9. Bone Injuries
• Usually high energy injuries
• Immediate pain, usually associated with an
• Deformity, Swelling, Pain to palpate, Pain
to axially load.
• Types of breaks
– stress fracture, spiral fracture, transverse break
10. Stress Fractures
• Begin as pain with
• Progress to pain with
activity and constant
• Most commonly
affected areas are the
foot, shin and low
11. Fracture Management
• Fingers. Sign if not obvious is to press
through length of bone.
• Xray is gold standard test.
• Surgery if displaced or rotated
• four to six weeks if no surgery
• Other breaks follow similar principles.
Immobilisation or surgery depending on
13. Muscle Injuries
• Muscle Injuries are direct (corks), or
• Muscle tears are known as strains, and are
classed one to three
• Most commonly injured muscles are
hamstring, calf, and quadriceps.
• Muscle Tears have a very high recurrence
14. Muscle Tears
• Grade One Tear: 7-10 days
• Grade Two Tear: 4-7 weeks
• Grade Three Tears: >six weeks
• Rehab of the muscle tear very important.
Regaining strength, length and power.
• Pain is not the guide. Tensile strength
(ability to contract under load) does not
recover till several weeks
15. Muscle Corks
• Impact injuries
• Usually poorly
management should be
ice with full stretch.
• Definitely should not
16. Ligament Injuries
• Can be contact or non
• Involve the joint being
moved in a direction it
does not want to go.
• Pain is immediate
• Ligament in ankle and
knee are most
17. Ligament Injuries Cont.
• Injuries are graded one
• Grade three injuries
are full thickness tears
and usually require
• Grade two tears can
generally be managed
18. Ankle Ligaments
• Most commonly torn
are the Lateral
ligament and the
• Mechanism is usually
rolling over the ankle,
twisting on a fixed
foot (syndesmosis), or
falling over the heel
usually from a height
19. Management of Ankle Injuries
• Brace for four weeks if laxity present
• Strength training to improve peroneal and
gastroc muscle strength
• Stretching to restore range of movement,
• Balance or proprioception retraining.
20. Knee Ligaments
• Most Commonly torn are the ACL and
• ACL requires surgery. Is a non contact
injury. Happens when stepping or cutting.
• Medial ligament is usually a contact injury.
Managed conservatively with a brace for
four to six weeks.
• Posterior Cruciate Ligament rarer. Hardly
ever managed surgically even if fully torn.
22. Head Injuries
• Usually involve head contacting something
solid eg another head or knee
• If player is knocked out they should
definitely not continue to play.
• Aggression, twitching, vomiting, severe
headache, amnesia, and blurred vision are
all bad signs
• Mandatory three weeks out if knocked out
23. Head Injuries
• Three concussion episodes in one year
should sit out the whole year.
• Two impacts in rapid succession can result
• Should not consume alcohol, risk death
• If knocked out should not drive home,
should be monitored and should not sleep
till that night.
24. Eye Injuries
• Involves foreign
object into eye socket.
• Can result in loss of
vision or eye.
• Immediate hospital
26. Joint Dislocations
• Occurs when a joint is
taken out its socket
• Most commonly
affected are the fingers
shoulder, AC joint,
and patella femoral
joint. Ankles are
• Knee and hip
dislocations are rare
and VERY serious
30. Shoulder dislocations
• Mechanism outstretched arm forced
• In someone under 25 years, greater than 90
percent chance of doing it again
• Once dislocated three times need surgery
• Surgery follows six to nine month rehab
31. Shoulder dislocations
• Conservative approach after first dislocation
MIGHT prevent subsequent episodes and
• Four to eight weeks off.
• Strengthening of back and rotator cuff
• Improved proprioception in shoulder.
• Improved thoracic movement.
32. Other dislocations
• Knee and hip dislocations require
immediate hospital review. Person can lose
• Patellofemoral and AC dislocations are not
surgical. Tend to respond very well to
• Finger dislocations can be surgical
depending on direction of dislocation
35. Other joint injuries
• Other intra articular structures can be
These include bone cartilage interface,
called osteochondral injuries, meniscus
• Osteochondral injuries require prolonged
rest or surgery.
• Meniscal tears can settle with rest but often
need surgery, especially if knee is locking
36. Tendon Injuries
• Usually occur in older athletes when blood
supply starts to lessen.
• Can occur in younger athletes in high
• Tendons most commonly torn are rotator
cuff, achillies, patella.
• These are usually surgical injuries.
38. Tendon Injuries Cont.
• More common than tears are inflammations
• Tendonitis starts as pain with activity and
progresses to pain after activity.
• Very difficult to manage once established
due to the poor blood supply of tendons.
• Best managed early with rest, anti inflams,
and stretching and strengthening.
40. Back Injuries
• Can be traumatic or due to overuse.
• Stress Fractures can occur in sports where
athletes bend backward a lot (gymnastics)
• Any number of structures can be damaged,
and exact diagnosis is much more difficult.
• Back and neck injuries that occur on a
football field or with high energy
mechanism need to be taken very seriously