KNPE 331 Chapter Notes - Chapter Various: Anatomical Terms Of Location, Airway Obstruction, Hematuria
14-20
Roles and Responsibilities of the Athletic Trainer
• 5 domains of athletic training:
o Injury/illness prevention and wellness promotion.
• Conduct pre-participation exams; ensuring appropriate training and conditioning
of the athlete; monitoring environmental conditions to ensure safe participation;
selecting, properly fitting, and maintaining protective equipment; making certain
that the athlete is eating properly; making sure the athlete is using medications
properly, whilst discouraging substance abuse.
o Examination, assessment, and diagnosis.
• Include: brief medical history of exactly what happened according to the athlete;
observation; palpation; special tests.
o Immediate and emergency care.
o Therapeutic intervention.
o Healthcare administration and professional responsibilities.
• Professional Responsibilities of the Athletic Trainer:
o Education of students is very important.
249-263
• Tissue stresses - compression, tension, shearing, bending, torsion.
• Epimysium - perimysium - endomysium.
• Tendons tend to have the highest mechanical strength, good flexibility and elasticity.
• Muscle strain grades:
o 1 - some torn and stretched but full range of motion achievable.
o 2 - more painful, usually a divot, bleeding - hematoma - range of motion decreased.
o 3 - complete rupture of the muscle - significant impairment - lots of pain.
• Usually big muscles.
• Muscle Cramps: Extremely painful involuntary muscle contractions that occur most commonly
in the calf, hamstrings, quadriceps, or abdomen.
o Usually from overload and fatigue.
o Increased muscle spindle activity whilst decreasing Golgi tendon organ activity, thus
increasing a reflex contraction.
• Muscle Guarding: Muscles 'splint' to protect damaged muscle - limit range of movement.
• Spasms - clonic and tonic.
• Muscle soreness:
o Acute-onset muscle soreness - accompanies fatigue.
o Delayed muscle soreness - 12 hours after injury. Most intense 48 hours after.
• Tendons are harder to injure because they are stronger than the muscles.
• Tendonitis can cause crepitus (crackling feeling/sound).
o Tenosynovitis is similar.
• Tendonosis is quite common - like tendonitis but without inflammation.
• Myofascial trigger points usually in muscles used in postural support.
• Contusion:
o Ecchymosis occurs from bleeding that makes a bluish-purple discoloration of skin.
o Can get calcium deposits - myositis ossificans from repeated blows.
• A contracture is associated with a joint that, because of muscle injury, has developed
unyielding and resisting scar tissue.
• Ligament sprain grades:
o 1 - stretching with minimal instability and mild to moderate pain with localized swelling
and stiffness.
o 2 - some tearing and separation - moderate to severe pain, swelling, and joint stiffness.
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o 3 - total tearing - instability - subluxation - severe to no pain - stiff joints - surgery
sometimes.
• Diastasis: Separation of two articulating bones.
• Osteoathritis most often affects the weight bearing joints - knees, hips, and lumbar spine.
o Pain on one side from the friction + stiffness.
o Glucosamine sulfate is a safe and relatively effective treatment for osteoarthritis.
• Bursitis - from bursae that are pieces of synovial membrane that contain a small amount of
fluid.
o Can be extremely painful and movement restricting.
• Capsulitis and synovitis are chronic and from repeated joint sprains or micro-traumas.
• Bone's 5 functions:
o Body support; organ protection; movement; calcium storage; formation of blood cells.
• Osteoblasts help the bone grow (clasts help with width).
o Epiphyseal growth plates are important.
• Bones and Wolff's Law - every change in the form and function of a bone, or change in its
function alone, is followed by certain definite changes in its internal architecture.
• Clavicle is vulnerable to fractures due to its changing shape. Hollow cylinders are least
vulnerable.
• Causes of stress fractures:
o Overtraining.
o Going back into competition too soon after injury or illness.
o Going from one event to other without proper training in the second event.
o Starting initial training too quickly.
o Changing habits or the environment (e.g., running surfaces, the bank of a track, or
shoes).
• Stress fractures initially don't hurt when inactive but eventually will do - can hurt with
percussion onto area.
o Tibia, fibia, metatarsal shaft, calcaneus, femur, etc., are most common areas.
• A musculoskeletal injury to a child or an adolescent should always be considered to involve a
possible epiphyseal condition.
• 5 types of epiphyseal growth plate injuries:
o I - complete separation of the physis in relation to the metaphysis without fracture to
the bone.
o II - separation of growth plate and a small portion of the metaphysis.
o III - fracture of the physis.
o IV - fracture of portion of the physis and metaphysis.
o V - no displacement of the physis, but crushing force can cause growth deformity.
• Osteochondrosis - degenerative changes in the ossification centers of the epiphyses of bones,
especially during periods of rapid growth in children.
• Most common nerve injury is neuropraxia produced by direct trauma.
o Disruption in conduction of the impulse down the nerve fibre.
• Paresthesia - numbness and tingling.
• Neuritis is a chronic nerve problem.
o Can go from minor nerve problems to paralysis.
• Nerve trauma can be produced by overstretching or compression.
199-203
• Combo of cotton and polyester socks are better and dry faster.
• Running shoes last roughly 350-550 miles before needing to be replaced.
• Parts of the shoe:
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o Toe box, midsole, arch support, heel wedge, heel counter, Achilles tendon pad, shank,
outer sole, uppers, last.
• Two types of traction, translational and rotational.
• Orthotic helps correct a biomechanical problem.
• Heel cups are good for - plantar fasciitis, heel spur, Achilles tendonitis, and heel bursitis.
268-272 - Tissue Healing
• 3 stages of repair: inflammatory, fibroblastic repair phase, and the maturation remodeling
phase.
o Inflammatory - rubor, tumor, tenderness and pain (dolor), increased temperature
(calor), and loss of function (functiolaesa).
• Chemical mediators - histamine (vasodilation and swelling), leukotrienes
(margination), cytokines, and prostaglandins.
• Platelets adhere to collagen fibers to create a sticky matrix on the vascular wall.
• Blood coagulation = thromboplastin - prothrombin - thrombin - fibrinogen -
insoluble fibrin clot.
• Chronic inflammation can lead to tissue necrosis.
o Fibroblastic repair phase - fibroplasia (scar formation).
• 4-6 weeks roughly.
• Granulation tissue builds up - fibroplasts, collagen, capillaries.
• Extracellular matrix - collagen, elastin, ground substance, proteoglycans,
glycosaminoglycans.
o Maturation remodeling stage - long term process.
• Decrease in type III collagen fibres and increase in type I.
• May take several years to complete.
• Controlled mobilization is better than immobilization for scar formation. Though a brief period
of immobilization is good.
• Factors that impede healing:
o Edema - due to separation of tissues.
o Hemorrhage - additional tissue damage.
o Poor vascular supply.
o Separation of tissue.
o Muscle spasm.
o Atrophy.
o Corticosteroids.
o Keloids and hypertrophic scars - keloids are when rate of collagen production exceed
breakdown in maturation stage of healing.
o Infection.
o Humidity, climate, and oxygen tension.
o Health, age, and nutrition - like vitamin C, K, and A. Zinc and amino acids too.
398-406 - Cold and Heat
• Benefits of heat - increasing extensibility of collagen tissues; decreasing joint stiffness;
reducing pain; relieving muscle spasm; reducing inflammation, edema, and exudate in the post
acute phase of healing; and increasing blood flow.
• Both heat and cold relieve pain via the gate control theory of pain modulation.
• Heat transferred through conduction, radiation, and convection. Also conversion.
• Dry heat is easier to handle.
• Therapies:
o Hydrocollator packs - good but superficial.
o Whirlpool therapy - conduction and convection.
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Document Summary
Roles and responsibilities of the athletic trainer: 5 domains of athletic training: Include: brief medical history of exactly what happened according to the athlete; observation; palpation; special tests. Immediate and emergency care: therapeutic intervention, healthcare administration and professional responsibilities, professional responsibilities of the athletic trainer, education of students is very important. Increased muscle spindle activity whilst decreasing golgi tendon organ activity, thus increasing a reflex contraction: muscle guarding: muscles "splint" to protect damaged muscle - limit range of movement, muscle soreness: Spasms - clonic and tonic: acute-onset muscle soreness - accompanies fatigue, delayed muscle soreness - 12 hours after injury. I - complete separation of the physis in relation to the metaphysis without fracture to the bone. Ii - separation of growth plate and a small portion of the metaphysis. 268-272 - tissue healing: 3 stages of repair: inflammatory, fibroblastic repair phase, and the maturation remodeling phase. Though a brief period of immobilization is good.
