Brian Siddall, M.A., A.T., ATC Supervisor of A.T. Services

1. Brian Siddall, M.A., A.T., ATCSupervisor of A.T. Services

2. Common Sport Injuries • Inflammation (itis): the bodies natural reaction to injury or disease • Tendonitis: inflammation of a tendon (connective tissue connecting muscle to bone) • Bursitis: inflammation of a fluid sac that naturally reduces friction b/w 2 structures • Sprain: tearing of a ligament that connects bone to bone (Grade I – III) • Strain: tearing of a muscle (Grade I – III)

3. Upper Extremity Injuries • Shoulder dislocation/subluxation • A-C sprain (separated shoulder) • Elbow Hyperextension • Wrist Sprain - Fractures • Mallet finger

4. Shoulder Dislocation/Subluxation • Definition: Dislocation of the shoulder is when the humeral head (ball) completely comes off of the glenoid (socket). This needs to be reduced in order to get back in place Subluxation is when humeral head shifts over the glenoid but reduces back in place on its own

5. Shoulder Dislocation/Subluxation

6. Shoulder Dislocation/Subluxation • Causes: Typically caused by traumatic injury such as a fall or contact injury Individuals that dislocate are more susceptible for dislocations or subluxations again

7. Shoulder Dislocation/Subluxation • Prevention: • Strengthen the muscles of the shoulder and arm • If you have an athlete with a history of dislocations, consider bracing of the shoulder

8. A-C Sprain (separated shoulder) • Definition: Sprain of the ligaments that connect the acromion (A) to the clavicle (C) Graded I, II, or III depending on the degree of tearing and separation of the ligamentous fibers

9. A-C Sprain (separated shoulder)

10. A-C Sprain (separated shoulder) • Causes • Always caused by contact injury such as falling onto the shoulder or running into object with the top of shoulder

11. A – C Sprain Protection

12. Elbow Hyperextension • Elbow hyperextension injury occurs when the elbow is bent back the wrong way. This type of injury will occur more frequently in contact sports. The elbow pain is caused when the elbow is forced to bend the wrong way or hyperextend causing damage to the ligaments and structures of the elbow.

13. Elbow Hyperextension - Evaluation Hyperextension AROM Valgus Stress Test

14. Elbow Protection Ligaments of Elbow Hyperextension Brace

15. Wrist Sprains • Causes: Wrist sprains are most often caused by a fall onto an outstretched hand.

16. Wrist Fractures

17. Mallet Finger • Rupture of the extensor mechanism that actively extends the digit

18. PAUSE

19. Lower Extremity Injuries • Contusions / Strains Other: • Quad Plantar Fasciitis • Groin Tendonitis Achille’s tendonitis Patellar tendonitis Sprains ACL MCL/LCL Ankle inversion

20. Quad Contusions • Caused by direct blow to anterior thigh. • Concerned with amount of bleeding in muscle due to femoral artery. • Inability to flex knee – AROM • Comprised protection to knee joint

21. Quad Contusions Anterior Quad Contusion Position to Ice Quad

22. Groin Strain • Definition: • Muscular Strain of the Inner thigh muscles typically Resulting from deceleration of The femur in a lateral plane • Graded I – III depending on Amount of torn muscle fibers

23. Groin Strain • Cause • Rapid deceleration of the body in a lateral plane • Poor muscular conditioning to control body in this plane of motion • Inadequate flexibility • Can be slow healers because of low blood supply

24. Groin Strain • Prevention: • Proper warm-up, dynamic, and static stretches prior to activity • Pre-season and in-season conditioning program incorporating directional changes

25. Achilles' Tendonitis • Definition: • Inflammation of the The tendon that connects The calf muscle to the Heel

26. Achilles' Tendonitis • Causes: • Overuse type injury resulting from improper muscular control of the foot and ankle • Biomechanical deviations at the foot (over pronator) that increase stress to the Achilles’ tendon • Lack of flexibility of the foot and ankle • Over-training

27. Achilles' Tendonitis • Prevention: • Pre-season and In-season conditioning program • Flexibility exercises of the foot and ankle • May benefit from foot orthotics if poor foot structure

28. Patellar Tendonitis • Definition: • Inflammation of the Tendon that connects the Kneecap to the lower leg

29. Patellar Tendonitis • Causes: • Weakness of the supporting muscles of the knee which include the hip abductors, rotators, quadriceps, and calf muscles • Skeletal alignment and biomechanical faults at the hip, knee, and foot/ankle (women more susceptible due to skeletal structure) • Over-training • Inadequate muscle flexibility • Improper pre-season conditioning

30. Patellar Tendonitis • Prevention: • Proper pre-season and in-season conditioning focusing on hip, thigh and lower leg strengthening • Address poor flexibility with dynamic and static stretches • Address biomechanical deficits with knee bracing or foot orthotics • Allow adequate recovery time

31. Ankle Sprains (Inversion Sprain) • Definition: • Sprain of the ligaments On the outer aspect of the Ankle that connect the fibula To talus/calcaneus “Roll the ankle” Graded I – III depending On the amount of fibers torn

32. Ankle Sprains (Inversion Sprain)

33. Ankle Sprains (Inversion Sprain) • Causes: • Ligamentous laxity (loose joint) that predisposes to ankle sprains • Uneven surfaces that create ankle movement beyond muscular and ligamentous stability (ie; landing on someone’s foot, stepping in a hole) • Poor muscular strength and coordination of the lower leg foot and ankle

34. Ankle Sprains (Inversion Sprain) • Prevention • Proper pre-season and in-season conditioning • Ensure training and playing surfaces are adequate • Prophylactic braces/ and or taping particularly if prior history of ankle sprains of either ankle

35. Fixation – Tib/Fib HIGH ANKLE SPRAIN Widening Tib/Fib

36. Squeeze/ External Rotation Test

37. ACL Sprain • Definition Sprain of the anterior cruciate ligament due to anterior tibial translation

38. ACL Sprain • Causes: • Traumatic Vs. Non-traumatic • Traumatic due to outside external force coming across the knee causing either the tibia to shift forward or the femur to shift backward

39. ACL Sprain • Causes • Non-Traumatic • A pivot or cut on a planted foot causes the body and femur to rotate over a fixed tibia. This torsion can cause ACL to be stretched beyond its limitations • Higher incidence of female vs. male ACL non-traumatic injury • Poor muscular conditioning and coordination

40. MCL & LCL Sprain

41. MCL & LCL Sprain • MCL Definition: Sprain of the Medial Collateral Ligament which prevents injury by stabilizing the knee from buckling inwards. • LCL Definition: Sprain of the Lateral Collateral Ligament which prevents the outer surface of the knee from opening or gapping.

42. MCL & LCL Sprains • Causes: • Traumatic • Most often occur from a direct blow to the inside or outside of the knee. This can cause the ligaments of the opposite side to stretch too far causing a possible tear.

43. MCL & LCL Sprain • Causes: • Non-Traumatic • One leg is planted and/or gets caught on the ground while simultaneously, the athlete tries to turn to the side, away from the leg that is planted. • Injury can also occur to these ligaments by placing repeated stress on the ligament causing them to lose normal elasticity.

44. PLANTAR FASCIITIS • A common heel injury in runners • Pain starts @ in-step • Worse pain in A.M. • Pain increases w/wt. bearing

45. TREATMENT IDEAS • Ice massage with frozen bottle • Restrict wt. bearing if pain is intense • Avoid barefoot walking • Arch supports in shoes • Injection ????????? • Calf Tennis Ball Self MFR • Golf Balls Rolling