A.D.’s Corner: August 27,2009

Written by Dr. Scott Silverman Friday, 28 August 2009 00:00

A Talk with Our Athletic Trainer

As the summer ends, and the fall sports season is almost upon us, I thought it would be beneficial to tap into the school district athletic trainer’s knowledge about injury. The more an athlete knows about injury prevention, treatment and diagnosis, the better prepared they are to deal with them.

Peter Adragna is the athletic trainer for the Glen Cove School District. He attends games and practices to help athletes prepare against, prevent and deal with injuries. I asked Mr. Adragna to come up with a cheat sheet for injuries that would be helpful for athletes to review. The following is some basic terminology.

Injury First Aid (Always follow the advice of your doctor when injured. Chronic injuries may require physical therapy after doctor’s diagnosis. The following instructions are supplemental.)

R.I.C.E. Treatment:

Rest, Ice, Compression, Elevation

First aid for strains, sprains, contusions, dislocations, or uncomplicated fractures

Rest

Stop using injured part

Continued activity could cause further injury, delay healing, increase pain, and stimulate bleeding

Use crutches to avoid bearing weight on injuries of the leg, knee, ankle, or foot

Use splint for injuries of the arm, elbow, wrist, or hand

Ice

Hastens healing time by reducing swelling around injury

Sudden cold contracts blood vessels

Helps stop internal bleeding from injured capillaries and blood vessels

Keep damp or dry cloth between skin and ice pack

Do not apply ice for longer than 15 to 20 minutes at a time

For three days after injury

Apply every hour for 10 to 20 minutes

Apply ice after three days as long as pain or inflammation persist

Apply at least three times throughout the day for 15 to 20 minutes

Compression

Hastens healing time by reducing swelling around injury

Decreases seeping of fluid into injured area from adjacent tissue

Use elasticized bandage, compression sleeve, or cloth

Wrap injured part firmly

Do not impair blood supply

Too tight of compression may cause more swelling

Wrap over ice

Loosen the bandage if it gets too tight

Elevation

Elevate injured part above level of heart

Decreases swelling and pain

Use objects and pillows for props

* Some texts advocate PRICES (P=Protection, S=Support)

Medication

Some doctors may recommend the use of a non-steroid anti-inflammatory such as ibuprofen throughout the duration of the injury. Check with your physician.

Heat Treatment

Causes delay in healing if applied too soon after an injury

Wait at least 72 hours (three days)

Wait until swelling is gone

Some experts recommend going back and forth between cold and heat treatments.

Management of Inflammation

decrease healing time

decrease scar tissue formation

decrease chance of re-injury

Recovery

There will be a prolonged healing time if usual activities are resumed too soon

Proper care and sufficient healing time before resuming activity should prevent permanent disability if it is a first time injury.

If it is a repeat injury, complications are more likely to occur.

Strain

Injury to the muscle or tendon. Pain with moving or stretching the affected muscle or muscle spasms. Acute strains are caused by over stress or direct injury. Chronic strains are caused by overuse.

Mild strain (Grade I):

Slightly pulled muscle with no tearing of muscle or tendon. No loss of strength

Ability to produce strong yet painful muscle contractions

Requires self care through rehabilitation after doctor’s diagnosis

Average healing time: two to 10 days

Moderate strain (Grade II):

Tearing of muscle, tendon or at the bone attachment

Weak and painful attempts at muscular contraction

Requires physical therapy after doctor’s diagnosis

Average healing time: 10 days to 6 weeks

Severe strain (Grade III):

Rupture of muscle-tendon-bone attachment with separation

Extremely weak yet painless attempts at muscular contraction

Requires surgical repair and physical therapy after doctor’s diagnosis

Average healing time: 16 to 10 weeks

Sprain

Violent overstretching of ligament in a joint. Pain, tenderness, swelling or bruising at joint.

Mild strain (Grade I):

Tearing of some ligament. No loss of function

Requires self care through rehabilitation after doctor’s diagnosis

Average healing time: 2 to 6 weeks

Moderate strain (Grade II):

Rupture of portion of ligament resulting in some loss of function

Requires physical therapy after doctor’s diagnosis

Average healing time: 6 to 8 weeks

Severe strain (Grade III)::

Complete rupture of ligament or complete separation of ligament from bone. A sprain-fracture occurs when the ligament pulls loose a fragment of bone

1+ Joint surfaces displaced 3-5 mm

2+ Joint surfaces displaced 6-10 mm

1+ Joint surfaces displaced 10+ mm

Requires surgical repair and physical therapy after doctor’s diagnosis

Average healing time: eight to 10 weeks

Injury Information

Acute (traumatic injury)

Chronic (overuse injury)

Account for more than 50 percent of injuries in primary care practices

Classification Stages:

Pain after activity only

Pain during activity. Does not restrict performance

Pain during activity. Restricts performance

Chronic persistent pain, even at rest

See a qualified physician if you have an injury. Only a physician can give diagnosis and prescription for injury.