Sports Medicine - Options 3

Direct and indirect
Soft and hard tissue
Overuse

An injury caused by an external force
- A rugby player dislocates his shoulder when performing a tackle

An injury caused by an intrinsic force
- 100m sprinter tearing a hamstring mid race

An injury to any tissue other than bone and teeth
- A footballer tearing his ACL whilst changing direction

An injury explicity to bone and/or teeth
- A footballer dislocating his patella when colliding with an opposing player

A minor tissue injury that hasn't been given time to heal and thus worsened due to repetitive action and ultimately overuse.
- Soft tissue injuries such as tendinitis where the tissue connecting muscle to bone becomes inflamed, resulting in golfers elbow or tennis elbow
- Hard tissue injuries such as stress fractures of the tibia

Tears, sprains, contusions
Skin abrasions, lacerations and blisters
Inflammatory response

Tears occur when tissue is excessively streched and severed, these include sprains and strains
- Sprains is a tear in a ligament (streching/tearing of a ligment)
- Strains is a tear that occurs in a muscle (aka pulled hammy)

Contusions (bruise) is caused by a sudden blow to the body which causes internal bleeding as capillaries are ruptured

Strong dense connective tissues. Ligaments connect other bones to bones and tendons connect muscles to bones.

- A scraping or wearing away of the skin, resulting in pain and shallow bleeding (graze)

- A deep cut or tear to the skin eg: surfer getting 'fin-chopped'

- Blisters are a skin injury caused by friction or burning that leads to a build up of serum in the skin

Gentle cleansing, sterilisation of wounded area and covering with a non-stick dressing

Manage bleeding through applying; pressure, ice to slow bloodflow, a-non stick dressing and gentle cleansing

Apply padding such as a bandaid and remove the object causing friction or burning. Importantly do not pop but allow to heal

The bodies natural, non-specific response to injury and infection in which causes blood vessels to dilate, increasing white blood cells and bloodflow to the area. These luekocytes in-turn fight off infection

1) Acute Inflammatory phase = the fast and painful process by which vasodilation occurs and fluid (oedema) is released causing swelling (2-3 days)

2) Repair phase = where WBC clean up debris and faccilitate the formation of new fibres and tissue (3 days - 6 weeks)

3) Remodelling = replacement and strengthening of tissue in injured area, including increased production of scar tissue
(6 weeks - months)

RICER

Rest - to reduce bleeding and prevent further injury
Ice - reduce pain, swelling, bloodflow (bleeding)
Compression - bandage/covering to reduce swelling
Elevation - raising of injured area to: reduce swelling
Referral - appointment with doctor to understand nature

Fractures = very common hard tissue injury also known as a break which is simply a broken bone. There are three types

Dislocations = an abnormal separation in a joint between two bones. It can also cause damage to surronding soft tissue

Closed (simple) - remains inside the body and does not pierce skin

Complicated - the broken bone causes further damage to major nerves, organs or blood vessels

Open fracture (compound) - a break that pierces the skin and can be seen

Complete - clean through the bone resulting in two parts

Communited - result in more than two parts to the bone

Incomplete (greenstick) - does not break the whole way through the bone, thus the bone is still in one piece

- Assessment for medical attention

- Immobilisation

Both fractures and dislocations require the first aider to:
1) Follow DRSABCD (first aid procedures)
2) Follow STOP procedures (on-field assessment)
- Stop the athlete from further participating (S)
- Comfort, calm and gather insight into the injury (T)
- Check for other injuries, swelling, deformity or bruising (O)
- Control any bleeding, excessive pain in joint movement (P)

- If deemed not able to continue to play, engage in further assessment (TOTAPS) or seek medical attention

The process of restricting joint movement and supporting an injured area following a fracture of dislocation.

Examples include the use of a sling, splint or cast

Danger - check for danger
Response - check responsiveness
Send - seek medical attention (dial 000)
Airway - ensure airway is not blocked
Breathing
CPR
Defibrillation.

1) First aid DRSABCD procedure,
2) STOP (on-field assessment)
3) TOTAPS (off-field assessment)

TOTAPS

T) Talk - what happened, where, does it hurt
O) Observe - look for deformity, swelling, bruising
T) Touch - gently feel the injury to identify deformity, pain
A) Active movement - player performs joint movements (flex)
P) Passive movement - assesor physically mobilises/moves joint
S) Skills test - player performs sport-specifc skills (eg: tackling)

Used in the assessment of the injury after first aid (DRSABCD) and STOP steps have been followed to determine the nature and extent of the injury and if the athlete can continue to play.

If it is determined at any point throughout the steps that the athlete cannot continue to play, the TOTAPS assessment it stopped, the athlete is removed from play, and medical treatment is usually sought.

An on-field assessment done to quickly assess the injury and determine if further assessment is required (TOTAPS) or if the athlete can continue to play.
- Stop, Talk, Observe, Prevent further injury

2.1 Children and Young Athletes
- Medical Conditions
- Overuse Injuries
- Thermoregulation
- Appropriateness of Resistance training

Asthma
Diabetes
Epilepsy

Asthma is a medical condtion that affects the airways. Asthma is charachterised by inflammation of the airways and can be induced by exercise
- Ventolin puffer and sufficient warm-up/cool down

A condition in which the body does not produce or properly use insulin

high intensity activities where blood sugars may be depleted and risky environments (limited access to immediate sugars, heat)

Adequately eat before and after physical activity

Access to sugary drinks during physical activity

Disruption to brain function, causing a brief alteration to the level of consciousness and resulting in seizures or fits

Medication and supervision

A minor tissue injury that hasn't been given time to heal and thus worsened due to repetitive action and ultimately overuse.

Ceasing training, monitoring training loads, medical attention

Refers to the maintenance of a stable core body temperature. For children and young athletes thermoregulation is not as well developed as it is for adults due to undeveloped sweat glands making them more vulnerbale to the external environment

A highly debated issue. This is because there are many myths around the appropriateness of resistance training for children and young athletes.

Heart conditions
Fractures/Bone density
Flexibility/joint mobility

Heart conditions is a broad term used to refer to a number health issues including:
high blood pressure (hypertension)
Cardiovascular disease
Angina

Adult and aged athletes with heart conditions cannot participate in sports that require a high intensity. Instead they are advised to participate in sports and physical activities that can be done using low intensities such as:
- golf
- cycling
- tennis
- dancing

Fractures and bone density are greatly influenced by diet. Adult and aged athletes should eat plenty of fruit and vegetables in order to get all the nutrients in appropriate amounts that are required for health bone density and to avoid fractures. Eg: Calcium, iron, Vitamin D, Protein.

Poor bone density and osteoporosis limit the sport choices for adult and aged athletes. People with poor bone density should avoid contact sports or sports that involve powerful changes in direction that place large stress on bones. Recommended sports include:
- Cycling
- Walking
- Golf
- Tennis

This means that as adult and aged athletes begin to decrease their movement at particular joint or across their entire body, their flexibility decreases. Decreased flexibility and joint mobility leads to increased injury risk, particularly of sprains and strains

Poor flexibility and joint mobility is often a result of a decrease in sport and exercise participation. However, just as the muscles and joints adapted to a lack of use, so they will also adapt to increased use. Adult and aged athletes with poor flexibility can increase their flexibility and joint mobility by slowly increasing the range of motion at each joint through regular exercise.

EG: Participate in tai chi, or yoga at a beginners level and slowly move up in difficulty according to the instructor

- Eating disorders
- Iron deficiency
- Bone density
- Pregnancy

Eating disorders are detrimental to all athletes, but are particularly an issue among female athletes. Female athletes are often under pressure to fit the social pressures of the female physique and beauty, while still being a great athlete. Eating disorders, such as bulimia and anorexia, can result from these social pressures, or result from the demands of training for some sports, such as martial arts. Eating disorders decrease energy and nutrient intake, which negatively affects health and sports performance

- Iron deficiency is caused by decreased nutrient intake and a loss of iron through menstruation (or other forms of bleeding). Iron, is one of the key nutrients for sports performance, as it is required in order to allow haemoglobin to take the right shape so that it can combine with oxygen and transport it around the body. I.e. the less iron the less oxygen that can be transported and the less the body can use the aerobic energy system. This causes increases in fatigue due to greater reliance on the anaerobic systems (particularly the lactic acid energy system)
- Calcium and magnesium are particularly important for bone density. This is particularly important for female athletes, because females usually have thinner bones than men, and if oestrogen levels drop (oestrus cycle) so does their bone density

Female athletes need to manage menstruation along with everything else an athlete may need to deal with. Menstruation affects the female haemoglobin and iron levels, resulting in decreased oxygen carrying capacity, intensity levels, and motivation. It also causes varying degrees of pain and discomfort for the female athlete

Iron deficiency is caused by decreased nutrient intake and a loss of iron through menstruation (or other forms of bleeding). Iron, is one of the key nutrients for sports performance, as it is required in order to allow haemoglobin to take the right shape so that it can combine with oxygen and transport it around the body. I.e. the less iron the less oxygen that can be transported and the less the body can use the aerobic energy system. This causes increases in fatigue due to greater reliance on the anaerobic systems (particularly the lactic acid energy system), heightened lethargy and loss of motivation.

Bone density is a medical measure of the amount of minerals per square centimetre of bone. It is a key measurement to help determine the strength or fragility of the bone, where poor bone density is an indicator of osteoporosis. Bone density is a particular issue in female athletes as oestrogen levels drop, which leads to lower mineral counts. Calcium and vitamin D are of particular importance. Female athletes need to ensure they consume the right amount of calcium for bone development and either produce vitamin D through sun exposure or take a vitamin D supplements. Low bone density is more likely in female athletes who have an eating disorder or are post menopause. A decrease in density causes the bone to become more fragile, making the athlete more prone to fractures. This may affect female sport participation as high intensity and contact sports can cause the female athlete to suffer fractures.

Two main causes of Iron deficiency
- Bleeding (causes anaemia)
- Lack of iron in the athlete's diet.

Iron is needed to allow haemoglobin to bind with oxygen and transport it around the body. Oxygen is used in the aerobic energy system, and good delivery of oxygen will speed up recovery from the lactic acid energy system. If a female athlete has low iron levels, then they cannot deliver enough oxygen to their muscles to sustain sports performance, as they need to rely too heavily on the anaerobic energy systems

Relaxin production. This hormone is crucial in pregnancy for inhibiting contractions to prevent premature birth but more specifically its responsible for increasing blood flow to and relaxing the pelvis for pregnancy allowing for greater flexibility of joints amongst athletes. Whilst this may not seem like a problem, it can become a risk factor for injury such as dislocation if the female athlete stretches their joints beyond normal motion
- Blood volume/haemoglobin production. During pregnancy the female athletes blood volume and haemoglobin levels will increase. This is to ensure the baby is getting enough nutrients and oxygen, while still supporting the mother. The result is better oxygen delivery to working muscles during exercise as well. However, any benefits during pregnancy are lost with the increased weight and delivery of blood to the baby.
- Additional weight/shifted COG. Pregnant athletes will also put on weight and have their centre of gravity shifting forward. This will make exercise a higher intensity because of the extra weight, and make the woman more unstable. For this reason sports such as ice-skating may not be advisable for an athlete in late pregnancy.

- Physical preperation
- Sports policy and the sports environment
- Environmental considerations
- Taping and bandaging

- Pre screening
- Skill and technique
- Physical fitness
- Warm up, streching and cool down

Includes the pre-screening of would-be athletes to ensure they do not have any health or medical conditions that need to be catered for in a training program. Pre-screening for exercise has three stages, with the first stage being compulsory and the other 2 optional but recommended. It is a form of preventative action to enhance the wellbeing of the athlete

The first stage is a pre-screening questionnaire, that can be completed with a professional or self-administered. The aim of the pre-screening questionnaire's first stage is "to identify those individuals with a known disease, or signs or symptoms of disease, who may be at a higher risk of an adverse event during physical activity/exercise.

Eg; Past history with stroke or cardiovascular conditions

The second stage of the pre-screening questionnaire aims "to identify those individuals with risk factors or other conditions to assist with appropriate exercise prescription," and is administered by an exercise professional such as an Exercise Physiologist

The aim of the stage 3 measurements is "to obtain pre-exercise baseline measurements of other recognised cardiovascular and metabolic risk factors. Factors include
- BMI
- Waist girth

Skill and technique are vital for sports participation safety. High level skill and good technique help prevent injury and enhance the well-being of the athlete.At the beginning stages of skill acquisition, the athlete is focused on the skill at hand. This could be dribbling a soccer ball, hitting a cricket ball, or even just jogging. Regardless of the skill, if the athlete has lower skill levels then they will focus on the skill. This can result in greater injury. Technique is one of the greatest indicators for sports injury. Poor technique leads to higher injury rates, especially overuse injuries. Good technique, on the other hand, protects against injury and produces a better performance.

To be physically prepared for competition an athlete's physical fitness needs to be at a level that can manage the demands of the competition. Physical fitness helps reduce injuries in sport and is specific to the sport. That is, the athlete needs to be physically fit in all the components of fitness as they are required in their sport.

- Rules of sports and activities
- Modified rules for children
- Matching opponents
- Use of protective equipment
- Safe grounds, equipment and facilities

The rules of sports and activities are designed specifically for the sport or activity in order to promote safety and the wellbeing of the athlete. Rules of sports and activities help promote fair play, which helps to prevent injury as well. Of course, they also need to be enforced by referees and umpires who guard the games.

Many team sports such as football, rugby league, and hockey are played over two halves. As the sport increases in intensity such as futsal, basketball or netball, the court becomes smaller and breaks may increase in frequency. This is to help ensure the safety of the athletes participating in these sports. It helps ensure they have adequate access to water and that their bodies get a chance to refresh before competition continues.

Children and Young athletes require modified rules to cater for their specific needs. Of particular concern with children is their underdeveloped sweat glands and poor ability to regulate body temperature. Children are also smaller and need to have activities and sports catered to their size. modifications to ball sizes, field sizes, duration of competitions, smaller distances, and closer and smaller goals. These rule modifications help make participation in sports safer for the child and enhance their wellbeing.

Other rules are modified in order to enhance participation and enjoyment in the sport. Closer goals or hoops, make it easier for children to score goals and provide positive feedback to enhance enjoyment.

Matching opponents in competitive sports can be a complex or simple process depending on the type of sport. The four main ways of matching opponents include Age, size, sex and skill

Sports require skill, and athletes have varying skill levels regardless of age and size. Skill level should also be used to match opponents in sport to promote the athletes wellbeing. Almost every sport matches opponents using skill levels. Often this is done by grading teams, so that there is a first division or first grade team that is highly skilled and they play against other highly skilled athletes of the same age

Matching opponents by size helps to reduce the risk of injury as athletes are not forced to compete against people to much bigger than them. It is not safe to ask a 40Kg 13 year old to tackle a 80Kg 13 year old, even though they are the same age.
Matching opponents by their growth and development helps to promote safety in sports as player compete against people of the same age and similar size to help prevent injuries.

Most sports competitions also match their athletes by sex. Boys play boys, girls play girls and men play against men, while women play women. This matching of opponents is also done for safety reasons, to promote the wellbeing of the athlete. Males have more testosterone than females and so develop larger and stronger muscles than females

Protective equipment is purposely designed to help protect the athlete from injuries that may otherwise occur. Many sports have rules that govern compulsory equipment, while other athletes choose to wear certain protective equipment for their safety. Protective equipment can refer to equipment that players wear (1), or other forms of protective equipment(2).

(1): shin pads, mouth guards
(2): mats that athletes land on in sports like gymnastics and athletics (high jump, pole vault etc), padding around poles in netba

Grounds: Safe grounds (Courts & Fields): It is important that these grounds are kept in a safe order. It is dangerous to the athlete to play sports on fields that are uneven or have divots or holes in them. Such surfaces make injury more like and should not be used for sports competitions or physical activities.

Equipment: If equipment is not well maintained injuries result. This can be overuse injuries from running in old shoes, or acute injuries from being kicked in the shins through broken shin-pads. Broken bats, sticks or other equipment can also lead to injuries that could be avoided through maintenance of equipment to promote safety.
Furthermore, all equipment should suit the athlete using it. This is particularly important for children and young athletes, who use modified equipment to promote their safety. Smaller cricket bats, hockey masks and balls should be used to ensure the safety of the athlete

Facillities: : Facilities refers to the venue and the surrounds where the activity takes place. Facilities need to be safe both for the athletes and the spectators. Bathrooms should work, and running water and shade should be available. This helps to promote the wellbeing of the athlete and spectators of sports.

- Temperature regulation
- Climatic conditions
- guidlines for fluid intake
- Acclimatisation

convection, radiation, conduction, evaporation. Of these, we rely most heavily on evaporation to regulate body temperature through sweat.

heat transferred by mass motion of a fluid, such as air or water, when the heated fluid moves away from the source of heat, taking heat energy with it." For our purposes the source of heat is our body, so convection is heat removed by air or water passing over our body removing the heat as it goes. Convection naturally occurs as the athlete moves, by running, riding etc, through the air, or when a breeze is blowing.

the transfer of internal energy in the form of electromagnetic waves - usually infrared. As the body produces heat, some heat is lost through radiation

The transfer of heat between two objects in contact with each other". The heat transfer is always from the hotter object to the cooler one. During exercise, our bodies heat up due to the creation of heat when ATP is turned to ADP and P. If the body is warmer than the bike being ridden, some heat will be lost through conduction. However, if the athlete is cooler than the object, such as running on a hot road, then heat is conducted to the body.

Our bodies main mechanism for heat loss. Evaporation is "the transfer of heat from our body, to water (sweat), resulting in the water becoming a vapour and taking the heat away with it". Our bodies are well designed to sweat in the heat. Trained athletes will even begin to sweat before it is needed because their body knows it will be needed as the athlete continues to move and produce more heat.

Convection: If our body needs to lose more heat, placing the athlete in front of a fan, and pouring water over the skin are useful strategies the athlete can use to support convection as a temperature regulation mechanism. If the athlete's body is becoming too cold, then this mechanism of heat loss can be slowed by wearing a wind breaker jacket to prevent the wind from contacting the body surface, preserving heat.

Radiation: If the athlete is hot and needs to lose heat, exposing more skin to the environment can help to lose more heath by radiation. However, radiation is one of our bodies least effective mechanisms for temperature regulation.
If the athlete is cold, exposing the athlete to the sun or a warm fire will help to heat the body causing body temperature to rise.

Conduction: When an athlete is hot, conduction can be a great way to lose heat. Exposing the skin and lying down on a cool surface such as a rock, or metal will allow heat to be lost into the cooler object. The most used form of conduction is an ice-vest. Players will frequently wear ice-vests in order to keep their bodies cool. Ice-vests work as heat is conducted from the body into the ice, warming the ice and removing heat from the body.

Evaporation: If an athlete is hot evaporation can be increased, by adding water to the surface of the body (conduction). Actions such as pouring water over the body will leave more water on the body to evaporate off, taking the heat with it. Drinking plenty of fluid will also assist the evaporation process as it allows the body to continue to produce sweat without causing dehydration to the athlete. if the athlete is cold and wet, they will lose heat through evaporation. In this case, removing the water with a towel or taking off wet clothes, will help prevent heat lost due to evaporation.

The environmental temperature, humidity, wind, rain, altitude, and pollution levels. Each of these conditions affects athlete safety and need to be considered in order to enhance the wellbeing of the athlete

Every movement an athlete makes uses ATP via the krebs cycle releasing energy as both movement and heat. This heat needs to be removed from the body for safety. However, on hot days the athlete will also gain heat from the environment.
Hot climatic conditions add heat to the athlete particularly through radiation. This places the athlete at higher risk of hyperthermia and heat stroke. Hot conditions make it more difficult for the athlete to maintain their body temperature, and force the athlete to sweat more, which can lead to dehydration.

- Pouring water over the body
- Wearing light lose clothing
- Doing physical activity in the cooler times of the day and out of direct sunlight
- Rescheduling event in extreme heat

Cold conditions may result in the athlete losing too much heat and the body temperature dropping to unsafe levels. Athletes will sweat and send blood supply to the skin in order to lose heat when exercising. But, if this occurs when the weather is cold, they can lose too much heat. This may encourage vasocontriction

- Wearing long sleeves, or warm clothes such as snow jackets and pants
- Ensuring the athlete does not stand around in the cold waiting.
- Longer warm ups to prevent injury.

- The availability of cold water and ice, particularly an ice-vest would greatly assist the athlete to maintain a safe body temperature.
- Adequate fluid consumption will also help avoid dehydration in these condition

Humidity refers to the water concentration in the atmosphere. The more concentrated or humid the climatic conditions the less effective sweat and evaporation is at removing heat. Since this is our bodies main temperature regulation mechanism, it places the athlete in danger, especially if the weather is hot. For example, an athlete is more likely to experience hyperthermia as their heat loss is minimal and thermoregulation is hindered

Windy climatic conditions greatly increases the loss of heat through convection, though a warm wind will add heat to the athlete rather than removing it. Wind will also affect the movement of equipment such as balls, which can make play more dangerous as the ball can move unexpectedly and injury a player

Wearing of appropriate warm clothing, such as jackets, pants or skins to reduce wind contact with the skin and therefore reduce heat loss through convection. Warm clothing will also prevent some heat loss from evaporation.

Rain increases the heat lost through convection as water moves across the surface of the skin. This can be particularly dangerous if it occurs in cold and/or windy climatic conditions. Rainy conditions also make surfaces slippery, therefore increasing the risk of injury to a player. Many sports such as netball will be cancelled if the courts get wet, as play becomes to dangerous to the athlete

- Rescheduling games in the event of too wet/slippery conditions. Eg netball game
- Use of warm clothing such as undershirts, gloves, beanies

The altitude at which a sport or physical activity is conducted will influence player safety. This is because there are different oxygen concentrations in the air at varying altitudes. The higher the altitude the lower the oxygen concentration, the lower the altitude the greater the concentration. there is greater radiation from the sun at higher altitudes, placing the athlete at greater risk of sun burn. If an athlete has been doing physical activity at a low altitude and is then required to perform at a high altitude, their performance will decrease because they less oxygen moving into their blood and being transported to the muscles ➡️ Hypoxia

- Sunscreen for higher altitudes due to increased light intensities
- Acclimatisation: A physiological adaptation that occurs, is an increase in haemoglobin, which increases the amount of oxygen in the blood at the higher altitude allowing for an improved performance

Acclimatisation is when an athlete adjusts to a change in environment (such as a change in temperature, humidity, or altitude), allowing them to maintain performance in the new environmental conditions

Pollution is a climatic condition that refers to the presence of contaminants either in the air or the greater environment. The major concern for the athlete is air pollution, since they are breathing deeply and frequently as they exercise. Some contaminants have been linked with cancer, chronic bronchitis, or other issues such as asbestosis

- Wearing a mask
- No competition

Guidelines for fluid intake should be individualised as each athlete has a different sweat rate. However, general guidelines and principles can still be used to help determine an individuals drinking before, during and after performanc

Before Performance Goal - to ensure that they are properly hydrated.
During performance Goal - to prevent excessive dehydration, which is less than 2%.
After performance Goal - replaces the fluid lost during performance after it is completed.

consuming 2L a day of water for the average person, is a good beginning for fluid intake. However, factors such as time since last training/performance can affect athlete hydration and electrolyte levels. An athlete can check their hydration statue using a urine colour test. The darker the colour of the urine, the more dehydrated.
· Approximately 500mL of water or sports drink at least 4 hours before exercise

Approximately 150 mL of water every 15-20 min if exercise is less than 60 min.

DO NOT consume more than 1 L per hour of exercise.

An athlete should weight themselves post-performance and check their urine to help determine how much fluid needs to be consumed.

Fluid lost should be replaced within 2 hours after exercise
Approximately 1.5L of fluid should be consumed for every Kg of weight lost

1) 'Live High, Train High' = Live and train at higher altitudes (maximum exposure)
2) 'Live High, Train low' = Live at high altitudes but train at low. So the athlete can acclimatise to altitude while living there, and the training intensity can be maintained by training at sea level or low altitude
3) 'Live low, train High' = Live at normal/ low altitudes but train at high. The athlete is exercising in a low oxygen environment, whilst resting in a normal oxygen environment, improving performance at high altitudes ONLY. May decrease fitness levels due to lowered intensity levels

Preventative taping is when the athlete tapes a joint, such as the ankle, in order to prevent injury from occurring. Athletes who use preventative taping often have a history of injury in the joint taped. The most common joints taped include: the ankle, the knee, the shoulder, and the wrist.

Taping is not just used to prevent injury, but also in the treatment of injury. Taping for isolation of injury is about reducing pain during exercise and preventing further injury as the athlete is rehabilitated and begins to return to play. The goals of taping in the treatment of injury include:
limit range of motion
provide proprioceptive feedback to stimulate muscles for stability
increase stability of the joint

Bandaging for immediate treatment of injury is part of the RICER first aid treatment for soft tissue injuries. It helps to decrease bleeding and inflammation, while also providing support, especially if the injury is at a joint. The use of compression bandaging for immediate treatment of injury applies pressure to the injured areas and helps force fluid away from the area, or restricts fluid coming to the areas, reducing inflammation and bleeding.

- rehabilitation procedures
- return to play

- progressive mobilisation
- graduated exercise (stretching, conditioning, total body fitness)
- training
- use of heat and cold

Refers to the gradual increase in the joint range of motion/movement. Progressive mobilisation is required because of this tightening of the muscles and stiffening of the joint. Progressive mobilisation, slowly stretches the muscles (static, dynamic or PNF) allowing for a gradual increase in the range of motion at the joint. The gradual progression also helps increase the movement in the ligaments around the joint.
Progressive mobilisation should begin as early as possible, in order to help prevent scare tissue and to reduce the recovery time.

refers to the gradual increase in range of motion, intensity, and activities to help ensure the athlete's recovery is as pain free as possible. Graduated exercise is used in rehabilitation to ensure exercise intensity and activities progress with healing and do not cause further injury.

1) Streching
2) Conditioning
3) Total body fitness

an athlete should be doing any exercise possible while injured. This could be upper body training, while the athlete recovers from an injured ankle, or lower body training if they have just had a shoulder reconstruction. Regardless, this kind of training will only help slow down reversibility, and will not maintain previous total body fitness completely

Conditioning is the process of strengthening muscles and getting them back to their pre-injury levels. This is in relation to muscular strength, muscular endurance, speed, and power. Muscles often lose these while an athlete is injured, especially if it is a muscular strain. Conditioning is always specific to the injury, and the athlete involved

Hamstring tear or shoulder dislocation