Biomechanics of Injury

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Biomechanics of Injury: Notes

Sports injuries are divided into two categories: Acute and Chronic

Acute Injury
Acute injuries occur suddenly when playing or exercising. E.g. sprained ankles, strained back and fractured hands are acute injuries.

Signs of acute injury include:
Sudden severe pain
Swelling
Inability to place weight on a lower limb
Extreme tenderness in an upper limb
Inability to move a joint through full range of motion
Extreme limb weakness
Visible dislocation/break of bone

Acute phase of injury
The acute phase of an injury spans from the initial onset of injury to the first 72 hours after injury. During the acute stage, the body manifests the trauma with a physiologic response. This response is marked by swelling, discoloration, mild to severe localised pain, decreased range of motion, inability to bear full body weight and superficial temperature changes.

The sub acute phase of injury
The sub acute phase of an injury ranges from 72 hours after the initial injury to 90 days after. The sub acute stage is a crucial period in which the treating physician can ensure a rapid recovery. It is also the hardest phase to differentiate, because it does not have the classic physiological signs usually associated with the acute or chronic phases. Most often the swelling has diminished, the pain has decreased and the range of motion has slightly increased. Patient compliance becomes an issue because they no longer feel intense pain. Pain should not be the indicating factor that a patient has reached maximum medical improvement.

Chronic injury
Chronic injuries are a result of overusing one area of the body while playing a sport or exercising over a long period of time.

Signs of chronic injuries include:
Pain when playing
Pain when you exercise
A dull ache when at rest
Swelling

Chronic phases of injury
The chronic phase of an injury is characterized by prolonged length of disability and or pain to the afflicted area longer than 90 days. It is often marked by a significant decrease in range of motion, followed by a certain degree in dysfunction. For patients suffering from chronic injury, there will be minimal improvement in the condition after maximal treatment. There is also a constant threat of susceptibility to re-injury. Sports related injuries

Acute and restoration phases of an injury

Recovery from injury

Acute (0-4 days) Minimise effects of an injury
inflammationPromote healing (P.R.I.C.E.R principle)
Maintain rest of body

Restoration (5 days onwards) Begin stretching injured body-part proliferation leading to remodelling (lengthen muscle)
Muscle tensing (broaden muscle)

Ligament injuries are divided into 3 grades, which are;
Grade I: Grade I sprains involve only slight tissue damage and the area is tender to touch, swelling is only slight and the body part moves almost normally.

Grade II: Grade II sprains involve more severe injuries to ligament fibres, local pain is more intense and movement is more limited. (Grade I and II injuries are common when, for example the ankle is twisted)

Grade III: Grade III injuries are far more serious because they involve complete rupture of the tendons. There is considerable pain and swelling and it is impossible to take the body weight through the injured limb (ankle for example). These injuries often require surgery to repair the ruptured ligament followed by intense physiotherapy.

Muscle injuries (strains) are divided into 4 grades, which are; Grade I: Grade I muscle strains are usually mild. Strains involve tearing of only a few muscle fibres and subsequent local bruising. The symptoms of a grade I muscle strain are stiffness in the affected area, which lasts for a few days and then clears up very quickly.

Grade II: Grade II muscle strains are more moderate and severe. A larger number of muscle fibres are injured, and injury occurs over a greater area. The muscle...
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