SPORTS MEDICINE

Christopher Ryalino
SPORTS MEDICINE
 THE GOALS OF SPORTS MEDICINE ARE TO:
 PREVENT INJURY OR ANY SPORT-RELATED
PROBLEMS.
 PROVIDE A QUICK AND PROPER FIRST AID
TREATMENT.
 SPORTS MEDICINE IS NOT LIMITED TO
SPORTS.
 INCIDENCE RATE IN AMATEUR SETUP: 27-
39/100
WHAT TO DO
 ANALYZE THE SITUATION
 PROVIDE MEDICAL SERVICE
 DECIDE WHETHER FURTHER EVALUATION
IS NEEDED
 AND IF IT’S NOT, CAN THE PERSON
PERFORM THE ACTION AGAIN?
EPIDEMIOLOGY TRIANGLE

HOST
ATHLETE

AGEN ENVIRONME
T
CHARACTERISTIC, RULES EQUIPMENT,
NTFACILITIES
ASSOCIATION CURVE

INJURY RYALINO, 2003

PROFESSIONALISM
METHODS OF INJURY PREVENTION

 Proper conditioning and acclimatization.

 Avoidance of training exercises.
 A safe environment.
 Resolutions of previous injuries.
 Enforcement of rules concerned with safety, with continued
revisions as new risk factor is identified.
 Instruction of proper techniques.
 Appropriate safety equipment.
 A careful pre-participation medical examination.
 Matching of competitors by age, weight, and stage of maturation.
PRIMARY PREVENTION
 PREVENT BEFORE THE ILLNESS
 RULES AND LAWS OF THE GAME
 EQUIPMENT AND FACILITIES
 GOOD PREPARATION
 GOOD TRAINING
 ROUTINE MICAL EXAMINATION
SECONDARY PREVENTION
 EARLY DIAGNOSIS AND TREATMENT
 BASID LIFE SUPPORT
 FIRST AID
 DEFINITIVE TREATMENT
 PREVENT FURTHER ILLNESS
TERTIARY PREVENTIONS
 REHABILITATIONS
 RETURNS TO SPORTS ACTIVITY
 PREVENT DISABILITIES
PRE-PARTICIPATION
EXAMINATION
 “LATEST” INVENTION IN SPORTS
MEDICINE.
 A BRILLIANT WAY TO CREATE A SAFER
ENVIRONMENT FOR:
 ATHLETES / PARTICIPANTS
 THE ORGANIZER
 THE MEDICAL PERSONNELS
Despite all our varied and ultramodern
instruments, useful as they are, nothing can
replace the watchful eyes, the alert ears, a
tactful finger, and a logical mind.

Christopher Ryalino
NON-TRAUMATIC ILLNESSES

 EXERCISE-INDUCES ASTHMA
 CARDIOVASCULAR DISEASES
 DERMATOLOGY DISORDERS
 BLOOD-BORNE PATHOGENS
 ALLERGIC REACTION
 DYSPEPSIA
E.I.A
 E.I.A. IN NUMBERS:
 10% OCCURRED IN NORMAL POPS
 90% OCCURRED IN ASTHMA POPS.
 INDUCED BY EXHAUSTION
 TREATED SIMILARLY TO OTHER ASTHMA
PROBLEMS
ASTHMA ATTACK
 TO DIAGNOSE SOMEONE WITH ASTHMA
ATTACK, YOU SHOULD FIND THE
FOLLOWING:
 INCREASED RESPIRATION RATE
 INCREASED PULSE RATE DUE TO HYPOXIA
 PROLONGED EXPIRATION
 WHEEZING
 PRODUCTIVE COUGH
 CYANOSIS, OR PALE
 A HISTORY OF ASHTMA WILL DO
ASTHMA ATTACK
 RECOMMENDED PROCEDURES:
 POSITION THE PATIENT ACCORDING TO HOW
HE/SHE FEELS THE BEST. LET THEM FIND THEIR
BEST POSITION.
 ASK IF HE/SHE HAS A TURBUHALER MEDS.
 APPLY THE TURBUHALER ACCORDING TO THE
PATIENT’S REGULAR DOSE.
 IF THE ILLNESS IS BAD, YOU CAN ALSO USE
EPINEPHRINE, INJECTED INTRA-MUSCULARLY.
 AFTER THE AIRWAY IS CLEAR, PUT ON OXYGEN TO
COMPENSATE HYPOXIA PERIOD.
CARDIOVASCULAR DISEASES
 IN ATHLETE’S SETUP, 95% OF SUDDEN
DEATH CASES IS DUE TO
CARDIOVASCULAR DISORDERS.
 PRE-PARTICIPATORY EXAMINATION WILL
BE REGARDED AS THE MOST HEROIC
ELEMENT TO PREVENT THIS FROM
HAPPENING.
 THE HISTORY SHOULD INCLUDE: ANY
PREVIOUS MEDICAL HISTORY, PREVIOUS
HEART PROBLEMS, HEART PROBLEMS
HISTORY IN THE FAMILY
THE SYMPTOMS
 CHEST PAIN:
 CONTINUOUS
 ON EFFORT (EXERCISE)
 SYNCOPE
 BREATHING DIFFICULTY DURING
EXERCISES
 ABNORMALITY OF BLOOD PRESSURE OR
PULSE
DERMATOLOGIC DISORDERS
 DERMATOLOGIC PROBLEMS ARE RARELY
AN EMERGENCY.
 OUR RESPONSIBILITY IS TO PRVENT
OTHERS FROM GETTING IT FROM THE
PATIENT.
 IT’S A SENSITIVE ISSUE, SO TAKE A PROPER
AND RATIONAL MEASURE TO SOLVE IT.
BLOOD-BORNE PATHOGENS
 MOST TIMES, NO ROUTINE SCREENING IS
NECESSARY.
 SCREENING WILL BE A NECESSITY IF THE
SPORT IS INVOLVING HARD BODY
CONTACT.
 ANY SCREENED ATHLETE/PARTICIPANT
RESERVED THE RIGHT TO:
 HAVE THE RESULT TO BE KEPT AS
CONFIDENTIAL, AND
 GET THE RIGHT INFORMATION ABOUT
HIS/HER MEDICAL CONDITION.
ALLERGIC REACTION
 IN OUTDOOR SETUP, THE MOST LIKELY
CAUSE IS STING-BITE (INSECT BITE).
 OTHER CAUSES MAY BE: PLANTS,
ANIMALS, FOOD
 SYMPTOMS MAY VARY, INCLUDING:
 ITCHING (USUALLY MARKED BY URTICA)
 SWELLING (ANGIOEDEMA)
 HEADACHE, NAUCEA, BURNING, SHOCK
ALLERGY: complete possible
causes
 DRUG  PHYSICAL TRAUMA
 FOOD  INFECTION
 INSECT BITE  PSYCHOLOGICAL
 FOTOSENSITIZER DISORDER
 INHALANT AGENT  GENETIC DISORDER
 CONTACTANT  VARIOUS SYSTEMIC
DISEASES
ALLERGIC REACTION
 RECOMMENDED PROCEDURES:
 AVOID FURTHER CONTACT WITH THE
ALLERGENT.
 PROVIDE ANTI-ALLERGY THERAPY.
 MOST COMMON DRUGS:
 CTM (CHLOR-TRI-METHANE)
 LORATADINE, CETIRIZINE
 ANTI-ALLERGY INJECTION NECESSARILY
 DYPHENHYDRAMINE (INTRA-MUSCULARLY)
 DEXAMETHASONE (INTRA-
MUSCULARLY/VENOUSLY)
DYSPEPSIA
 DEFINED AS SYNDROMES OF UPPER ABDOMINAL
THAT ARE QUITE SETTLED DAN OFTENLY
RECURRING.
 POSSIBLE CAUSES:
 IRREGULAR MEAL HOURS
 OVEREXPOSED BY SOME AGENTS: CAFFEINE,
ALCOHOLS, ACIDS, SPICY FOODS.
 INFECTIONS, PSYCHOLOGICAL STRESS
 POSSIBLE SYMPTOMS:
 EPIGASTRIC PAIN OR DISCOMFORT, BLOATING,
NAUCEA, VOMITING, HEADACHES
DYSPEPSIA
 RECOMMENDED PROCEDURES:
 ADMINISTER ANTACIDES TO NEUTRALIZE
ACIDITY
 DO NOT ADMINISTER FOOD FIRST. WAIT UNTIL
AT LEAST 15 MINS TO ADMINISTER NEXT
MEAL. ANTACIDES WORK BEST IN EMPTY
STOMACH.
 MAINTENANCE: H2-ANTAGONIST
 AVOID OTHER MEDICATIONS THAT CAN
INCREASE ACIDITY (MOST PAIN KILLER,
DIAZEPAMS)
 EDUCATION TO AVOID FUTURE RECURRENCE
TRAUMATIC SPORT INJURIES
 HARD TISSUE INJURY
 FRACTURES
 DISLOCATION
 SOFT TISSUE INJURY
 SPRAIN
 STRAIN
 CONTUSSION
 BLEEDING
FRACTURES
 ANY DISCONTINUITY OF THE BONE IS
NAMED FRACTURE.

 CLASSIFICATION:
 OPEN FRACTURE, marked with also a discontinuity
of the related soft tissue (wounds).
 CLOSED FRACTURE, when injury only affect the
bones. No chance the bone made contact with air.
FRACTURES
 POSSIBLE CAUSES:
 DIRECT TRAUMA
 INDIRECT TRAUMA
 PATHOLOGIC FRACTURES

 NOT ALL FRACTURES ARE EMERGENCY.

ONLY OPEN FRACTURES ARE.
FRACTURES SIGN
 LOOK:
 MARKED DEFORMITY
 DISFUNCTIONING
 BRUISING
 SWELLING
 FEEL:
 TENDERNESS
 MOVE:
 ABNORMAL MOBILITY (FALSE MOVEMENT)
 PAIN
 CREPITATION
 DECREASED ROM
FRACTURES
 RECOMMENDED PROCEDURES:
 FIRST, DO NO HARM. PLEASE…
 REASSURE THE A-B-C IS SECURED. IF IT’S NOT,
STABILIZE FIRST. IF ANY BLEEDING OCCURS, APPLY
DIRECT PRESSURE TO THE WOUND.
 REPOSITION THE BONE TO THE CORRECT POSITION.
 IMMOBILIZE THE FRACTURED BONE.
 ESCORT TO HOSPITAL.
 DON’T GIVE ANY PAIN KILLER ORAL MEDICATION
IF IT’S AN OPEN WOUND.
DISLOCATION
 MALPOSITION OF BONE TO THE RELATING JOINTS.
 MAY HAPPEN SPONTANEOUSLY, BUT MOST TIMES
ARE DUE TO TRAUMAS.
 A PROPER HISTORY TAKING CAN ALMOST ALWAYS
DETERMINE THE DIAGNOSIS
 WHAT YOU MAY SEE:
 DEFORMITY
 FALSE MOVEMENT
 PAINFUL PATIENT
 SWELLING
DISLOCATION
 RECOMMENDED PROCEDURES:
 OBSERVE PATIENT’S MOST POSSIBLE
COMFORT POSITION AND MAINTAIN THE
POSITION.
 ESCORT TO NEAREST MEDICAL CENTRE.
 PAIN KILLER MEDICATION NECESSARILY.
 THE DEFINITIVE THERAPY WOULD BE
REPOSITION OF THE BONE, EITHER WITH
LOCAL ANESTHESIA OR GENERAL
ANESTHESIA.
SOFT TISSUE INJURIES
 SPRAIN
 INJURY OF JOINT’S CAPSULE OR JOINT’S
LIGAMENT
 STRAIN
 INJURY OF MUSCLES OR TENDINES
 CONTUSSION
 MUSCLE INJURY DUE TO DIRECT TRAUMA,
CAUSING HEMATOMES TO FORMED IN THE
RESPECTIVE SITE.
SPRAINS AND STRAINS
SPRAINS:
Torn or overstreched ligaments or joints.
Sprains tend to happen when the bones
that form the respective joint are forced to
move beyond their normal range of
motion.

STRAINS:
Torn or overstrecthed muscles or tendines.
Strains tend to happen when the muscles
are forced to contract extremely beyoond
its capacity.
Strains may be caused by one major
trauma, or also by repetitive minor
traumas.
OVERUSE INJURIES
 Rotator’s cuff tendinitis
 Jumper’s knee
 Patellofemoral pain
 Stress fracture
 Spondylosis / spondylolisthesis
 Little leaguer’s elbow
SOFT TISSUE INJURIES
 RECOMMENDED PROCEDURES:
 IN ACUTE PHASE, PERFORM “RICE”
TREATMENT
 REST
 ICE
 COMPRESSION
 ELEVATION
 REHABILITATION IS CONDUCTED IN THE SUB
ACUTE PHASE.
 PAIN KILLER, BOTH ORAL OR TOPICAL,
SHOULD BE GIVEN ACCORDINGLY.
BLEEDING
 BLEEDING USUALLY OCCUR
AS AN IMPACT OF SHARP-
EDGED TRAUMA.
 HUMAN BODY CAN CLOT THE
BLOOD ITSELF AS A LIFE-
SAVING AUTO MECHANISM.
 SO MOST OF THE TIMES,
BLEEDING WILL STOP WITHIN
1-3 MINUTES, DEPENDING ON
HOW MANY TISSUES AND
ORGANS ARE AFFECTED.
BLEEDING
 BUT WE STILL MUST DO SOMETHING:
 WE CAN’T TELL THE PATIENT: “TAKE IT EASY,
DUDE. THERE’S NOTHING TO BE DONE HERE.
IT WILL STOP BY ITSELF. DON’T WORRY.”
 THAT WILL LOOK SO UNPROFFESIONAL.
 MY EXPERIENCE AS TBM SAYS: “BEING DUMB
IS OKAY. BUT YOU HAVE TO ACT LIKE A PRO.”
 BESIDES, THERE ARE SOME CONDITIONS
WHEN THE PERSON CAN’T HEAL HIMSELF:
HEMATOLOGY DISORDER, ARTERIES RUPTURE,
ETC.
BLEEDING
 SUGGESTED PROCEDURES:
 APPLY DIRECT, CONSTANT PRESSURE TO THE
WOUND FOR 3-5 MINUTES.
 THEN EVALUATE THE BLEEDING.
 TREAT WOUND AS NECESSARY.
 ANY OPEN WOUND WILL NEED STITCHES.
EITHER DO IT YOURSELF OR ESCORT THE
PATIENT.
 ESCORT THE PATIENTS IF THE BLEEDING IS
PROLONGED.