Module 1: Introduction to sports injuries

Sports Injuries

1. Introduction
   1. Classifications
   2. Stage of healing
   3. Injuries and tissue types
   4. Acute injury
   5. Sub-Acute
   6. Chronic injury
   7. Impact injury
2. Injury activity
3. Soft-tissue injuries
   1. Haematoma
   2. Concussion
   3. Strains
   4. Sprains
   5. Bone-cartilage damage
4. Hard tissue injuries
   1. Dislocation
   2. Fractures
5. Overuse injuries
   1. Stress fractures
   2. Shin splints
   3. Tendonitis
6. Naming injuries activity
7. Signs and symptoms of injuries activity

Strains

A strain is a tear in a muscle or tendon due to excess tensile stress (pulled) through the tissues. This is commonly called a pulled or torn muscle.

Strains are usually indirect injuries being caused by an overloading or overstretching of the muscle unit. Any extreme loading of the muscle, such as with a heavy lift or powerful movement such as a sudden sprint, jump or strenuous throw, can result in injury.

Strains often occur in the presence of muscle fatigue, and the athlete may experience a 'snapping' sensation as the injury occurs. The overload can occur during concentric or eccentric phases of isotonic contraction, however, it is generally recognised that strong eccentric contractions are more commonly the cause of muscle injury (overloading as the muscle is lengthening).

The majority of strains tend to occur during normal range of movement (RoM). Muscle tissue tends to heal more effectively than other soft-tissues (e.g. tendons and ligaments) because of its rich blood supply.

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Strains are graded according to the severity of the injury:

First degree strain

A first degree strain is a minor partial tear. There will be mild to moderate pain on contraction or stretch, but usually very minor functional impairments, which will be more noticeable during more intense exercise.

The muscle may appear weaker than normal, and there may also be minor muscle spasms (tightening), possibly accompanied by a mild degree of swelling and decolouration. There is usually tenderness on local palpation (touch). Recovery is usually quick and complete if correct principles of management are applied.

Second degree strain

A second degree strain is a more severe partial tear, resulting from a more forceful contraction or stretching. There is a more pronounced set of signs and symptoms associated with a second degree strain.

Pain is moderate to strong during stretch, contraction and palpation, weakness is evident, swelling can be moderate to major, and function impaired to a greater degree.

Obviously, the greater the severity of damage, the longer the recovery will be. Second degree muscle injuries will normally heal, with good treatment and progressive remedial exercise, in three to six weeks.

Third degree strain

A third degree muscle strain is a complete rupture, where there is a complete or virtual lack of continuity in the affected area. This injury is the result of a very forceful contraction or overstretching. Typical signs and symptoms include:

• Severe pain as the injury occurs, which commonly reduces soon afterwards
• Significant weakness and loss of function
• Marked swelling
• Muscle spasm in adjacent muscles
• Complete loss of strength on specific resistance testing
• Local and diffused pain

This type of injury usually requires surgical repair, or at least a few weeks of immobilisation, prior to a comprehensive rehabilitation programme. Returning to full fitness often takes two to three months or longer.