A.P1,A.P2,A.M1, A.P3,A.M2, A.

D1 ACHIEVED

Unit 25: Sports

Injuries and
Management

Assignment 1: Explore
different types and
causes of common
sporting injuries and
how they affect sports
Performers
Types of sporting injuries

Hard tissue injuries

As a direct result of force being applied to the body, hard tissue injuries involve damage to the
bones and result in fractures, dislocations, and other breakages. When these kinds of injuries
happen, quick medical attention is usually needed. Loss of teeth, fractures, and dislocations are
examples of hard tissue injuries. Any harm to the skeletal system, in other words. The technical
term for a broken bone is a fracture, and there are several types of fractures with different levels
of complications. A dislocation is another common hard tissue injury. A joint can dislocate when
it is moved out of place. A.P1

Bones

Since hard tissue injuries involve direct force to the bones. Most hard tissue injuries affect the
bones. The most common hard tissue injury that directly impacts the bones is a fracture. There
are two primary groups of fractures:

1. simple fractures (closed fractures)

The bone is completely broken in this form of fracture, although it is still there beneath the skin.

2. Fractures that are compound (open)

When a bone breaks and protrudes through the skin, it is said to have a compound fracture.
These are only general categories; there are other additional fracture kinds, such as greenstick,
hairline, complex, and depressed. A.P1

Causes of fractures
Traumatic
When a bone is subjected to severe or excessive force, a traumatic fracture occurs. Examples
include fractures brought on by violent overextension, such as a twisting injury that might
fracture an ankle, and those brought on by impacts from falls or car accidents.
Traumatic fractures can be displaced or nondisplaced. A.P1

Nondisplaced fractures

They occur when a bone breaks or cracks while retaining its normal alignment. Nondisplaced
fractures usually just need to be treated with bracing, boots, or casting.A.P1
Displaced fractures

Any fracture in which two or more shattered bone fragments are not properly aligned is referred
to as a displaced fracture. Comminuted fractures are fractures in which the bone breaks into
several pieces, and open fractures, also known as compound fractures are fractures in which the
fracture occurs together with an open skin wound, are examples of severe cases. A doctor must
fix displaced fractures by either a closed reduction or an open reduction. A closed reduction
avoids surgery by manually moving the bone back into position. In an open reduction, incisions
are made and the bone is realigned using medical equipment. After that, the afflicted bone is
typically secured in place with the use of pins, screws, wires, or other devices.A.P1

The most typical injury while running is a repetitive strain injury. Running is repetitious and
involves using the same foot strike pattern over long distances. Displaced fractures can be caused
by repetitive strain, this can put a lot of pressure on the tibia causing it to split at a point and
protrude through the skin causing a displaced fracture. A.P1

Stress fractures

When a particular bone is continually subjected to a mild to moderate amount of force over time,
a stress fracture can result. A stress fracture occurs when a bone breaks, however, it rarely results
in displacement (misalignment).

In marathon runners, stress fractures can occur for a number of reasons. Muscle fatigue renders
muscles incapable of absorbing additional shock, which leads to stress fractures. The weary
muscle eventually transmits the excess tension to the bone, resulting in a small crack. The hip,
leg, and foot bones are where stress fractures in runners most frequently occur, but the majority
more than 80% occur in the legs. The tibia is where stress fractures from running most frequently
occur. Although considerably less common, stress fractures can also happen in the pelvis of
runners. A.P1
Physiological responses to fractures

Inflammation phase of a fracture (duration: hours to days): Blood vessels are torn as a result of
fractured bones, and a blood clot or haematoma forms as a result. This mostly occurs with open
fractures where the bone is poking through the skin and torn several blood vessels and tissue.
Cytokines (Signalling proteins called cytokines that assist your body's immune system manage
inflammation), growth factors, and prostaglandins (hormone-like chemicals that have an impact
on several biological processes, such as pain, swelling, and contractions) are all released as a
result of the inflammatory response and are crucial for healing. A matrix for the development of
primary callus tissue and organised bone is created when fibrovascular tissue enters the fracture
haematoma.A.P2

The phase of repair (duration: days to weeks): From the fracture haematoma, a thick mass of
callus develops around the ends of the bones. Within 7–10 days following injury, new bone can
be seen on X-rays thanks to the recruitment of bone-forming cells from a variety of sources.
Over the course of several weeks, the soft callus is organised and transformed into a hard callus.
If the fracture is not well supported, a soft callus, which is plastic, can easily distort or expand
and contract. Hard callus represents the stage of "clinical union," in which the fracture is no
longer sensitive to touch or movement while being weaker than normal bone and better equipped
to tolerate external forces. A.P2/A.M1

Remodelling phase (duration: months to years): The final stage, which could go on for years, is
the longest. Remodelling is the process in which the callus and healed fracture react to activity,
outside stimuli, functional needs, and growth. The fracture site is smoothed and sculpted until it
appears significantly more normal on an x-ray, and any extra bone (external callus) is removed.
In accordance with the aforementioned remodelling rules, epiphyses will gradually realign and
any residual tilting may be repaired. A.P2/A.M1

Nutritional changes
Fractures are injuries that affect the bones, when a runner suffers from a fracture certain changes
to their nutrition and food consumption have to occur to speed up the healing process. Nutrition
can also strengthen the bones throughout the healing process, this ensures that by the time the
athlete is back in training, they will be more than ready to participate. Inadequate consumption of
several vitamins, especially A and D, as well as other minerals, like calcium, may have an impact
on bone health or even the speed and extent of bone healing in the event of a fracture. A.P3
To speed up the healing process an athlete needs to increase the intake of these crucial vitamins
and minerals.
Calcium increases bone density making it harder for injuries such as this from occurring.
Consuming calcium during the healing process will help the bones heal faster and develop higher
bone density. Once the bones are healed they will be harder to fracture. Apart from calcium,
consuming vitamins A and D in higher amounts is also advised. When the new threads of bone
cells start to grow after a fracture vitamin A is crucial in the rebuilding of these cells. Vitamin A
is a fat-soluble vitamin that aids heavily in the building of stronger and healthier bones. Vitamin
A has an impact on osteoblasts, which create bone. A.P3To aid in healing your fracture, this
vitamin should be consumed regularly. It aids in calcium absorption, utilisation, and
mineralisation of bones in your blood. Spending a small period of time outside each day can be
beneficial since sunlight provides vitamin D to your skin; for someone with fair skin, 15 minutes
may be plenty. Only a few foods, including egg yolks and fatty fish, naturally contain vitamin D;
however, it is often added by manufacturers to other foods, like milk or orange juice. Protein is
also important in the healing process. When recovering protein should be an essential addition to
the diet. It makes up around half of the structure of your bones. Your body needs it to mend a
fracture by creating new bone. It also aids in the absorption and utilisation of calcium, another
essential vitamin for strong bones.A.P3/A.M2

Joints

Bursitis

A knee bursa, a little sac filled with fluid that is located close to your knee joint, can become
inflamed. Between your bones and the tendons, muscles, and skin close to your joints, bursae
lessen friction and cushion pressure points.

Knee bursitis can affect any of your knee's bursa, although it most frequently affects the ones
around your kneecap or on the inside of your knee, below the joint.
Knee bursitis can cause immense pain and limit mobility. A.P1

Causes of bursitis at the knee

Knee bursitis may result from:

● The pressure is applied repeatedly and continuously, especially while knelt on a hard
surface.
● Excessive use or demanding activities.
● A forceful blow to the knee.
● Bursal bacterial infection.

In runners the most common causes are excessive activities, this can be adding more to their
training regime or pushing their training to last for longer periods of time. This type of strenuous
activity can cause bursitis in the knee. Another cause for runners might be a hard blow to the
knee or knees. This can be during competition or training too, a runner can fall and land on the
knees causing the knees to take a lot of the impact. The pes anserine bursa, which is located on
the inside of the knee below the joint, is the most common area that becomes painful and swollen
in runners.A.P1

Mechanisms of injury

For a runner, bursitis can be caused by several factors. Running requires repetitive knee
movements, which can put too much pressure and friction on the bursa, inflaming it. This is
especially true if the runner abruptly increases the amount, frequency, or intensity of their
training, which can result in overuse problems. Overtraining can cause the viscosity of the bursa
to increase resulting in additional friction. Apart from training or competing too much, runners
with muscle imbalances such as tight hamstrings and weak quadriceps can cause additional stress
to the bursa causing inflammation to happen.
Another contributing factor is poor running form or technique, which can put stress on the bursa
and raise the risk of knee bursitis. Additionally, wearing the wrong shoes can aggravate knee
bursitis. The knee joint and bursa can be put under stress by shoes that don't provide enough
cushioning or support, are worn out, or don't fit properly. A.P2 Mechanisms of injury

Physiological responses to the injury

Signs and symptoms

Depending on which bursa is impacted and what is causing the inflammation, there are different
knee bursitis signs and symptoms. When you apply pressure to the affected area of your knee, it
may generally feel warm, sensitive, and swollen. In addition, pain can occur even while you are
at rest or when you move. Sometimes the bursa can get enlarged and cause immense amounts of
pain, along with swelling it can limit your range of motion and mobility. A.P2

The symptoms of a knee injury may manifest quickly. However, most occurrences of knee
bursitis are caused by friction and irritation of the bursa, which happens in vocations that demand
frequent kneeling on hard surfaces; as a result, symptoms typically appear gradually and might
get worse with time.A.P2

Inflammatory Responses to knee bursitis

In response to the injury there is increased blood flow to the site of injury, the affected area's
blood vessels widen, allowing more blood to flow to the area of inflammation. White blood cells
and cytokines are brought to the area by the increased blood flow, aiding in the fight against
infection and the removal of damaged tissue. Additionally, the increased blood flow causes an
accumulation of fluid in the injured area, which results in oedema. This swelling can aid in
immobilising the injured joint and preventing further damage. The release of inflammatory
mediators can result in pain and discomfort in the affected area as the body's immunological
response intensifies. Around the knee joint, this discomfort is typically experienced as a dull
ache or throbbing sensation. It may also feel warm or heated to the touch because of the
increased blood flow to the affected area. The skin around the afflicted bursa may occasionally
become red and swollen, displaying an ongoing inflammatory response.A.P2/A.M1
Physiological responses.

Whether your bursa is inflamed or infected will determine the course of treatment for knee
bursitis. The majority of knee bursitis cases that only feature inflammation can be handled at
home without the need for medical attention. Rest, ice, compression, and elevation are the four
components of the RICE treatment. This is a home remedy; if it does not relieve your knee's
discomfort and swelling within a week or two, consult an orthopedist for a diagnosis.
 ● Since prolonged pressure is one of the causes of bursa swelling, you can prevent further
inflammation by resting the knee.
● To avoid frostbite on your knee, apply ice for 15 to 20 minutes multiple times each day.
Make sure the ice pack is first wrapped in a towel.
● To offer support and minimise swelling, gently compress the knee.
● Elevation encourages appropriate blood flow away from the location of inflammation by
gravity, which reduces swelling. A.P2/A.M1

Nutritional changes

Consume fatty fish, whole grains, fruits, and veggies to help lower inflammation. Steer clear of
processed foods and those with lots of sugar or fat. The following supplements could be
beneficial. Supplements might not be suitable for everyone and could have negative side effects.
Omega-3 fatty acids, such as those found in flaxseed oil or fish oil. Although there is conflicting
research regarding whether fish oil reduces inflammation, it does appear to gradually lessen the
number of inflammatory chemicals your body produces. Omega-3 fatty acids may make bleeding
more likely. Ask your doctor before taking fish oil. Flavonoids and vitamin C work together to
repair connective tissue, including cartilage. Monounsaturated fat, which is anti-inflammatory, is
abundant in avocados. Additionally, they contain plenty of vitamin E, which has anti-
inflammatory properties. Lower risk of joint injury has been associated with diets rich in these
substancesA.P2

Soft tissue injuries

Sprains

Damage to the ligaments surrounding a joint is known as a sprain. Ligaments, which keep bones
together, are strong, flexible fibres. The joint will hurt and swell when a ligament is
overstretched or torn. A strain involves an injury to a muscle or to the band of tissue that
connects a muscle to a bone, whereas a sprain involves damage to the bands of tissue that hold
two bones together.
Sprains at the ankles occur when the foot turns inwards when you turn while running.
A.P1
Causes
A direct or indirect injury (trauma) that forces the joint out of alignment and overstretched it,
often tearing the supporting ligaments, resulting in a sprain. Examples of accidents that can result
in a sprain include:
● Rolling your ankle while moving in a new direction, jumping, or running.
● Tripping or slipping on a damp or uneven surface.
 ● Receiving a blow to the body, such as in contact sports may result in direct hits or
balance shifts and falls.
In a marathon runner, a sprain might happen at the ankle simply because the athlete has
overtrained and put a lot of pressure and stress on the ankles. This might happen when the runner
missteps and the ankle shifts inwards suddenly. The overtraining makes the ankle weak and any
slight mistake can cause the sprain.A.P1 Mechanisms of injury

Another cause may be the terrain the runner is training or competing in. Things such as rocks,
uneven terrain and holes in the ground can cause a sprain. The athlete can step on a rock and roll
his ankle or step into a small hole in the ground. Fatigue can also factor in a runner suffering
from a sprain.

Mechanisms of the injury

The pressures result in the ligaments stretching past their usual length when there is a severe
inward or outward rotation of the foot in relation to the ankle.A.P1 The ligaments could tear if
the force is too great.
When your foot is planted unevenly on the ground, you could lose balance. You might stumble
and lose your footing. Pain and swelling happen when the soft tissue structures of the ankle are
subjected to extreme force. You might even hear a pop. The degree of the sprain is determined
by the amount of force. Grade 1 injuries are minor sprains. Grade 2 is a moderate sprain. A
Grade 3 strain qualifies as serious.A.P2 Physiological response

Grade Physical signs Impairment Injury process Treatment

Grade 1 Light tenderness and Minimal Small tears on No casting or splinting is

swelling the collagen required.
fibres.
Mostly isometric exercises.

Exercises that involve the full

range of motion and
stretching.A.P2/A.M1

Grade 2 moderate swelling and Moderate Complete tears Air splint to immobilise.
discomfort. of some collagen
fibres in the Physical treatment includes
Reduction in range of ligament. strengthening and stretching
motion. activities.
A.P2/A.M1
The athlete is possibly
 unstable.

Grade 3 Significant pain and severe Complete Immobilisation

swelling. rapture of the
ligament. Physical therapy lasting
Instability longer than that for grade 2
sprains.
Surgery may be required to
reconstruct.A.P2/A.M1
Physiological response

Signs and symptoms of a sprain

Depending on the extent of the injury, signs and symptoms may differ. They may consist of:
● Pain.
● Swelling, which may be a sign of underlying inflammation in the soft tissue around the
joint or in the joint itself.
● Bruising.
● Particularly noticeable instability can be found in weight-bearing joints like the knee or
ankle.
● loss of joint mobility and functional abilities.A.P2

Inflammatory responses to a sprain.

Your body enters an inflammatory phase in the initial stages of the injury. What occurs at this
stage is as follows;
The symptoms of inflammation, including swelling, redness, heat, pain at rest, and loss of
function, tend to appear during the first 48 hours. Movement is uncomfortable during the range
of motion test, and the patient is unable to move the afflicted ankle to its normal range of motion
due to muscular guarding. The changed chemical state that irritates the nearby nerve is what
causes discomfort and restricted movement. Muscle guarding, which is the body's method of
immobilising a painful location, is an increase in tissue tension brought on by oedema or joint
effusion.A.P2
In most cases, this phase lasts 4 to 6 days, unless the injury is persistent.

Patients are frequently advised to immobilise the ankle joint for the first few days after the injury
until the pain and swelling go down. After tissue damage, the inflammation starts to subside with
appropriate care during the second to the fourth day, the clot starts to dissolve, and the affected
area starts to heal. The average duration of this is an extra 10 to 17 days (14 to 21 days after the
injury took place), although it can persist up to 6 weeks. An unpleasant and painful feeling fades
or goes away. This is part of the tissue response to the sprain. This final stage is to restore
function to its optimal level before the sprain, which has been reduced. This occurs four to six
weeks following the injury. If the discomfort and swelling have already subsided, you can move
on to strengthening exercises by adding resistance to the resistance band while exercising your
feet while seated for a prolonged period of time. In order to improve balance and prevent
recurrent ankle sprains, exercises to promote ankle stimulation and joint awareness are also
started at this time.A.P2

The length of time it takes to recover from a sprained ankle depends on the severity of the
damage. A small sprain might take two weeks to recover, whereas a serious sprain might take six
to twelve weeks.A.P2/A.M1 Well done.

Nutritional changes

A sprained ankle, for example, can result in a sports injury that is quite inflammatory. Omega-3
fatty acid-rich foods can aid in reducing this inflammation.

Foods like walnuts and chia seeds are the greatest place to start if you want to add omega-3 fatty
acids to your diet. Fish, which is naturally high in protein, has a significant quantity of omega-3
fatty acids. However, consuming an excessive amount of omega-3 fatty acids can have the
opposite impact. Therefore, make sure to eat meals that contain essential nutrients rather than
vitamin or powder supplements. Oils frequently contain omega-6 fats, which also reduce
inflammation. Cooking with canola oil, sunflower oil, corn oil, and other comparable products
can offer this advantage. Another popular method for reducing inflammation is coconut oil. A.P3

Zinc plays a critical role in your body's ability to mend damaged tissue, just like protein does.
Additionally, a deficiency in zinc intake, according to nutritionists and physical therapists, can
cause the healing process to be prolonged. Foods that are frequently found to be high in zinc
include meat, fish, shellfish, and whole grains. Other excellent options are nuts. Zinc
supplementation should be avoided, though. They are one of the best ways to consume a lot of
zinc, but they can also cause a copper deficit in your body. A.P2/A.M1 Psychological Changes,
Nutritional demande.

Tendonitis

Inflammation of the tendon, a flexible strip of tissue that connects muscle to bones, is known as
tendonitis. Tendonitis frequently results from repetitive motion causing an overuse injury in the
affected area. The elbow, hand, wrist, shoulder, hip, knee, ankle, and foot are among the
frequently impacted body parts. A marathon runner is most likely to experience hip tendonitis,
this is because that’s the area where most of the repetitive motion happens in runners. A.P1

Hip tendonitis, often referred to as hip flexor tendonitis or tendinitis of the hip, can occur as a
result of overuse injuries to the muscles that pull on the tendons that are linked to the hip bone.
The hip may experience irritation and inflammation as a result of this. Pain, slight swelling, and
tenderness are common symptoms of tendons that are inflamed or irritated close to the hip
joint.A.P1 Mechanisms of tendonitis.

Mechanisms of injury

Causes of hip tendonitis

The most common cause of hip pain is overuse. Hip tendons can become inflamed and injured
by tendonitis, which results from overusing your hip joints, which can also strain your hip
muscles. The repetitive motion while running is a large contributing factor to tendonitis.
Marathon runners are expected to constantly train in order to keep their stamina up and stay fit
for the next competition. The constant increase of intensity in the training regimes can cause a
runner to suffer tendonitis. Hip tendonitis can also be brought on by; Exercise advancement that
occurs too quickly without sufficient training, as well as repetitive stress from overuseA.P1

Hip flexor tendonitis develops as a result of constant straining and tugging on the rectus femoris
and iliopsoas muscles, which causes pain and inflammation. A clinical examination and the
detection of severe discomfort near the hip joint help the University Hospitals' highly skilled
sports medicine specialists identify tendonitis. To rule out more significant issues that could be
the source of the discomfort, imaging studies may also be done. Tendonitis is a chronic injury
that normally heals slowly, frequently taking weeks or months to fully recover from.A.P1

Physiological responses to the injury

Signs and symptoms
Hip tendonitis signs and symptoms include
● Front of the hip swelling, pain, and tenderness
● Activities that entail hip flexion make the pain greater
● Stiffness in the hip
● Reduction in range of motion
A.P2 Symptoms of injury
The most typical sign of hip tendonitis is pain that gradually worsens over time. Other symptoms
might include reduced pain during warm-up but intensified pain during exercise. Stiffness is
common but another symptom is stiffness after long periods of rest especially in the morning.
During a thorough physical examination, your general care physician, orthopedist, or sports
medicine physician can identify hip tendonitis. Your flexibility, joint stability, and range of
motion will all be evaluated. Your doctor will also talk about the training that caused the injury
and check for torn or ruptured tendons in the hip. To determine whether a major tear or a hip
fracture is the source of the discomfort, the doctor may occasionally request an X-ray or MRI.

Rest and anti-inflammatory medicine to lessen inflammation are early treatments for hip
tendonitis.A.P2/A.M1

Physical therapy
In the early stages of hip tendonitis, physical therapy aims to lessen discomfort and
inflammation. Massage, ultrasound, or electrical stimulation are all examples of physical
therapies that can be used to accelerate the healing process and limit further harm. Additionally,
your physical therapist will recommend exercises to strengthen and stretch the affected area as
well as to balance out any muscle imbalances.A.P2

Orthotics
can assist in enhancing patellar function and knee alignment.

Surgery
After all nonsurgical methods have been tried, surgery is a final resort. By reestablishing blood
flow to the wounded hip or quadricep, surgery promotes recovery. The tendon is restored once
the injured tissue has been removed. The majority of surgical patients will undergo arthroscopic
surgery, which is less intrusive and allows patients to leave the hospital on the same day.

Hip tendonitis can be treated with physical therapy for four to six weeks if surgery has not
already been performed. Physical therapy aims to enhance hip functionality while also reducing
pain and inflammation. Following surgery, physical rehabilitation is intensive and requires a full
team of professionals, including your orthopaedic surgeon. To create a treatment strategy for
your situation, the team will collaborate. As you advance, physical therapy will be more intense
to make sure you are fully recovered before returning to your regular activities.A.P2/A.M1

Nutritional changes

First and foremost, you must lower body-wide inflammation to speed up healing and prevent
injuries while also lessening the unpleasant symptoms of tendonitis. Here is a list of foods to
include in your diet as well as those to cut back on or completely cut out.

Antioxidants found in vegetables, especially dark leafy greens, help battle oxidative stress, one
of the main causes of inflammation. These nutrient-dense vegetables are also loaded with
minerals like magnesium and vitamins like A, C, D, and K. They are high in fibre, which can
help you feel fuller for longer and feed healthy bacteria in your digestive system. Vegetables
such as:
● Brussels sprouts
● broccoli
● spinach
● Kale
● cabbage
Try to fill at least half of your plate with veggies, whether they are fresh or cooked. You should
try to cut back on and eventually avoid pro-inflammatory foods that can aggravate the symptoms
of tendinitis;
Inflammation is prolonged by alcohol.
Caffeine has been shown to bind to calcium and cause bone resorption.
Too much salt might make potassium ineffective.
Sugar: impairs immunological response, hinders wound healing, and causes inflammation
Fried and processed foods are a great source of omega-6 fatty acids, which promote
inflammation.A.P3

Concussion
A bump, blow, or jolt to the head or a strike to the body that causes the head and brain to move
quickly back and forth results in a concussion, a type of traumatic brain injury (TBI). The brain
may twist or bounce as a result of the fast movement, causing chemical changes in the brain and
occasionally stretching and harming brain cells. Due to the fact that concussions are typically not
life-threatening, medical professionals may refer to them as "mild" brain injuries. However, a
concussion can have catastrophic consequences.A.P1

Causes of concussions

Concussions are most frequently caused by falls. If you participate in a contact sport, such as
football or soccer, concussions are also prevalent. The majority of people normally fully recover
from a concussion. In runners, concussions can be caused by trips and falls, if a runner trips and
falls down knocking their head on the ground they will suffer from a concussion. They can also
collide with each other, although it is not common, runners can collide dangerously due to
uneven terrain. Overtraining can also lead to concussions. This is because when a runner
overtrains and fatigues his body, during the competition they will suffer from poor judgement,
vision impairment and incoordination causing the runner to fall easily. Running may increase the
risk of concussions for people with pre-existing disorders that impair balance, coordination, or
cognitive function. These diseases can affect the integrity of the skull or brain, neurological
abnormalities, past head trauma, or other conditions.A.P1 Causes of concussions.

Signs and symptoms of a concussion

Concussion symptoms and indications can be subtle and may not appear right away. The
duration of symptoms can be days, weeks, or even longer.

Headache, memory loss (amnesia), and confusion are typical signs of a concussive traumatic
brain injury. The event that led to the concussion is typically forgotten as a result of the amnesia.
Physical concussion symptoms and indicators include:

● Headache
● ringing in the ears
● Nausea
● Vomiting
● fatigue or drowsiness
● hazy vision
Concussion symptoms can manifest both right away and days afterwards. A few examples
include:

● problems with memory and focus

● Irritability and other changes in personality
● sensitivity to noise and light
● disruptions in sleep
● issues with psychological adjustment and depression
● Sense of smell and taste issues
A.P1 Signs of a concussion.

Physiological responses to a concussion

One of the most common physiological responses to a concussion is the disruption of neural
activity when a runner suffers a blow to the head the brain chemicals quickly change and all
neural activity is disrupted.
After a concussion, the brain may undergo metabolic changes, such as adjustments to the way it
uses energy and a reduction in cerebral blood flow. These modifications may impact the brain
cells' access to nutrients and oxygen. The brain can release a number of neurotransmitters as a
result of concussions. Neurotransmitter imbalances, including those in glutamate and dopamine,
might affect brain function and aggravate symptoms. A protective barrier that controls the flow
of substances between the bloodstream and the brain is known as the blood-brain barrier. This
barrier may become less effective as a result of a concussion, potentially allowing dangerous
substances to enter the brain. Concussions can result in abnormal brain wave patterns, including
a drop in alpha waves and an increase in delta and theta waves, according to
electroencephalography (EEG) research. These changes could be a result of changes in brain
activity.A.P2/A.M1 Physiological response.
Microglia, which are immune cells, get activated and release proinflammatory substances after a
concussion. These substances include cytokines like tumour necrosis factor-alpha (TNF-alpha),
interleukin-1 (IL-1), and interleukin-6 (IL-6). These cytokines can increase inflammation and
assist in controlling the immune response. Blood flow to the damaged area of the brain increases
in response to injury. As a result of the inflammatory reaction, there is an increase in blood flow
to the brain, or cerebral hyperemia, which carries nutrition, oxygen, and immune cells to promote
healing. The blood-brain barrier, a safety barrier that controls the movement of chemicals from
the bloodstream to the brain, can be damaged by concussions. Increased permeability brought on
by the rupture of this barrier may make it simpler for immune cells and inflammatory chemicals
to enter the brain.A.P2/A.M1

The three stages of concussion recovery are:

● The acute period of symptoms

● Phase of recovery
● Recovered phase
Numerous variables and individual differences affect how long is spent in each phase.
The period from damage to the start of the symptomatic phase of recovery is known as the acute
symptomatic phase. This stage often lasts fewer than three days. You should visit the emergency
room if you encounter any of the following "Red Flag Symptoms" during this stage:

● Longer than one minute of unconsciousness

● Getting more confused or having trouble staying awake
● Recurring vomiting
● Seizure or jerking
● Acute or worsening headache
Near complete rest is crucial in the first one to two days after sustaining a concussion. Even
though symptoms may be extremely restrictive during the acute symptomatic phase, it is
advisable to gradually resume light thinking and physical activity after the first few days.

The recovery stage can be identified by:

● Reduction of symptoms
● The capacity to engage in more demanding mental and physical tasks without
experiencing worsening symptoms
● Gradual recovery from your injury

It is typical for symptoms to get worse at this stage with more thinking and activity. As you
progress through the recovery stage, your symptoms should gradually get better until you are
symptom-free at rest, then with mental activities and finally with physical activity.A.P2/A.M1
Although there are several significant elements that affect recovery, age seems to be particularly
significant. For people under the age of 18, a typical recovery period is 30 days; for those over
the age of 18, it is 14 days. Recovery treatment aims to prevent protracted recovery, but 10 to
30% of concussion sufferers may experience it. Concussion recovery is dynamic, requiring
ongoing monitoring and phase-specific care. Returning to training and sports is a significant
recovery milestone. Every one of these goals is attained progressively, progressing from
symptom-restricted activities to full involvement.A.P2/A.M1
Nutritional changes

Magnesium and zinc levels fall right away after a concussion. Magnesium and zinc are both vital
components that the brain uses to lower inflammation and enhance cognition after damage. In
order to lessen the consequences of a concussion, it may be beneficial to eat foods high in
antioxidants, magnesium, and zinc because these nutrients can help your brain heal after an
injury. A.P2
Here are more foods that can help heal your brain after a concussion;

A fruit high in flavonoids is cranberries. Like blueberries, they assist in fighting off free radicals
and reducing brain inflammation.

Try to eat fresh cranberries for the greatest nutritional benefits. Cranberry juice and jellied
cranberry sauce are high in sugar and lack numerous nutrients. This makes them less useful for
people who have suffered concussions. Broccoli is a great food for lowering inflammation in the
brain after a concussion since it is full of antioxidants and other chemicals.

Vitamin K is also abundant in it. In fact, one cup of broccoli provides more than 100% of the
adult's daily need for vitamin K. The fact that vitamin K is essential for the production of
sphingolipids makes it particularly beneficial for brain health in addition to helping to boost
cognition and memory. A form of fat called sphingolipids is tightly packed in your central
nervous system and aids in the communication of brain cells.
A.P2/A.M1

Psychological Responses to Injuries

Athletes who sustain injuries during competition may experience psychological effects in
addition to the disruption of their physical capabilities. Clinical depression can occur in some
athletes, especially those who have sustained long-term injuries. It is crucial that players have
ongoing assistance, especially those who are forced to quit due to injury. they will be forced to
lose a position on the team. The significance of their position on the squad worsens this, wage
losses that would result from it. Anxiety about regaining fitness and recurrence fears might lead
to a downward spiral into sadness. The signs can show up as both mental and physical signs of
anxiety.A.P3
Due to their disconnection from the team and their teammates, an injured performer may
experience severe isolation. How much they relied on their teammates' emotional support and
companionship will determine how this separation affects them. An athlete's motivation for their
sport may decline as the injury's duration lengthens. They could lose sight of the advantages that
initially drew them to and kept them engaged in sports. Recovering from setbacks may make it
harder to remain motivated. The denial changes to anger as the injury is acknowledged. They
may be angry with themselves or with others. When an injury prevents a performer from
achieving their goal, especially a long-term injury, they may feel dissatisfied. A lack of physical
activity or specialised sports frustrates athletes who want a return to competitive play. The
athlete may still experience some anxieties even after being given the all-clear to return, such as
anxiety about getting hurt again and anxiety about not being fully recovered. A.P3/A.M2

Stress is a significant risk factor for injuries and can affect how people react to them, recover
from them, and resume playing afterwards. Injury-related psychological reactions can cause or
reveal mental health problems such as suicidal thoughts, depression, anxiety, disordered eating,
and substance abuse. Treatment for athletes' mental health encounters many obstacles. They
frequently believe that asking for help is a sign of weakness and believe that they should be able
to overcome psychological challenges just as easily as physical ones. Because they may not have
learned good coping mechanisms, athletes may find it difficult to react to injuries.
A.P3/A.M2

It is well known that psychological stress affects how well the immune system functions, and
that a healthy immune system is essential for quick and efficient tissue healing. Psychological
stress can increase the amount of time it takes for tissue to heal and repair by at least 25%. The
immune system is crucial to healing, and stress affects how well your immune system can
function. One of the hormones that react strongly to stress is cortisol. The production of pro-
inflammatory cytokines at the wound site, which is crucial for the early stages of the healing
process, is one of the processes that is interfered with by stress-induced elevations in cortisol.
When a runner suffers from an injury, the first response psychologically will be stress. This is
because marathon running requires constant training, with the athlete unable to train they will
develop stress, they will start worrying about their fitness levels and their speed and on top of
that they will be stressed about their sponsorships and finances. If this stress is constant and
recurring then the rehabilitation process will slow the tissue healing process, especially from an
injury such as a displaced fracture. A.M2/A.D1

Self-doubt, pessimism, and a lack of drive might result from negative thoughts and expectations
regarding the healing process. Athletes with negative views may act in self-destructive ways, be
less compliant with treatment regimens, and feel less in control of their recovery. Unrealistic
hopes for the speed or results of the healing process can leave them feeling frustrated,
disappointed, and defeated. This could lead to a decline in motivation, poor adherence to
treatment plans, and detrimental effects on general well-being. A.M2/A.D1
Justification of factors that cause injuries and affect rehabilitation

Poor coaching

The risk of injury can be influenced by external variables like coaching and supervision. This
could lead to a performer hurting themselves by using improper technique, playing the game
incorrectly, or playing it too riskily. For example, if a coach uses a one fits all training schedule
for different runners without taking into consideration their strengths, weaknesses and
differences. This can cause athletes who are not used to specific intensities in their training to
burn out and develop overuse injuries such as hip tendonitis. This can also lead to the coach
resting athletes for a shorter period of time. A.P1
For the coach to improve on these aspects they could have one on one sessions with the athletes
where they sort of conduct an interview. These sessions could give the coach more in-depth
knowledge about the limitations of specific athletes and figure out their strengths and
weaknesses. Improving communication is also a great way to improve coaching, by
communicating with the runners the coach can know if they are tired or if they feel any
symptoms that might indicate an injury so it could be dealt with early. The coach can also take
an extra step in making sure their runner is following the correct nutrition plan, this will avoid
the player from becoming weak during the competition avoiding things such as falls which can
cause concussions or even sudden cardiac arrest. A.D1

Terrain

Different runners train and prefer different surfaces. This can be beneficial to them and also
detrimental, this is because during the competition the surface is the same for all runners.
Different types of terrain have certain effects on the runner's muscles. It can be more interesting
and challenging for the muscles to run on different surfaces from time to time. Softer terrain,
such as grass, dirt, trails, and gravel, soften the impact on the running stride and may help the
recovery from the workout happen more quickly. For the runner, they would need to familiarise
themselves with the surface they are going to be competing on. A.P1

Terrain can affect a runner's ability to compete. This can be by the surface being uneven which
will affect the fatigue levels of the runner. They will be running at irregular speeds because the
surface is climbing and sloping at sudden points in the marathon. Apart from that the surface can
have potholes and small rocks and stones. Both of these are a remedy for ankle twists and
sprains. Not only that but the holes can go as far as causing fractures and knee injuries for the
runner by causing the athlete to fall and land on their knees or shins. A.M1

The terrain can be improved by regularly maintaining and repairing the current terrain to make
sure that the running surface is smooth, even, and risk-free. This can entail patching up potholes,
clearing the area of trash, and smoothing down any rough or uneven surfaces. The layout of the
course can also have a big impact on the quality of the terrain. To offer runners a range of
challenges, the course should ideally have a combination of flat, uphill, and downhill sectors. It's
also critical to think about the type of running surface that will be used. A more comfortable
running experience for athletes can be achieved by resurfacing the surface or covering it with a
material that offers better grip and cushioning, such as rubberized surfaces.A.D1

Overtraining

Muscles, tendons, and ligaments might become strained when you run more intensely and
beyond your present level of fitness. A typical overuse injury in runners is shin discomfort. A.P1
When an athlete overtrains, their body's capacity to recover from exercise declines, which raises
their risk of injury. Chronic fatigue brought on by overtraining can result in muscular
imbalances, incorrect posture, and greater strain on joints and muscles. Additionally, an athlete's
immune system may become weakened from overtraining, increasing their risk of getting sick or
hurt. A.M1
The importance of sticking to an organised training schedule with proper rest and recovery times
cannot be emphasised in order to prevent overtraining and lower the chance of injury. It's crucial
to pay attention to your body's signals and modify your exercise programme as necessary. This
may entail using rest days, lowering the volume or intensity of training, or combining cross-
training exercises that promote fitness maintenance while allowing for recovery. Prioritising
healthy eating, drinking, and sleeping habits will also aid in recovery and lower the risk of
injury.A.D1

Finances and rehabilitation

The financial strains brought on by injuries can have a serious negative effect on athletes' mental
health. Financial stress is a typical reaction as athletes worry about the cost of medical care,
rehabilitation, and possible wage loss during recovery time. Athletes may be concerned about
their capacity to maintain their current performance level and generate income in the future,
which can add to their anxiety. Additionally, injuries may affect contracts and sponsorships,
raising worries about losing funding. Due to the long-term repercussions of their injuries,
athletes may also confront the emotional and financial burden of leaving their activity, which can
involve retraining fees and significant salary differences. A.M2

The athlete's present financial condition, including any income lost as a result of injury and
increased medical costs, should be taken into account when creating a budget. Prioritising
necessities like rent, utilities, and food should be part of this budget, which should also set aside
money for medical expenses and rehab charges. Until they can resume full-time training and
competition, the athlete may need to reduce their non-essential spending. Athletes must adapt
their budgets, account for potential revenue loss, and research insurance coverage during the
rehabilitation phase, which adds an additional layer of stress. Athletes who seek assistance from
financial experts and sports psychologists can navigate these financial issues, develop stress-
management techniques, and keep a positive attitude throughout the healing process.A.D1

Goal setting during rehabilitation

Setting goals is crucial for rehabilitation because it can help the athlete feel motivated, especially
if those goals are practical and have a direct connection to daily tasks. A meaningful objective
can increase patient involvement and encourage an athlete to take part in rehabilitation so they
can reach their objectives.
This can positively influence the rehabilitation process. Goal setting gives the athlete motivation
to get up and work on getting better from the injury. The athlete has specific goals set throughout
the day that he will need to complete to get through the rehabilitation process. Achieving these
goals will give a sense of accomplishment, purpose and direction. Goal setting also helps the
athlete focus on what is important during the whole process of healing. Goals also provide
benchmarks for achieving progress. Having goals makes it easier to track the athlete's progress
not just for the athlete but for people around the athlete tasked with helping him through the
whole recovery journey. Regularly checking these self-set benchmarks can go a long way in
boosting the athlete's motivation and helping them realise the impact of their work. It can also
help medical professionals analyse the effectiveness of the program they have set for the
athlete’s recovery. Recovery can be a mentally challenging process that frequently includes
frustration, setbacks, and emotional stress. Setting goals gives the athlete a sense of control and
accomplishment, which aids in maintaining a positive outlook. Setting both short-term and long-
term goals allows individuals to break down the recovery process into manageable steps,
reducing overwhelming feelings and promoting a sense of accomplishment with each milestone
achieved. This upbeat approach may have a favourable effect on mental health, boosting general
emotional toughness and aiding a more successful rehabilitation process. Setting reasonable
goals aids athletes in sticking with their recovery programme. They are more likely to stick with
their rehabilitation regimen, exercise schedules, and other recommended interventions if their
goals are in line with their capabilities and limits. This encourages consistency and compliance,
both of which are essential for getting the best results from injury recovery. A.M2/A.D1

Social support

A solid network of support can have a big impact on healing. Social support from loved ones,
close friends, and medical professionals can offer comfort on an emotional level, useful
assistance, and encouragement. It can also support a positive outlook, lessen feelings of
loneliness and help the athlete deal with the obstacles of injury, all of which aid in the healing
process. Serious injuries would prevent the athlete from doing some of the everyday tasks they
were able to carry out before, this can include small things such as moving around the house.
Practical help with tasks like domestic chores, transportation, or personal care can be considered
a kind of social support. By providing support, the injured athlete is relieved of some of their
responsibilities, their basic needs are satisfied, and they are able to concentrate more fully on
their recovery. Information and education about the injuries, available treatments, and
rehabilitation techniques can be obtained through social support. Informed decisions about a
person's rehabilitation plan can be made thanks to the knowledge and resources shared by family,
friends, and healthcare experts. Accurate information is readily available, which empowers
people, encourages active involvement in their recovery, and improves the efficiency of their
care. A.M2/A.D1

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