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Unit 15. Assignment 1. Signs & symptoms of sports injuries and the physiological and psychological responses to injury and rehabilitation.
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This assignment was marked and IV'd at a distinction level.
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Unit 15. Assignment 1. Signs & symptoms of sports injuries and the physiological and psychologicalresponses to injury and rehabilitation
(Blogspot 2022)
I am currently undertaking a work placement at Fitworxs physiotherapy clinic in Kingston. The manager
of the clinic is an experienced sports therapist and works with many local people with sports-related
injuries. I am shadowing their work to gain a better insight into a variety of sports injuries and how the
body responds physically and psychologically to those injuries. I will also review the subsequent
rehabilitation processes.
The 5 acute injuries that this report will focus on are: transverse fracture, meniscal tear, dislocation,
acute compartment syndrome, and osteochondral damage. The 5 overuse injuries that this report will
focus on are: stress fracture, apophysitis, synovitis, osteoarthritis, and chondropathy.
Acute & Overuse Injuries:
Acute injuries occur suddenly, such as when someone trips, gets struck, or bends a joint, but chronic
injuries typically arise from overusing a particular body part and manifest progressively over time.
Sprains and dislocations are examples of acute injuries, whereas stress fractures and shin splints are
examples of chronic injuries (Garrick 2017).
Throughout this report, each injury will look at signs and symptoms of injuries, as well as the
physiological and psychological impacts and response to injuries. A person's sentiments or sensations
are considered symptoms, whereas observable traits are signs (Medically, What’s the Difference
Between Signs and Symptoms? n.d.). Psychological impacts are how injuries impact on your overall
mental and emotional wellbeing and some common psychological impacts to injury includes poor self-
esteem, anxiety, and sadness (Smith 1996). Psychological responses are emotional responses from
injuries and some common responses include sadness, loneliness, annoyance, lack of motivation, rage,
and frustration, as well as changes in eating and sleep patterns, as well as disengagement (Putukian
2022). Physiological impacts are what or how the body feels after injury and they often include pain,
numbness, damaged peripheral nerves, damaged nerve roots and weakness (Physical impacts n.d.).
Physiological responses are the body's automatic reactions to a stimulus, in this case injuries, and some
,common responses include blood vessel fluid leaking into the surrounding tissue causing redness,
swelling, and warmth—the revealing indications of acute inflammation and damage. Additionally,
nearby nerve cells work to communicate pain to the brain and spinal cord (Stages of Healing Process-
What Happens When You Injure Yourself 2017).
Transverse fracture:
(Transverse Fracture: Symptoms, Causes & Treatment n.d.)
Transverse fractures are a type of bone fracture that occurs when a bone is broken perpendicular to its
length. On an X-ray, the fracture will look like a straight line running in the opposite direction of the
bone. They can occur in any bone in the body, but typically affect longer bones after trauma like a fall or
accident (Transverse Fracture: Symptoms, Causes & Treatment n.d.). Long bones in the body are
typically affected by transverse fractures. The femur, tibia, fibula, humerus, radius, ulna, and clavicle are
the most common long bones. Pain, tenderness, and the inability to move a section of your body as
normally as you can are all symptoms of a transverse fracture. Signs include swelling, inflammation, or
discolouration, and/or a lump or malformation that is not typically present on your body (Transverse
Fracture: Symptoms, Causes & Treatment n.d.).
One of the most common types of fractures, particularly in long bones, are transverse fractures
(Transverse Fracture: Symptoms, Causes & Treatment n.d.). For example, in MMA 4 out of 15 fractures
and dislocations that occur are transverse fractures of the mid-shaft of the ulna, making it the most
common in MMA fractures and dislocations (Rahmani, Joyce & McCarthy 2017). This would occur
because of the impact forces from blocking hard kicks with the forearms and with the tibia bone having
much greater bone density compared to the ulna during a transverse collision, it is almost impossible for
the tibia bone to break over the ulna, hence why in this type of collision, it is common for transverse
fractures to occur in the ulna.
, Different kinetics would be involved in the different severities of transverse fractures. For instance, if a
person is struck from the side by a van as they cross the street, their femur could sustain a compound
transverse fracture. The different kinetics involved in this example include gravity, ground reaction
forces, impact of objects, compression forces, ligament forces and musculotendinous forces. Gravity is
involved because it acts on everyone and is the force that is keeping the pedestrian and van on the
ground so they will always experience 9.81 N of force. Ground reaction forces are involved because they
are keeping the pedestrian and van from falling through the ground, hence why the femur is in place up
until the collision and there will be 9.81 N of force to equal gravity’s force. The impact on objects is
remarkably high in this incident hence why the transverse fracture is a compound fracture. The van is
travelling at 30 mph (13.4 m/s) with a mass of 2000 kg and the pedestrian’s mass is 80 kg and is walking
at a velocity of 1.8 m/s meaning that the change in velocity from the van’s impact is massive, resulting in
large acceleration of the femur, placing lots of force on the femur bone. When calculated, the
momentum going through the femur would be 26,800 kgm/s (2000kg x 13.4 m/s) as the pedestrian’s
velocity is occurring in a perpendicular direction to the van meaning that the collision is not head-to-
head because the pedestrian is being hit from side on. As force equals change in momentum over time,
the force going the femur can be calculated. As the van’s momentum is 26,800 kgm/s and the
pedestrian’s momentum is 144 kgm/s (80 kg x 1.8 m/s) and the collision occurred in 0.096 seconds,
meaning that the force going through the femur would be 277,666.7 N (26,800 kgm/s - 144 kgm/s
/0.096 s). Compression forces from gravity would be 9.81 N/kg so it is not excessively big. As the
pedestrian has had no previous knee or hip injuries, the ligament and musculotendinous forces keeping
their knee in place is good, meaning it is more resistant to movement, making a femur fracture less
likely, but despite the ligament and musculotendinous forces being high, the impact force of objects is
so large that it causes the femur to fracture as it only takes 4,000 N of compressive force to break a
femur (Bowman 2019), which means this number would be smaller if the force is horizontal like the
collision. Assuming that the force of the collision is evenly distributed throughout the body, the femur
makes up 0.36% of the pedestrian's body mass [0.290 kg (How much does a human femur weigh?,
2022)/80 kg], meaning that the rough force through the femur is 1006.5 N (0.0036 x 277,666.7 N).
Three major phases make up the pathophysiological sequence of events that take place after a fracture
for bone repair (Bahney et al. 2019; Bigham ‐Sadegh & Oryan 2015; Kostenuik & Mirza 2017) which are
the inflammatory phase, reparative phase, and remodelling phase. During phase 1 otherwise known as
the inflammatory phase, the area between the ends of the fracture is filled with blood, creating a
haematoma immediately after the fracture occurs. This stops further bleeding and gives the influx of
inflammatory cells structural and metabolic support. Cytokines (small proteins that affect growth of
blood cells and other cells that aid inflammation responses), growth factors (substance able to stimulate
cellular differentiation, wound healing, and cellular proliferation), and prostaglandins (group of lipids
made at sites of tissue damage to heal injury) are all released because of the inflammatory response and
are crucial for healing. Fibrovascular tissue (composed of fibrous connective tissue and abundant
vascular supply) receive fibroblasts (produce collagen proteins that support the preservation of tissues'
structure), chondroblasts (cartilage forming cells), and capillary ingrowth (to help form a scar). This
creates a matrix for the development of primary callus and bone. Phase 1 lasts about a week and results
in the formation of a primary, non-mineralized callus (Bigham ‐Sadegh & Oryan 2015). During phase 2
otherwise known as the reparative phase which lasts a few weeks, stimulations of the osteoprogenitor
cells (stem cells in bones for bone repair and growth) occur which converts primary callus into a bone
callus. The woven bone that is created by these cells stabilises the fracture site (Bigham ‐Sadegh & Oryan
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