Sports Medicine (Option 1)
How are sport injuries classified and managed? CQ1
Direct and Indirect
Direct Injuries are as a result of an external blow or force applied to a certain part of the body. This could
be from another player (head clash when making a tackle in rugby) or an object (cricket ball hits the
batsman above the pad in the thigh). These injuries can range in severity from minor bruises to
something more serious such as fractures and internal bleeding (contusions).
Indirect Injuries occur when the injury is distant from the direct impact (landing awkwardly in a
handstand resulting in a dislocation of the shoulder). These injuries occur as a result of internal forces
which refer to putting yourself at risk through poor equipment, overstretching, poor technique or
inadequate warmups (incorrectly throwing a shotput and dislocating your shoulder because it was
stretched beyond its range of motion and there had been no prior warm up).
Overuse Injuries
Overuse Injuries are as a result of excessive and repetitive force placed on the bones and other
connecting tissues of the body. Common causes are poor technique, inadequate rest, excessive workload
or poor equipment. These types of injuries need to be treated and given time to heal before returning to
play otherwise minor damage could develop into a serious, long term injury. (Common overuse injuries
include Shin Splint from running too far too often or stress fractures in the lower back of a pace bowler)
Soft and Hard Tissue Injuries
Soft Tissue Injuries can occur to muscles, tendons, ligaments, cartilage or skin. Examples include:
o Sprains occur when the joint capsule and its connecting ligaments are stretched beyond the
normal range of motion. This type of injury is also described as a torn ligament fibre. Ligaments
are designed to be rigid and relatively in-elastic, connecting bone to bone and providing stability
to the joint. Sprains are often assessed as either Grade 1 (minor) to Grade 3 (complete rupture),
(for example, an AFL player changes direction quickly and ruptures his Anterior Cruciate
Ligament), this would be an indirect soft tissue injury.
o Strains occur when muscle fibres or tendons are overstretched or torn to some degree. This type
of injury can be quite painful and will often result in bruising around the injured site (for example
an athlete accelerates very quickly and ruptures their Achillies tendon) similarly to sprains and
muscle tears they can be categorised as Grade 1, 2 or 3.
o Contusions are caused by a direct force or blow to an area of soft tissue on the body. (For
example, an opponent's knee strikes into the quadriceps of another player during a game of
soccer.) This would likely result in a contusion which is also known as corks, bruises,
haematomas and these types of contact injuries can result in internal bleeding.
o Skin Abrasions occur when a force impacts the skin, causing superficial damage, no deeper than
the epidermis layer of the skin, although there may be slight bleeding. An example of this is
when a Netballer falls over on the court and grazes their hand. The hard surface in conjunction
with the athlete's momentum causes the skin to scrape and/pr split. When an abrasion occurs it
, is easy for foreign materials to embed themselves into the wound, therefore, it is important to
try to dislodge and disinfect these injuries.
o Lacerations are irregular tears in the skin, which leaves an open wound. Extra care is required for
this type of cut to ensure the prevention of further infection. Lacerations can occur easily (for
example, a head clash can result in a laceration on the forehead of an athlete) additionally, any
laceration over 1cm, must be referred to a doctor, especially in the case of a head or mouth
injury.
o Blisters refer to when fluid collects underneath the epidermal (or surface) layer of the skin due
to consistent rubbing (for example, wearing in new shoes can result in blisters on your feet).
o Inflammatory Response is initiated when the body is injured. The purpose of this process is to
protect the body and fight against any damaging substances, rid the site of dying or dead tissue
cells and aid in the regeneration and repair of tissue cells. The inflammatory response consists of
3 phases:
▪ Phase 1 - The inflammatory stage: Blood flow increases to the area causing pain and
swelling around the site of injury. This phase is characterised by a lack of movement and
damage to the cells and surrounding tissue area.
▪ Phase 2 - The repair and regenerative stage: The second phase starts after the initial 48
hours and can last anywhere from 3 days to 6 weeks. During this stage damaged tissue is
broken down, fibres are repairs and scar tissue forms.
▪ Phase 3 - The remodelling/repair stage: The final phase can take months as scar tissue is
increased and replacement tissue is strengthened.
Management of Soft Tissue Injuries can be conducted via the RICER principle (Rest, Ice, Compression,
Elevation & Referral) outlines the full range of methods which should be immediately applied to manage
soft tissue injuries:
o Rest - It is important to make the athlete as comfortable as possible, this may involve lying down
to decrease blood flow to the injured site.
o Ice - or a cold pack, should be applied to the injured site to reduce swelling, pain and
vasoconstriction of localised blood vessels.
o Compression - A firm bandage wrapped over the injured site, as well as above and below the
injury, will constrict and reduce the swelling.
o Elevation - The injured site must be raised above the level of the heart to restrict blood flow and
reduce bleeding, swelling and pain.
o Referral - After initial treatment it is essential to refer the athlete to a qualified professional like
a doctor or physio so they can diagnose the injury as early as possible, provide further treatment
and suggest appropriate rehabilitation plans.
What NOT to do - HARM ACRONYM
o Heat
o Alcohol
o Running
o Massage
Hard Tissue Injuries can occur to Bones and Teeth. Example include:
o Fractures occur when a bone experiences a great amount of direct or indirect force resulting in a
break. There are many different types of fractures that can cause Soft Tissue Injuries (for
example, a skier land awkwardly and fractures his tibia, it is a compound fracture) in a situation
like this, the bone has pierced the skin, therefore, it also creates a soft tissue injury. Other types
, of fractures include complicated (when the bone causes further damage to major nerves, organs
or blood vessels and can be life threatening), closed/simple and open/compound fractures.
o Dislocations occur when a joint exceeds its range of motion resulting in the displacement of a
bone at a joint. Dislocations cause severe pain and are visually apparent because of the
deformity they cause. Dislocations can occur easily (A skier turns and lands awkwardly
dislocating their hip) in a situation like this it is important not to attempt to relocate the bone
unless you are a trained medic, as incorrect placement can affect ligaments, muscles and
tendons in the area.
o Teeth Injuries are the other type of hard tissue injury and are quite common, they include
complete dislodgements, chips and cracks. (A cricket player is fielding close to the batsman when
he hits it into the fielder and dislodges one tooth and chips another.)
Management of Hard Tissue Injuries is vital as incorrect treatment can result in damaged muscles,
ligaments and other organs. When dealing with hard tissue injuries the two most important things are
assessing the injury and immobilising the injured area as much as possible.
o Assessment for medical attention - Most hard tissue injuries require medical attention,
generally medical attention is required if:
▪ There is obvious deformity
▪ There is uncontrolled bleeding
▪ The casualty is unable to complete the TOTAPS regime
o Immobilisation is a vital element when dealing with hard tissue injuries, this is because further
movement can inflict greater amounts of pain or worsen the severity of the injury.
Immobilisation strategies vary depending on where and what the injury is (For example, an
athlete suffers from a dislocated shoulder, a sling should be used if available, however, using the
shirt of the athlete is also adequate) this prevents the humerus from moving and holds the arm
in a stable position. If the athlete is suffering from a head or neck injury (Use a neck brace and lie
the casualty on their back, prevent any twisting of the spine).
Assessment of Injuries
Assessments of Injuries are vital and are used to determine whether an athlete is in an adequate
position to continue play. It is used to assess the extent and type of the injury, if the player is able to
complete the assessment they are eligible to return to play, however, if they cannot they should seek
further medical attention. This can be assessed through the TOTAPS regime.
o Talk to the athlete to find out exactly what happened. This provides valuable information about
the nature of the injury. (For example an athlete rolls their ankle, in this situation you should Talk
to the athlete about the injury to receive the correct information)
o Observe any signs of swelling or deformity. The easiest way to test swelling is to compare both
sides of the body. Obvious deformity or swelling are indications of damage to soft or hard tissue,
which means further professional attention is likely. (For example an athlete rolls their ankle, in
this situation you should Observe and compare the ankle to the other)
o Touch the injured site with consent if observation fails to yield results, by gently touching the
site, you may be able any further painful areas or deformities that were not apparent visually.
Gentle pressure should be applied and the athlete should inform you if there is pain when
touching certain areas.
o Active Movement the athlete will need to test a movement around the injured site by
performing actions such as flexion, extension and rotation to determine whether the mobility of
, the joint has been affected. (For example an athlete rolls their ankle, the athlete should conduct
Active Movement like dorsi flexion, plantar flexion and ankle rotation to identify any movement
concerns)
o Passive Movement if full range of motion is not evident, the assessor or sports trainer need to
physically mobilise the joint to test the range of motion and identify any instability and painful
areas.
o Skills Test the athlete must conduct sport specific movements that mimic those which are
performed during the game, including walking, running, side stepping, changing direction and
jumping.
How does sports medicine address the demands of specific athletes?
CQ2
Children and Young Athletes
Young athletes and young children have particular needs and require additional attention when
performing in any sport or physical activity. It is also vital that all athletes, parents, coaches and
support staff are aware of any conditions that children or young athletes suffer from.
Medical Conditions
Asthma
is characterised by difficulty breathing, wheezing, coughing or shortness inbreath and can
negatively affect an athlete if not managed properly. Asthma can be induced by a range of
factors including; exercise, air quality, insufficient warm ups and psychological influences.
Asthma attacks are triggered by the way airways leading to the lungs become constricted,
causing tightness in the chest area and breathing difficulties. Specific needs include:
● Asthma Plan/Ventolin Inhaler
● Good Air quality
● Sufficient warm up
Diabetes
is a disease that is commonly found in children and young athletes.
Type 1 diabetes is when the athlete is unable to produce Insulin, thus, preventing
them from naturally balancing glucose levels in their blood stream, categorising them
as insulin dependent. Type 1 is also naturally occurring, non hereditary and completely
random.
Type 2 diabetes occurs from lifestyle choices and is when the individual is unable to
produce enough insulin to balance their blood glucose levels.
Hyperglycaemia or high blood sugar, is triggered when too much glucose is in the
athlete's bloodstream or when an under allocation of insulin happens leading high
blood glucose levels. Common signs and symptoms of hyperglycaemia include thirst,
agitation, constant urination and inability to think.
Hypoglycaemia or low blood sugar, is triggered when the athlete consumes not
enough glucose or sugar, this also happens when too much insulin is pumped into the
blood stream effecting in very low blood glucose levels. Common symptoms include
How are sport injuries classified and managed? CQ1
Direct and Indirect
Direct Injuries are as a result of an external blow or force applied to a certain part of the body. This could
be from another player (head clash when making a tackle in rugby) or an object (cricket ball hits the
batsman above the pad in the thigh). These injuries can range in severity from minor bruises to
something more serious such as fractures and internal bleeding (contusions).
Indirect Injuries occur when the injury is distant from the direct impact (landing awkwardly in a
handstand resulting in a dislocation of the shoulder). These injuries occur as a result of internal forces
which refer to putting yourself at risk through poor equipment, overstretching, poor technique or
inadequate warmups (incorrectly throwing a shotput and dislocating your shoulder because it was
stretched beyond its range of motion and there had been no prior warm up).
Overuse Injuries
Overuse Injuries are as a result of excessive and repetitive force placed on the bones and other
connecting tissues of the body. Common causes are poor technique, inadequate rest, excessive workload
or poor equipment. These types of injuries need to be treated and given time to heal before returning to
play otherwise minor damage could develop into a serious, long term injury. (Common overuse injuries
include Shin Splint from running too far too often or stress fractures in the lower back of a pace bowler)
Soft and Hard Tissue Injuries
Soft Tissue Injuries can occur to muscles, tendons, ligaments, cartilage or skin. Examples include:
o Sprains occur when the joint capsule and its connecting ligaments are stretched beyond the
normal range of motion. This type of injury is also described as a torn ligament fibre. Ligaments
are designed to be rigid and relatively in-elastic, connecting bone to bone and providing stability
to the joint. Sprains are often assessed as either Grade 1 (minor) to Grade 3 (complete rupture),
(for example, an AFL player changes direction quickly and ruptures his Anterior Cruciate
Ligament), this would be an indirect soft tissue injury.
o Strains occur when muscle fibres or tendons are overstretched or torn to some degree. This type
of injury can be quite painful and will often result in bruising around the injured site (for example
an athlete accelerates very quickly and ruptures their Achillies tendon) similarly to sprains and
muscle tears they can be categorised as Grade 1, 2 or 3.
o Contusions are caused by a direct force or blow to an area of soft tissue on the body. (For
example, an opponent's knee strikes into the quadriceps of another player during a game of
soccer.) This would likely result in a contusion which is also known as corks, bruises,
haematomas and these types of contact injuries can result in internal bleeding.
o Skin Abrasions occur when a force impacts the skin, causing superficial damage, no deeper than
the epidermis layer of the skin, although there may be slight bleeding. An example of this is
when a Netballer falls over on the court and grazes their hand. The hard surface in conjunction
with the athlete's momentum causes the skin to scrape and/pr split. When an abrasion occurs it
, is easy for foreign materials to embed themselves into the wound, therefore, it is important to
try to dislodge and disinfect these injuries.
o Lacerations are irregular tears in the skin, which leaves an open wound. Extra care is required for
this type of cut to ensure the prevention of further infection. Lacerations can occur easily (for
example, a head clash can result in a laceration on the forehead of an athlete) additionally, any
laceration over 1cm, must be referred to a doctor, especially in the case of a head or mouth
injury.
o Blisters refer to when fluid collects underneath the epidermal (or surface) layer of the skin due
to consistent rubbing (for example, wearing in new shoes can result in blisters on your feet).
o Inflammatory Response is initiated when the body is injured. The purpose of this process is to
protect the body and fight against any damaging substances, rid the site of dying or dead tissue
cells and aid in the regeneration and repair of tissue cells. The inflammatory response consists of
3 phases:
▪ Phase 1 - The inflammatory stage: Blood flow increases to the area causing pain and
swelling around the site of injury. This phase is characterised by a lack of movement and
damage to the cells and surrounding tissue area.
▪ Phase 2 - The repair and regenerative stage: The second phase starts after the initial 48
hours and can last anywhere from 3 days to 6 weeks. During this stage damaged tissue is
broken down, fibres are repairs and scar tissue forms.
▪ Phase 3 - The remodelling/repair stage: The final phase can take months as scar tissue is
increased and replacement tissue is strengthened.
Management of Soft Tissue Injuries can be conducted via the RICER principle (Rest, Ice, Compression,
Elevation & Referral) outlines the full range of methods which should be immediately applied to manage
soft tissue injuries:
o Rest - It is important to make the athlete as comfortable as possible, this may involve lying down
to decrease blood flow to the injured site.
o Ice - or a cold pack, should be applied to the injured site to reduce swelling, pain and
vasoconstriction of localised blood vessels.
o Compression - A firm bandage wrapped over the injured site, as well as above and below the
injury, will constrict and reduce the swelling.
o Elevation - The injured site must be raised above the level of the heart to restrict blood flow and
reduce bleeding, swelling and pain.
o Referral - After initial treatment it is essential to refer the athlete to a qualified professional like
a doctor or physio so they can diagnose the injury as early as possible, provide further treatment
and suggest appropriate rehabilitation plans.
What NOT to do - HARM ACRONYM
o Heat
o Alcohol
o Running
o Massage
Hard Tissue Injuries can occur to Bones and Teeth. Example include:
o Fractures occur when a bone experiences a great amount of direct or indirect force resulting in a
break. There are many different types of fractures that can cause Soft Tissue Injuries (for
example, a skier land awkwardly and fractures his tibia, it is a compound fracture) in a situation
like this, the bone has pierced the skin, therefore, it also creates a soft tissue injury. Other types
, of fractures include complicated (when the bone causes further damage to major nerves, organs
or blood vessels and can be life threatening), closed/simple and open/compound fractures.
o Dislocations occur when a joint exceeds its range of motion resulting in the displacement of a
bone at a joint. Dislocations cause severe pain and are visually apparent because of the
deformity they cause. Dislocations can occur easily (A skier turns and lands awkwardly
dislocating their hip) in a situation like this it is important not to attempt to relocate the bone
unless you are a trained medic, as incorrect placement can affect ligaments, muscles and
tendons in the area.
o Teeth Injuries are the other type of hard tissue injury and are quite common, they include
complete dislodgements, chips and cracks. (A cricket player is fielding close to the batsman when
he hits it into the fielder and dislodges one tooth and chips another.)
Management of Hard Tissue Injuries is vital as incorrect treatment can result in damaged muscles,
ligaments and other organs. When dealing with hard tissue injuries the two most important things are
assessing the injury and immobilising the injured area as much as possible.
o Assessment for medical attention - Most hard tissue injuries require medical attention,
generally medical attention is required if:
▪ There is obvious deformity
▪ There is uncontrolled bleeding
▪ The casualty is unable to complete the TOTAPS regime
o Immobilisation is a vital element when dealing with hard tissue injuries, this is because further
movement can inflict greater amounts of pain or worsen the severity of the injury.
Immobilisation strategies vary depending on where and what the injury is (For example, an
athlete suffers from a dislocated shoulder, a sling should be used if available, however, using the
shirt of the athlete is also adequate) this prevents the humerus from moving and holds the arm
in a stable position. If the athlete is suffering from a head or neck injury (Use a neck brace and lie
the casualty on their back, prevent any twisting of the spine).
Assessment of Injuries
Assessments of Injuries are vital and are used to determine whether an athlete is in an adequate
position to continue play. It is used to assess the extent and type of the injury, if the player is able to
complete the assessment they are eligible to return to play, however, if they cannot they should seek
further medical attention. This can be assessed through the TOTAPS regime.
o Talk to the athlete to find out exactly what happened. This provides valuable information about
the nature of the injury. (For example an athlete rolls their ankle, in this situation you should Talk
to the athlete about the injury to receive the correct information)
o Observe any signs of swelling or deformity. The easiest way to test swelling is to compare both
sides of the body. Obvious deformity or swelling are indications of damage to soft or hard tissue,
which means further professional attention is likely. (For example an athlete rolls their ankle, in
this situation you should Observe and compare the ankle to the other)
o Touch the injured site with consent if observation fails to yield results, by gently touching the
site, you may be able any further painful areas or deformities that were not apparent visually.
Gentle pressure should be applied and the athlete should inform you if there is pain when
touching certain areas.
o Active Movement the athlete will need to test a movement around the injured site by
performing actions such as flexion, extension and rotation to determine whether the mobility of
, the joint has been affected. (For example an athlete rolls their ankle, the athlete should conduct
Active Movement like dorsi flexion, plantar flexion and ankle rotation to identify any movement
concerns)
o Passive Movement if full range of motion is not evident, the assessor or sports trainer need to
physically mobilise the joint to test the range of motion and identify any instability and painful
areas.
o Skills Test the athlete must conduct sport specific movements that mimic those which are
performed during the game, including walking, running, side stepping, changing direction and
jumping.
How does sports medicine address the demands of specific athletes?
CQ2
Children and Young Athletes
Young athletes and young children have particular needs and require additional attention when
performing in any sport or physical activity. It is also vital that all athletes, parents, coaches and
support staff are aware of any conditions that children or young athletes suffer from.
Medical Conditions
Asthma
is characterised by difficulty breathing, wheezing, coughing or shortness inbreath and can
negatively affect an athlete if not managed properly. Asthma can be induced by a range of
factors including; exercise, air quality, insufficient warm ups and psychological influences.
Asthma attacks are triggered by the way airways leading to the lungs become constricted,
causing tightness in the chest area and breathing difficulties. Specific needs include:
● Asthma Plan/Ventolin Inhaler
● Good Air quality
● Sufficient warm up
Diabetes
is a disease that is commonly found in children and young athletes.
Type 1 diabetes is when the athlete is unable to produce Insulin, thus, preventing
them from naturally balancing glucose levels in their blood stream, categorising them
as insulin dependent. Type 1 is also naturally occurring, non hereditary and completely
random.
Type 2 diabetes occurs from lifestyle choices and is when the individual is unable to
produce enough insulin to balance their blood glucose levels.
Hyperglycaemia or high blood sugar, is triggered when too much glucose is in the
athlete's bloodstream or when an under allocation of insulin happens leading high
blood glucose levels. Common signs and symptoms of hyperglycaemia include thirst,
agitation, constant urination and inability to think.
Hypoglycaemia or low blood sugar, is triggered when the athlete consumes not
enough glucose or sugar, this also happens when too much insulin is pumped into the
blood stream effecting in very low blood glucose levels. Common symptoms include
