Unit 6Healing and Inflammation

What seems to happen at the injury site? What happens to the brain?

Injury is a part of athletic participation

Athletes have to learn how to cope with Injuries Temporarily

interference with performance

Extended time away from their sport

Sports Medicine professionals understand How the body heals

Help the athlete have a full recovery

Injuries Sudden onset Definite time of

occurrence Generally result

from Large force Overcomes tissue

being acted upon Characterized by

Sudden onset of symptoms

Traced to a specific event

Sprained ankle Torn ACL Hamstring Strain

Injuries Occur from

prolonged over-use Onset not traced to

one specific event Generally

Small force repeated over and over

Extended period of time

Usually caused by biomechanical issues: Improper form or

technique Unaccustomed to a

new sport or activity

Genetic components Hyperpronation Scoliosis Muscle imbalances,

etc.

Achilles tendinitis Jumpers knee

(patellar tendonitis) Shin Splints (Medial

Tibial Stress Syndrome)

Osgood Schlatters

What is inflammation? What occurs during the process of

inflammation?

The body’s normal response to injury

Series of events that attempts to Minimize further

tissue damage Localize trauma Create environment

for healing to occur

The inflammatory response may Resolve injury Repair damaged

tissue Persist as chronic

inflammation While the word

usually has a bad connotation, it should be noted that Process is normal Necessary for

healing to occur

Not all tissues respond the same

Many of the inflammatory processes can cause secondary issues

Sports medicine attempts Limit adverse affects Encourage the

advantageous affects

This phase is marked by initial damage (primary cell death) to the affected tissues

Blood vessels bring oxygen and nutrients to the tissues

Blood vessels are not intact Normal blood flow to

cells is disrupted Tissue death occurs

(secondary cell death)

Cell death Hypoxia

Results from lack of oxygen to tissue

General increase in Blood flow which brings

Blood cells Chemicals

Clean up cellular debris and initiate healing

Inflammation begins and is seen

Pain comes from 2 mechanisms Pain receptors

triggered by initial trauma

Chemicals that are released into the area

Sources tell the body that Damage has

occurred Encourages

decreased activity Healing can take place

Decreased activity is important for proper healing Pain medication can

actually hinder this process

Write about the worst injury that you have had. Tell how it happened How long it took to heal What you had to do to get it to heal

Swelling occurs due to 4 mechanisms

1. Initial trauma Blood vessels rupture Blood leaks out of blood

vessels into the extracellular compartment

2. Damaged cells fail to retain intracellular fluid

Fluid is lost to the extracellular compartment

3. Cellular debris Increased proteins

in the extracellular fluid Hypertonic solution

Draws fluid out of cells

4. Blood vessels vasodilate

Small vessels become porous Fluid loss from blood

vessels

Swelling Increase secondary

cell death due to hypoxia

Compression wrap Decrease mechanisms Limit swelling

Controlled motion Limits swelling Encourages

extracellular drainage Venous return through

the skeletal muscle pump

Blood vessels stimulated to dilate

This vasodilatation causes Increase in

circulation Brings white blood cells

to engulf cellular debris Macrophages and

neutrophils Prepare the area for

healing to begin

Redness because of the heat

Loss of function results because Damage to

supportive structures

Due to pain Not always

complete loss The acute phase

usually last from onset to 48 to 72 hours

Regeneration mechanisms Work with damaged

tissue Cellular debris has

been removed Next step is to

regain adequate blood flow Form capillary buds to

connect existing vessels

Blood flow normalized

Regeneration of damaged tissues begins

Body’s ability to regenerate various tissues is limited

Most damaged body tissue repaired with “scar tissue”

Scar tissue is composed of a protein called collagen

Specialized cells migrate into the area Begin the process

of regeneration Fibroblasts

Responsible for collagen production

Collagen Extremely strong Elastic properties

Not the same as the existing tissues

Effective in regaining normal abilities of the tissue

As long as the damage is not overly extensive

Occurs for all damaged tissue in the body

Except bone which heals with actual bone tissue

This phase usually lasts 3 to 4 weeks

What is rehabilitation? What usually occurs during a session?

Overlaps the Subacute phase

May continue for up to 1 year

Fibroblasts are decreased Collagen fibers

Strengthen and attempt to align with existing fibers

“Controlled motion” can assist in this process

This type of rehabilitation Prevents the formation of

adhesions Can form as collagen fibers

contract in an effort to strengthen

Tissues have been overly stretched

Tweaked “Micro-tears” in the

tissue develop Symptoms include:

Pain Minor swelling Loss of function that

may or may not limit activity

Integrity of the fibers is generally maintained

A complete rupture of the tissue

Pop Symptoms include:

Severe Pain Moderate to severe

swelling Probable ecchymosis Complete loss of

integrity of the joint Complete loss of

function