To be fit and healthy it is important that you exercise, however, exercise too much and you could injure yourself. This can be caused by;
An accident while training
Insufficient equipment
Pushing yourself too hard
Not warming up properly
Sports injuries can be classed into two categories;
Acute injury
Overuse injury
An acute injury is on in which there is rapid onset of pain is resulting from an incident that has been traumatic for example, an injury. It is normally impact on a specific part of the body.
Examples of acute injuries are;
Sprains are injuries to ligaments by stretching them too far or by being torn. Ligaments are fibrous tissue which holds bones together as well as to keep your body in position preventing any unwanted movements. Examples of ligaments are; the calcaneoifbular ligament in the ankle which is the damaged ligament in the picture on the right.
A sprain is an injury to a muscle or to a tendon. Muscles move your skeleton and this in turn pulls on a tendon which is connected to a bone. Both can be stretched but if they are stretched to far it can cause a tear in it.
A contusion or bruise in common terms, is one of the most common sports injuries. These occur when a blood vessel underneath the skin ruptures due to compressive force to a muscle. Blood then leaks into the dermis layer of the skin, causing discoloration. This can also occur to organs.
Dislocation is the separation of two bones at their meeting joint due to sudden force to the joint; this is clearly shown by the picture on the left. Therefore, the bone is no longer in its normal position. Dislocation can cause damage to the tissues surrounding the bone as well as any ligaments attached to the bone. Damage can also be done to the blood vessels and nerves.
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A fracture is a condition where the bone has broken or when there is a crack present in the bone. These occur due to high force or stress on the bone. Fractures can occur in any bone in the human body, however, bones can normally withstand most impacts and it is only if the force is too much it fractures. There are several different classes which fractures can be classed into; all are identified on the right.
Closed/Simple fracture is when the bone is only damaged and there has been no damage done to the tissue or skin surrounding the bone.
Compound/Open fracture is when the skin or tissue surrounding the fracture has been damaged. There is a higher risk of infection with this type due to the damage to the skin.
Overuse injuries are those that are caused by recurring actions which damage tendons, ligaments, muscles and tissues in the same place over a period of time.
Common overuse injuries are;
Tennis elbow is due to injury of both the muscle and tendon on the outside of the radius and ulna, or more specifically the lateral epicondyle. It is caused my overuse of the forearm muscles resulting in pain. It is most common in tennis players; however, you do not need to be a tennis play to get this.
Golfer’s elbow is a similar condition to tennis elbow, only this condition affects the muscle and tendons on the inside of the arm.
Iliotibial band syndrome (ITBS) is caused by repetitive trauma to the Iliotibial band which is present in legs and runs along the outside of the thigh which keeps the knee in place as it flexes and extends. ITBS is the overuse of this band resulting in pain specifically during running and inflammation of the iliotibial band.
A Shin splint occur when there is a recurring and a large amount of exercise being done. This puts large amounts of pressure onto the leg which can cause injury to the bone and tissue that surrounds it. Shin splints can also be where small tears develop in the interosseous membrane in the leg or tiny fractures develop on the surface of the tibia.
Sports injuries are very common. One of which is a broken leg, this happened to American football wide receiver Tyrone Prothro who played for the University of Alabama between 2003 and 2005.
On 1st October 2005, during a game versus the Florida Gators, Prothro went for a touchdown pass and got hit in the air and the way he landed on the ground he fractured both the tibia and fibula.
Since the leg is deformed, this would be classed as a severe tibia and fibula fracture resulting in the inability to stand and walk as well as weakness in both the leg and foot. Damage was more than likely done to the surrounding tissue, nerves and blood vessels.
First aid
First aid is very important when it comes to an injured person. There are a number of rules in which you can follow;
DR ABC is a mnemonic which is used soon after someone got injured;
Danger –
Check the area and make sure you and the people around you are safe, especially the injured person.
Response –
Can the injured person hear you?
Can they open and close their eyes?
Any movements?
Response to touch?
Airway –
Is there a blockage in the throat or have they swallowed their tongue?
Is the head in a suitable position to allow breathing?
Care should be taken not to make anything worse but the airway must be cleared if it is blocked.
Breathing –
Can the injured person breathe clearly?
Circulation –
Is there a pulse?
Is the pulse weak / strong / racing
R.I.C.E is another mnemonic that is used for tissue injuries;
Rest –
This is important for repairing the body as without it more strain would be placed on the injured area leading to more injury.
Ice –
Ice is perfect for reducing inflammation and any pain caused. It is recommended that you ice for 20 minutes and then no ice for 20 minutes. This can reduce the chance of getting frostbite, as well as wrapping the ice in a towel before placing it on the injured area. If you use the ice for too long, this can prolong the repairing time as it will restrict the blood flow to the area, which can reduce the nutrients getting the tissues of the injured area.
Compression –
Compression is used to reduce the swelling that is from inflammation but everyone does get some swelling. For this an elastic bandage is better as it does not restrict the blood flow as is not to be too tight.
Elevation –
Elevation is good at reducing swelling by the higher amount of blood which returns to the systemic circulation.
This break is easy to diagnose by the use of modern imaging techniques;
X-rays
CT scan
MRI scan
Bone scan
Extremity ultrasound
However, in Tyrone Prothro circumstances, he was given an X-ray as this was the fastest technique to use and is the least expensive.
X-rays are high photon energy electromagnetic radiation which can be used in both diagnosis and therapy. As the rays pass thought the body, the photons present in your body are absorbed at different rates; this is what produces the image. The materials in your body which are dense, like bone, show up as white areas on the image. The parts of your body which are made of softer material, like muscles and organs, show up as darker areas. X-rays can be dangerous if the does given is too much for the body, however, medical x-rays are normally are a very small dose level, meaning the chance of radiation damage to your body is small.
Due to the way in which Tyrone Prothro fractured his tibia and fibula, surgery had to be the option due to being the quickest option as without it, it would take years to heal or might never heal and will constantly be in pain. He had to get three separate surgeries due to the damage done to the tissue, nerve and blood vessel damage.
The doctors put an intramedullary rod in his leg which will align the leg and help to fix the fracture.
The IM rod was inserted into the interior of the bones, where the bone marrow is present. This is the best way to help heal the broken tibia and fibula as it does not support the bone; instead it shares the load with the bone.
Rehabilitation of the broken tibia and fibula would be used to restore the function of the limb, as best as possible and to reduce the discomfort the patient is in. The patient may need the use of crutches, depending on the weight bearing position.
The doctor may also decide if Tyrone would need the use of an orthopaedic cast, which means the leg would be covered by plaster to create a shell type casing. This is to reduce the movement the injured limb to do which will decrease the healing time. Once the cast has been removed, the patient will have to visit a physiotherapist to regain strength and range of motion in the leg. However, it will never be the same as what he had before the injury.
Both the tibia and fibula may start to heal within 6 to 16 weeks of the injury, but the capability of the bone to sustain a heavy load could take up to a year, meaning the injured may be is some sort of discomfort until then.
REHABILITATION VISITS
Non-surgical
Specialist
Fracture, Tibia or Fibula
Physical Therapist
Up to 20 visits within 8 weeks
Surgical
Specialist
Fracture, Tibia or Fibula
Physical Therapist
Up to 16 visits within 8 weeks
http://www.mdguidelines.com/fracture-tibia-or-fibula/rehabilitation
The table is how often you would have to visit a physiotherapist if you had a broken tibia and fibula. Or Tyrone Prothro, surgery was the option, meaning once he was released from hospital and ready, he would have to visit the physiotherapist 16 times within the space of 8 weeks, means 2 times a week.
Due to the damage that was done and his leg never fully recovering, meaning he was advised never to play football again, his career finished.
Prevention of sports injuries
There are six steps that are highly important to reduce the risk of sports injuries;
Warm up
Do not over do it
Stay hydrated
Using the right technique
Use of the proper equipment
Cool down
Sports occupation
The sports profession that I have chosen to examine in this unit is physiotherapy.
Physiotherapy helps to restore the function and movement in any part of the body where the human has been effect by a disability, illness or injury. This is normally done through movement, exercise and education.
The American Board of Physical Therapy Specialties (ABPTS), state that there are 8 credible types of physiotherapy;
Sports – This has to be the most common type of physiotherapy, being used every day. It is the management of injuries for all types of athletes, amateur to Olympian. It involves the treatment and healing of injuries.
Orthopedic – This type helps to identify and care for injuries or disorders of the musculoskeletal system.
Pediatric – This type is all about improving coordination and balance within a human as well as their motor skills. It can also be used to focus on strength and endurance. Humans with conditions such as, spina bifida and cerebral palsy. Normally this is used on children and adolescents.
Cardiovascular and Pulmonary – This is for the treatment of humans with cardiovascular and pulmonary disorders, as well as those who have had cardiac or pulmonary surgery such as, bypass surgery. This is used in humans with the following disorders; pulmonary fibrosis, CORD (Chronic Obstructive Respiratory Disease), heart attacks.
Geriatric – This type of physiotherapy is for the vast amount of conditions that affect humans as they grow old and therefore would only be practiced on the elderly. A few examples of the conditions are as follows; Alzheimer’s disease, cancer, arthritis and osteoporosis.
Neurological – This type is practiced on those with a neurological disorder such as, Alzheimer’s disease, cerebral palsy, Parkinson’s disease and motor neurone disease
Clinical electrophysiology – This type normally is used with electrophysiological evaluation where an EMG (electromyography) is used.
Integumentary – This is used as a treatment for skin and organ conditions like burns and wounds.
University level
Physiotherapy is degree based career, meaning you have to go through university if you wish to become a physiotherapist.
University of Ulster is the only university in Northern Ireland to offer a degree, specifically, a BSc Hons in physiotherapy. ‘The university states that applicants must;
Hold a GCSE pass in English Language at Grade C or above (or equivalent).
You must also have obtained a GCSE pass in Mathematics at grade C or above (or equivalent).
A level
Grades BBB to include one science subject from Biology, Chemistry, Maths, Physics or Double Award Applied Science (with a BB in Double Award Applied Science).
Irish Leaving Certificate
B2B2B3B3B3 at higher level – to include two subjects from Maths, Physics, Biology or Chemistry.
English and Maths Grade D at Higher Level or Grade C at Ordinary Level.
BTEC National Diploma
Successful completion of a science related BTEC National Diploma with a DDM profile.
Pass with overall average of 70 – 71% to include 70% in each final year module. Final year modules must include 2 from the following:- Maths (with maths to be presented at level 3), Biology, Physics, Chemistry.
Applicants must also sit the Health Professions Admissions Test results in a satisfactory performance in the HPAT.
As well as testing all candidates are required to undergo a medical examination and criminal records check (AccessNI).’
http://prospectus.ulster.ac.uk/course/?id=9773
BSc Hons in Physiotherapy is a three year course results in peoples meeting the demand of physiotherapists in the current health care system, the NHS or via private practices.
In each of the three years you study;
Year 1
Development of professional identity and professionalism – ‘Knowledge and Skills for Professional Practice’, and ‘Communication and Psychology for the Health Sciences’.
An understanding of core subjects: Physiology and, Structure, Function and Assessment of the Human Body.
Specific skills are taught with regard to cardio-respiratory, electrotherapy, walking rehabilitation and therapeutic exercise.
Students undertake a one week orientation and a six week clinical placement.
Year 2
Neurological rehabilitation.
Spinal dysfunction and rehabilitation.
Musculoskeletal.
Pediatrics.
Oncology.
Amputation rehabilitation.
Students undertake two six week clinical placements.
Year 3
Cardio-respiratory and professional issues develop awareness of the role of the physiotherapist within the multidisciplinary team and in a changing clinical environment.
Students undertake an investigative project or dissertation
Students undertake two six week clinical placements.
http://prospectus.ulster.ac.uk/course/?id=9773
Professional Organisations
Once you have completed the course, you leave with a BSc (Bachelor of Science) in Physiotherapy and are therefore eligible for ‘registration with the Health and Care Professions Council (HCPC), this was set up with the Health Service reform 2002 and membership of the Chartered Society of Physiotherapy (CSP).
As a physiotherapy student at the University of Ulster, they recommend that you join CSP as soon as possible with membership being a one off payment.
Personal Qualities
As a physiotherapist it is important that they are fit and healthy, to set an example to your clients. Good communication and social skills are key to ensure a good relationship between the therapist and the patient. Tolerance and patience is an important quality, due to this being a very hand on career.
Careers
Beyond obtaining the BSc in physiotherapy, you can either go into a career or do a postgraduate degree, MSc which is a Master of Science. The University of Ulster offers Physiotherapy at MSc level. If one does not want to go on to do a postgraduate degree then it is possible to go into the world of work, the possibilities are endless with physiotherapy due to the vast amounts of sports played in the world or any other types of physiotherapy (ABPTS) are needed on a daily basis.
NHS vs. Private Care
There are various jobs available on the NHS (National Health Service) and private practitioners, both of which are highly regarded.
With the NHS based jobs, they would be working in a hospital environment and are needed in most of the departments;
Outpatients
Intensive care
Women’s health
Care of the elderly
Stroke patients
Orthopedics
Mental illness
Learning difficulties
Occupational health
Terminally ill
Pediatrics
This means that they will constantly be on the clocked and needed for various things. Physiotherapists do not just work in the hospital surrounding; they would work in various environments;
Industry
Special schools
The private sector (for example, private practice)
Education
Leisure & sport
For physiotherapists that are in the private sector would work in the same principles as those on the NHS, however, the private section physios will have to be paid for.
There are three bands for physiotherapists on the NHS, all have a different salary;
£21,176 – £27,534 (band 5)
£25,472 – £34,189 for specialist physiotherapists (band 6)
£30,460 – £40,157 for advanced physiotherapists (band 7)
The physiotherapists that work in the private sector will generally have the same salary as those on the NHS.
Medical Physics – Roger Muncaster
http://www.nhs.uk/conditions/sports-injuries/Pages/Introduction.aspx
http://www.sportsmd.com/sportsmd_articles/id/347.aspx
http://sportsmedicine.about.com/od/glossary/g/acute_def.htm
http://orthopedics.about.com/cs/sprainsstrains/a/sprain.htm
http://www.howtotreatasprainedankle.org/wp-content/uploads/2011/11/sprained-ankle-pic.jpg
http://www.examples10.com/e/ligaments/
http://www.umm.edu/graphics/images/en/19618.jpg
http://emedicine.medscape.com/article/88153-overview
http://www.emedicinehealth.com/script/main/art.asp?articlekey=135557&ref=132720
http://images.emedicinehealth.com/images/healthwise/medical/hw/n5550698.jpg
http://www.empowher.com/files/ebsco/images/si55550720.jpg
http://www.chanorthopaedics.com.sg/wp-content/uploads/2011/09/type-of-fracture.gif
http://www.medicalnewstoday.com/articles/173312.php
http://www.nsmi.org.uk/articles/overuse-injuries.html
http://img.webmd.boots.com/dtmcms/live/webmd_uk/consumer_assets/site_images/articles/health_and_medical_reference/joints_bones_and_muscles/arthritis_tennis_elbow.jpg
http://www.webmd.boots.com/osteoarthritis/guide/tennis-elbow
http://davidrobertsphysio.co.uk/wp-content/uploads/golferselbow.gif
http://www.sdri.net/wp-content/uploads/2010/02/ITBS1-201×300.jpg
http://www.medicinenet.com/iliotibial_band_syndrome/article.htm
http://0.tqn.com/f/p/440/graphics/images/en/19482.jpg
http://sportsmedicine.about.com/b/2007/08/21/shin-splints.htm
http://www.nhs.uk/conditions/shin-splints/Pages/Introduction.aspx
http://blog.al.com/rapsheet/2009/04/medium_t1_proth_si.jpg
http://www.manlyweb.com/sports/injuries/prothro.htm
http://medical.cdn.patient.co.uk/images/i77_l.jpg
http://www.freemd.com/tibia-fracture/overview.htm
http://image.sciencesource.com/photos/preview/7w/7w2937.jpg
http://www.teachpe.com/multi/dr_abc.htm
http://www.freemd.com/tibia-fracture/evaluation.htm
http://sportsmedicine.about.com/cs/rehab/a/rice.htm
http://www.body-dynamics.co.uk/rice.html
http://www.nhs.uk/conditions/x-ray/pages/introduction.aspx
http://www.tyroneprothro.com/news.htm
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http://orthopedics.about.com/cs/brokenbones/g/imrod.htm
http://www.mdguidelines.com/fracture-tibia-or-fibula/rehabilitation
http://www.louisbarnett.com/leg-cast.jpg
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http://www.nhs.uk/Conditions/Sports-injuries/Pages/Prevention.aspx
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