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The Body’s Response to Trauma. When the body is subjected to injurious stress it will respond in a systematic and predictable manner. Poor management of an athletic injury can contribute to: Delayed healing Unsightly scar Permanent disability Death. The Body’s Response to Physical Trauma.
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When the body is subjected to injurious stress it will respond in a systematic and predictable manner.
Poor management of an athletic injury can contribute to: • Delayed healing • Unsightly scar • Permanent disability • Death
The Body’s Response to Physical Trauma • The body’s immediate and long-term response to physical trauma are essentially the same. • The process of inflammation and healing. • Ideally, the end result is optimal recovery. • This cycle can vary greatly in its length and conclude in less-than-optimal recovery.
Most athletic injury is caused by some type of trauma: • Direct blow • Rotational stress • Forced abnormal motion • Overstretching • When these forces are greater than the tissue can withstand, varying degrees of damage will result.
Athletic injury frequently involves the: • Skin • Muscles • Tendons • Ligaments • Bones • Nerves
A certain amount of hemorrhaging, or bleeding will also be present. • Internal • External
The body responds to hemorrhage by activating the clotting mechanism. • To control bleeding. • Direct cell damage. • Lose nutrition and normal function. • Necrosis – cell death
The necrotic tissue and extravasated blood will eventually result in the formation of a hematoma. • Scab
The damaged tissue and extravasated blood resulting primarily from direct trauma are termed: • Initial insult • Primary injury • Other than brining bleeding under control, have very little control on the extent of primary injury.
Additional damage will occur that is secondary to the primary injury: • Secondary injury • Athletic trainers can greatly affect this phase of the athletic injury cycle.
Acute Inflammatory Process • This begins minutes after the onset of injury. • Inflammation is the basic response of injury to the body. • Physical • Bacterial • Thermal • Chemical
The body’s defense mechanism to injury regardless of cause. • The goals of the inflammatory process are. • 1. to localize the extent of the injured area. • 2. To rid both the body and the injury site of waste products resulting from primary and secondary injury.
3. Enhance healing. • There are three phases in the inflammatory response. • Phase I: Acute Vascular Response. • Phase II: Repair and Regeneration. • Phase III: Remodeling and Maturation.
The exact duration of each phase is not definite because the phases overlap and there is much variability from one injury or individual to another.
Phase I: Acute Vascular Response • After the injury there is an immediate transient constriction of local blood vessels. • Decreased blood flow to the injured area. • Last 5 to 10 minutes.
Edema then occurs and may continue for 24 to 48 hours. • Cells damaged by hypoxia. • Increase the size of the hematoma.
The inflammatory process is an important defense mechanism that occurs for a specific purpose. • Protect and heal the injured area. • There are five signs associated with the inflammation process. • 1. Redness(Rubor): Caused by dilation of arterioles and increased blood to the injured area.
2. Swelling(Tumor): caused by the accumulation of blood and damaged tissue cells in the primary injury area. • Blood, hypoxic-damaged tissue debris, and edema resulting from the secondary reaction. • Heat(Calor): caused by increased biochemical activity in the affected tissues and increased blood flow to the skin.
4. Pain(Dolor): Caused by direct injury to nerve fibers, as well as pressure of the hematoma or area of edema on nerve endings. 5. Loss of Function(FunctioLaesa): Caused by the resulting pain and swelling and/or actual destruction of the anatomical structure.
The primary function of the inflammatory response process in the days following injury is to rid the area of waste products. • Successful completion of this phase marks the end of the inflammatory response phase.
Pain-Spasm cycle. • Pain and muscle spasm of varying degrees accompany musculoskeletal injuries. • Muscle spasm is a protective mechanism, designed to prevent further damage. • Splint the injured area. More spasms more pain, more pain more spasms.
The process of wound healing begins with the acute inflammatory reaction and then accelerates when: • Enough of the hematoma has been removed to permit the growth of new tissue.. • Most tissue involved with athletic injury do not have the ability to regenerate their respective specialized cells. • Scar formation.
Epidermis and bone tissue regenerate. • Other soft tissues of the body form scar tissue. • Scar formation is identical in all tissues of the body. • Final appearance and function will vary. • Treatment and rehabilitation.