Extrinsic and Intrinsic Risk Factors for Sports Injury

Assignment 1

What are extrinsic risk factors?

An extrinsic Factor are variables that you are unable to control to prevent yourself from an injury. So an extrinsic risk factors are injuries you cannot blame it something that will happen natural or you have been led to that injury. Extrinsic risk factors category that you are unable to control are the following five which are coaching, incorrect techniques, environmental factors, clothing footwear and equipment and finally safety hazards.

The Examples of extrinsic factors could be coaching

A coach can show lack of communication skills, leaderships and methods between him and his players which will prevent lack of trusts and their players won’t be so confident to the training and could do the training method wrong and then get injured from doing that this could be classed as an Extrinsic Risk Factors.

Clothing footwear and equipment

Wearing an incorrect clothing for your sport will cause you massive injury for example if you were to play tennis you would wear rugby/football boots if you did you would be slipping all over the place as you don’t have enough grip to handle the surface of the tennis court. It is always important to wear the correct uniform that will protect you for your sport, if you don’t wear the right items for your sport and you get hurt by not wearing something that was supposed to cover you could end up leading out getting injured for a long time.

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Environmental:

Environmental factors can cause sports injuries as an individual could only ever train in the sun and on a hard pitch but say it came to game day and it is raining with a muggy pitch, or snowing, this individual is not going to be used to the conditions meaning that they could cause the individual to act differently, which could could injury, or the individual could perform the same as they usually do which could as well as positive have a negative impact on the individuals performance and them causing a sporting injury for themselves.

Safety hazards

Safety hazards are placed to help try and reduce the risk of injury, a risk assessment must be taken before activity on a playing field because there could be anything on the pitch that could cause injury to an individual, if the risk assessment is not taken then as already stated, a player could go in for a slide tackle and yet come off with a very large, deep cut down their leg as they could have gone sliding across grass or anything else with a sharp edge, this is why a risk assessment must be done and safety hazards must be put into place.

These can affect you and your team because they are a man down and if one of these injuries happened to you from the list up it can happen to all of your team mates which would be a massive blow of your team doing well as they would not be very trustworthy.

What are intrinsic risk factors?

An Intrinsic risk factor us is a risk or force from the body. So these would be internal forces, which are stresses from within the body. Intrinsic factors are variables that you are able to prevent yourself from an injury. There are six different variables that fit into the intrinsic factors category and they are Flexibility and joint laxity, Nutrition, Leg length discrepancies, Fitness levels, Age and finally weight and your size.

The following intrinsic examples are flexibility:

The flexibility: can cause a sporting injury because by trying to over stretch a muscle or trying to perform a move which requires the joints that are not attached very well. For example, in the game football the most common injury is either pulled hamstring this is done because the while the players are running they are stretching their muscles out too much which will eventually pull a muscle in the leg

Nutrition: can cause a sporting injury by a player not having enough energy and maybe making sill mistakes that could lead to either them or someone else picking up an injury. For example, footballer needs to have enough energy to perform well in a game and have good concatenation at all time if they don’t have the right energy to perform their sport they will not be able to do as well as they could and could eventually pick up an injury

Fitness levels: can cause a sporting injury because if someone has a low fitness level they will be classified as un fit and in sport you need to have a good fitness level to compete with your sport, the lower your fitness level is the more tired you become and the more tired you and you keep pushing yourself that could prevent another injury. For example, if a footballer has a low fitness he will get tired and will be asked to sub off because he hasn’t got enough energy to keep up with the tempo of the football game

Age: could cause a sporting injury as an individual gets older due to their bone strength their bones get weaker as they get older their bone strength would not be as as good as they were when they were younger, for example if a 60-year-old tried to play football against a 25-year-old it is bound that the 25-year-old would perform better because he would have better fitness and he has the right mentality to play the sport.

Weight and size: can cause injuries for your sport because if a player is overweight they have an additional stress put on their muscles, the more over weight you are the more you will struggle to keep up with your sport.

Assignment 2

What are preventative measures?

Preventive measures mean that are things you can do to avoid getting injured, so for example in for a football before the football match starts the referee of the game will have to inspect the pitch so look if the grass is in good condition to play on lookout for any others stuff that will injure the football player during the game.

However, during the game football players should wear the correct equipment’s to keep them safe during the game. In the game football you need to wear shim pads to help you from getting kicked in the knee.

The coaches should be able to keep you motivated and chilled out and not stressed out by doing over complicated training sessions, the training sessions should be well planned out and should know how the training session will work. The coach or the trainer should have a basic knowledge of what their players are working at they should have a basic information of where your fitness level is at for example if a football player had a low level of fitness the coach should make him work on some cardio at the gym before making him do a training session involving a lot of running.

To avoid injuries in football by using the equipment’s the ball they use either in a football match or a training session has to be at the right air pressure if there is too much air pressure the ball will become too hard to kick and could cause injury for the player who is kicking the football.

Which individuals are important in preventing risks to your sport performers?

In the game football there are many people who can help you to prevent getting injured in the football game itself and at the training sessions the coach could help you and give you advice on not to do certain moves because you could get injured for example in football if you go in for a header you shouldn’t close your eyes as one you could either head-butt or get head-butted by someone else, you will lose balance and could land awkwardly.

In the game football a physiotherapist could help you or tell you to avoid doing certain stuff so you won’t get injured and the same thing goes with a referee he will do the same thing giving you advice.

What types of equipment or procedures are there in your sport to help prevent sports injuries?

In football you have to wear the right football boots, this means you can only wear a football boot with the right studs in the boot. The football stud has to be being hybrid a mixture of metal and plastic at the same time, this is because one it need to stop you sliding about and stops you leaving holes in the football pitch because if you leave holes in the pitch and you trip over in the hole you could get injured by this that is the reason why to wear the right football boots in a football game.

In football the players have to wear the right shin pads because it need to protect their shins, but you have to wear the correct shin pads because it has to cover the whole of your shin.

If you do not wear shin pads you have a chance of getting a small bruise on your shin and if you do get a major injury by not wearing your shin pads it will most likely be a broken none, the other equipment.

If you do not wear the correct football boots in the game you have a chance of landing on your ankle awkwardly or messing your ankle up as you do not have enough grip to sustain on the football pitch.

How do these help prevent sport injuries?

Shin Pads: In football the shin pads are there to protect your shins and stop you from getting hurt by getting kicked in the shins, this will be because the opponent who you are going in for with a tackle will sometimes miss the ball and could end up studding you in the shin which would get you injured so the shin pads is there to protect you from getting hurt or getting any serious injury.

Goalkeeper Gloves: In football the goalkeepers have to wear football gloves this is because when someone strikes a ball real hard the goalkeeper needs to have metal plates behind each fingertip in the gloves to stop them bending their fingers all the way back as it could seriously injury them or even get them to dislocate their fingers if they don’t wear the gloves.

Football boots:  football players have to wear the right football boots with the right football studs if they wear the right studs they will have enough grip on the pitch and won’t be sliding all over the place, however if they were the wrong studs they could get injured as they will be sliding all over the place and could get injured by this however they could injure the other opponent by having the wrong studs which will not be very good in the game.

Assignment 3

If an athlete had sprained their ankle during a tennis match would be classed as an acute injury as it happened on a sudden impact however, this would also be classed as an extrinsic factor. Physiological the athlete who had just sprained his ankle wouldn’t be able to walk or move the ankle as he had just sprained It. However, it would then start to swell and he would be in a lot of pain. There would be a lot of redness around his ankle due to blood vessels increasing due to blood flow.

Physiological responses all depend on how the person respond or deal with the injury, some injuries will cause so much trouble for the person and he will not be mentally strong enough without being stressed about it. The athlete could be scared to think the same thing will happen again to him, he will be annoyed because he won’t be able to perform as well as he/she was doing while doing the injury or just after he has recovered. If the athlete sprains his ankle during a competition, he will suffer from stress and anxiety the feelings will be increased as the injury progress will worry the athlete because the athlete might be out for a long time and he will not know when he will return or if he will return to his full form to perform as well as he was doing.

The athlete may not feel motivated to do the sport because he might of been waiting for a long to time to heal or recover from his injury, some of the athletes may suffer from depression because he will be constantly having mood swings he may be sad and angry at himself or even someone else for causing this injury to happen to him. Some of the athlete may try to return to their sport as quickly as possible because they want to play their sports as quick as possible this is bad, if they have not return to full fitness and they are trying to participate in the sport there is a big potential of making his injury worse that he suffering. Some of the athletes may not talk to their team mates or hide away from society for a while because he either wants to be on his own.

A sprain is classed a soft tissue damage this is a damage to the ligaments, a sudden twist, impact or a fall that makes the joint move outside its normal range of movements normally a sprain happens in ankle, knees, wrist and thumb. Damage tissue take place as soon as an injury accrues this means the body will respond in different ways and they are:

• The primary damage will respond in Mechanism the signs and symptoms for this would be pain and inflammation, pressure and friction can cause inflammation which is associated with most of the sports injuries.
• This will acquire most of the sport injuries

Returning athletes to competition after sport injury is a key role of athletic trainers and physical therapists. Negative psychological responses to injury often result in a lack of rehabilitation commitment they have done for that programme.

Psychological skills can be used during sport injury rehabilitation to motivate athletes to help them commit to the rehabilitation programme, this is done to increase speed of recovery, to control anxiety levels, and to help boost their confidence. Also the best people to help the athlete injury would be a physical therapists and an athletic trainer

However, those who hold negative attitudes toward certain psychological skills are less likely to progress during their rehabilitation. Therefore, receiving formal training probably would increase positive attitudes toward the use of psychological skills and would strengthen the likelihood that they are used during rehabilitation. Overall, athletic trainers and physical therapists hold positive attitudes on the effectiveness of psychological skills to enhance the rehabilitation process.

Some athletes can be angry about their injury some may get angry for returning to training to early or some athletes may blame the coach for their injury some athletes may be isolated from their teammates by this I mean being away from their team mates, either resting or with the physio so they could be missing out on jokes with the team and being left out on specific activities the club/team may do.

However, a common issue in the long term injury is that the athlete’s wants to return to the competition in their career to early but they will also not be able to release tension through training because they are frustrated that they can’t play, some athletes may deny any other injury happening to them and will do anything to try and return to their sport too quickly. Some athletes may show signs of clinical depression including decreased energy levels, constant sadness, they won’t find any motivation to do training and get their health or recover from their injury as soon as possible.

When an athlete returns from their injury their confidence would have decreased there are a couple of reasons for this for example if a footballer returns to the starting line-up after an injury he will be cautious and careful when playing because he doesn’t want the same injury to happen again so he will not perform the best he could straight away some athletes will show a decreased confidence in their own skill levels.as the duration of the injury increases, an athletes motivation towards their sport may decrease, they could lose contact with the positives that got them and kept them involved in sport in the first place, this will set backs in recovery could hit motivation further.

Frustration – This frustration is most common in long term injuries and is likely to come as a result of the rehabilitation process that follows the injury. It could either be frustration at having to do it or frustration at the lack of progress. Lack of progress may be due to the process taking longer than anticipated or simply from the athlete’s impatience and eagerness to get back into playing their sport again.

Also, setting unrealistic targets for the athlete to meet is likely to frustrate them when they fail to meet the target. Depression When injured, some athletes may show signs of depression, such as decreased energy levels, constant sadness and withdrawal from social contact. This may be because, if they were part of a team based sport such as football, rugby or basketball they know all training is done together as a team, forming bonds and it has a rewarding social aspect.

If an athlete is injured, depending on the severity of the injury, they are often made to train separately, usually at different times to their teammates. This removes the social aspect from their sport. Athletes may feel they’re missing out on events that occur within training, such as any training developments.

Some athletes will psychologically respond different to some other athletes some athletes may respond to the reaction to receiving the injury they just had or the reaction to treating an injury now some athletes will show fear as a psychological response. Fear is a vital response to physical and emotional danger but it is far from life or death matters.

Returning athletes to competition after sport injury is a key role of athletic trainers and physical therapists.

Negative psychological responses to injury often result in a lack of commitment to their rehabilitation or if they are taking too long on their rehabilitation programme however recovery rates prompting those who work with injured athletes to look for additional strategies to improve the overall rehabilitation process. Psychological skills can be used during sport injury rehabilitation to motivate athletes to adhere to rehabilitation, to increase speed of recovery, to control anxiety levels, and to gain back their confidence. In addition, athletic trainers and physical therapists are in the best position to educate athletes on the use of psychological interventions to enhance the recovery process.

However, those who hold negative attitudes toward certain psychological skills are less likely to implement them during rehabilitation. Therefore, receiving formal training probably would increase positive attitudes toward the use of psychological skills and would strengthen the likelihood that they are used during rehabilitation. Overall, athletic trainers and physical therapists hold positive attitudes on the effectiveness of psychological skills to enhance the rehabilitation process.

Physiological Response:

Physiological response is a bodily response such as, swelling this does not affect an athlete mentally. It is an instinctive reaction to an injury, in this situation would be a sport related injury. However psychological response mean it is a mental response to an injury, meaning different variables will influence things such as injury duration and recover. This shows in an athlete’s emotions which could be known as, anger, depression motivation and frustration. Sports injuries are generally unavoidable but recent developments have been put into place to prevent sports injuries within reason, athletes have to deal with injuries regardless of the severity most of these injuries can happen at any time. In this section I am going to talk about the physiological responses to injury in sports, the types of responses of injury I am going to talk about are:

• Primary responses to injury
• Inflammatory stage
• Bleeding
• The proliferative stage
• The maturation stage
• Scar tissue

Primary response and Inflammatory stage:

The primary responses to injury are quick straight forwards in that the you feel pain and there is inflammation however these stages will last between 1-5 days. This will then lead onto the second stage. The second stage is the inflammatory stage, this stages tend to last between three and five days. You will know that you have begun the inflammatory stage when you begin to feel pain, this is due to an increase of pressure in the damaged area from local nerve fibres. The second category which occurs in the inflammatory stage is the swelling at and around the damaged area, this is because the bleeding from the torn blood vessels and tissue fluids leaving the cells are surrounding the area, after the swelling has occurred, the individual will begin to notice that the area of injury has either increased in redness or discolouration has occurred, this is due to the vasodilation of the undamaged blood vessels which are nearby to the damaged area. The fourth stage is when there is heat around the injury, this is caused by dilation and circulation of the blood vessels around the area of injury. Finally, the final stage is the loss of function, the loss of function will only occur is most of the stages stated before are present, the loss of function could include a range from a reduced loss of function of a total loss of function where the individual is unable to carry any weight on the injury.

Bleeding:

Many people do not like the sight of blood but bleeding is a major physiological response to all injuries as the red and white blood cells must surround the injured area for the whole healing process to even begin. However, the amount of bleeding determines the severity of the injury, for example the more bleeding that occurs, the more severe the injury is, the less bleeding that occurs, the less severity of the injury.

The proliferative stage:

The proliferative stage is also known as the healing stage and can last between two and five weeks, this is when new tissue is laid down at the injury and a new network of capillaries and lymphatics are developed to help improve the circulation and drainage. There is also a rapid production of fibroblasts at the injury site which develop in connective tissues and are responsible for repaid (Fibroblasts are the precursors to collagen).

The maturation stage:

The maturation stage is the final stage of which could last from three weeks up to a period of many months. In this stage damaged tissues gain strength and as a result of that there is an increase of structural organisation. 

Scar tissue:

Scar tissues form as part of the remodelling process and need to be mobilised to regain the full function of the tissue.

There are three stages of injury and they are:

• The actuate stage
• The sub-acute stage
• The chronic stage

The acute stage

The acute stage is the stage that will immediately follow up on the injury and it can normally last up to one week. This is because the stage that comes straight after the injury takes place, they symptoms will be most severe. Some of the characteristic of this stage include inflammation, often some sort of visible bruising or redness will appear around the area, the damage control will begin to happen and there will be pain present in the stage.

The sub stage

The sub stage can last up to several weeks and is the stage which is focused on healing and repairing. However, some of the characteristics of this stage are:

• An increase range in movement
• slow reduction of pain and inflammation and swelling.
• Injured and fragile tissue is present round the area of injury.

The chronic stage:

This stage can last from months to years after the injury, in some cases the patient may never heal completely and therefore remain in this stage. However, the patient will only enter this stage if their recovery is incomplete or delayed and this will happen about 6-7 weeks after the injury. However, some of the characteristics of this stage include:

• There may be pain present at the end of the range of movement.
• Total range of movement may be reducing
• Connective tissue may be shortened in the form of adhesion and fubrosis.

Assignment 4

In the game football the most common injury will either pull or Strain their hamstrings, when these football players pull their hamstring it is important for the referee or coach to go and check on them and using the SALTAPS method which has meaning for each letter and they are:

• S is to stop the game if the player goes down.
• A is to ask the player what happens how they are or to even ask them what type of injury has happened to them if they know.
• L is to look at signs if the player is hurt so by facial expression or even their body posture.
• T is to touch the injured site but you should touch it gently with care.
• A is to check if the player can move at all if he cannot move he needs to be taken off in a stretcher.
• P is for passive movement: if applies move the limb/join t to full extent and note or analyse the player’s reaction.
•  S is for Stand up if the player decides him think he can play on and decides to run the injury off you will need to keep a close on the player in case you think he is going to get injured even more.

However, you will know at times not too use some parts of the SALTAPS method because the player might not feel comfortable or he might not be able to do some of the methods you want him to do.

The coach should identify what hamstring the player has pulled or strained straight away they would know for a grade 1 hamstring would be the player would be able to walk but it might take him a while to walk of the pitch, for a grade 2 they would start limping instead of walking it off and you would notice that there would be a lot of swelling and pain around his hamstring and finally for a grade 3 hamstring strain is a severe injury which would involve a tear to half or all the muscles, from this the player would need to be taken off straight away, the player would be advised to use crutches to help him walk.

Know if one the players pull their Hamstring the first sign of symptoms is that they will either start to feel the hamstring and will not be able to run now as a first aid worker the first thing you would have to do is check if the player is okay and start asking him questions if his hamstring is okay and walk him off once you have walked him of and got him to lay back the advice given for a hamstring strain is to rest the leg so what it means by resting the leg is not to put weight on the leg sometimes if the pain on the person legs is really bad they are advised to be put on crutches, swelling will be noticeable straight away and bruising would appear within 24 hours.

You will need to put an ice pack on your leg to reduce the swelling and pain you would be advised to do it for 20-40 minutes for every three hours for a couple of the days. You will have to compress your leg so by using an elastic bandage around the leg to keep down the swelling on your leg, and when you’re laying down or sitting you will need to put a pillow on your leg.  You will also be advice by a doctor or physiotherapist to do some exercises but only the exercises they have recommended you too do.

In the game boxing there are many ways of the boxer could get injured/Hurt from the boxing game but the one I am going to talk about is concussion, a concussion is caused by the brain shaking inside your skull. This would cause a temporary loss of consciousness or functioning. In the sport boxing if the boxer had concussion it would be important for the referee too stop the boxing match straight away because they do not want the boxer to suffer from bleeding in the brain, if the boxer still has concussion the referee doesn’t want the opponent to keep hitting him in the head because the opponent can suffer from brain damage for example a couple of weeks ago there was a boxing match on between Chris Eubank Jnr and Nick Blackwell and Chris Eubank Jnr knocked out the Nick Blackwell however, the boxer had suffered from bleeding in the head and had to put in a coma because they wanted all the bleeding in the brain/skull to ease down so he could recover by doing nothing. But that is not the worse Chris Eubanks Jnr dad once knocked an opponent out and gave his opponent brain damage and turned him disabled, so in the game of boxing it is important for the referee to stop the boxing match early at times to protect the other opponents from suffering from any of these injuries or even worse.

The signs and symptoms for a concussion in boxing is that they start to move around slowly and you can tell by their movements around the ring. This should defiantly indicate the referee to stop the game if the boxer opponents are moving around the ring really badly however it isn’t always easy to spot when the boxer has concussion there are other signs and symptoms and they are:

• Brief loss of consciousness after the injury
• Memory problems
• Double vision or blurred vision
• Headache
• Nausea or Vomiting
• Slowed reaction to stimuli
• Sensitive to light or noise

As a coach you should be able to advice your boxer on how to improve his ability while in the boxing game or even prevent injuries, however as a coach you should be able to advice your boxer to stop doing certain punches so it will not hurt or give their opponents a serious injury.  An example I will use for this is in the boxing match when Chris Eubank knocked out Nick Blackwell his coach and Dad kept telling him to avoid hitting him in the head and go for body shots but he decided to ignore and hit him in the head which eventually knocked him out and gave him bleeding in the head then had to be put in coma straight away.

After the person has been diagnosed with concussion the correct treatment you would have to do would be a couple of thing which I am about to list:

• You should apply a cold compress to the injury to reduce swelling.
• Take paracetamol to control the pain
• Get plenty of rest and avoid stressful situations where possible.
• Avoid drinking any alcohol or taking recreational drugs.

Once the person has suffered concussion you need to keep talking to him and make sure he mustn’t fall asleep because if he falls asleep the doctors won’t be able to tell if he is still suffering from concussion so they advise them to not fall asleep for more than 4 hours. Once a boxer has suffered concussion they shouldn’t play any sport (Boxing) for at least three weeks unless if they have permission from a doctor then they can start playing it.

In the game rugby you could dislocated your shoulder by getting tackled and getting dropped on the floor, this will move the joint out of position this would dislocate the shoulder. You can tell the rugby player has dislocated his shoulder by looking at his shoulder a bone will be sticking out and he will not be able to move his arm or shoulder properly, there are many more sign and symptoms for dislocated shoulder which are:

• Swelling or bruising
• Intense Pain
• Inability to move the joint
• Tenderness of the shoulder and collarbone

The rugby player would be taken off straight away and taken to the hospital where they would have to pop it back in place once they have done that you would have been told to wear a sling to prevent the injury happening so you wouldn’t put so much pressure for it to pop back out, you would be advice to ice your shoulder to reduce the pain you’re feeling you would have to do that for 20-30minute every three to four hours, for 2 to 3 days, you would be advised to take pain killers which would also help ease down the pain you’re feeling. You would have been told to go to the physiotherapy to do some exercises so it will help you get ready for whatever sport you play however you can only do the exercises you have been recommended to do by the doctor.

However, you cannot prevent dislocating your shoulder because it is classed as and Extrinsic factor you cannot do anything to prevent dislocating your shoulder as you can’t stop someone tackling you and you dislocating your shoulder.

A dislocated shoulder takes quite a long time for the rugby player to recover it normally takes between 6-8 weeks for his shoulder to be in full capability for him to move his arm forward and backwards and sideways, once he returns to his sport it could take him a while till he returns to full form.

Once they have fully recovered from their injury they would have to do a couple of drills to get their momentum back from their game this is to get them to get their shoulder used to the movements and get them feeling comfortable before the rugby game starts.

In the game tennis you’re most likely to have an injury to be involved with your arm and leg but I am going to be talking about a tennis player injuring his ankle with a sprained ankle.  A sprained ankle is being to the tough bands of tissue which is known as the ligaments that surround and connect the bones of the leg to the foot. Most sprained ankles happen when the person accidentally twist or turns his/her ankle in an awkward way, this can stretch or tear the ligaments that hold your ankle bones and joints together. The signs and symptoms for a sprained ankle would be:

• Swelling
• Tenderness
• Bruising
• Pain
• Inability to put weight on the affected ankle
• Skin discoloration
• Stiffness.

You will have to go to the hospital after this injury has happened and the doctor would have to do a couple of exercise to figure out which ligaments has either been damaged or torn, during the exercise the doctor may move your ankle joint in different ways to check your how far you can twist your ankle around.

Treating your sprained ankle properly may prevent chronic pain and instability, you would have to follow the RICE procedure to help you treat your sprained ankle properly. The procedure for sprained ankle is:

• Rest your ankle by not walking on it. Use crutches if necessary if you want to walk to places.
• Ice it to keep down the swelling. Don’t put ice directly on the skin, it would be advisable to use a thin piece of cloth such as a pillow case between the ice bag and skin.
• Compression can help control swelling as well as immobilize and support your injury.
• Elevate the foot by reclining and propping it up and above the waist or heart as needed.

Treating a sprained ankle is important to promote recovery and to prevent further discomfort. Your doctor may provide you with some tips and items that you can use to care for the sprain while you recover. The recovery time for a sprained ankle is you can start walking after a week or two then you may be able to use your ankle after 6 – 8 weeks and you’ll probably be able to return to sporting activities after eight to 12 weeks, however as soon as the person returns to his full fitness he might struggle as he will be worried to sprain his ankle again so he will need time to return to his full momentum so he could start performing like he was.

Assignment 5

The first injury I am going to talk about is a grade 2 hamstring tear and the second injury I am going to talk about is a dislocated shoulder.

Hamstring injury can normally be a strain or a tear to one or more of the three muscles right at the back of your thigh. Hamstring strains and tear are one of the common and painful sports injury that occur to people. I am going to be talking about a hamstring grade 2 tear.

Hamstring injuries are often cause by explosive movements when running, once you have teared your hamstring you will feel a pain in the back of your thigh when you try to extend your leg or you will feel tenderness, swelling and especially bruising the affected area.

Now as a first aider if I got to the scene I would check the area if for potential danger to the client and myself and would ask to stop the game. I would ask if the player/person was okay and ask him what he thinks what happened to him to make sure he is okay because he is still responding to me.

If the person has teared his hamstring the healing process for that would take a will it could take up to 12 weeks for his injury to recover or for him to start recovering well from his grade 2 Hamstring tear. The early treatment for a grade 2 hamstring tear would be too apply cold packs to your hamstring from about 15-20 minutes every three hours during the day, we would advise not to put the ice pack directly to your skin wrap a cloth round the cold pack to help it.

The next thing you would have to do for recovery would be compression a compressor bandage to the thigh to limit any swelling and any movement that could cause any further damage to your hamstring. You could use a simple elastic bandage or elasticated tubular bandage. You should always keep your leg raised and supported on a pillow as much as possible to help reduce any swelling you’re suffering from, keep your leg as still as you possibly can and avoid and physical activity, if you need to move around you would be advised to use crutches.

After you have rested after a couple of weeks you would start having your leg back and then you would be advised to do gentle exercise and stretches, however returning to do exercise too quickly could make your injury worse but avoiding exercise for too long can cause your hamstring muscle to shrink and scar tissue to form around the tear.

After a couple of weeks, you would be told to go a therapist and the therapist would apply sorts of massage techniques on your hamstring he would then advise you on a full program which would include stretching, strengthening and functional exercises.

The strengthening and stretching exercises for a hamstring tear would be:

• Hamstring Flexion – you would have to face down and begin by trying to bring your heel to your bottom against resistance of your therapist.
• High step ups- step onto a high step you would be advised to start at a position hip at 90 degrees on the step.
• Sitting hamstring stretch – sit on a chair and extend your leg until you feel a gentle stretch in your hamstrings.

There would be psychological considerations because the athlete might be The athlete may not feel motivated to do the sport because he might of been waiting for a long to time to heal or recover from his injury, some of the athletes may suffer from depression because he will be constantly having mood swings he may be sad and angry at himself or even someone else for causing this injury to happen to him.

Some of the athlete may try to return to their sport as quickly as possible because they want to play their sports as quick as possible this is bad, if they have not return to full fitness and they are trying to participate in the sport there is a big potential of making his injury worse that he suffering.

Early stage: rehabilitation is gentle exercise allowing for the damaged tissue to heal. This stage is often rushed and will result in poor quality healing and will be prone to re-injury.

Mid stage: rehabilitation involves progressively loading the muscles/tendons/bones or ligaments to develop tensile strength producing a healed tissue that will be able to withstand the stresses and strains of everyday life and exercise.

Late: -the final stage (late) of rehabilitation is where the tissue adapts and is stressed using functional exercises and drills to ensure the body is ready to return to play.

Rehabilitation exercises should begin as soon as possible (after the initial inflammatory phase – 72 hours) and should ‘usually’ be done been pain free with a few rare exceptions. Be careful with the phrase “no pain, no gain” as in most cases this is not the case. Pain is the body’s response telling you to stop or slow down and if ignored, healing will be impaired.

There are a few exceptions to this, such as the tendinopathy protocols used to rehabilitate Achilles and patella tendon injuries. A medical professional’s advice should be sought before embarking on such a regime as more harm can be done than good if carried out incorrectly. It is also important that the athlete understands the reasons for following a particular treatment regime or exercise program. For a rehab program to be successful the following tips are important:

• Begin as soon as possible, once the initial inflammation phase has passed (usually 72 hours post injury).
• Understand why and how you are doing the exercises or treatment.
• Follow a precise but individualized exercise program to follow.
• Make the most of the available facilities.

Now the second injury I am going to talk about is dislocated shoulder by the athlete, you can dislocate your shoulder by a fall or a blow of causes the top of your arm bone to pop out of the shoulder socket. However, unlike the joints in your body the shoulder joint is very flexible you can almost move it any direction, however there is a high chance of your shoulder slipping out of the joint.

Once you have disc located your shoulder and popped it back in place you it normally takes 6-8 weeks for you to have full range movement of your arm, however you would have to go the physiotherapist for a couple of weeks helping you have better movement and repair the damaged tissues and nerves that were destroyed. You might have dislocated your shoulder by falling onto your shoulder, especially on a hard surface, being hit in the shoulder or trying to break a fall with your hand.

The symptoms of a dislocated shoulder are:

• Pain in the shoulder and upper arm that hurts more when you move the area
• Deformation of the shoulder a bump in the front or back of your shoulder, depending on how the bone has been dislocated
• The symptoms of a separated shoulder are:
• Intense pain as soon as the injury occurs
• Tenderness of the shoulder and collarbone
• Swelling
• Bruising
• Deformed shoulder

After the shoulder bone is repositioned you can use conservative treatment to reduce pain and swelling. To treat the injury, you should:

• Ice your shoulder to reduce pain and swelling. Do it for 20-30 minutes every three to four hours for 2 to 3 days or longer.
• Use a sling or should immobilizer to prevent further injury until you get a medical treatment, then follow the doctor’s advice about whether or not to use a sing
• You should practice stretching and strengthening exercises if your doctor recommends them.

The symptoms of a separated shoulder are:

• Intense pain as soon as the injury occurs
• Tenderness of the shoulder and collarbone
• Swelling
• Bruising
• Deformed shoulder

After the shoulder bone is repositioned you can use conservative treatment to reduce pain and swelling. To treat the injury, you should:

• Ice your shoulder to reduce pain and swelling. Do it for 20-30 minutes every three to four hours for 2 to 3 days or longer.
• Use a sling or should immobilizer to prevent further injury until you get a medical treatment, then follow the doctor’s advice about whether or not to use a sing
• You should practice stretching and strengthening exercises if your doctor recommends them.

Rehabilitation programme for Dislocated Shoulder:

Once your shoulder has been popped back into to place the first thing you will have to do is wear a polishing this will be done because it will keep your shoulder comfortable while it is trying to heal, you should wear your polishing for 2-3 weeks’ maximum however if you have broken your shoulder then you should wear it for at least 6 weeks.

Throughout the 2-3 weeks you may suffer from pain so your doctor may give you some prescription to take or you could take some painkillers like paracetamol, you could also put an ice bag on the sore area to help you from suffering pain there.

You will be requested to go and see a physiotherapist after 2-3 three weeks once you have been there the physiotherapist will make you do some gentle movements out of your sling to help you reduce stiffness and relieve some of the pain. It is important for you to avoid holding your arm up at a 90-degree angle especially if force is being applied.

The first couple of exercises your physiotherapist could tell you to do is an isometric shoulder exercise, isometric means without movement also known as static contraction, these are exercises where the muscles are being worked without moving the joint and are often quite useful if the joint itself is still healing.

1. The first exercise is isometric extension this is standing with your back against a wall with your arms by your side. While keeping your elbows and wrist straight, push back into the wall and hold for 5 seconds you could push it to 10 seconds long if you are finding this to easy you should repeat this roughly 5 times.
2. The second exercise is external rotation- stand facing a door frame keep the elbow bent to 90 degrees and place the back of the hand against the frame, push against the frame of the door and hold for 5 seconds again if you are finding this to easy you could hold it for five seconds however do this exercise at least 5 times.

The physiotherapist may make you do some internal rotation this will be the most important exercise as it strengthens the muscles which will help you prevent an anterior shoulder dislocation. However, in the early stages it is important to keep the shoulder joint in the inner range of motion.

1. The first external rotation exercise is called abduction this is where you stand on one end of the band and hold the other end keeping the elbow straight, pull your arm out to the side so that the hand ends up level with your shoulder.
2. The second exercise is called flexion stand on the band holding the other end in the hand of your injured and Keeping the elbow straight, pull your hand straight up in front of you to about shoulder height. Once you are comfortable with the exercises above the resistance band can be replaced with weights to progress the strengthening exercises.

Rehabilitation programme for grade 2 Hamstring tear

 To begin your rehabilitation programme, you would start with hamstring stretches this would be a very gentle static stretches initially moving onto more dynamic sport specific stretches as the injury heals different stretches will target the muscle in different ways depending on exactly where the muscle tear is, some hamstring strains are nearer the knee and others may be higher up in the muscles. Hamstring muscle strengthening is thought of in terms of gradually increasing the load on the muscle. Strengthening exercises should always be done pain free. If it hurts, then it isn’t helping. In the early stages of hamstring rehabilitation basic static exercises are done often using a therapist or partner to provide resistance.

Later in the rehab program timed shuttle runs and sprints like professional footballer would be expected to be able to do are included. It is important to progress this far before returning to competitive matches or re-injury is likely.

The first couple of exercises you could do for you hamstring strain is to obviously rest for a while so for this you could do the rice method which is, rest, ice, compression and elevation. This is aimed at reducing the bleeding and damage within the muscle tissue. You could start off with these following exercises/stretches when you start to heal from your hamstring strain:

1. Gentle Hamstring stretching can begin, sitting on a Gym Mat and slowly bending forward, sliding the hands down the thighs. The patient should stop when the tension of a stretch in the Hamstring begins to be felt – the position should then be held for thirty seconds and they should do this at least 3 times.
2. The patient starts by sitting on the gym mat and sliding the heel up to the bottom. They should do this 20 times and 3 times each day. If this can be done without pain, progress to the next position can be made.
3. The patient lies on their front and brings the heel up to the bottom they should do this 20 times and 3 times each day. If this can be done without pain, progress to the next position can be made.
4. 5 minutes at first, then build up in 5 minute increments. Once the patient can do 15 minutes they should build up to half pace running. Squats can begin – repetitions x 20, 3 times daily. Hamstring curls using a resistance weight machine can also begin. Everything should be pain-free.