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The Physiological and Psychological responses to sports injuries

The Physiological and Psychological responses to sports injuries. P3 & P4/ M2/ D1. Physiological Responses to Injury. Damaged Tissue and primary response:. Inflammation. Inflammation is a protective attempt by the body to remove harm and to initiate the healing process

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The Physiological and Psychological responses to sports injuries

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  1. The Physiological and Psychological responses to sports injuries P3 & P4/ M2/ D1

  2. Physiological Responses to Injury

  3. Damaged Tissue and primary response: Inflammation Inflammation is a protective attempt by the body to remove harm and to initiate the healing process It occurs within a few minutes to hours of injury • The 5 key characteristics of inflammation are: • Pain • Redness • Swelling • Heat • Immobility (loss of function)

  4. The Inflammatory Response Injury causes tissue damage The damaged tissue releases chemicals Blood vessels dilate (widen) allowing increased blood flow to the injured area. This causes; LOSS OF FUNCTION BLEEDING SWELLING HEAT PAIN REDNESS

  5. The clotting Mechanism (Coagulation) • Clotting, also known as “coagulation”, occurs almost immediately after injury to a blood vessel. It is the process of blood changing from its usual liquid state to a solid form. • There are 3 stages: • Formation of Prothrombinase • When liquid blood comes into contact with certain molecules (or foreign objects) it stimulates the formation of an enzyme called Prothrombinase. • Prothrombin is then converted to Thrombin • The enzyme Prothrominase converts Prothrombin into Thrombin (another enzyme) • Fibrinogen is converted into Fibrin • Thrombin converts Fibrinogen into Fibrin which forms the tread-like scaffolding structures that form a clot/ and eventual SCAB.

  6. Here is a links to a video animation of inflammation & coagulation which may help your understanding! A cartoon animation of the full Clotting process in detail including all the info you need http://www.youtube.com/watch?v=9QVTHDM90io

  7. Scar Tissue and Remodelling process: A scar is a result of the body's repair mechanism after injury on many tissues. Scar tissue replaces normal tissue after it is damaged. Scar tissue is the formation and laying down of a protein called “collagen”. This is a fibrous tissue that replaces the tissue that has been damaged. It is not as elastic and pliable as skin and muscular tissue which makes it a lower quality tissue and less effective and efficient at doing its job.

  8. Sprains and Strains: Sprains and Strains are overstretching or tearing of tissue. Sprains involve ligamentous tissue and strains involve muscular tissue. Both involve pain and discomfort , deformity, swelling, bruising, impaired movement and loss of function. strain A stretching or tearing of muscle/tendon sprain A stretching, or tearing, of one or more ligaments. Sprains and Strains can be classified as first, second and third degree, depending on the amount of fibers involved.

  9. GRADES OF INJURY: LIGAMENT SPRAIN MUSCLE STRAIN

  10. Haematomas (inter/intra): A haematoma, is a localized collection of blood outside the blood vessels, usually caused by trauma (in this case a muscle). It is different from a bruise, which is the spread of blood under the skin in a thin layer. • There are 2 types of haematoma: • Intramuscular • This injury only effects the muscle fibre tissue and therefore bleeding is contained within the sheath that surrounds the muscle. Pressure within the muscle builds up which can become very painful. The fluid is unable to escape as the muscle sheath prevents it, acting like a balloon. Healing takes longer as bleeding stays in one area and has to be broken down. • You are less likely to see visible bruising. • Intermuscular • This type of injury includes the muscle and also the muscle sheath and therefore bleeding is not contained and can spread (for example with gravity). Initial bleeding can last longer, however recovery is often faster than intra muscular as the blood and fluids can flow away from the site of injury. • You are more likely to see bruising.

  11. Criteria P3 and P4 aim to address the issue of occurrence of sports injuries and the resulting symptoms, both physiologically and psychologically • Damaged tissue: • Primary damage response, healing response, the clotting mechanism • Scar tissue: • The importance of scar tissue control in the re-modelling process • Specific to injury: • Sprain/strain(signs and symptoms of first, second and third degree), haematomas (inter/intra) If the explanation is sufficient enough and related to the concept of sports injury, then it is possible that grading criterion M2andD1 (analysis) may also be achieved. To push for the Distinction go into further detail and analyse what might happen if a player ignored the physiological and psychological signs and symptoms of injury. Use examples of professional athletes, with news reports or newspaper articles if possible. Response to injury Anger, anxiety, depression, frustration, isolated from team mates Response to treatment and rehabilitation Anxiety, frustration, need for motivation, use of goal setting

  12. What you guys can do… • · Damaged tissue- primary response (inflammation) • · The Clotting Mechanism • · Scar Tissue/ Re-modeling process • Signs and Symptoms a coach should look out for to identify; • o A sprain • o A strain • Grading system (1st/ 2nd • Haematoma • (Including severity and types of haematoma Design a leaflet that describes in a informative manner the following points:

  13. Psychological Responses to Injury

  14. Aaron Ramsey In February, 2010, during an Arsenal v Stoke match Aaron Ramsey fractured both his right tibia and fibula which required surgery. He experienced one of the worst possible injuries and faced months of gruelling physio and rehab. • Put yourself in his shoes…. • How do you think he felt?....

  15. After the initial shock and denialof receiving the injury, Aaron would experience emotions of; Anger– Aaron would have been very angry, maybe asking “Why me?” Anxiety– Feelings of anxiety would be present with Aaron asking himself questions such as “Will I recover from this?” “Do I need surgery?” “Will I ever get back to full fitness & play at the same level?” Depression– Aaron will no longer be experiencing the adrenalin rush and the feel good hormones of when playing football. This may cause feelings of depression. Frustration– Aaron may feel this out of boredom of rehab & being restricted to a timescales e.g. wanting to progress to running but his Physio/Surgeon not letting him until 3 months post injury Psychological Responses to Injury: Anger, Anxiety, Depression & Frustration How would you as the Physio combat these negative emotions? These emotions will vary depending on the individuals personality, playing status & degree of injury

  16. Psychological Responses to Injury: Isolation from team mates… Whilst completing physio sessions and rehab you are removed from the normal training group. This can result in you feeling isolated from the group. Having social interaction with team mates and a support network from within the club can help reduce the stress of an injury and maintain group cohesion.

  17. Once the initial recovery from surgery was over Aaron faced the gruelling task of physio. He had the prospect of long days, weeks and months in rehab. He would have experienced emotions such as… Psychological Responses to Treatment & Rehab: Anxiety – fear of re-injury, fear of future prognosis e.g. arthritis in the future in he continue to play. Feelings of anxiety will be heightened if he has Trait Anxiety is a Type A personality Frustration – uncertainty of the timescale of return e.g. if his return to training date keeps getting put back, watching his team mates play in important games your missing out on Drop in Motivation – this may be caused by the return date to training seems so far away, he can’t see the light at the end of the tunnel. It would be the responsibility of the Physio and back room staff to raise his moral levels and keep him motivated. This could be helped by goal setting.

  18. The Use of Goal Setting Being told on day 1 that he wouldn’t play a competitive game for 8 months, would have been devastating for Aaron. His motivation for Physio and regaining his strength would have started high but would more than likely have dropped after the initial phase of physio. Psychological Responses to Treatment & Rehab: A way to improve motivation and enthusiasm would be to set Aaron goals & SMART targets. For example, rather than being told; “lets work towards getting match fit in 8 months” He may have been told; “lets work towards weight bearing in 6 weeks” Then, following that; “lets work towards running in 3 months” Having smaller, realistic and achievable goals would help boost motivation. Achieving a goal every few weeks would give Aaron a sense of accomplishment and boost his self confidence, giving him more motivation to work hard in the next phase of rehab.

  19. Criteria P3 and P4 aim to address the issue of occurrence of sports injuries and the resulting symptoms, both physiologically and psychologically • Damaged tissue: • Primary damage response, healing response, the clotting mechanism • Scar tissue: • The importance of scar tissue control in the re-modelling process • Specific to injury: • Sprain/strain(signs and symptoms of first, second and third degree), haematomas (inter/intra) If the explanation is sufficient enough and related to the concept of sports injury, then it is possible that grading criterion M2andD1 (analysis) may also be achieved. To push for the Distinction go into further detail and analyse what might happen if a player ignored the physiological and psychological signs and symptoms of injury. Use examples of professional athletes, with news reports or newspaper articles if possible. Response to injury Anger, anxiety, depression, frustration, isolated from team mates Response to treatment and rehabilitation Anxiety, frustration, need for motivation, use of goal setting

  20. What you guys can do… • Emotions experienced • o Anger • o Anxiety • o Depression • o Frustration • Isolation from team mates • o Response to treatment: • Drop in motivation • Frustration • Goal setting Think back to your last serious injury, if you have had one. If not, try to imagine a career threatening injury; think about all the emotions you would experience. Write a diary for an injured player identifying all the psychological responses that may occur. You could write multiple daily entries or create one weekly entry. To make sure you cover the grading criteria, ensure you include the following points:

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