CHAPTER 7 - Safety Practices in Sports and Exercise

Causes of Sports Injuries

What are injuries? Why is my risk at getting injured higher now that I am more active?

Individuals who engage in various types of physical activities such as sports and exercise have a higher
risk of getting injured as compared to those who practice a sedentary lifestyle. However, the potential
benefits of an active lifestyle outweigh the risks of suffering an injury.

Injuries are damaged tissues or organs which occur when it encounters trauma or physical force that is
greater than what it can resist or absorb.

The tissues are able to withstand varying degrees of stress and strain but it will break down if it
experiences an impact that is stronger than what it can tolerate.

Factors influencing the ability of our tissues or organs to effectively resist or absorb forces include
inherent abnormality, age, technique, fitness level, equipment, and environmental aspects.

Direction of Forces Applied to Musculoskeletal Structures

Tissues and organs react to the impact and direction of the force.

Tensile forces are those that act away from the center of the structure, causing a pull or stretch.

Compressive force impact the center causing it to bend or fold.

Shear forces are opposing forces toward the different ends of the structure causing it to twist.

The mechanism of how the force was applied is just as important as its impact.

The bone is strong in resisting compressive strength

Muscle tendon units are strong at resisting tensile forces.

Injuries in sports and fitness commonly affect the musculoskeletal structures. The ligaments, tendons,
muscles, and bones have inherent strength that helps withstand strong forces.

The strength properties of each musculoskeletal structure vary according to the density of collagen and
elastin fibers present. Its ability to withstand sudden or acute forces also depends on that tissues (i.e.,
fat) that soften the impact on the structure.

In general, sports injuries can be classified into two: acute and chronic/overuse.

Acute injuries have signs and symptoms (e.g., pain, swelling) that manifest immediately after force
application.
Chronic or overuse injuries have signs and symptoms that occur after a long period of exposure to the
force.

Examples of Acute Injuries are sprains, strains, fractures, dislocations, and wounds.

An excessive stretching force can cause the fibers of the ligament, muscle, or tendon to break.

Sprain is an overstretched ligament. It can be classitied as miId, moderate, or severe, depending on the
loss of function and the number of torn fibers.

A strain is also caused by excessive stretching that causes tears in the muscIe-tendon unit.

Fractures are breaks in the continuity of the bone. It usually occurs as a result of high impact forces that
cause the bone to bend or twist.

Dislocations are bones that are pushed out from their joint capsule.

How do overuse injuries occur? How are they classified?

Overuse injuries are common among individuals who have been training for a long period of time with
minimal rest and recovery between sessions. During training, the musculoskeletal structures receive
higher loads than what it is used to. However, the body has the ability to heal and recover from this,
given enough recovery time and nutrition.

Overuse injures include stress fractures (bone), tendinopathy (muscle-tendon unit), osteoarthritis (joint),
and bursitis (fluid filled sac).

There are three types of overuse injuries according to severity: Stage I, Stage II, and Stage III.

Stage I injury, the athletes will complain of pain only after the activity, game, or training session.

Stage II injury, the athletes will complain during and after an activity but do not feel it during test.

Stage III injury, the athletes feels pain whether at rest or play.

Are certain at more risk of getting injured? What factors increase the risk of injury?

It is widely accepted that people engaging in sports or fitness training have a higher risk of getting
injured. Children and older people are also at a higher risk because of poor motor control and weak
musculoskeletal structures.

There are certain characteristics or factors that increase the likelihood of injury.
Risk factors are classified as non-modifiable (i.e., age, gender) and modifiable (i.e., tournament rules,
apparel).

These risk factors increase the susceptibility of the individual to injury but it does not cause the injury.

Some experts classify risk factors as

Intrinsic (i.e., individual factors)

Extrinsic (i.e., environmental factors).

The most common intrinsic risk factor is muscle imbalance between muscle pairs (i.e., quadriceps
hamstrings) where the muscle becomes a little too tight.

According to several studies, obese individuals and those with poor fitness level have a higher risk of
getting injured.

Studies also show that injuries are associated with age. Fractures and other acute injuries are common
among the youth while overuse injuries are common among older individuals.

Environment or extrinsic factors - include the use of protective equipment and footwear, coaching
experience and qualitication, rule modification, and use of a structured warm-up before the game.

Why does a body part swell after getting injured?

During acute injuries, the body will initiate the healing process through the inflammatory response. The
inflammatory response removes the damaged tissue by increasing blood flow and activating the
lymphatic system to the injured site.

Swelling occurs due to fluid accumulation as a result of increased blood flow and blood vessel
permeability.

Aside from swelling, inflammation is also characterized by pain, redness, and warmth. The muscles
surrounding the area contract to guard the injured site and prevent aggravation.

During inflammation, special cells remove the damaged tissue to provide a foundation where new tissue
can grow.

The laying down of new cells and blood vessels in the injured site is the actual repair phase.

The repair phase can last for several days or months, depending on the type of injury. The new tissue
does not have the strength of the originaI tissue and it is still prone to re-iniury.

During the last phase or the maturation phase the tissue will become stronger as it aligns itself to
provide maximal resistance to tensile forces.
The entire healing process takes several months to a year to complete. It is important that proper care is
given to the injury to minimize delay and maximize strength of new tissue.

COMMON SPORTS INJURIES

What are the most common acute injuries?

Sprain

Sprains are overstretched ligaments. The ligaments stabilize and limit joint mobility.

The most common sprains are located at the lower limbs such as the ankle and knee because they are
subjected to stress daily. Moreover, sports participation increases the likelihood of twisting the knee and
ankle.

A completely tom ligament may need surgical reconstruction before the athlete is allowed to play again.
A sprained joint will take several days or months to heal, depending on the severity.

A commonly sprained ligament is the anterior cruciate ligament (ACL). The ACL is a connective tissue that
helps stabilize the knee every time the muscles contract.

The injury commonly occurs when the knee twists while weight is placed on it due to improper landing
after a jump, running too fast or without proper warm-up. It is common in soccer, basketball, and
volleyball.

The ninjury usually takes several weeks or months to recover depending on Its severity.

Surgery is recommended for individuals who suffer a complete ACL rupture especially if they still want to
pursue the same level of physical activity.

Strain

Strain is a twist, pull, or tear of muscle or tendon (a cord of tissue that connects the muscle to bone)

It Is also an acute, non-contact injury that results from overstretching or over contraction.

The most common strains are located at the lower limbs such as the hamstring and calf muscle.

The healing process usually takes six to eight weeks

Fracture

The most common fractures are located at the upper limbs such as the hand and forearm.

Fractures are more common in growing bones because it is Iess dense.

Fractures in the upper limb occur when individuals support their weight using their hands when they fall
or slip.

There are different types of fractures and the healing period is between three weeks to several months,
depending on the severity of the injury.

It is normally treated with immobilization by attaching a faxator or a cast.

Dislocation

Dislocations commonly occur in joints that allow greater range of motion.

The most common dislocations are located at the upper limbs such as the shoulder and elbow. These
joints are commonly affected when an individual uses his/her hand to support his/her weight when
he/she falls.

When the bone is pushed out of the proper alignment, the injury will cause a deformity and constant
pain.

The individual will not be able to move the affected limb.The pain will be relieved once the bone is
repositioned.

Concussion

Concussions are life-threatening injuries because they disrupt the normal function of the brain.

A severe blow to the head could cause the blood vessels in the brain to rupture. As the blood leaks out
of the ruptured blood vessels, it will accumulate inside the skull.

The accumulated blood will put pressure on the brain, blocking the blood supply to different areas of the
brain.

If the condition is not resolved immediately the brain starts to die.

It is important for the individual to go to a medical facility as soon as possible so the injury will not
worsen.
What are the most common chronic injuries?

Stress Fracture

Stress fractures commonly occur among runners who train for long periods without adequate rest
periods.

According to a study, running athletes who averaged more than 65 kilometers a week have a higher risk
to stress fracture.

This type of fracture does not require immobilizatlon but the individual has to stop exercise for around
four weeks to give it time to heal.

Tendinopathy /Tendinitis

The most common overuse injury in sports involves the muscle-tendom unit called tendinopathy or
tendinitis.

It is usually due to muscle imbalance between muscle pairs.

The most common site of tendinitis in the upper limb involves the muscle-tendon units around the
elbow (i.e., golfer's elbow, tennis elbow).

The most common site of tendinins In the lower extremities involves the muscle-tendon units
surrounding the knee (i.e., Jumper’s knee).

The pain usually eases during activity but will worsen after playing.

The individual should maintain fitness but avoid activities that utilize the injured muscle-tendon unit. The
recovery period usually takes three weeks to several months.

Osteoarthritis

Osteoarthritis is the wear and tear of a joint that results to its deterioration. The friction deteriorates the
cartilage that protects the bones from rubbing against each other.

The knee joint is the common site for the degenerative changes that occur in the cartilage. An individual
feels pain and a grinding sensation as it worsens.

The recovery period takes several months because of poor blood supply to the area.

In severe cases, doctors may recommend surgery to replace the joint.

Bursitis

The bursa is a sac-like musculoskeletal structure that provides support and cushioning to the joint.
It protects commonly used joints such as the shoulders and the knee from repetitive mechanical stress
(i.e., friction).

This injury is common in swimmers and runners.

The recovery period usually takes two weeks to a month.

Can heat illnesses lead to a life-threatening condition?

Heat illnesses (e.g., cramps, stroke) are due to excessive dehydration and high body temperature
commonly attributed to training in poor weather conditions. Adverse or poor weather conditions like too
much heat prevent the body to cool down through perspiration.

The most life-threatening case of heat illness is heat stroke.

This condition is likely to occur if an athlete trains outdoors for several hours and the air temperature is
above 35 degrees Celsius and the relative humidity is above 80%.

SPORTS INJURY PREVENTION

Most sports injuries can be prevented with adequate preparation and proper knowledge. The following
strategies can minimize the occurrence of these injuries:

1. Adopt a comprehensive Training Program

A Comprehensive Training Program goes beyond addressing the fitness parameters such as aerobic
capacity and strength. It is a hollistic program that suits an individual's needs and demands.

2. Use protective equipment and practice correct technique

Individuals derive fun from playing sports and othet physical activities (e.g., dance) that they sometimes
forget to wear proper protective gears.

Injuries while playing a sport or game can be prevented by using some protective equipment.

3. Incorporate recovery strategies in the training program

Training and exercise is a controlled form of stress that stimulates the body to become stronger.

4. Follow rules and decorum during competition

Tournament directors and sports official draw up rules and regulations for any competition to maintain
fairness and safety for everyone involved.
How can the possibility of getting injured while training be minimized?

Fitness and training injuries can be prevented if an individual takes the necessary preparations and
precautions on the following variables:

1. Proper attire

The attire should be appropriate for the chosen adiwty. It is important to consider comfort and
protection when choosing an appropriate attire.

2. Proper technique

An individual needs to consult a trainer and ask for proper instruction in performing the chosen activity
or exercise.

3. Gym etiquette

Individuals that subscribe to gym facilities should be aware of the rules and etiquette. Each facility has its
own list of rules but these are the most common:

Ask for a spotter when lifting loads close to 1RM.

Do not drop the barbell at the end of the set.

Put weights and dumbbells on designated racks.

Be aware of the exercise area for each equipment.

Do not use mobile phone inside the gym. On a track, inner lane is for walking while outer lane is for
running.

Do not engage in horseplay nor talk in a loud voice.

Do not wear loose jewelry while working out.

4. Proper environmental conditions

lt is advisable to check the environmental conditions before the exercise session. It is possible that the
area or the weather is not conducive for the activity.

5. Adequate recovery

The recovery period is just as important as the workout session. It is important to provide the body with
an adequate and proper nutrition to recover.

How to choose the right kind of shoes?

Shoes are very important in preventing injuries while playing or training. The shoes can help correct foot
movement and reduce the risk of injuries. Here are some recommendations when choosing the right
pair of shoes:

1. Choose a shoe specific to the sports or activity

Shoe technology has improved over the past decades.

Most of the shoes are designed to function excellently in the activity it was desugned for.

2. Determine appropriate shoe size

The fit of the shoe is just as important as the shoe type.

Wear socks when fitting the shoe.

Allow a half-inch gap between the big toe and the tip of the shoe for maximum comfort. The toes should
have enough room to wiggle after securing the lace.

The heel should not slip out when you run or walk. Try to walk or run with the shoe. It should feel good
and comfortable on your foot while running.

3. Evaluate foot movement pattern

Individuals should be aware of how their feet move during physical activity. Shoes can help correct
excessive movement, which will reduce risk of overuse injuries.

When the inside part of the soles are worn out more than the outside pert, the foot is experiencing
overpronation.

When the outside part of the soles are more worn out than the inside part, the foot is experiencing
underpronation.