P.

E and HEALTH 11
SAFETY PRACTICES IN SPORTS AND EXERCISE

CAUSES OF SPORTS INJURIES

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

Most of the injuries are preventable and awareness of the risk factors will help in reducing the risk. Furthermore, vigilance and safety
measures can dramatically reduce the occurrence of injuries.

Injuries are damaged tissues 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.

Tissues and organs react to the impact and direction of the force. Tensile forces are those that act away
from the center to the structure, causing a pull or stretch. Compressive forces 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 with muscle-tendon units are strong at resisting tensile forces.
An individual who engages in various types of strenuous activities will expose his/her body to those
forces which could result to an injury.

Aside from the knowledge of the forces that cause injury, it is important to understand the ability of the structures to resist or absorb
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 elastic fibers present. Its ability to withstand sudden or acute forces also depends on the 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 that manifest immediately after force application. On the other hand, the signs and symptoms of chronic or
overuse injuries occur after a long period of exposure to the force.

Structure Function Acute Injury

Ligaments Stabilize joints Sprain
Tendons Attaches muscles to bones Strain
Muscles Creates movements Strain
Bones Anchor for muscles Fracture
Joints Fulcrum for movements Dislocation

Sprains, strains, fractures, dislocation, and wounds are examples of acute injuries. An excessive stretching force can cause the fibers of
the ligament, muscle, or tendon to break. An overstretched ligament is called a sprain. Sprains can be classified as mild, moderate, or
severe, depending on the loss of function and the number of torn fibers. A similar classification is used for a strained muscle. A strain
is also caused by excessive stretching that causes tears in muscle-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.

CLASSIFICATION OF INJURIES
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. Some individuals that train too hard and too soon
are not able to cope with the increased demand resulting to microscopic injuries. These microscopic injuries will accumulate over
time, resulting to overuse or chronic injury.
Classification of Sprains and Strains According to Severity
Category Fibers damaged Loss of Function
Mild (First Degree) Minimal Tear Pain when moved
Moderate (Second Degree) Partial Tear Pain at rest and when moved
Severe (Third Degree) Complete Tear Complete loss of function
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FACTORS INCREASING 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 higher risk because of poor motor control and weak musculoskeletal structures. There are certain characteristics or factors
that increase the likelihood of injury. These risk factors increase the susceptibility of the individual to injury but it does not cause the
injury. Risk factors are classified as non-modifiable and modifiable. Some experts classify risk factors as intrinsic (individual factors)
or extrinsic (environmental factors). The most common intrinsic risk factor is muscle imbalance between muscle pairs where the
muscle becomes a little too tight. Since women in general have wider hips, a high Q angle is the quadriceps is a common risk factor
among them. A high Q angle has been associated with acute injuries to the knee joint.

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.
Other factors related to the environment or extrinsic factors
 Use of protective equipment and footwear
 Coaching experience and qualification
 Rule modification
 Use of structured warm-up before game

Why does a body part swell after getting injured?

Swelling is the result of the increased movement of fluid and white blood cells into the injured area. The release of chemicals and the
compression of nerves in the area of injury cause pain. The pain and swelling can keep the athlete from using the injured part, serving
to protect it from further injury.

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 original tissue and it is still prone to re-
injury. It is during the last phase or the maturation phase that the issue 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. There are factors that may prolong the healing period such as
too much swelling, limited blood supply, old age, and weak muscle strength. It is important that proper care is given to the injury to
minimize delay and maximize strength of new tissue. Chronic injuries undergo a similar healing process but special attention should
be given to determine its cause. Individuals should refrain from training until the cause of the injury is identified, to avoid recurrence.

Injury Type of injury Common cause of Injury

Sprain Acute Twisting or pulling force
Strain Acute Pulling force during rapid acceleration
Fracture Acute Falling or breaking a fall
Dislocation Acute Falling or breaking a fall
Stress fracture Overuse Repetitive high impact stress
Tendinopathy Overuse Repetitive movement using poor technique
Osteoarthritis Overuse Repetitive high impact stress
bursitis overuse Repetitive movement using poor technique

PE & HEALTH 11
COMMON SPORTS INJURIES
SPORTS INJURIES
While participation in sports and physical activity has a lot of positive aspects such as improving fitness levels and being involved in a
social group with common interest, it also has negative aspect in the form of incurring physical injury. This unit will identify different
types of sports injuries and how they can occur. It will discuss physiological responses to injury and will suggest methods of
prevention and treatment of sports injuries

On the other hand, sports injuries are those that happen when playing sports or performing exercises.
Some are from accidents. Others can result from poor training practices or improper gear. Some people get injured when they are not
in proper condition. No proper warm-up and stretching before you play or exercise can also lead to injuries. The most common sports
injuries are
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 ACUTE INJURIES

Sprain is a tear of ligament fibers, muscles or tendons supporting a joint. This can occur when a joint
is extended beyond its normal range of movement. A sprain may involve a small number of fibers
through to a complete rupture. In extreme circumstances, the fibers of the ligament, muscle or tendon
may remain intact and rip from the bone.

Contusion or bruise is bleeding into the soft tissue. It is caused by a direct blow from another person, an
implement or an object. A bruise can occur to any soft tissue of the body.

Concussion is caused by a direct blow to the head. Depending on the severity of the concussion, injury
can cause varying levels of impairment of brain function. Concussions are categorized as mild (grade 1),
moderate (grade 2), or severe (grade 3) depending upon symptoms.

Dislocation occurs when the ball of a joint is forced out of its socket (i.e. arm forced out of the shoulder
joint). A dislocation must be reset by proper medical professionals

Fracture is a break, crack, or shattering of a bone. In closed fractures, the broken bone does not pierce the skin,
while in open fractures, the broken bone breaks the skin's surface

Strains are injuries that involve the stretching, partial tearing, or complete tearing of a tendon. Strains are
categorized as first, second, or third degree. Chronic strains are injuries that gradually build up from
overuse or repetitive stress.

CHRONIC INJURIES
STRESS FRACTURE
It commonly occur among runners who train for long periods without adequate rest periods. According to the study, running athletes who
averaged more than 65 kilometers a week have a higher risk to stress fracture. The repetitive workload creates micro trauma-as thick as a
strand of a hair-in the bone and gets bigger over time. The usual area affected is the shinbone. The individual feels a dull aching pain that
worsens over time. This type of fracture does not require immobilization 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-tendon 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
 lower extremities involves the muscle-tendon units surrounding the knee
The pain usually eases during activity but will worsen after playing.

OSTEOARTHRITIS
It is the wearing and tearing of a joint that result to its deterioration. The friction deteriorates the cartilage that protects the bones from
rubbing against each other. The knee joint is the common site of the degenerative changes that occur in the cartilage. An individual feels the
pain and a grinding sensation as it worsens. The condition further aggravates when the individual is overweight or obese. 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
inflammation of the bursa interrupts the surrounding structures, causing pain during movement. The recovery period usually takes two
weeks to a month.

HEAT ILLNESSES

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 Heat illnesses 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.

Hypothermia
It occurs when body temperature is lower than the normal average of 37 degrees Celsius. It happens when the body has more heat loss
than production. The usual cause of hypothermia is when the body is subjected to too much cold, mostly through the weather and water.
Hyperthermia
Happens when the body overheats and cannot dissipate, usually at a body temperature of more than 38 degree Celsius. Its common causes
are high fever or too much heat exposure. Proper ventilation and hydration help prevent hyperthermia.
Dehydration
Dehydration happens when the fluid in your body is used or lost more than the fluid you drink or intake. If your body does not have
enough water or fluid to do its normal functions, hence, you get dehydrated. Anyone may become dehydrated, as to the people who are
more at risk, young ones or children and the older adults are more at risk.
Overexertion
This refers to the pressure one puts in himself or herself, too much pressure that leads to a simple discomfort that might extend to a more
serious injury.
SIGNS OF DEHYDRATION
 Dizziness  Flushed skin  Dry skin
 Fatigue  Headache  Hot skin
 Weakness  Blurred vision  Rapid pulse
 Dry mouth  Difficulty swallowing  Frequent need to urinate

Kinds of Injury
Acute injuries occur suddenly when playing or exercising. Sprained ankles, strained backs, and fractured hands are acute injuries.
Signs of an acute injury include:

 Sudden, severe pain.  Not being able to move a joint as normal.

 Swelling  Extreme leg or arm weakness.
 Not being able to place weight on a leg, knee, ankle, or foot.  A bone or joint that is visibly out of place.
 An arm, elbow, wrist, hand, or finger that is very tender.
Chronic injuries happen after you play a sport or exercise for a long time. Signs of a chronic injury include:
 Pain when you play.  A dull ache when you rest.
 Pain when you exercise.  Swelling

SPORTS INJURY PREVENTION

Stay conditioned.
Keeping your body is shape over the summer is one
of the best ways to avoid injury. Conditioning helps ensure
that muscles stay strengthened that are used during play.
Don’t forget to hydrate.
Dehydration can easily be avoided by drinking water
before and after exercise. Drinking fluids 30 minutes prior to
participating in any activity is encouraged. Water breaks
should also be taken every 15-20 minutes during activity. The
more active you are the more fluids you should be putting
back into your body. Don’t forget to bring extra water to stay
hydrated!
Make time for rest.
Athletes should take one to two days off during the
week to rest. Resting during practices and games is also
essential. This will help prevent overuse of muscles.
Warm up and stretch.
Set aside time before every practice to stretch.
Starting with 10 minutes of jogging or any light activity is
helpful. Then go onto stretching major muscles used during
the activity. Stretching is important before any activity
because it releases muscle tension. Regular stretching not only
helps to warm up your muscles but it also increases flexibility.
Use recommended safety equipment.
Wearing proper equipment will not guarantee that no
injuries will occur but it lowers the chances. Keep the neck,
shoulder, elbow, chest, and knee and shin areas protected by
wearing proper gear. This includes pads, helmets, mouthpiece,
face guards, protective cups and eyewear which should be
worn at all times.
Play safe.
Rules and regulations are set in place for a reason – to help
prevent injuries. Make sure your children pay attention to
what is being instructed by coaches and referees to help them
play more safely with their team and their opponents.

How can I treat Injuries?

When it comes to sport and exercise, the possibility of injury is always present.
Inflammation and pain often occur after injuries to the ankle, knee, or joint. And the well-known R.I.C.E treatment method can help
reduce this swelling, relieve pain, and promote flexibility and healing. In fact, R.I.C.E treatment is a mainstay for sports trainers and
other athletic health experts.
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The benefits of the RICE method can be explained by stage:
REST Immobilization prevents further injury and gives the body time to recover.
ICE Cold reduces pain by numbing the affected area.
COMPRESSION Pressure keeps swelling under control.
ELEVATION Keeping the injured body part above the heart reduces swelling and the associated pain and discomfort.

Aside from the injury prevention techniques mentioned above, there are also some personal safeties protocols that we need to consider
before and after playing a sport or doing moderate to vigorous physical activities. Some of the personal safety protocols are as follows:
What to bring?
 Water
 Extra clothes
 Towels and caps

What to do?
 Prepare yourself. Know your limits so as not to overwork your body. Overworking your body might put your life to a threat.
 Drink a lot of water. Do not wait to feel thirsty. If you know have sweat a lot already drink water immediately.
 Change clothes. Do not let the wet cloth dry up in your body.
 Use towel. Use towel to wipe out excessive sweating.

Remember this:
When the body does not have enough fluid needed to function normally, it is dehydrated. This happens when lost body fluid is not
replaced. Dehydration causes a person to have a dry thirsty mouth, become fatigued, have less urine yield with dark color, and in
severe case, unconsciousness. The usual causes of dehydration are hot weather condition, too much perspiration, high fever, diarrhea,
vomiting, and excessive exercise without taking in enough fluid. To nurse dehydration, the body will need to replenish lost fluids and
electrolytes. Drink at least eight glasses of water a day and up to 12 glasses during summer months.
Hydration is also the soundest way to prevent dehydration. Prevention is better than cure, and the ways to prevent dehydration include
the intake of adequate fluids, watery fruits and vegetables and avoiding hot environment.

P.E and Health 11

SPORTS INJURY MANAGEMENT
INJURY PREVENTION
Injury prevention is NOT the same as diagnosis. The doctor is the only person allowed to diagnose the condition of a patient.
Evaluation happens in the field while the diagnostic process occurs in the doctor’s clinic. The diagnostic process accounts all the
information needed to see a holistic picture of the cause and severity of the injury such as patient’s history, comprehensive physical
examination, special tests, and diagnostic tests (e.g., MRI, X-ray), among others. On the other hand, the goal of the injury evaluation
process is to rule out the presence of a severe injury or a life-threatening condition, how to transport the patient, and the appropriate
first-aid while transporting the patient.
The coach or athletic trainer should have a background on injury evaluation and management to bridge the gap between the playing
field and the hospital. The first part of the evaluation process is called the primary survey. This is quick evaluation if there are life-
threatening injuries present. The evaluation needs to consider if the patient should be moved or transported immediately to a medical
facility.
SPORTS INJURIES LEAD TO DEATH
One of the life-threatening sports injuries is concussion or traumatic brain injury. This injury is common to contact and combat sports
(i.e., boxing) and is caused by a strong blow to the head that temporarily impairs brain function. Aside from being unconscious, the
injured athlete might show other signs such as amnesia, loss of balance, poor motor coordination, and slurred speech. These signs may
manifest right after the trauma or it could be delayed for a few hours.

CLASSIFICATION OF CONCUSSION
Category Description Characteristics
Grade 1 Mild No loss of consciousness, condition normalizes in less than 15 minutes
Grade 2 Moderate No loss of consciousness, condition normalizes beyond 15 minutes
Grade 2 Severe Loss of consciousness

Concussions can be life-threatening if blood vessels in the brain are ruptured. As blood leaks from the blood vessel into the skull, the
brain is deprived of oxygen-rich blood, a situation which can lead to death. As the blood accumulates inside the skull, the brain is
pushed toward the skull and impedes the blood flow to other parts of the brain.

DETERMINING LIFE THREATENING CONDITION

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The coach or a trainer has to perform a primary survey to determine if the injured athlete is in a life-threatening condition.
2 Tell-tale signs:
1. Unconscious
2. Not Breathing
How to respond to the injured athlete?
a. If the injured is breathing but unconscious, do not move the body unless the neck and back is stabilized to prevent
complications.
b. Call the attention of the emergency medical services (nurse, doctor, ambulance) and monitor the vital signs (breathing, pulse)
of the patient until medical help arrives.
c. If the injured athlete is unconscious and not breathing, alert the emergency medical services and perform cardiopulmonary
resuscitation (CPR) until medical help arrives.

The CPR technique incorporates the chest compressions and rescue breaths to facilitate blood flow to the brain and prolong the life of
the person. The American Heart Association (AHA) recommends the first responder to administer CPR as soon as possible to increase
the survival rate.

CPR is performed by placing the heel of one hand on the top of the breast bone at the level of the nipple
while the other hand is on top with fingers interlocking with the fingers of the hand that is on the chest.
The breast bone has to be compressed to a depth of one and a half inch to two inches. The person
performing the CPR should compress the chest at a rate of 100 times a minute. If the first responder is
willing to give rescue breaths, he/she may do so after every 30 compressions. The first responder has to
seal the mouth with his/her mouth and pinch the nose before giving a rescue breath. The pinch on the nose
is released to allow air to come out and the first responder gives another recue breath after one second.
Each cycle is comprised of 30 compressions and two rescue breaths. The cycle should be performed over and over until he emergency
medical services takes over.

BEFORE GIVING CPR

1. Scene size-up.
Check the scene and the person. Make sure the scene is safe, then tap the person on the shoulder and shout "Are you
OK?" to ensure that the person needs help.
2. Activate medical Help.
Call 911/medical help for assistance. If it's evident that the person needs help, call
(or ask a bystander to call) 911, then send someone to get an AED. (If an AED is AED- Automated External
unavailable, or a there is no bystander to access it, stay with the victim, call 911 Defibrillator)
and begin administering assistance.)
3. Assessing Responsive
4. ness
A-Alert
V- voice
P- pain
U-unconscious/unresponsive
5. Check Airway.
Open the airway (mouth/nose). With the person lying on his or her back, tilt the head back slightly to lift the chin.
6. Check for breathing and circulation.
Listen carefully, for no more than 10 seconds, for sounds of breathing. (Occasional gasping sounds do not equate to
breathing.) If there is no breathing begin CPR.
L- LOOK L-LISTEN F-FEEL
 Look at the chest, listen to the breath and feel the pulse

7. Recovery position.
WHEN TO STOP CPR?
S-Sign of life
T- Turn over to professionals
O-operator is exhausted
P-physician assumes responsibility
S-scene become unsafe

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