Essentials of Athletic Injury Management, Test 3
Terms
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- Stages in Grief Process
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Denial
Anger
Bargaining
Depression
Acceptance - Guidelines for treating an athlete with an injury
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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
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1. reaction to injury
2. reaction to rehab
3. reaction to return to play decision, including career termination - Reactions to injury requiring short rehab
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injury- initial shock/ fear, then relief at severity
rehab- optimistic but impatient
RTP- eage - Reaction to injury requiring longer rehab
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injury- fear, anger, devastation
rehab- loss of vigor
RTP- cautious, fearful - Reaction to chronic injury
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injury- frustration, anger, annoyance
rehab- questioning
RTP- questioning - Reaction to a career-ending injury
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injury- grief process
rehab- negative, seems senseless
no RTP- grief process - What variables predispose an athlete to injury?
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Personality variables
Psychosocial variables - Psychosocial variables
- Negative stress predisposes an athlete to injury
- Personality variables
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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
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decreased energy
decreased libido
hypersomnia
impaired social activity - Tx for SAD
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light therapy
counseling
chemical therapy - Eating Disorders
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Anorexia Nervosa- not eating
Bulimia Nervosa- binge & purge - physical effects of eating disorders
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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
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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 - Hyperthermia
- elevated body temperature
- methods of heat regulation
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metabolic heat production
conductive heat exchange
convective heat exchange
radiant heat exchange
evaporative heat loss - discuss evaporative heat loss
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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 - psychrometer
- measures relative humidity
- heat cramps
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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
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profuse sweating
pale, clammy skin
increased temperature
fatigue
excessive thirst
increased pulse
nausea
headache
diziness - Tx for heat exhaustion
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get them into cooler area
remove excessive clothing
hydrate, maybe by IV
monitor body temp - Heatstroke
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most severe heat emergency, a medical emergency like shock
body can’t regulate temperature - S/S of heatstroke
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hot, dry skin
dizziness
lightheaded
shallow respiration
nausea
unconsciousness
rapid pulse
body temp 106 or more
loss of coordination - Tx for heatstroke
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rapid transport
sponge w/ cool water
remove excess clothing
hydrate
ice packs at major arteries; armpits, groin, back of neck - Prevention of heat emergencies
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⬢ proper fluid intake
⬢ gradual acclimatization
⬢ identify susceptible individuals
⬢ keep weight records
⬢ appropriate uniform selection - discuss proper fluid intake
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• 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
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large people
⬢ Overfat b/c adipose tissue stores increase body temp
⬢ Muscular b/c muscle contractions produce heat - Cold emergencies
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hypothermia
frostnip
frostbite - Hypothermia
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lowered body temperature
shivering stops between 85-90o - Deadly body temperature ranges
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below 85o
above 107o - frostnip
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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
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hard, cold skin
pale, waxy skin
blistering - 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
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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
- SPF
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sun protection factor;
increases acceptable exposure time by a factor of SPF
over unprotected skin - Short term goals for any therapeutic modality
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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
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stretching
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
- thermotherapy
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any kind of heat therapy
hydroculators, paraffin, hot tub, ultrasound, massage - indications for thermotherapy
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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
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acute inflammation/ injury
hypoesthesia (must monitor)
poor circulation
pregnancy
over eyes or genitals - Cryotherapy
- cold therapy like ice, cold baths
- contraindications for cryotherapy
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poor circulation
hypoesthesia
cold allergies
Reynaud’s syndrome
use during competition immediately prior to RTP - Electric Stimulation
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e-stim uses:
counteract pain
force muscle contractions for reeducation
pulsed contractions to decrease swelling (lymphatic drainage) - Ultrasound uses
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continuous setting provides deep heat
pulsed setting for initial swelling - Fluidotherapy
- heat through a circulating medium, warm air
- Diathermy
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short wave diathermies larger area
microwave diathermies smaller area - indications for cryotherapy
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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
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epidermis
dermis
subcutis - Influenza
- 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
- rhinitis
- inflamation of the nasal mucous lining; can be allergic or non-allergic
- bronchitis
- inflamation of the mucous membranes of the bronchial tubes
- S/S of bronchitis
- yellow discharge, wheezing, difficulty breathing, slight fever
- mononucleosis
- viral disease caused by the Epstein-Barr virus; called the kissing disease b/c transmitted by saliva
- etiology for mononucleosis
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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)
- impetigo
- a bacterial strep infection
- boil
- staph infection originating in a hair folicle
- folliculitis
- 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
- shingles
- anemia
- lack of iron
- iron defeciency anemia
- low levels of hemoglobin and hematocrit
- hemoglobin
- molecules that carry oxygen in blood
- hematocrit
- 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
- hypoglycemia
- 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
- hyperglycemia
- 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