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Essentials of Athletic Injury Management, Test 3


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Stages in Grief Process
Guidelines for treating an athlete with an injury
1. treat the person, not the injury
2. Communicate well and clearly
3. set measurable goals
4. refer when necessary
Reactive phases of the injury and rehab process
1. reaction to injury
2. reaction to rehab
3. reaction to return to play decision, including career termination
Reactions to injury requiring short rehab
injury- initial shock/ fear, then relief at severity
rehab- optimistic but impatient
RTP- eage
Reaction to injury requiring longer rehab
injury- fear, anger, devastation
rehab- loss of vigor
RTP- cautious, fearful
Reaction to chronic injury
injury- frustration, anger, annoyance
rehab- questioning
RTP- questioning
Reaction to a career-ending injury
injury- grief process
rehab- negative, seems senseless
no RTP- grief process
What variables predispose an athlete to injury?
Personality variables
Psychosocial variables
Psychosocial variables
Negative stress predisposes an athlete to injury
Personality variables
Locus of control- examined, but has no effect
Self-concept- low self-concept deal poorly w/ stress & seeks attention, increasing incidence of injury
Seasonal Affective Disorder
SAD- caused by lack of exposure to sunlight; more common in women
S/S of SAD
decreased energy
decreased libido
impaired social activity
Tx for SAD
light therapy
chemical therapy
Eating Disorders
Anorexia Nervosa- not eating
Bulimia Nervosa- binge & purge
physical effects of eating disorders
esophageal inflammation
erosion of tooth enamel
hormonal imbalances-can cause amenorrhea and osteoporosis
electrolyte imbalance leading to kidney & heart problems
psych issues, depression
Warning signs of eating disorder
changes in physical appearance, thin hair, sores around mouth
mood swings
defensive re: questions
avoid eating in public
frequent bathroom trip
excessive exercise
continual concerns about weight
consumption of food not consistent w/ weight gain
elevated body temperature
methods of heat regulation
metabolic heat production
conductive heat exchange
convective heat exchange
radiant heat exchange
evaporative heat loss
discuss evaporative heat loss
it can remove up to 80% of body heat on a dry day
when relative humidity is 65%, sweating is impaired
when relative humidity is 75%, sweating is virtually ineffective
measures relative humidity
heat cramps
least severe of heat emergencies
involuntary muscle contractions due to electrolyte loss; calves & abdomen most common; prevent by hydration before exercise
Tx: not much you can do, stretch, hydrate
heat exhaustion
direct result of dehydration, can be dangerous
S/S of heat exhaustion
profuse sweating
pale, clammy skin
increased temperature
excessive thirst
increased pulse
Tx for heat exhaustion
get them into cooler area
remove excessive clothing
hydrate, maybe by IV
monitor body temp
most severe heat emergency, a medical emergency like shock
body can’t regulate temperature
S/S of heatstroke
hot, dry skin
shallow respiration
rapid pulse
body temp 106 or more
loss of coordination
Tx for heatstroke
rapid transport
sponge w/ cool water
remove excess clothing
ice packs at major arteries; armpits, groin, back of neck
Prevention of heat emergencies
⬢ proper fluid intake
⬢ gradual acclimatization
⬢ identify susceptible individuals
⬢ keep weight records
⬢ appropriate uniform selection
discuss proper fluid intake
• We need water & electrolytes
• We need ½ oz. of water for every pound of body weight, then ↑ as needed
• Water colder than room temp absorbs faster
• Urine color is the best gauge
Identify individuals susceptible to heat stroke
large people
⬢ Overfat b/c adipose tissue stores increase body temp
⬢ Muscular b/c muscle contractions produce heat
Cold emergencies
lowered body temperature
shivering stops between 85-90o
Deadly body temperature ranges
below 85o
above 107o
only the outer layer of skin freezes
usually ears, nose, chin, fingers, toes
skin firm from cold, but usually doesn’t blister
don’t rub area, blow or put in warm place to rewarm area
S/S of frostbite
hard, cold skin
pale, waxy skin
How can weight records help maintain adequate hydration?
3-5% of body weight lost during an event is too much; hold the athlete out from play until hydration is bette
flash-to-bang method
count seconds between lightning and thunder
divide by 5
= how many miles away lightning is
at 30 seconds (6 miles), clear field
RTP guidelines for lightning
wait at least 30 minutes after last sound of thunder
sun protection factor;
increases acceptable exposure time by a factor of SPF
over unprotected skin
Short term goals for any therapeutic modality
address swelling
increase ROM
decrease pain
increase strength, power & endurance
increase neuromuscular control (balance)
maintain cardiovascular fitness
how to address swelling
measure with a tape measure & keep monitoring for changes
how to increase ROM
PNF AAROM static stretching
functional goals
activity specific; set goals for things that will be needed for RTP or work/ life
Underlying goal of any therapeutic modality
to create an optimum environment for healing, not to speed up the process
any kind of heat therapy
hydroculators, paraffin, hot tub, ultrasound, massage
indications for thermotherapy
when you want vasodilatation or to increase flexibility by increasing extensibility of collagen
to decrease pain by acting as a counter irritant
to decrease muscle spasm
contraindications for thermotherapy
acute inflammation/ injury
hypoesthesia (must monitor)
poor circulation
over eyes or genitals
cold therapy like ice, cold baths
contraindications for cryotherapy
poor circulation
cold allergies
Reynaud’s syndrome
use during competition immediately prior to RTP
Electric Stimulation
e-stim uses:
counteract pain
force muscle contractions for reeducation
pulsed contractions to decrease swelling (lymphatic drainage)
Ultrasound uses
continuous setting provides deep heat
pulsed setting for initial swelling
heat through a circulating medium, warm air
short wave diathermies larger area
microwave diathermies smaller area
indications for cryotherapy
when you want vasoconstriction
to decrease pain by slowing nerve conduction to decrease the risk of secondary hypoxic injury
to decrease flexibility
3 layers of skin
a viral infection, usually part of an annual epidemic
S/S of Influenza
fever, cough, headache, nausea, vomiting, general malaise, general body aches
Tx for influenza
sympomatic: analgesics, cough suppresents, steam
inflamation of the nasal mucous lining; can be allergic or non-allergic
inflamation of the mucous membranes of the bronchial tubes
S/S of bronchitis
yellow discharge, wheezing, difficulty breathing, slight fever
viral disease caused by the Epstein-Barr virus; called the kissing disease b/c transmitted by saliva
etiology for mononucleosis
incubates for 4-6 weeks
duration is usually 3 weeks
common secondary complication of mononucleosis
spleenomegoly, enlarged spleen
S/S week 1 of mononucleosis
decreased appetite, fatigue, malaise, general muscle ache
Week 2 S/S of mononucleosis
fever, swollen lymph glands, sore throat, possibility of skin rash, enlarged spleen
RTP considerations for mononucleosis
all S/S gone, especially enlarged spleen, blood work is clean
Kinds of skin infections
viral, bacterial, fungal
common viral skin infections
herpes simplex 1, herpes simplex 2, herpes gladiatorum, herpes zoster, human papilloma virus
bacterial skin infections
staphylococcus, streptococcus
fungal skin infections
ringworm (tinea)
a bacterial strep infection
staph infection originating in a hair folicle
inflamation of hair folicles
herpes simplex
results in eruption of vessicles that reappear in the same spot
herpes simplex 1
cold sore, fever blister
herpes simplex 2
genital herpes
herpes zoster
lack of iron
iron defeciency anemia
low levels of hemoglobin and hematocrit
molecules that carry oxygen in blood
red blood cells
S/S of iron deficiency anemia
fatigue, lethargy, muscle fatigue, soreness
care for iron deficiency anemia
refer for blood work; management includes eating more red meat, avoiding tea & coffee, ingesting vitamin C and iron supplements
sickle-cell anemia
genetic condition where hematocrit is abnormally shaped; function is diminished and its life span is less
sickle-cell anemia crisis symptoms
intense abdominal and leg pain, fever, fatigue, muscle weakness, skin pallor, abdominal pain in UR quadrant
treatment of sickle-cell anemia crisis
symptomatic, remove from area causing symptoms
insulin shock, low blood sugar
S/S of hypoglycemia
rapid onest, physical weakness, drooping eyelids, moist pale skin, shallow respirations
care for hypoglycemia
when in doubt, give sugar; prevent through correct diet
diabetic coma, too much blood sugar
S/S of hypergylcemia
slower onset, fruity smelling breath, labored breathing, mental confusion, extreme thirst
care for hyperglycemia
rapid transport, give sugar as juice, tablet or goo

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