Sports Medicine Handbook - CSAA

Providing Sports Medicine Coverage
to schools throughout Kentuckiana
Assumption
Sports Medicine
Handbook - CSAA
Eastern High School
Presentation Academy
Ballard
IUS
Sacred Heart Academy
Boyce College
Jeffersontown High School
Seneca High School
Butler
Jeffersonville High School
St. Catherine
Louisville Ballet
Central High School
Male High School
Spalding
Christian Academy
of Louisville
Moore High School
Collegiate
Nelson County
Trinity
Valley
Voted Best Places to Work
2005, 2006, 2007, 2008, 2009
Give Your Best Everyday
Get The Best on Saturdays
Saturday Sports Injury Clinic
Aug. 15 to Nov. 21
8 a.m.
KORT Old Brownsboro Crossing
4950 Norton Healthcare Boulevard, Suite 102
Louisville, KY 40241
Parents, coaches, athletic trainers and athletes:
A weekend can seem like a week when you have a sports injury.
This fall, you can rest easy knowing that KORT’s free Saturday
Sports Injury Clinic is there for you.
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Your FREE Screening Includes:
Consultation with a Physical Therapist
Medical & Treatment History
Strength and Flexibility Testing
Neurological Screening
Review / Discussion of Results
Follow-up With Your Physician
The clinic opens at 8 a.m. each Saturday
and you must sign in no later than 9 a.m. in
order to be seen. Patients will be seen on a
first-come, first-served basis.
For more information, call KORT at
502.339.6490 or visit www.kort.com.
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Introduction
KORT and its clinics have always been involved with local communities
by providing educational information on a wide range of topics. We continue
this tradition by providing you with this Sports Medicine Handbook. The handbook is designed to provide you with information on variety of injuries that can
occur while participating in a physical activity. While this handbook will provide
you with some important information it is not to be used as a medical guide or
to stop someone from seeing a physician.
We hope you will find this Sports Medicine Handbook useful.
Table of Contents
Introduction
Calling 911
Cold vs. Heat Dental Injuries Lightning Safety
Dislocations and Broken Bones Muscle Strains Head Injuries - Concussions
Heat Illness
Heat/Humidity Practice Guidelines
Eye Injuries
Louisville Clinic Locations
Lexington Clinic Locations
Nose Bleeds Shoulder Injuries
Tennis and Golfer’s Elbow
Low Back Pain Knee Injuries Shin Splints
Ankle Injuries Cold Pack Recipe
About Us
Free Screen Card
Aquatics
What to Eat
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Calling 911
Free 15 Minute Screening
The most important thing you can do whenever someone
goes unconscious or has a life-threatening emergency
is to call 9-1-1. When you call 9-1-1 you are bringing
trained medical professionals to help the individual. (Some
communities may not have a 9-1-1 system, so it is important to know what
number to call in an emergency situation in your community).
Call 911 for all emergencies including but not limited to:
Unconsciousness
Back or Neck Injury
Loss of Breathing
Serious Fracture
No Pulse
Heat Illness
When calling 9-1-1, follow these simple steps:
1. STAY CALM... by doing to you will be able to provide the most
accurate information in an organized manner. This will help the dispatcher to relay the correct information to the appropriate services.
2. GIVE CORRECT INFORMATION...make sure you give the dispatcher the correct information. You will need to provide the following information:
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Location of the emergency, name of the town, intersection, landmarks, room numbers, etc.
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Your name.
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Explain what happened...tell the dispatcher what type of emergency is taking place. Such as a collision, explosion, fire, etc.
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Number of the victims...tell the dispatcher how many people are involved in the emergency.
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Condition of the victims...what type of emergency are they having. Such as being unconscious or bleeding. Also tell the dispatcher what type of care is the victim receiving.
3. DO NOT HANG UP!!!...until the dispatcher has received all of the information and has hung up the phone.
4. STAY...with the victim until help arrives.
Why would I need a free screen?
If you or anyone you know is having pain with motion (when you move, it hurts), then
come to KORT for a free physical therapy screen. If we can't help you, we will direct you
to the right physician or other professional. Typical physical therapy patients can have
neck or back pain, sports injuries, general sprains and strains, carpel tunnel syndrome,
pain or limited function from surgery, work-related injuries or other accidents.
Your FREE Screening May Include:
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Consultation with one of our physical therapists
Medical and treatment history
Strength and flexibility testing
Neurological evaluation
Discussion of results
Follow up on findings to your physician
Call any KORT location today to begin your road to recovery or to better your overall
physical health. Your complimentary screening will give you the motivation you need to
live a life that includes better health and a better understanding of healthy fitness routines.
Call now to set up your one-on-one appointment!
We will gladly work with your doctor of choice!
Free Screening Coupon
Name:
By calling your local emergency number you are putting the victim
in touch with medical professionals who can provide care.
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Coupon is good for one visit only.
Sports Medicine Handbook 2009
KORT has been the foremost provider of sports medicine services since 1987, currently
serving nearly 30 Kentucky and Indiana high school, collegiate, and professional
organizations. KORT consists of over 35 physical therapy clinics located in Louisville,
Lexington, central Kentucky, and southern Indiana. For more information, call us toll-free
at 1-800-645-KORT or log onto www.kort.com.
• On-Field Medical Treatment
• Educational Seminars
• CPR Certification
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You Can Feel Confident With KORT
Our licensed physical therapists and staff are thoroughly trained in
all aspects of physical rehabilitation and testing, and have years of
experience in cases like yours. Your doctor has confidence in cases
like yours. Your doctor has confidence in our ability to carry out your
treatment successfully; and you can be assured that KORT professionals
will provide the highest level of care you and your physician expect.
Quality In Physical Therapy
High Patient Satisfaction
Physical therapy is an important part of
your rehabilitative treatment and KORT
strives to meet the highest standards for
quality care!
According to ongoing surveys, more
than 99% of KORT patients say they
would return to KORT if they ever need
physical therapy again.
Progress Tracking
Consistent Care
Our computerized database helps us
predict the course of your treatment so
you know what to expect. Individualized
record-keeping lets you compare results
at every session so you can see the
progress you've made.
KORT recruits and keeps an exceptional
staff, to assure you of consistent
quality care. Our commitment to
staff development has resulted in the
industry’s highest staff retention rate.
Dedication to Service
Specialized Care
KORT has more board-certified specialists
than any other physical therapy provider
in Kentucky. You have immediate
access to specialists in orthopedics,
hand therapy, clinical electrophysiology
(EMG & NCV), strength conditioning
and sports medicine.
All patients are seen within 24 hours of
referral, and timely reports are sent to
your physician and others involved in
your case. KORT regularly participates
in community education programs and
health fairs, and provides free screenings
to school athletic teams.
Thoroughly Trained Staff
KORT licensed staff members complete
over 25 hours of continuing education
per year plus additional training in five
speciality areas. Our therapists are
recognized experts who frequently serve
as speakers at professional meetings and
conferences and whose writings appear
in clinical journals and textbooks.
Cold vs. Heat
When an injury happens often the first question that is asked
is “should I put ice or heat on it?” We will look at what role
cold and heat play in the healing of an injury and when you
should use them.
Cold Treatment should be used for the first 48 to 72 hours following an
injury.
I ICE: Following an injury, ice or a cold application should be used. The ice helps to promote local constriction of the blood vessels, which in turn helps to control the swelling. It also helps to decrease the pain in the injured area. Ice should be applied to the injured area for up to 72 hours following the injury. The ice application should be left on the injured area for around 20 minutes with an hour in between each time you ice. You should place a barrier in between the ice and skin (an example would be a towel).
C COMPRESSION: Compression helps to put external pressure on an injury and helps decrease the swelling. You should not sleep with a compression wrap on the injury.
E ELEVATION: Elevating the injury will also help to decrease the swelling in the injured area.
You should only elevate the injury if it does not cause discomfort to the injured area.
If you have any questions regarding the extent of damage to the injured area
then you should see a physician.
Heat Treatment after the first 72 hours.
Once the ice treatment has been started for over 48 to 72 hours then you
can switch over to heat. Heat will help to promote blood flow to the injured area. This will help to remove the damaged tissue and help with the
healing process.
Heat should be applied for 15 to 20 minutes with a barrier in between the heat source and the skin (an example would be a towel).
Once the injury has started to heal and feel better then you will want to put ice on the area following any activity that involves using the injured area. Soreness and swelling are common after an injury.
See page 22 for a home cold pack recipe that is easy to make.
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4
Dental Injuries
Any blow to the jaw area can potentially cause injury to the teeth.
Dental injuries can occur regardless of the sport being played. By
knowing what to do and how to do it can help save a tooth. The
following are some guidelines to use when a tooth injury occurs.
Complete Dislocation of the Tooth
If the tooth is completely knocked out you should do the following:
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Do not handle the tooth by its roots.
If there is debris on the tooth rinse with water.
Try to replace the tooth back into the socket as quickly as possible. You can stabilize the tooth by biting down on a handkerchief or towel.
If you are unable to replant the tooth then place the tooth in cold milk. If milk is not available then wrap the tooth in a saline soaked gauze.
If you do not have milk or saline, put the tooth under the athlete’s tongue. This should only be done if the athlete is conscious.
The last resort will be to place the tooth in a cup of water.
Home Remedy Cold Pack Recipe
Materials Needed:
Ziplock baggies (1/2 to 1 gallon size)
Water
Rubbing Alcohol
Directions:
Add water and alcohol in a ratio of 2(water): 1(alcohol) or 3(water): 11/2(alcohol)
Add more alcohol for a slushier cold pack. Can leave cold packs in freezer for up to one month.
You need to get the tooth replanted within 30 minutes for the highest degree
of success. You need to transport the individual immediately to the dentist.
Hint:
Fractured Tooth
When a tooth is fractured it is often very sensitive as the air irritates the nerve
endings. A person with a fractured tooth is often more comfortable keeping their
mouth closed. The following should be done when a fractured tooth occurs.
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Use double baggies for leakage control!!!
Cold packs will conform to any body area because of the alcohol that is in the cold pack.
Keep any loose portions of the tooth and take them to the dentist with you.
Stabilize the remaining piece of tooth with a handkerchief or towel.
Immediately transport the individual and the tooth fragments to the dentist.
Mouth Guards
A majority of dental injuries can be prevented if the individual wears a mouth
guard. Besides protecting the teeth, a mouth guard will also help prevent a
possible cerebral concussion and/or jaw injury. Maximum protection is afforded
when the mouth guard is composed of a flexible, resilient material and is form
fitted to the teeth and upper jaw.
Ice for about 20 minutes as needed for pain,
swelling and/or muscle soreness. Wait at least one hour
before doing another treatment.
Individuals involved in contact sports such as football, field and ice
hockey and lacrosse should wear a mouth guard. Other sports such as
basketball and soccer can also benefit from wearing mouth guards. If
you have any questions contact your dentist.
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Ankle Sprains
Lightning Safety
The ankle joint is one of the most injured joints in the body. It comprises 10 to
30% of all sports related injuries. The ankle sprain typically will occur due to the
“rolling” of the foot when running, pivoting, or jumping and landing. Most of the
injuries affect the outside portion of the ankle and will cause swelling, bruising,
loss of function and instability.
Every year around a hundred people are killed by lightening
strikes in the United States, this is more than hurricanes
and tornadoes combined. Numerous lightening strikes occur
every year and knowing how to protect yourself when a storm
approaches will decrease the chances that an injury will occur.
Ankle sprains are often graded according to the level of
severity. Here are the three grades of ankle sprains:
When Outdoors...
Grade I: Stretching of the ligament(s), mild pain with
little or no swelling.
Grade II: 25-75% tear of the ligament(s), moderate to
severe pain and swelling.
Grade III: More than 75% tear of the ligament(s), severe
pain, swelling and instability.
Once an ankle sprain occurs it is important to begin rehabilitation quickly. The
rehabilitation of an ankle injury can be broken down into three phases. Here
are the three phases of ankle rehabilitation:
Phase I: (0-3 days). Follow the PRICE principle: Protection against further
injury by using a brace or ace wrap. Rest the injured ankle in an elevated
position. Ice every 2-4 hours for 20 minutes to reduce swelling and pain.
Compression, using an ace wrap to reduce the swelling. Elevation of the ankle
when resting to reduce swelling.
Phase II: This phase begins when you can bear full weight. The goal of this
phase is to restore normal ankle range of motion, flexibility and strength. You
should consult a physical therapist or athletic trainer at a Kentucky Orthopedic
Rehab Team clinic to obtain appropriate exercises for your condition.
Phase III: This phase works on restoring functional strength, agility, and sport/
exercise specific activity. Again, consult a physical therapist for exercises that
are appropriate to your injury and needs.
When you first see lightening or hear thunder it will be time to seek shelter immediately. You can use the flash-to-bang count to find out how close the lightening is to you. You start by counting after you see a flash until you hear the thunder. You will then take that number and divide it by 5 to see how far the lightening is away in miles. If you are unable to count above 30 then you need to seek shelter immediately.
When seeking shelter avoid water, high ground and open spaces. Places such as canopies, trees, picnic shelters or anything with metal objects are unsafe places.
When possible look for a shelter that is completely enclosed, such as a vehicle with the windows completely closed, or a substantial building.
If you are unable to seek shelter then you need to crouch down and put your feet together. This will allow you to become a lower and smaller object. When crouching down try to avoid being close to other people by putting a minimum of 15ft. in between you and someone else.
All activities should be suspended for up to 30 minutes after the last observed lightening or thunder.
If someone should become injured from a lightening strike, call 911 immediately.
Most lightening strikes that cause injury or death occur between 2:00 pm and 6:00 pm. June, July and August are the peak months for lightening strikes.
Important Precautions...
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If the swelling and pain are severe, then you should seek a physician to rule out a fracture
If you cannot fully weight bear after 3 days, see a physician consultation.
Early movement (without severe pain) of the ankle is important.
If you limp moderately to severely then crutches are recommended.
Ensure that you are restored to normal function and relatively pain free before pursuing sports/exercise activities.
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Information obtained from the National Lightening Safety Institute, the National Oceanic
Atmospheric Administration and the National Athletic Trainers Association.
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Dislocations and Broken Bones
During activity a joint or bone may become overstressed, thus
resulting in either a dislocation or a broken bone. When either
one occurs damage can also occur to the tissue surrounding the
joint or even nerve damage.
Dislocations are often more recognizable when they occur than
a broken bone. An individual who has suffered a dislocation will
often have some type of deformity that is noticeable. Whenever a
dislocation occurs there is a possibility that a bone may be fractured.
A broken bone is sometimes not as recognizable as a
dislocation. Broken bones can occur anywhere on the body and
will often need an x-ray to diagnose.
The following are tips in the event you think an individual has suffered a
dislocation or broken bone.
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If you suspect a dislocation or broken bone and the individual has some severe bleeding then you need to call for an ambulance.
DO NOT attempt to straighten or change the position of the injured area...always immobilize the injury in the position you found it.
DO NOT move the individual unless you have the injured area immobilized.
DO NOT move the individual if they have sustained an injury to the hips and legs.
If there is an open wound try to minimize infection by not breathing on the injury or washing the injury. Place a sterile dressing on the wound before you splint the injured area.
Once you have immobilized the injured area you will need to check the individual’s circulation above and below the splint. You want to make sure the individual has a pulse beyond the splint, otherwise further damage may occur.
Try to keep the individual still. Any further movement of the injured area
may cause more damage.
Continue to monitor the individual. Check to make sure the individual is not suffering from shock. You can do this by laying them down and raising their feet ten inches off the ground. YOU SHOULD NOT treat someone for shock if you suspect they have a head, neck, back, hips or leg injury.
Dislocations and broken bones occur in any setting. What you do when it occurs
will help the individual on their road to recovery. If at any time you have any
concerns about the severity of the injury, call your local emergency number.
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Shin Splints
Shin splints are a general term for several syndromes that affect many
athletes at one time or another during their athletic careers. Shin splints
are often defined by leg pain that occurs over the front side of the
shin. This pain is usually due to micro-tearing and inflammation of the
surrounding tissues. Anterior (front) tibial stress syndrome can affect
the bony portion of the shin (tibia), the connective tissue, and the tibialis
anterior muscle. Medial (inside) tibial stress syndrome affects the inside
aspect of the shin and may involve the posterior tibialis muscle, the
periosteum of the tibia and the surrounding connective tissue.
Symptoms
Initially the athlete or active individual may complain of a dull aching pain that
occurs after a sudden increase in running activity or a sudden change in surface
or activity or exercise (e.g. switching from grass to asphalt). Pain can occur at the
beginning of the workout, disappear as the athlete warms up and then occur again
2 to 3 hours after the workout is completed.
Cause of Injury
1. Sudden changes in running or playing surfaces. Surfaces that are hard such as a basketball court or an asphalt running track can increase the chances of developing shin splints.
2. Improper or worn shoes can also increase the amount of stress that is translated to the lower leg muscles. Good cushioned shoes help to disperse and absorb the impact forces caused by running and jumping on hard surfaces.
3. Muscular imbalances and tightness can also cause shin pain. If the muscles in the back of the lower leg are tight then this can cause added stress on the muscles on the front of the lower leg.
4. Sudden increases in speed or distance training can result in inadequate adaptation by the muscles of the lower leg.
5. Improper running style can cause shin splints. Normal running style, or gait, is characterized by the heel striking the ground absorbing the shock. Some individuals are “toe” runners/walkers that causes the stress of the activity to be absorbed at the balls of the feet. This results in abnormal stress to the lower leg muscles.
Treatment
If you are experiencing shin splints then you should stop the activity that may be
causing the pain. Check the surface that you are running on, the shoes you are
wearing and your running style. In addition, you should put ice on the affected
area for 8 to 10 minutes following activity. You can also take over-the-counter
anti-inflammatory medications (Motrin, Alleve, etc.). You can also do some heel
cord (achilles) stretching. Stretching exercises should be performed statically (no
bouncing) 3 times for 30 seconds.
If symptoms don’t improve see a physician.
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The Knee
The knee is one of the most traumatized joints in the human
body and one of the most complex. Athletic activity can place
a great amount of stress on the knee, which can result in
a season ending injury. The following is some of the most
common injuries that occur to the knee.
Patellofemoral Pain
This is a common term used for pain under or around the kneecap. Pain is usually experienced when moving the knee from a bent to straight position or with weight-bearing activities such as squatting, going up and down stairs and kneeling. Prolonged sitting can also cause pain. The pain is often caused when the kneecap deviates outside of the patellar groove. Patellofemoral pain occurs most often in females. Patellofemoral pain can be diagnosed by seeing a physician.
Cartilage Tear
Cartilage tear (also known as meniscal tear) often occurs in the knee when it is weight-bearing combined with a rotary force while extending or flexing the knee. The knee is made up of two separate pieces of cartilage. They
exist on either side of the knee where it bends. The purpose of the
cartilage is to act as a cushion between the femur and tibia. Symptoms of cartilage tears can include severe pain and loss of motion, a locked knee with inability to flex or extend fully and/or pain in the area of the tear. A cartilage tear can be diagnosed by seeing a physician.
Ligament Tear
Ligament tears in the knee are often considered the most significant injuries with the longest time for recovery. Of all ligament injuries the anterior cruciate ligament (ACL) is most commonly the most seriously disrupted ligament in the knee. The ACL is often torn when someone decelerates and makes a sharp cutting motion or when the knee is hit from the front with the foot planted. The person who tears their ACL often will feel a “pop” and some instability along with swelling. The other ligaments that are most often torn are the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). The MCL and LCL are located on either side of the knee. These ligaments are often torn when the knee suffers
a blow from the side of the knee. People who have torn either ligament may have some pain on the ligament, some swelling and feeling of instability. A ligament injury can be diagnosed by seeing a physician.
Patella Tendonitis
This is located just below the kneecap. The tendon can become inflamed with sudden or repetitive forceful extension. This often occurs in basketball players and is known as “jumpers knee”. The pain can occur during and/or after practice. Seeing a physician will help with the diagnosis of tendonitis and medicine to help with the pain.
Whenever a knee injury occurs a physician should be seen.
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Muscle Strains
Movement of the body is achieved through the contraction of muscle tissue,
which is attached to bone by connective tissue known as tendons. When a
muscle contracts, it pulls the tendon which then moves the bone to which it
is attached, initiating movement in a body segment. Motion during athletic
activities is very complex and requires multiple contractions of many muscles in
a coordinated manner. During these complex movements, muscles can be over
stretched or contract too violently causing injury to the muscle or tendon. This
is often referred to as “pulled” or “torn” muscle. The medical term for this type
of injury is a strain.
When a strain occurs, it is graded on its severity. There are three levels of
muscle strains:
First Degree: Is minimal stretching of the muscle-tendon unit without
permanent injury. A person with a first degree strain will complain of mild
soreness over the muscle or tendon area.
Second Degree: Is more severe than the first degree strain and often results
when the muscle-tendon unit is partially torn. Second degree will have a
moderate decrease in strength and function with a slightly noticeable amount of
swelling and deformity.
Third Degree: Is when the muscle-tendon unit is completely torn resulting in
severe pain, deformity, and loss of function. Third degree strain will often have
noticeable amount of deformity, discoloration around the injury site, significant
pain and swelling, and a major decrease in strength and function.
Treatment of Muscle Strains
Initial treatment for this type of injury should include the PRICE
principle (Protection, Rest, Ice, Compression, and Elevation). Ice
should be applied for 15-20 minutes, 3-4 times/day. Compression
of the injury site using an ace wrap will help to provide support
and decrease swelling. Remember that when applying an ace
wrap, you should begin at the distal end of the limb (furthest away
from your body) and wrap to the proximal end of the limb (closest
to your body), compressing the injured site firmly, but not too
tightly. Elevation of the extremity will help to promote a decrease
in swelling around the injury site as well. Athletes with injuries that
present obvious deformity, as well as significant loss of strength
should be referred to a physician for evaluation and follow-up care.
Prevention
Make sure you warm-up prior to practice, or competition. Warm-up should last at
least 10 minutes. Maintain good strength throughout the body. Muscles that are
strong and well conditioned are able to control the demands imposed by athletic
activity much more easily. Make sure to stretch prior to activity. Stretching is most
effective after the body has warmed up from doing warm-up activities.
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Head Injuries - Concussions
Concussions occur after an individual has suffered a
blow to the head. Concussions can cause an individual to
suffer memory loss or even to be knocked out. If anyone
suffers a head injury they should seek medical attention.
Concussions are graded upon their severity and have a
variety of signs and symptoms. Both are discussed.
Low Back Pain
Low back pain will strike 50-80% of all individuals at some point in their lifetime.
Low back pain can arise from a variety of sources including sport/exercise
activities, motor vehicle accidents, industrial labor or simply unknown reasons.
Grade II
Confusion, no loss of consciousness and some mental
abnormalities for more than fifteen minutes. Individuals with a Grade II
concussion should NOT return to activity and need to see a physician.
Treatment
As vast are the causes of low back pain, so too are
the treatment schemes. In the case of an acute low
back injury, ice, rest, non-steroidal anti-inflammatory
drugs, and a gradual return to activity have long
been the school of thought in the United States.
But, it is important to note that recovery is rarely
complete without the addition of specific exercise
programs involving passive and active motion. It is
important to avoid returning to an activity prior to full
recovery and becoming too aggressive with the rehabilitation which will delay
the recovery time instead of promoting it. If at any time you develop low back
pain make sure you follow-up with a physician.
Grade III Individual loses consciousness, for either seconds or for minutes
or longer. If an individual suffers a Grade III concussion then you should
call your local emergency number immediately.
Prevention
Prevention of low back pain can be broken down into three principles. They are
the following:
The following are symptoms that can occur to someone who has a
concussion. If the individual suffers from one or more of these symptoms, you
should contact your physician.
The following are the different grades of concussions.
Grade I
Confusion, no loss of consciousness and some mental
abnormalities for less than fifteen minutes. Individual can return to full activity
if all symptoms clear up within fifteen minutes.
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Vomiting
Severe headache
Confusion
Bleeding from the nose or ears
Pupils of different sizes
Garbled speech
Elevated temperature above one hundred degrees
Convulsions or seizures
Returning to Competition
The physician must be the final authority on whether an athlete continues to
participate in a collision sport after suffering a concussion.
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Flexibility - It is important to maintain normal muscular flexibility. If untreated, chronic tightness will render the joint less mobile and will make it more prone to injury. It is important to stretch without pain for 30-60 seconds three times.
Muscular Strength/Endurance - Achieving normal functional strength in the low back, abdomen (trunk), and the lower extremities will enable the individual to overcome the various forces placed on the spine. Activities such as bending, lifting, and squatting exert forces of exponential magnitude in the lumbar spine and often are not realized until an injury occurs. To build endurance, it is necessary to perform high repetitions with lower resistance. Caution should be used when working out. Try to avoid doing exercises that cause any low back discomfort.
Cardiovascular Fitness - This component plays an integral part in promoting vascularization of the soft tissue of the spine. Adequate blood supply to the structures of the spine promotes recovery and resistance to fatigue. The American College of Sportsmedicine (ACSM) recommends performing activities which require large muscle groups and are preformed continuously for 20-30 minutes, 3-5 days a week.
Head injuries must be taken seriously. After the injury occurs the person can still
develop post-concussion syndromes. These include impaired memory, lack of
concentration, anxiety, irritability, fatigue, depression and visual disturbances.
If at any time you develop low back pain
follow-up with a physician.
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Tennis and Golfers Elbow
Throughout many activities in life, the elbow is often
the subject of high stress. These stresses can lead to
various problems within and around the elbow causing
pain and decrease function. Playing tennis or golfing
are examples of two activities that can cause repetitive
motions while at work. The pain often occurs in two
areas of the elbow known as epicondyles. Depending
on which epicondyle is injured will determine if it is a
“tennis” elbow or a “golfers” elbow.
“Tennis” Elbow:Is the most common overuse injury of the elbow and is diagnosed by a physician as lateral epicondylitis. The repetitive
stress to the elbow can cause microscopic tears and inflammation to the tendons and muscles that help to extend the wrist. Individuals who have pain over the outside of the elbow may have “tennis” elbow. The pain will often radiate from
the elbow towards the wrist.
“Golfers” Elbow: Is diagnosed by a physician as medial epicondylitis. Just as “tennis” elbow inflammation can occur to the tendon, “golfers” elbow is noticeable when the individual complains of pain on the inside portion of the elbow.
Treatment:
Treatment for both “tennis” and “golfers” elbow is similar. Both require rest, ice, taking anti-inflammatories and a modification of the activity causing pain. If symptoms do not improve then you should see a physician.
Prevention:
Live by the old saying “an ounce of prevention is worth a
pound of cure”. So regardless of what the activity might be
to try to remember to use proper body mechanics and techniques. A KORT physical therapist or athletic trainer can help you identify any potential problems that may cause you pain.
Maintaining good strength and flexibility are two important factors in the prevention of overuse injuries to the elbow. The more flexible and stronger the muscles are the better they can handle the stress being placed on them.
Elbow injuries can occur for a variety of reasons. The two discussed here,
“tennis” elbow and “golfers” elbow both occur due to repetitive stresses being
placed on the elbow. If an injury occurs to your elbow then see a physician.
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Heat Illness
Whenever you work or play outside in a hot, humid
environment you increase your chances of suffering a heat
related illness. The following are the different types of heat
illnesses, how to treat someone suffering from heat illness and
things you can do to prevent heat illness.
There are three different types of Heat Illness.
Heat cramps: Is when an extremely painful muscle spasm occurs,
most often in the legs and abdomen. The muscles will cramp due to an
imbalance between the water and electrolytes in the muscle.
Treatment: Take the person to a cool place and have them drink large
quantities of water. You can also do mild stretching of the muscles
that are affected. Once someone starts to cramp it may be difficult for
them to continue to participate since they will likely cramp again. If the
condition does not improve then seek medical attention.
Heat exhaustion: Will occur when someone fails to replace the
fluids lost through sweating. The person with heat exhaustion will
have profuse sweating, pale skin, dizziness, nausea or vomiting,
headaches, rapid pulse and possible hyperventilation. They may also
become disoriented and light headed.
Treatment: Take the person to a cooler place. Remove or loosen tight
clothing and apply wet cloths. Monitor the person’s condition...if their
condition should become worse then seek medical attention.
Heat stroke: Heat stroke is a serious and life threatening emergency.
A person with heat stroke may suddenly collapse and have changes in
consciousness. They will have flushed red skin, very little sweating (if
any), and shallow breathing.
Treatment: CALL 9-1-1. Take the person to a cool place and bring
down their temperature with a cool bath. Monitor the persons breathing
conditions. Do not give the person anything to eat or drink if they are
having changes in consciousness. Stay with the person until medical
help arrives.
Prevention of heat related illnesses: Wear lightweight and light colored
clothing. Avoid wearing dark colors such as black or dark blue. Light colored
clothing will reflect some of the sun’s energy. Drink plenty of water or electrolyte
fluids on a regular basis even if you are not thirsty. Avoid doing strenuous
activity without a break to cool down. Also eat smaller meals more often.
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Proper Hydration
Types of Sports Drinks:
Fluid Replacers
Examples: Water, Gatorade, 10K, Quickick, Max
These drinks are absorbed as quickly as water and typically are used for activities lasting less than 2 hours.
Carbohydrate Loaders
Examples: Gatorlode, Exceed High, Carboplex
These drinks replace more muscle glycogen to enhance greater endurance.
They should be used after ultra-endurance events to increase muscle glycogen resynthesis after exercise.
Nutrition Supplements
Examples: Gatorpro, Exceed Sports, Ultra Energy
These supplements are fortified with vitamins and minerals and they help athletes who wish to skip a high fat meal, or as extra calories for athletes who wish to gain weight.
What Not to Drink:
•Drinks with Carbohydrate (CHO) concentrations of greater than eight percent should
be avoided.
•Fruit juices, CHO gels, sodas, and sports drinks that have a CHO greater than six to eight percent are not recommended during exercise as sole beverages.
•Beverages containing caffeine, alcohol, and carbonation are not to be used because of
the high risk of dehydration associated with excess urine production, or decreased voluntary fluid intake.
Hydration Tips and Fluid Guidelines:
•Drink according to a schedule based on individual fluid needs.
•Drink before, during and after practices and games.
•Drink 17-20 ounces of water or sports drinks with six to eight percent CHO, two to three hours before exercise.
•Drink another 7-10 ounces of water or sport drink 10 to 20 minutes before exercise.
•Drink early - by the time you're thirsty, you're already dehydrated.
•In general, every 10-20 minutes drink at least 7-10 ounces of water or sports drink to maintain hydration, and remember to drink beyond your thirst.
•Drink fluids based on the amount of sweat and urine loss.
•Within two hours, drink enough to replace any weight loss from exercise.
•Drink approximately 20-24 ounces of sports drink per pound of weight loss.
•Dehydration usually occurs with a weight loss of two percent of body weight or more.
What to Drink During Exercise:
•If exercise lasts more than 45-50 minutes or is intense, a sports drink should be provided during the session.
Shoulder Injuries
The shoulder complex is a very complicated area of the body. It has a lot of
mobility, which in turn makes it one of the most susceptible joints to injury. The
shoulder experiences a lot of stress when involved with overhead motions like
throwing a baseball, serving in tennis and volleyball, and swimming. Shoulder
injuries occur often with sports but can also occur due to a traumatic injury or
from repetitive use. The following are some of the most common injuries that
occur to the shoulder.
Shoulder Impingement
Shoulder Impingement occurs due to an overuse which results in the pinching
of the muscles in the shoulder called the rotator cuff muscles. Once this
pinching begins the tendons of the muscles can become inflamed, swollen and
painful.
Separated Shoulder
A separated shoulder occurs when the ligament that holds the collarbone
(also known as the clavicle) is torn due to injury. The ligament is located on
the end of the collarbone that makes up the shoulder joint. This injury can
occur when someone falls on their shoulder, gets hit on the shoulder or falls
on an outstretched arm. Symptoms of a separated shoulder include pain and
deformity of the clavicle. The end of the clavicle closest to the shoulder will
appear raised when compared to the other shoulder. The individual that is
injured should be taken to see a physician immediately.
Dislocated Shoulder
A shoulder dislocation often occurs when the shoulder comes out of the joint.
Dislocations can occur from falling down on the shoulder, falling down on an
outstretched arm or from having the arm pushed backwards while the arm
is out to the side at shoulder level. Dislocations will be noticeable due to a
deformity when looking at the shoulder. The upper arm will tend to be towards
the front of the body instead of to the side; the shoulder will look like it has a
drop off instead of being rounded and the individual involved tends to be in pain.
•The carbohydrate concentration in the ideal fluid replacement solution should be in the range of six to eight percent CHO.
•During events when a high rate of fluid intake is necessary to sustain hydration, sports drinks with less than seven percent CHO should be used to optimize fluid delivery. These sports drinks have a faster gastric emptying rate and thus aid in hydration.
•Sports drinks with a CHO content of 10 percent have a slow gastric emptying rate and contribute to dehydration and should be avoided during exercise.
•Fluids with salt (sodium chloride) are beneficial to increasing thirst and voluntary fluid intake as well as offsetting the amount of fluid lost with sweat.
•Salt should never be added to drinks, and salt tablets should be avoided.
•Cool beverages at temperatures between 50 to 59 degrees Fahrenheit are recommended for best results with fluid replacement.
Treatment
With any shoulder injury the most important thing to do is immobilize the
shoulder joint while making sure the person is comfortable. If you do
wrap anything around the arm, make sure it is loose so that it won’t cut off
circulation.
Journal of Athletic Training: 35(2): 212-224; NFHS Handbook Heat Related Illness, Sandra Shultz PhD, ATC, CSCS, Steven Zinder, MS, ATC
Make sure the individual that has a shoulder
injury is seen by a physician ASAP
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16
Nose Bleeds
Whenever the facial area receives a direct blow, nosebleeds can occur.
Nosebleeds can also occur from medications or allergies. Most nosebleeds
stop spontaneously after a short period of time. The following are some steps
you can take to help manage a nosebleed:
•
Have the person sit upright. **(See below)
•
Apply a cold compress over the nose.
•
You can have the person apply direct pressure to the affected nostril for around 5 minutes.
•
If the bleeding doesn’t stop after five minutes then you can put some gauze or cotton in the nostril. This will serve as a corking action and help with blood clotting. If you use the gauze or cotton make sure to leave the end protruding out of the nose, this will help to facilitate the removal.
Once the bleeding has stopped the person can return back to activity. The
person should try to avoid blowing their nose for up to two hours.
If the nosebleed is persistent then they should seek medical attention.
**Do not sit the person up if it appears that they may have a head or neck
injury. Do not move them if they are unconscious. If they are unconscious
you should seek medical attention immediately by calling 911.**
Eye Injuries
Eye injuries account for approximately 1% percent of all injuries. However, with
an eye injury the proper care is essential in making sure no more damage is
done or vision lost. The following are different types of eye injuries that can
occur and suggestions on the best way to handle them.
Black Eye
A black eye occurs when the eye suffers a blow, causing bruising to occur. The
tissue around the eye becomes discolored and often swollen. When a person
suffers a black eye you should check to make sure they have no problems with
their vision. Care of an eye contusion should include cold application for at
least half an hour. No pressure should be put on the eye itself. If the individual
has distorted vision they should rest for 24 hours before returning to activity.
Foreign Object in the Eye
A foreign object in the eye can produce considerable pain and disability.
Whenever a foreign object is in the eye you should NOT rub the eye. Rubbing
the eye may cause the foreign object to scratch the cornea. If there is
difficulty removing the foreign object then the individual should be seen
by a physician as soon as possible.
Corneal Abrasions
An individual with a corneal abrasion will often have watering of the eye and
severe pain. The individual may also have a muscle spasm around the eye,
which may make it difficult to open the eye. If a corneal abrasion occurs you
should patch the eye and send them to a physician.
Retinal Detachment
Retinal detachment occurs when the retina partially or completely detaches
from the underlying retinal pigment epithelium. This occurs more often in
people with nearsightedness. The detachment itself is painless and the early
signs include seeing what appears to be spots floating before the eye, flashes
of light or blurred vision. As the detachment progresses the individual may
complain of a “curtain” falling over the field of vision. If the individual complains
of these symptoms, they should see a physician.
The above are some of the eye injuries that may occur.
If anyone is injured in the eye area you should see a physician.
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