ACUTE INJURY CARE OF SPORTS INJURIES



ACUTE INJURY CARE OF SPORTS INJURIES

DEFINITION OF ACUTE INJURY

An acute injury may be defined as an injury that has a rapid onset with a specific history of how the injury occurred and is usually of short duration. Several examples of acute injuries are the following: A baseball player getting hit by a pitched ball. A basketball player jumping up for a rebound and then landing on another person's foot and "twisting" his or her ankle. A running back planting his foot to make a cut and his knee "giving out". The above examples occur rapidly and the athlete usually remembers exactly what happened to cause the injury.

TREATMENT OF ACUTE INJURIES

A large number of sports related injuries to the musculoskeletal system will involve soft-tissue structures such as muscles, tendons, and ligaments. Injuries to these structures may range from muscle strains, ligament sprains, to contusions (bruises). These injuries may also range from mild to severe. R.I.C.E.R. (rest, ice, compression, elevation, rehabilitation) should be used to treat most soft-tissue injuries until proper medical advice can be obtained. Qualified medical personnel for treatment would include but is not limited to athletic trainers, physical therapists, and physicians.

REST

One step of acute injury care is to rest the injured body part. This period of rest may vary from a few minutes to several months depending on the type and severity of injury. This rest period is important for two reasons: First, it will provide the body with a chance to control the effects of trauma (ie: swelling, pain, muscle spasm). Secondly, it will prevent any additional damage that could occur from continued activity until the injury has been properly healed and rehabilitated.

ICE

A few of the body's natural responses to trauma/injury are pain, swelling, and muscle spasm. Immediately after an acute injury, ice should be applied to the injured area. This is best accomplished by putting ice into a bag and wrapping the ice bag directly to the skin. The ice bag should be held in place with an elastic wrap for 20 minutes. Frostbite will not occur unless the ice is held in place for longer than 30 minutes at one time. After 20 minutes of icing, the ice should be left off for at least 40 minutes. After 40 minutes, the above steps can then be repeated.

The physiological effects of cold on the body are as follows:

1. Decreased pain due to decreased nerve conductivity.

2. Decreased swelling due to decreased blood flow to injured area.

3. Decreased metabolism of injured area which results in less tissue damage.

4. Decreased muscle spasm which results in decrease pain.

5. Increased blood clotting which results in less bleeding/swelling.

The above effects of cold help to decrease the body's natural responses to trauma. This will help to prevent slowing down of the healing process and return the athlete to activity as soon as safely possible.

COMPRESSION

As mentioned earlier, a compression elastic wrap such as an ACE wrap should be used to hold the ice bag in place during the 20 minutes of icing. When the injured area is not being iced, the compression wrap should be applied again. The purpose of this is to provide compression in order to help decrease or prevent further swelling from accumulation. Application of a compression wrap can be accomplished by wrapping the injured area with circular of figure of eight motions. Start the warp below the injury and work the wrap up and past the injured area. The wrap should always be applied below the injury and worked up the extremity or toward the direction of the heart. Ideally the wrap should be "snug" but not so tight as to restrict normal blood flow to the extremities. A felt horshoe or felt pad can also be used along with an elastic wrap to apply additional pressure to the area with the most swelling.

ELEVATION

During and after icing, the injured area should be elevated above the level of the heart. Elevation will help to prevent additional swelling and can also decrease existing swelling. The effects of gravity and decreased blood flow to the extremity cause this decrease or prevention of swelling while the limb is elevated.

REHABILITATION

Most athletic injuries will require some type of rehabilitation as a final step before progressing back to full activity. Returning to competitive activity before and injured area is properly healed and rehabilitated can predispose an athlete to reinjury. Rehabilitation will consist primarily of regaining full motion/flexibility and strength of the injured area/joint. Additional bracing or support of the injured joint may also be necessary before return to full activity. Refer to the Rehabilitation of Athletic Injuries handout for more details on rehabilitation.

BONY INJURIES

Two of the more serious injuries that involve the bony structures and require immediate attention by a physician are fractured (broken) bones or dislocated joints. These injuries will usually require splinting/immobilization by a qualified person and then transportation to a hospital. Signs of a fracture or dislocation may include the following:

1. deformity

2. severe pain

3. immediate swelling/discoloration

4. crepitation or grinding over the injured area

5. inability to move a joint

One complication of youth injuries is the increased risk of bony injuries due to the delayed onset of complete calcification of bones. A particular area of concern is fractures to the epiphyses (growth plates) in young athletes. Fractures to this area are of great concern and can lead to growth complications such as shortened extremities. The occurrence and severity of this complication are greatly increased when proper medical care is delayed or not followed.

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