Injuries Injuries

Lesson Goals;Lesson Goals;Become familiar with specific injuries to

the shoulder, knee, elbow and ankle

Be able to identify different types of injuries

Discuss causality of specific injuries i.e; motion, mechanics and overuse

Explore taping techniques to immobilize and protect an injured limb or joint

Shoulder InjuriesShoulder InjuriesMulti-Axial Joint

↑ ROM ↑ Risk of Injury

↑ Mobility ↓ Stability

Overhead movement ↑ Stress to Shoulder Joint

Many Types of Shoulder Injuries:- Tendonitis- Impingement Syndrome (very common)- Tears, Fractures, Separations & Dislocations

ImpingementImpingement Syndrome Syndrome

Most common in the AC JointAcute or Chronic? Why?Lack of space and many structures passing

through the AC jointCaused by excessive abduction of the Humerus

(why abd?)

Implications;Bone Spurs Inflammation of structures and joint capsuleLoss of ROM, function and eventually strengthPreventative measures?

ImpingementImpingement syndromesyndrome

AC Separations & SprainsAC Separations & SprainsFunction: - allows to raise arm above head

Mechanism of Injury: - direct force (body check) - falling on outstretched hands

Severity: - grade 1,2,3, sprains - grade 3 = completely torn

- step or piano key deformity- surgery required

Recovery & Prognosis: - RICE!!! & Sling (different types) - Restore full ROM - Restored Strength - Return to play at athletes discretion

DislocationsDislocations andand SeparationsSeparations

A dislocation occurs when a bone is displaced from its original location. Depending on the severity, tendons and ligament may be sprained or torn.

The joint looks deformed/awkward Painful when touched The joint is not useable

Medical attention is required! Do not try to put it back in place yourself!, you may cause more damage!

SHOULDER DISLOCATIONSSHOULDER DISLOCATIONS- Account for 50% of all dislocations in the body

- ROM- relies on supporting muscles for stability- surgery usually not necessary, unless tissues are torn,- RICE & Sling

- Anterior Dislocation most common (95% of all shoulder dislocations)

- Head of the Humerus is forced out anteriorly & Inferiorly

- direct impact or forced abduction & external rotation

- Recovery:- RICE, Restore ROM & strength rotator cuff muscles- Release tension in dominant muscles (pecs, lats, trapezius)- Post Surgery joint immobilized for up to 6 weeks (sling)- several months for full recovery- more susceptible to for more dislocations in the

future…..why?

Rotator cuff musclesRotator cuff muscles

Elbow InjuriesElbow Injuries

Medial Epicondylitis: (golfer’s elbow)

Inflammation on the medial aspect of the elbowInvolves muscles that originate at the medial aspect of the elbow

Cause: (chronic overuse)- repeated flexion & or pronation (wrist)- golf, pitching, javelin, bicycling, weightlifting

Recovery:- can be lengthy (months/years)- RICE- deep tissue manipulation (ART)- practice proper technique (deadlift example)

- massage wrist flexors- stretch wrist extensors- strengthen wrist flexors- condition wrist extensors

Elbow InjuriesElbow InjuriesLateral Epicondylitis (tennis elbow)

- inflammation of the lateral aspect of the elbow- involves muscles that originate at the lateral aspect of the elbow

Cause: (chronic overuse)- repeated extension & or supination of the wrist- novice player, poor technique, poor equipment (heavy racquet)- inadequate strength, power, flexibility & endurance

Recovery for both:- can be lengthy (months)- RICE- deep tissue manipulation (ART)- practice proper technique

- massage wrist extensors- stretch wrist flexors- strengthen wrist extensors- condition wrist flexors

Knee InjuriesKnee InjuriesMost traumatized joint…why?

- Many sports place stress on the knee- Complexity of joint increases its chance for injury

Most common injuries:- Patello-Femoral pain syndrome (Chronic)

- Improper tracking of the patella due to muscle length & tension issues (pulley system)

- Ligament Injuries (ACL & PCL)

- Factors contributing to Knee Injuries: Position of knee ( joint angles ) Foot fixed to the ground (cleats?) Angle & Force of Trauma Previous injury (degree, proper rehabilitation) Strength of muscles crossing the joint Improper execution of movement Muscle imbalances

ACL & PCL InjuriesACL & PCL Injuries- ACL prevents anterior translation of tibia

- Injury most commonly occurs from planting & twisting motion

- PCL prevents posterior translation of the tibia- Injury most commonly occurs from hyperextension - falling on the tibia with the knee flexed at 90°- Not as common due to strength of PCL compared to ACL

- Recovery:- RICE, Strengthen & improve flexibility of muscles around

Knee & Hip- (Post Reconstructive Surgery)

- Biking within first 2 months- Light jogging within 4 months- Return to sport within 6-9 months minimum

The KneeThe Knee

http://wvir.images.worldnow.com/images/181327_G.jpg

Jumpers KneeJumpers Knee

““Jumpers Knee”Jumpers Knee” Inflammation of the inferior aspect of the Patellar Tendon Similar to Patellar Tendinitis or Patellar-Femoral

Syndrome Caused by excessive jumping (incorrectly) Pain is right below the knee cap

Treatment?

Correct jumping technique Similarly to Patellar Tendinitis, correct muscle length and

tension discrepancies RICE! Tape Jumpers Knee to aid in healing and recovery!

Ankle & Foot InjuriesAnkle & Foot Injuries

- High risk for injury

- Foot in contact with the ground

- Supports entire body

- First joint to absorb forces from the ground

- Composed of 26 bones- 15 Phalanges, 5 Metatarsals, 7 Tarsals, Tibia &

Fibula (most complex joint)

http://www.hawaii.edu/medicine/pediatrics/pemxray/v3c03.html

Lateral & Medial aspects Lateral & Medial aspects of the Ankleof the Ankle

Ankle & Foot InjuriesAnkle & Foot Injuries- Inversion Sprains (turning over on your ankle)

- Involve 1 or all 3 of the lateral ankle ligaments- Anterior & Posterior Talofibular Ligaments- Calcaneo Fibular Ligament

- Most Common ankle injury……why? Lateral supporting ligaments WEAK Medial supporting ligament(s) STRONG it is more difficult to Evert the foot because the Talus butts up

against the distal head of the Fibula Eversion sprains are often mistaken for distal Fibular head

fractures

- Mechanism of Injury:- Explosive side-by-side motion, such as in tennis or basketball- Ankle sprain can occur during any weight-bearing activity (walking) - Inversion sprains are very common for individuals who wear high

heeled shoes

Ankle & FootAnkle & Foot- Other Potential Mechanisms of Injury?

Landing from a jump Stepping or landing on opponent’s foot Changing directions Decelerating Uneven surfaces Improper footwear for sport in question

- Diagnosis:- Pain, swelling, tenderness, unable to walk, bear weight, visual

deformity

- Recovery:- RICE, ROM & Strength of supporting structures- “PROPRIOCEPTION!!” (Neural & Muscular Balance) VERY

IMPORTANT!

- Moderate ankle sprain (grade 1 & 2) 1 to 6 weeks of rehabilitation

- Severe Ankle sprain (grade 3) 8 to 12 months of rehabilitation

Where do many injuries originate Where do many injuries originate from and why do they occur in from and why do they occur in the first place?the first place? Although the injury & symptom may be in one of the joints

studied in this unit, the fact is that a good majority of all injuries stem from an improper position of the hip.

More particularly, the muscles that attach to the hip are struggling to keep the hip in a neutral position during bracing and movement.

Your exercise and control and stability program should begin with reestablishing proper muscle balance within the hip joint.

The second most common reason for most injuries is improper execution of movement.

The third most common reason is poor nutrition, mental/emotional stress and poor sleeping patterns or not enough sleep (recovery)

Test your knowledge part Test your knowledge part 11

1) what are the 3 most common injuries to the shoulder joint?

2) what are the 2 most common chronic injuries to the elbow joint?

3) what are the 4 most common injuries to the knee joint?

4) what are the 2 most common injuries to the ankle joint?

Test your knowledge part Test your knowledge part 22

1) This injury causes a piano key deformity in the shoulder

2) This injury causes pain inside the shoulder joint, especially during abduction of the humerus.

3) This injury causes pain on the medial aspect of the elbow joint

4) This injury causes pain on the tibial tuberosity or inferior aspect of the patella

5) This injury causes inflammation and swelling on the lateral maleolus of the ankle

Test your knowledge part 3Test your knowledge part 31)To treat this injury, rehabilitation of the rotator cuff

muscles is crucial

2) This injury requires massaging the extensors of the forearm as a first step to recovery

3) This ankle injury is less common due to the strength and size of the deltoid ligament

4) This knee injury is often followed by severe swelling and little to no pain after the immediate trauma

5) Most injuries originate from structural imbalance of this joint