Sports Injury Classification

Classification of Sports Injury

Acute

/ Traumatic

Overuse

Chronic
direct blow, collision, impact

extrinsic causes:
SYAHRUL RIDHWAN BIN MORAZUKI SPORTS SCIENCE, UTM

intrinsic causes:
ligament sprain, muscle strain

Acute Injury - Tendon

Stress
1 Toe Portion

3 2 1

2 Linear Portion 3 Rupture

TENDON

0 2 4 6 8 10

Strain (%)

Normal Physiological Range Grade I Tear Grade II Tear Grade III Tear

Acute Injury - Tendon

LIGAMENT

Acute Injury - Ligament

Grade I Sprain

Sprain / tear 3 grades (continuum) Functional - Clinical relations

I
Overstretching Few Ruptured Fibres Conservative

II
Significant No. Ruptured Fibres Active Treatment

III
Complete Rupture Surgery

Pain on stressing ligament No increased in joint laxity

Grade II Sprain

Grade III Sprain (Rupture)

Pain on stressing ligament

may / may not painful on stressing gross joint laxity without a firm end point

Increased joint laxity with definite end point

Acute Injury - Muscle Strain

Muscle fibres fail to cope with imposed demands Among most common sporting injuries Recurrent (particularly hamstrings) Sudden acceleration or deceleration are common injury mechanisms Eccentric action mode Elasticity

MUSCLE STRAIN

Grade I Strain

Grade II Strain

Overstretching

Large number muscle fibres ruptured Pain and swelling Reduced strength Pain limited movement

Small number muscle fibres ruptured

Localised pain

No strength loss

Grade III Strain

Acute Injury - Muscle

Complete tear of muscle Often seen at musculo-tendinous junction Significant strength loss Obvious visual defect

Contusion (bruise): direct blow local damage

HARM
Heat Alcohol Rest Massage

bleeding hematoma (myositis ossificans??)

Acute Injuries - Articular Cartilage

Chondral & osteochondral fractures more common than previously thought Better detection - MRI, CT, arthroscopy Fragments sheared from articular surfaces especially with subluxation or dislocation High index of suspicion if apparently simple joint sprain does not resolve continuing to be painful and swollen Damage to articular cartilage may be an important factor in premature osteoarthritis

ARTICULAR CARTILAGE

Growth Plate Injury (Salter & Harris)

JOINT

Acute Injuries - Joint

Subluxation
Articulating surfaces remain partially in contact with each other

Acute Injuries - Joint

less stable joints (shoulder / fingers) more likely to dislocate all dislocations and subluxations result in injury to the surrounding joint capsule and ligaments

Dislocation
Trauma produces complete dissociation of the articulating joint surfaces

Bone Fractures

Common sporting injury Direct trauma (blow) Indirect trauma (twisting) Closed vs open fracture

BONE FRACTURES

Bone Fracture Classification

Complex

Simple

Transverse

Oblique

Spiral

Comminuted

Avulsion

Epiphyseal Injury Classifications (Salter &

Harris)
Type I Type II Type III Type IV Type V Complete separation of the epiphysis from the metaphysis with no fracture to the bone Separation of the epiphysis & a small portion of the metaphysis Fracture of the epiphysis Fracture of a part of the epiphysis & metaphysis Compression of the epiphysis without fracture, resulting in compromised epiphyseal function

Epiphyseal Injury Classifications

Epiphyseal Injury Classifications