 off
Decrease in metabolism, vasoconstriction
Decreases swelling & pain.

Heat
Post-acute, not acute: apply only 72 hours after injury.
Increases blood and lymphatic flow, can increase swelling.
Relaxation
6 layers between pack and skin

Front 31

Modalities

Back 31

Massage: 72 hours after injury.
Increases flexibility
Relieve tension, reduce trigger points
Decrease pain: decrease edema & build up of fluid.
Ultrasound
Deep heat
Promotes the healing process

Front 32

Modalities

Back 32

Electrical Stimulation
Decrease pain
Muscle Re-education
Strengthening: beginning level of strengthening.
Pumping: on & off e-stem, reduces swelling.
Accupressure

Front 33

Full Recovery/Return To Play

Back 33

Full ROM: active not passive.
Full strength: 90-95% of uninjured side.
Neuromuscular control: balance.
Cardio Fitness
Pass functional tests
Refer to Dr. for clearance results in liability on the Dr. & not on the trainer.

Front 34

Environment

Back 34

Potential Dangers: hurricane, lightning, tornadoes, wind, cold, earthquake.
Well-being of athletes
Legal Concerns: lightning.

Front 35

Hyperthermia

Back 35

One of the most common issues.
Hot, humid: indoors & outdoors.
100% preventable because of hydration.
Increase in core temp.
Heat stress is completely preventable
Body’s ability to maintain core temp
Conduction
Convection
Radiation
Evaporation via sweat.

Front 36

Hyperthermia

Back 36

Cool down with ice packs.
Sweat glands & artery spots.
65% humidity: body diminishes ability to evaporate sweat.
75% humidity: almost complete inability to evaporate sweat.
Heat Index: helps to determine what gear football players should wear.
Wet bulb globe temperature index
Dry Bulb: low humidity.
Wet Bulb: relative humidity.

Front 37

Hyperthermia

Back 37

Heat Syncope
Rapid fatigue
Pooling of blood due to slowing of blood flow.
Dizziness, fainting, nausea
Tx: cool environment, fluids should be replaced with electrolytes.
Heat Cramps
Painful muscle spasms
Location:legs & especially calves.
Due to: lack of hydration & electrolytes.
Tx: fluid replacement, ice, stretch (can be painful), don't use salt tabs because it can cause rapid dehydration.

Front 38

Hyperthermia

Back 38

Heat Exhaustion
Occurs due to: excessive sweating resulting in dehydration.
Sx: profuse sweating, pale skin, core temp: 102, dizziness, inc resp, inc pulse & tachycardia.
Attempt to notice early sx onset
Tx: Fluids, cool environment, decrease core temp,
referral for: hospital to receive an IV w/ the fluid bag kept on ice.

Front 39

Hyperthermia

Back 39

Heatstroke: most dangerous, is a medical emergency. Clothes removed but leave undergarments on.
1/3s: 1/3 live, 1/3 die & 1/3 have permanent brain damage.
45 minutes cool core temp. down.
Sudden collapse with unconsciousness
Sx: flushed skin, dec sweating, shallow breathing, rapid/strong pulse, core temp of: 104 degrees.
Body looses ability to: cool itself down & needs rapid external help.
Tx: EMS, lower core temp

Front 40

Hyperthermia

Back 40

Hyponatremia: too much H20
Decreased sodium
Too much fluid ingestion
Compromise the CNS
Sx: headache, nausea/vomiting, swelling of:hands & feet.
lethargy, apathy, agitation
Tx: EMS

Front 41

Prevention

Back 41

Fluid Replacement: Gatorade.
Rehydrate
Fluid replacement should match: amount lost.
Intervals of: 15 min. during activity.
Color of urine should be clear or pale yellow. Urine should be yellow only in the morning or while taking a multi-vitamin.
Sports Drinks
6% carbohydrate to digest easily & to keep glycogen up.
14g carbs/8 ounces
Don't dilute

Front 42

Prevention

Back 42

Acclimatization: athlete used to the environment.
10-14 days to acclimatize.
Identify susceptible individuals
Large muscle mass, overweight
Poor fitness levels: ex. two-a-days when athlete is not fully conditioned.
Medications/supplements: Creatine.

Front 43

Prevention

Back 43

Weight Records
Before/after practices & games.
3-5% loss of body weight could lead to heat illnesses.
Replace water with Gatorade or foods with large H2O content.
Uniforms/Equipment
Time of day
Color: light when hot and dark when cool.
Material: wicking material
Lightweight

Front 44

Hypothermia

Back 44

Bench warmers are most susceptible.
Decrease core temp
Sufficient increase in metabolic rate
Predisposing athlete: bench warmer.
Low temp, wind, dampness, wind chill.
Shivering
85-90° shivering stops because the body can't heat itself.

Front 45

Hypothermia

Back 45

Fluid replacement is needed due to dehydration though athlete doesn't feel the need to drink.
Dehydration reduces blood volume
Frostnip: top layer of skin.
Exposed parts
Sx: firm, cold, painless, may blister
Frostbite
Superficial (top layers of skin): pale, hard, cold, waxy
Deep layers of skin: Medical Emergency, cold, hard, pale/black, numb
Warm-up slowly, only use luke-warm water,don't rub skin because ice crystals in the skin will make skin come off.

Front 46

Prevention

Back 46

Clothing
Layers
Activity

Front 47

Sun

Back 47

Overexposure: runners have the highest rate of skin cancer.
Support Staff are at risk for skin cancer.
Susceptible individuals: fair skin, kids, elderly, certain medications.
Suncreen
SPF- Any will be beneficial.
Every 15-30 minutes reapply even if sweat proof.
Long-term effects
Premature aging wrinkles.
Cancer:
A-Asymetry
B-Border
C-Color
D-Diameter

Front 48

Lightning

Back 48

Can strike you 10 miles away
110 deaths/yr
Denver ranking: #2
Lightning can strike from: 10 miles away.
When you see the lightning strike:clear fields, wait.
EAP: wait for 30 min. after last lightning strike.
Chain of command
Protective shelter
Ball up & spread out from others.

Front 49

Lightning

Back 49

Detection
Flash to bang: count the time between the flash to the bang & divide by 5 that will tell you the distance.
Detectors
RTP: return to play,
30 minutes before returning outside.

Front 50

Altitude

Back 50

Acute Mountain Sickness
Excess fluid retention in cells
Headache, nausea, vomiting, sleep
Tx: Hydrate, go to lower altitude if possible, rest.
Pulmonary Edema
Fluid build up in lungs
Tx:Go to hospital to drain.
Moist cough, headache, weakness, could result in infection
Sickle Cell Trait Reaction
Cells will clump together
Causes an enlarged spleen, can rupture

Front 51

Viral Infections

Back 51

Herpes
Simplex
Type 1, 2: Type 1 above the waist, Type 2 below the waist.
Zoster- re-outbreak of the chicken pox.
Dermatome: where outbreak occurs along the dermatome spots.
Compromised immune system

Front 52

Viral Infections

Back 52

Herpes
Sx: tingling, itching, soreness, redness (erythema)
Ill: can become sick with mild flu-like Sx.
Painful, fluid-filled, crusty sores due to scratching.
10 days: time to fully heal.
Tx: active lesions vs. dormant: dormant virus will break out again.

Front 53

Verruca Virus

Back 53

Flat warts, plantar warts, venereal warts
Human papilloma virus: common on fingers
Contaminated equipment.
Sx: small, round, elevated: not typically painful.
Subject to bacterial infections & needs to be cleaned & covered.
Tx: protected, frozen, burned

Front 54

Bacterial Infections

Back 54

Most likely to infect the skin:
Streptococcus
Strep
Staphylococcus
Staph: most common

Front 55

Bacterial Infections

Back 55

Impetigo: occurs late summer to early fall.
Strep is a type of infection.
Sx: small vesicles, pustules, yellow crust
Boil/furuncle
Staph
Hair follicle infection
Sx: large, pus filled, painful sac
Folliculitis: hair follicles become infected: razor burn.
Carbuncle: large boil or many small ones clumped together.

Front 56

Bacterial Infections

Back 56

Methicillin-Resistant Staphylococcus Aureus: due to antibiotic resistance.
Staph strain type of bacteria.
Hospital, compromised immune system, close quarter living, sharing
Sx: redness, swelling, tenderness
#1 cause for hospital deaths due to non-admittance causes.
Elderly are more susceptible.
Sharing personal items can spread it: i.e. razors.
Tx: Broad spectrum antibiotics via IV.

Front 57

Fungal Infections

Back 57

Grow in a dark, moist environment.
Grow in unsanitary conditions
Ringworm
Most common
Skin, hair, nail
Highly Infectious
Sx: small, round, increase in diameter outward
Tx: anti-fungal ointment

Front 58

Fungal Infections

Back 58

Tinea Cruris: jock itch.
Groin
Sx: red/brown lesions, itching
Tinea Pedis: athlete's foot.
Foot
Space between 3rd and 4th toes is where it starts
Sx: scaling, thickening, itching
No black socks or no socks at all.
After shower or swimming pool, dry the infected area last so that you don't spread it.
Tx: anti-fungal ointment.

Front 59

Respiratory Conditions

Back 59

Rhinovirus: common cold
Sx: runny nose, headache, watery eyes, sore throat, sneezing, cough, aches, chills, sweats, fever
Tx: of sx
Influenza
Sx: malaise, nausea/vomiting, diarrhea, fatigue
Tx: of sx
Vaccine

Front 60

Respiratory Conditions

Back 60

Sinusitis: sinus infection.
Bacteria causing inflammation in sinus cavity lining
Sx: swelling, tender, pressure, headache
Tx: antibiotics, vasoconstrictor
Pharyngitis
Sore throat due to: post nasal drip
Sx: dryness, soreness, pain, red, swelling
Tx: of sx

Front 61

Respiratory Conditions

Back 61

Seasonal Allergies
Airborne pollens
Sx: itching, watery eyes, nasal discharge, red/swelling of eyes, cough
Tx: antihistamines: benadryl
Bronchitis
Follows a viral infection (such as a cold)-Upper Respiratory Tract
Sx: cough, yellow secretion, low-grade fever, wheeze when breathing.
Tx: of sx

Front 62

Respiratory Conditions

Back 62

Bronchial Asthma
Stressors: anxiety, altitude change, allergies, humidity, temperature changes, strong smells.
Sx: spasm/inflammation, difficulty breathing, coughing, wheezing, shortness of breath
Tx: eliminate or reduce stressors, inhaler
Exercise-Induced
Sx: swelling, chest tightness, shortness of breath, coughing
Tx: warm-up slowly, inhaler
Cold temps can set up exercise induced asthma attacks.

Front 63

Gastrointestinal Disorders

Back 63

Dyspepsia: acid reflux.
Food, stress, spasm, inflammation
Sx: nausea, flatulence from either end.
Tx: identify cause, antacids
Constipation
Decreased moisture, fiber (too much or not enough), nerves, laxatives
Sx: cramping, pain, difficulty having bowel movement.
Tx: increase fiber, meds

Front 64

GI Disorders

Back 64

Vomiting
Irritation in the stomach
Tx: antinausea, fluids
Diarrhea
Diet, inflammation, infection, drugs
Sx: cramping, nausea, frequent BMs
Tx: fluids, bland food-BRAT diet
B: bananas
R: rice
A: applesauce
T: toast

Front 65

Mononucleosis

Back 65

Viral infection-throat
Young adults-children are the most susceptible
4-6 weeks out of play, blood work has to be normal to return to play & spleen can't be palpated.
Enlarged spleen
Sx: headache, fatigue, muscle ache
Fever, glands, throat
Tx: of sx, rest

Front 66

Anemia

Back 66

Iron-Deficiency: most common
decrease of hemoglobin & red blood cells.
Sx: decreased performance, tired, craving dirt, rocks, crunchy things & protein.
Tx: diet, supplement
Sickle-Cell
Hereditary anemia-abnormal shape of RBC
Sx: fever, fatigue, paleness, weakness, ab pain
Tx: anticoagulants because you could have blood clots leading to stroke, pain, spleen

Front 67

Diabetes Mellitus

Back 67

Hereditary vs. Developmental
Blood sugar vs. Insulin
Control
Insulin Shock
Too little sugar
Sx: weakness, moist/pale skin, dec respirations
Tx: sugar

Front 68

Epilepsy

Back 68

Genetic, brain metabolism, hx of injury
Sport restrictions
Petit mal, grand mal
Sx: altered consciousness, motor, sensory, tonic-clonic
Tx: meds, onset, cushion, clothes, mouth, EMS

Front 69

Meningitis

Back 69

Inflammation
Meningococcus Bacterium
Sx: fever, stiff neck, headache, photophobia, vomiting, convulsions, coma
Tx: spinal tap, isolation, meds

Front 70

Hypertension

Back 70

Cardiorespiratory condition
Primary: no disease associated
Sx: dizziness, redness, headache, fatigue, epistaxis
Tx: meds, alcohol, smoking, diet, exercise

Front 71

Respiratory Conditions

Back 71

Seasonal Allergies
Airborne pollens
Sx: itching, watery eyes, nasal discharge, red/swelling of eyes, cough
Tx: antihistamines
Bronchitis
Follows a viral infection-Upper Respiratory Tract
Sx: cough, yellow secretion, fever, wheeze
Tx: of sx

Front 72

Respiratory Conditions

Back 72

Bronchial Asthma
Stressors
Sx: spasm/inflammation, difficulty breathing, coughing, wheezing, shortness of breath
Tx: stressor, inhaler
Exercise-Induced
Sx: swelling, chest tightness, shortness of breath, coughing
Tx: warm-up, inhaler

Front 73

Gastrointestinal Disorders

Back 73

Dyspepsia
Food, stress, spasm, inflammation
Sx: nausea, flatulence
Tx: identify, antacids
Constipation
Decreased moisture, fiber, nerves, laxatives
Sx: cramping, pain, difficulty
Tx: increase fiber, meds

Front 74

GI Disorders

Back 74

Vomiting
Irritation in the stomach
Tx: antinausea, fluids
Diarrhea
Diet, inflammation, infection, drugs
Sx: cramping, nausea, frequent BMs
Tx: fluids, bland food-BRAT diet

Front 75

Mononucleosis

Back 75

Viral infection-throat
Young adults-children
4-6 weeks
Enlarged spleen
Sx: headache, fatigue, muscle ache
Fever, glands, throat
Tx: of sx, rest

Front 76

Anemia

Back 76

Iron-Deficiency: most common
Sx: decreased performance, tired, craving
Tx: diet, supplement
Sickle-Cell
Hereditary anemia-abnormal shape
Sx: fever, fatigue, paleness, weakness, ab pain
Tx: anticoagulants, pain, spleen

Front 77

Diabetes Mellitus

Back 77

Hereditary vs. Developmental
Blood sugar vs. Insulin
Control
Insulin Shock
Too little sugar
Sx: weakness, moist/pale skin, dec respirations
Tx: sugar

Front 78

Epilepsy

Back 78

Genetic, brain metabolism, hx of injury
Sport restrictions
Petit mal, grand mal
Sx: altered consciousness, motor, sensory, tonic-clonic
Tx: meds, onset, cushion, clothes, mouth, EMS

Front 79

Meningitis

Back 79

Inflammation
Meningococcus Bacterium
Sx: fever, stiff neck, headache, photophobia, vomiting, convulsions, coma
Tx: spinal tap, isolation, meds

Front 80

Hypertension

Back 80

Cardiorespiratory condition
Primary: no disease associated
Sx: dizziness, redness, headache, fatigue, epistaxis
Tx: meds, alcohol, smoking, diet, exercise