7.1   Physiological Factors Determining the Component of Physical Fitness

Exercise physiology is a study of the body’s response to exercise, which includes skeletal, muscular, nervous, endocrine, cardiovascular, metabolic, respiratory, digestive, urinary and reproductive systems.

• All systems work jointly, with the metabolic system producing energy and taking care of intake and output of energy, the cardiovascular system controlling circulation, transporting oxygen and energy to muscles and waste products from muscles to kidney, the respiratory system taking in air, diffuses oxygen to lungs and muscle tissue, and removing carbon dioxide from the body.
• Neuromuscular and skeletal systems allow body movements through muscle contraction, while neuroendocrine and Immune systems help to maintain homeostasis.

 

7.1.1  SKELETAL MUSCLES FACTOR

Skeletal muscles are composed of two categories: Slow twitch fibres (Type I fibres) and Fast twitch fibres (Type II fibres) with the proportion of fibres determined by genetics, hormones and exercise habits. They possess four properties: contractility, excitability, extensibility, and elasticity, which determine their fitness.

1. Slow twitch fibres or Type I fibres contain large numbers of oxidative enzymes, have more capillaries, and higher concentration of myoglobin and mitochondrial enzymes than fast twitch fibres, promoting aerobic activity and resistance against fatigue.

• They contract at a low rate and keep contracting for longer duration without fatigue, producing large amounts of energy slowly.
• Slow twitch fibres help in long distance running, swimming, cycling, and other activities.
• Endurance athletes have a higher percentage of Type I fibres and a lower percentage of Type II fibres.

2. Fast twitch fibres or Type II fibres are lighter and faster, but have limited aerobic capacity and low fatigue resistance.

• They also have fast contraction rate, tire rapidly, and can produce small amounts of energy quickly.
• They do not require blood supply to produce energy, so their colour is lighter as compared to slow twitch fibre.
• Fast twitch muscle fibre helps in anaerobic activities like jumps, throws, and sprint.
• Sprinters have a higher percentage of Type II fibres and a lower percentage of Type I fibres

 

7.1.2  ENERGY PRODUCTION FACTOR

• Cellular respiration is a process in which ATP (Adenosine triphosphate) is formed through food it provides energy for food.
• Three energy systems are the ATP (Creatine phosphate) system, anaerobic system, and aerobic system.
• ATP-CP provides energy in the form of carbohydrates, proteins, and fats, while fats provide a larger amount of energy.
• Aerobic activities are dynamic and short-term, while anaerobic systems provide energy for long-term activities like jumps, throws, sprints, weightlifting, and powerlifting.
• The predominant energy system in each type of activity is determined by type, duration, intensity of exercise, long and short-term nutritional status, and proportions of muscle fibres.

 

7.1.3  CARDIORESPIRATORY FACTOR

• The Cardiorespiratory system is a combination of respiratory and cardiovascular systems which work to transport oxygen to cells and support metabolism.
• During exercise, the demand for energy increases and oxygen is needed in appropriate volume.
• The respiratory system works together with pulmonary ventilation, external respiration, and internal respiration to meet the demand.
• The cardiovascular response to exercise is proportional to the demands of skeletal muscles for Oxygen, such as Maximal oxygen consumption (VO2 Max), blood pressure, blood volume, oxygen diffusion and extraction, muscle and arterial blood flow.

 

7.1.4    PHYSICAL FITNESS COMPONENTS DETERMINED BY THE PHYSIOLOGICAL FACTORS

Strength : Strength is the ability of the body to work against resistance and has different sub-types such as Maximum Strength, Explosive Strength, Strength, Endurance etc.

• Different sports require different amount of strength and according to that, a mixture of slow twitch fibre and fast twitch fibre is needed.
• In games like weightlifting, jumps, sprint or power, agility and strength dominating sports where force production is high, fatigue is quick, fast twitch fiber percentage must be high in muscles.

Physiological Factors Determining Strength :

      (1)  Muscle size : More the muscle mass, more forceful contraction. Males tend to be stronger because of higher Muscle mass and larger size. Muscle size and strength can be improved by strength training.

      (2)  Body weight : Individuals who are heavier are generally stronger than individual who are lighter. There is positive correlation between body weight and strength. As in case of weightlifting it is seen that heavier weight lifters lift heavier weight. Therefore, body weight determines strength.

      (3)  Muscle composition : Each muscle consist of two types of muscle fibers, fast twitch fibers (white fibers) and slow twitch fibers (Red fibers). The fast twitch fibers are capable to contract faster and therefore produce more force, whereas slow twitch fibers are capable of contracting for a longer duration.

            Therefore the muscles with more of fast twitch fibers can produce more strength. The percentage of slow and fast fibers is genetically determined and thus determines the strength of a person.

      (4)  Nerve impulse intensity : A muscle is composed of many motor units. The force of muscle depends on the number of contracting motor units. Whenever a stronger nerve impulse from central nervous system excites more motor units, the muscle will contract more strongly thus producing more force or strength.

Effect of regular exercise :

• Hypertrophy of muscle/change in shape and size of muscle
• Better posture
• Delayed fatigue
• Better reaction time
• Swifter muscle movement
• Better muscle tone
• Formation of more capillaries
• Control extra fat
• Change in connective tissue
• Non-functioning fibers become active
• Lactic acid tolerance

Endurance : Endurance is the ability of the body to work for a longer period without getting fatigued.

• It varies from brisk walk to running to marathon, but is common in long duration and low fatigue activities.
• Slow twitch fibre percentage must be higher than fast twitch fibre to give better performance.
• Aerobic system provides energy, while Maximal oxygen consumption (Vo2) and ventilation capacity play a major role in endurance training.

Physiological Factors Determining Endurance :

      (1)  Aerobic capacity : Activities for a certain length of time using energy derived from-oxygen intake- oxygen transport-oxygen uptake and energy resources.

      (2)  Lactic acid tolerance : Ability to tolerate higher concentration and removal of lactic acid.

      (3)  Muscle composition : Slow twitch and fast twitch muscle fibers determine the type of endurance activities.

      (4)  Movement economy : Saving energy through efficient movements is always an advantage in the endurance activities.

Speed : Speed is the ability to cover maximum distance in shortest period.

• In speed training percentage of fast twitch fibres is very high in muscles, these activities include 100m race, roller skating, or any movements that require work to be done in minimum possible time.
• A vital physiological factor to give best speed performance is motor neuron stimulation.
• The brain sends a message to the muscles to act fast.
• To meet the demand of energy, the ATP CP system works.

Physiological Factors Determining Speed :

      (1)  Mobility of the nervous system/reaction time

      (2)  Muscle composition

      (3)  Explosive strength

      (4)  Cardiovascular efficiency

      (5)  Bio-chemical reserves and metabolic power

Flexibility : Flexibility is the ability of muscle and tendons to lengthen without getting damaged.

• Physiological factors such as elasticity and extendibility of muscles, type of joint, and homothermic temperature are key determinants of flexibility.
• Muscles, tendons, and ligaments are key components that affect flexibility.
• Agonists are the muscles that contract to perform a certain action,
• antagonists are muscles that oppose the prime movers.
• synergists are muscles that work together to modify the action of the agonist.
• Synergists include Conjoint, Neutralizer and Stabilizer muscles.

Some Important Definitions : •  Aerobic Exercise is a type of cardiovascular conditioning that involves activities such as brisk walking, swimming, running, or cycling.It involves breathing and heart rate increasing with oxygen. •  Anaerobic Exercise is an activity that breaks down glucose for energy without using oxygen, releasing a lot of energy within a short period of time. •  ATP(Adenosine Triphosphate) is a complex organic chemical that provides energy for many processes in living cells, such as nerve impulse propagation, muscle contraction, and chemical synthesis. •  ATP-PCr is the main energy source for high intensity exercise of up to 10 seconds, such as lifting a weight, swinging a golf club, doing a push-up, and throwing a hammer. •  Myoglobin is a red iron-containing protein pigment found in muscles that is similar to haemoglobin Mitochondrion, which are round or long cellular organelles that produce energy and are rich in fats, proteins, and enzymes. Cardiac Output : Cardiac output is the total volume of blood pumped by the heart in one minute. Cardiac output = Heart rate × Stroke volume

 

7.2   Effect of Exercise on Muscular System

Exercise involves a series of sustained muscle contractions, of either long or short duration, depending on the nature of the physical activity.

 

7.2.1  SHORT TERM EFFECT OF EXERCISES ON MUSCULAR SYSTEM

1. Increased blood supply : During exercise, in order to match demand of fuel to muscle, the supply or concentration of blood increases in the whole body or, in the particular muscle group where activity is largely impacted.
2. Increased muscle temperature : During exercises muscles demand energy, which comes from contracting muscles. During the process, a lot of heat energy is generated which increases the temperature of muscles, and/ or the body.
3. Increased muscle flexibility : Due to increase in blood flow and rise in temperature, elasticity of muscles increases. Stretching and mobility exercises also play a dominant role in increasing muscular flexibility.
4. Accumulation of Lactate : Muscles requires oxygen. If blood supply does not provide appropriate volume of oxygen to muscles, it leads to accumulation of lactate acid in muscles which result in pain, and soreness in muscles.
5. Micro-tears in Muscle Fibres : During exercises muscle tissue is placed under stress which results in micro-tears in muscle fibres. The body responds by repairing the muscle fibres and making them larger. When a muscle gets bigger, this process is called hypertrophy

 

7.2.2  LONG TERM EFFECTS OF EXERCISE ON MUSCULAR SYSTEM

1. Hypertrophy of Muscle : Scientific and systematic exercise leads to increase in thickness of muscle fibres that results in increase in muscle size also known as muscle hypertrophy.
2. Increase in Strength of Ligaments and Tendons : regular exercise helps to strengthen bones, ligaments, and tendons. This helps prevent injury and promotes performance.
3. Increase in Size and Number of Mitochondria : Aerobic exercises leads to increase in size and numbers of mitochondria, and which take in more oxygen and produce more ATP and energy.
4. Increase in Myoglobin Storage : Long term effect of aerobic exercise is to increase the storage of myoglobin which transports oxygen to mitochondria. Large amount of myoglobin means large amount of oxygen and large amount of energy.
5. Increase in Glycogen Storage : Glycogen is generally stored in muscles and liver. Regular exercise helps the body to increase the storage of glycogen which may give continuous energy for 90 to 120 minutes.
6. Increase in Oxidation/Metabolism : Endurance exercise training increases the capacity of skeletal muscle fat oxidation by increasing mitochondrial density. Long term exercises demand a lot of energy, and to meet this demand, metabolism increases due to oxidation of fat. This leads to increase in provision of energy.
7. Increase in Lactate Acid Tolerance : Regular exercises help to tolerate pain and sourness in muscles due to accumulation of lactate acid.

 

7.3   Effect of Exercise on Cardiorespiratory System

Cardiorespiratory system consists of two parts. They are :

Cardiovascular system : The heart, blood vessels and blood function to deliver oxygen, remove CO₂ and other metabolic waste products, transport hormones, regulate body fluid balance, and regulate immune function.

Respiratory system :

• The important parts of the respiratory system are the nose, nasal cavity, pharynx, larynx, trachea, bronchi, and lungs.
• Air can also enter the respiratory system through the oral cavity.
• Its major functions include, transporting air to the lungs, exchanging gases (O₂ and CO₂) between the air and blood, and regulating blood pH.

Effects of Exercise on Cardio-respiratory System : When we do exercise there are some immediate effects and long term effects on cardio-respiratory system as – stroke volume increases, cardiac output increases, blood flow increases, heart rate decreases, depth of respiration increases, Strengthen the diaphragm muscles, unused alveolus becomes active, aerobic capacity increases, increase in tidal volume, vital capacity increases and increase in the size of lungs and heart etc.

Effects of Exercise on Muscular System : When we do exercise regularly there are some changes that take place in our muscular system like – it strengthens the muscles fiber, change in the shape and size of muscles, muscle tone improves, reduces extra fat, improves reaction time, efficiency in the movement of muscles, non-functioning fibers become active, delays fatigue and body posture remains correct etc.

 

7.3.1  EFFECT OF EXERCISE ON CARDIOVASCULAR

What are the long term effects of regular exercise on the cardio-vascular system? Explain :

• Increase in of heart rate
• Decrease in resting heart rate
• Stroke volume increases at rest
• Increase in cardiac output
• Increase in blood flow
• Decrease in blood pressure
• Increase in blood volume
• Quicker recovery rate
• Reduced risk of heart disease

Cardiac Output : Cardiac output is the volume of the blood pumped by the heart, measured in liters per minute. It is a product of stroke volume and heart rate. It is the amount/volume of blood pumped out by the heart in one minute.

Stroke Volume : Amount of blood pumped by left ventricle in per beat.

At rest period – 50 to 70 ml/beat

During exercise – 110 to 130 ml/beat

Or   Amount of blood ejected by heart in one stroke.

Hypertrophy of muscles : Increase in number of muscle fibres and size of muscle components resulting into enlargement of skeletal muscles.

7.3.1.1  Short Term Effects of Exercise on Cardiovascular System

1. Increased Heart Rate : Exercise makes the body work harder that increases the demand for oxygen, which is met by an increase in blood circulation and heart rate.
2. Increased Blood Circulation : Blood circulation increases as the heart rate increases, allowing oxygen to be delivered to tissues and organs.
3. Increase in cardiac output : Endurance exercise increases systolic blood pressure due to increased cardiac output, while most types of training have minimal change in diastolic blood pressure.
4. Increased Stroke Volume : The volume of blood pumped during one beat (contraction) is called stroke volume. Stroke volume increases during exercise as more oxygen is needed to deliver blood to muscles. After an endurance training programme, the capacity of heart to pump blood in one contraction increased by 20-50%.
5. Increased Cardiac Output : Cardiac output is the amount of blood pumped out by each ventricle of the heart in 1 minute. It is the product of the heart rate (HR) and stroke volume (SV). Resting cardiac output is approximately 5.0 L/min and varies depending on the size of the person. Maximal cardiac output varies between less than 20 L/min to 40 L/min in sedentary individuals and elite endurance athletes. Increase in heart rate and stroke volume results in increase in cardiac output.

7.3.1.2  Long Term Effects of Exercise on Cardiovascular System

1. Increased Size and Strength of Heart : Cardiac hypertrophy is the increase in strength and size of the heart through aerobic exercises.
2. Low Level of Accumulation of Lactic Acid : Anaerobic respiration is the process of converting glucose into energy without oxygen. During this process, lactic acid is created, which makes muscles tired and painful. Regular exercises help muscles adjust to lower levels of oxygen and the circulatory system develops to transport oxygen to different parts of the body, resulting in low levels of lactic acid.
3. Decrease in Resting Heart Rate : Improved efficiency of the heart causes the heart to pump less blood to meet the needs of the body, resulting in a decrease in heart rate at rest which is called as Bradycardia.
4. Normal Blood Pressure : Regular exercise can reduce systolic and diastolic blood pressure. Regular exercise helps keep the blood pressure normal.
5. Increase in Stroke Volume and Cardiac Output : The size and strength of the heart increases, heart pumps blood more efficiently with increase in stoke volume and cardiac output.
6. Increase in Capillaries Network : Exercise increases the capillaries network, allowing for greater oxygen to be transported to the muscles, improving their ability to perform intense exercise. This helps to prevent the decline in capillary function that occurs with age.

 

7.3.2  EFFECT OF EXERCISE ON RESPIRATORY SYSTEM

Oxygen intake : The amount of oxygen intake by an athlete from the atmosphere is called oxygen intake. It depend upon lungs size, strength of muscles and number of alveoli.

Oxygen uptake : The amount of oxygen which can be absorbed and consumed by the working muscles from the blood is called oxygen uptake.

Effect of Exercise on Respiratory System :

• Strengthens will power to push beyond the capacity of regular training
• Decreases rate of respiration during exercise and at rest
• Strengthens muscles of diaphragm and chest
• Increase in tidal volume capacity
• Activates unused alveoli since more oxygen is required for endurance activities
• Avoid second wind with strong will power
• Efficient gaseous exchange
• Increase in residual air volume
• Increase in size of lungs and chest
• Increase in vital air capacity
• Increase in endurance
• Exhale and inhale in fast pace prevents accumulation of waste in lungs and prevents lungs diseases
• Increase depth of respiration
• Increase pulmonary diffusion
• Supply more O2 to muscles
• Strengthen the respiratory muscles
• Unused alveoli become active
• Faster recovery rate
• Maximum minute ventilation increased
• Strengthens diaphragm muscles

7.3.2.1  Short Term Effects of Exercise in Respiratory System

1. Respiratory Rate Increases : The respiratory rate increases during exercise to meet the increased demand, with the normal respiration rate at rest being 12-20 breaths per minute and increased to 40 breaths per minutes.
2. Tidal Volume Increases : Tidal volume is the amount of air inhaled and exhaled in one breath, and increases with exercise to take in more oxygen and remove carbon dioxide.
3. Rate of Exchange of Gas Increases : Regular exercise increases the rate of exchange of gas in lungs.

7.3.2.2  Long Term Effects of Exercise in Respiratory System

1. Increased Efficiency of Respiratory Muscles : Due to regular exercise efficiency of respiratory muscles increases, inhalation and exhalation become fluent. This helps to meet the demand of oxygen.
2. Increased Lung volume : Continuous exercises done for long duration help to increase the capacity and volume of lungs. Vital capacity increases almost 100 % as compared to that of a normal individual.
3. Increased Pulmonary Diffusion : Pulmonary Diffusion refers to the capacity of the lungs to allow oxygen and carbon dioxide to pass in and out of the blood. Regular sub-maximal exercise training develops the scope of increasing the exchange of gases, and in this process the size of the alveoli also increases.
4. Increased Residual Volume : Residual volume is the volume of air that remains in the lungs after forceful expiration. Regular exercise increases residual volume that helps to exchange the gases in normal limits.

 

7.4   Physiological Changes Due to Ageing

• Ageing, an inevitable and extremely complex multifactorial process, is characterized by the progressive degeneration of organ systems and tissues.
• It is largely determined by genetics, and influenced by a wide range of environmental factors, such as diet, exercise, exposure to micro-organisms and pollutants.

Physiological Changes Taking Place Due to Ageing : Ageing is a slow and never ending process. As a result structural and functional activities begin to decline. It is inevitable.

Physiological changes which occur due to ageing :

• Changes in muscle size and strength
• Changes in metabolism and body composition
• Changes in nervous system (reaction time, movement time)
• Changes in cardio-vascular system
• Changes in capacity of respiratory system
• Changes in bone density
• Flexibility decreases
• Changes in sensory organs
• Changes in digestive and excretory system.

1. Muscular Strength :

• Strength is the maximal force that a muscle or muscle group can generate.
• Men and women usually attain their highest strength levels between ages 20 and 40.
• Decline in eccentric strength begins at a later age and progresses more slowly than those in concentric strength.
• Strength loss begins at a later age for women than for men.
• A 40% to 50% reduction in muscle mass from muscle fibre atrophy and actual loss of motor units between ages 25 and 80 is the primary cause of reduced strength, even among healthy, physically active men and women.

2. Neural Function :

• Ageing has caused a 40% decline in spinal cord axons and a 10% decline nerve conduction velocity, leading to a reduction in neuromuscular performance assessed by simple and complex reaction and movement times.
• Ageing most adversely affects the time required to detect a stimulus and process the information to produce a response.

3. Endocrine Changes with Ageing :

• The endocrine system consists of a host organ (gland), chemical messengers (hormones), and a target or receptor organ.
• Approximately 40% of individuals aged between 65 and 75 years and 50% of those older than 80 have impaired glucose tolerance leading to Type 2 diabetes.
• Thyroid dysfunction, primarily from lowered pituitary gland release of the thyroid-stimulating hormone thyrotropin, is common among the elderly and affects metabolic function, including decreased glucose metabolism and protein synthesis.
• Mean pulse amplitude, duration, and fraction of secreted growth hormone (GH) gradually decrease with ageing, a condition termed somatopause.

4. Pulmonary Function : Mechanical constraints on the pulmonary system cause deterioration in static and dynamic lung function measures, as well as decreased ventilation and gas exchange kinetics during exercise.
5. Cardiovascular Function :

• Cardiovascular function and aerobic capacity decrease with age due to lower maximum heart rate, reduced peripheral blood flow capacity.
• Reduced peripheral blood flow capacity accompanies age-related decreases in muscle mass.
• Sedentary living also causes losses in functional capacity.

6. Body Composition : Body composition is the percentage of fat, bone, water, and muscle in human bodies, and after age 60, total body mass decreases.
7. Bone Mass :

• Bone Mass is a measure of the amount of minerals in a certain volume of bone.
• Osteoporosis is a major problem in postmenopausal women, resulting in loss of bone mass as the skeleton demineralizes and becomes porous.
• Bone mass can decrease by 30% to 50% in persons older than age 60.

 

7.5   Sports Injuries

The physical damage caused to tissue, bone, or any other organ of the body while in action and further leading to withdrawal from participation or experience pain while performing movement actions is called injury in sports and exercise.

Or  Some physical damage or insult to the body that occurs during athletic practice or competition causing a resultant loss of capacity or impairing performance. It is referred as injury in sports and exercise.

Or  A sports injury may be defined as damage to the tissues of the body that occurs as a result of sport or exercise.

Or  Sports injury is any stress or overstretch put on soft tissues or bone on or off the field, resulting in pain and hindering performance. Common injuries include cut, tear, overstretching of tissues, breakage of bone or dislocation of joints. These injuries can occur during sport, athletic activities or during certain exercises.

 

7.5.1  CLASSIFICATION OF SPORTS INJURIES

Sports Injuries can be classified according to the cause of the injury :

Direct Injuries : They are sustained from an external force causing injury at a point of contact.

Indirect Injuries : It usually involves the athlete damaging the soft tissues such as ligaments tendons or muscles of the body through internal or external force.

Soft Tissue Injuries : Any injuries to skin muscles or ligaments are soft tissue injuries.

Hard Tissue Injuries : Injuries that occur in bones and cartilages.

Overuse Injuries : They are sustained from continuous or repetitive stress, incorrect technique, or equipment or too much training.

Common sports injuries and their prevention :

Soft tissue injuries	Bone injuries	Joint injuries
• Contusion • Strain • Sprain • Abrasion • Bruises	• Simple fracture • Compound fracture • Complicated fracture • Communicated fracture • Greenstick fracture	• Dislocation of lower jar • Dislocation of shoulder joint • Dislocation of hip joint • Dislocation of wrist

 

7.5.2  TYPES OF SPORTS INJURIES

7.5.2.1  Skin injuries

1. Puncture wound : wound caused by piercing by a sharp and pointed object.
2. Avulsion : tearing away of a part of the skin.

Common Sports Injuries while Enlisting the Sub-parts :

Soft tissue injuries	Bone injuries	Joint injuries
(a) Contusion (b) Bruises (c) Sprain (d) Strain (e) Abrasion	(a) Simple fracture (b) Complicated fracture (c) Impacted fracture (d) Green stick fracture (e) Compound fracture (f) Comminuted fracture	(a) Shoulder dislocation (b) Hip dislocation (c) Lower jaw dislocation

 

7.5.3  SOFT TISSUE INJURIES (eg., Muscles, Ligaments)

Soft Tissue Injuries : Soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Soft tissue injury includes sprain, strain, contusion, abrasion and bruises.

1. Abrasion : Abrasion is skin injury. It is the injury of skin in which skin is scrapped or rubbed by friction

Or   Injury caused by falling on rough or firm surface.

Or   Abrasion injuries most commonly occur due to moving contact with a rough surface, causing a grinding, or rubbing away of the upper superficial layers of the epidermis.

• Cause : Abrasion injuries commonly occur when exposed skin encounters a rough surface, causing a grinding or rubbing away of the upper layers of epidermis.
• Prevention : Safety gear (Helmet, anal guards,) should be worn while playing.
• Treatment : Clean the surface of the affected part. Stop bleeding at the earliest by compression bandages. Anti-tetanus injection should be provided.

2. Laceration : Laceration is an irregular cut on the skin with a sharp object or sharp edged sports equipment.

Or   A laceration is an irregular and jagged wound from a sharp object or sports equipment.

• Cause : Mostly, laceration is the result of the skin hitting an adjacent object, or an object hitting the skin with force.
• Prevention : Proper personal equipment, including eye protection can be helpful in preventing the same.
• Treatment : Clean the surface of the effected part. Stop bleeding at the earliest by compression bandages.

3. Incision : Incision is a soft tissue injury. It may occur due to sharp edged object of sports equipment’s or spikes etc. Sometimes arteries or veins may be cut. Blood usually comes out freely from incision.

• Cause : Can be caused by a clean, sharp-edged object – such as a knife, razor or glass splinter.
• Prevention : The area should be free from the sharp edges.
• Treatment : Gently wash the affected area with soap and water to remove the dirt. Dry the incision with a clean, fresh towel before applying the dressing.

4. Contusion : A soft tissue injury in which blood vessels in the muscles are broken and internal bleeding may occur on the injured part generally caused by direct hit with blunt object.

Or   Bruise caused by a direct blow to some part of the body. eg., knee of a player knocks against the thigh of another person.

• Cause : When a part of the body is struck by enough force to crush underlying muscle fibres and connective tissue without breaking the skin, a contusion may occur. It can be due to a blow from a collision with a player or a piece of equipment or because of a heavy fall.
• Prevention : All the safety gear to be worn upon while playing (Helmet, anal guards,) should be worn.
• Treatment : Non-steroidal anti- inflammatory drugs such as Ibuprofen, or other medications for pain relief as prescribed by the doctor.

Symptoms of contusion : (1) Swelling and pain; (2) Muscle fail to respond; (3) Stiffness over the area; (4) Redness start, may turn blue or black.

Management for contusion : (1) Proper use protective sports equipment; (2) If there is more swelling use anti inflammatory; (3) Cold compression should be use immediately; (4) Do flexibility exercise for rehabilitation; (5) After three days apply heat instead of ice pack.

5. Sprain : Injury of ligament of joints, caused by the violent overstretching of ligament in a joint or the movement of the joint in abnormal directions. It is characterised by pain, tenderness, swelling at the joint.

Or   Sprain is the stretching or tearing of ligaments, the fibrous tissue that connects bones in the joints.

A sprain occurs when you overextend or tear a ligament while surely stressing a joint.

The most common location for a sprain is in your ankle.

• Cause : A sprain occurs when one overextends or tears a ligament while severely straining a joint.
• Prevention : Regular stretching and strengthening exercises for any kind of sport can be the preventive measure for such kind of sports injury.
• Treatment : RICE (rest, ice, compression and elevation).

6. Strain : Injury of muscle or tendon, three types- mild, moderate, severe.

Or   Strain is an injury to the muscles which are attached to a bone.

A strain is an injury to either a muscle or a tendon generally caused by overuse, force, or stretching.

It can be caused by an overstretch of a muscle or tendon, resulting in a partial or complete tear.

A strain could be an acute or chronic soft tissue injury that is a twist, pull or tear of a muscle or the tendon.

• Cause : Strains occur suddenly (acute strain) or develop slowly over time (chronic strain). Causes include lifting of heavy objects, running, jumping, throwing etc.
• Prevention : Regular stretching and strengthening exercise for any kind of sport can be the preventive measure for strain.
• Treatment : It can be managed by applying ice packs and maintaining the strained muscle in a stretched position. (PRICE: protection, rest, ice, compression, and elevation).

PRICE Procedure as a Treatment for Soft Tissue Injury :

Protection : Protect the injured area by using a support.

Rest : In the initial phase it is best to give complete rest to the injured part for at least 48 hours.

Ice : Ice should be applied on the injured area as soon as possible to reduce swelling and limit internal bleeding.

Compression : Applying pressure on the injured part , such as ankle, wrist or muscle is helpful in reducing internal bleeding and swelling. This can be done by wrapping the injured part with elastic bandage or cloth.

Elevation : If possible elevate the injured part immediately, this will reduce the flow of blood towards the injured part and thus reduce swelling.

 

7.5.4  HARD TISSUE INJURIES

7.5.4.1  Joint injuries

Dislocation of the joints – in which adjoining bones are displaced from their normal position.

• Dislocations are joint injuries that force the ends of bones out of position due to a fall or a blow.
• A joint dislocation, also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet.
• A partial dislocation is referred to as a subluxation.
• Dislocation can be caused by a trauma or the weakening of muscles and tendons, and can be treated through medication, manipulation, rest or surgery.

Causes :

• Trauma that forces a joint out of place causes a dislocation, which can be caused by accidents, falls, and contact sports.
• Dislocations also occur during regular activities when the muscles and tendons surrounding the joint are weak.
• It is more common in older people with weaker muscles and balance issues.

Symptoms : Symptoms of a dislocation vary depending on the severity and location of the injury. The symptoms of a dislocated joint include :

(1) Severe pain over the joint

(2) Swelling of the joint

(3) Inability to move the joint

(4) Changing shape of joint

(5) Bruising

(6) Loss of ability to move the joint

(7) Visibly deformed joint (bone looks out of place)

Management of dislocation : (1) Support the joint using cushion or padding; (2) Keep the person calm and cool; (3) Let the injured person sit or lie in a comfortable position; (4) Use ice pack on dislocation area; (5) Call medical help immediately.

Treatment : Treatment can vary based on the severity of the injury, and the joint that is dislocated. Applying ice and keeping the joint elevated can help reduce pain while you wait to see a doctor. Treatment includes:

Medication : Your doctor may recommend medication to reduce pain from a dislocation

Manipulation : A doctor returns the bones to their proper places.

Rest : Once the joint is back in place, you may need to protect it and keep it immobile. Using a sling or splint can help the area heal fully

Rehabilitation : Physical therapy exercises strengthen the muscles and ligaments around the joint to help support it.

Surgery : The dislocation can lead to surgery if manipulation does not work, as it can damage blood vessels, nerves, bones, muscles, and ligaments.

First Aid : First Aid is the immediate and temporary care given to a victim of accident or sudden illness before the arrival of the Doctor.

Management :

• Call for immediate medical help.
• Do not move the joint to replace it.
• Keep the person in a comfortable position.
• Apply cold packs around the area to reduce swelling.
• Immobilize the area with a splint.
• Pain killer as advised by doctor.

 

7.5.5  Bone injuries

• Fracture is a break in the continuity of the bone.
• The fractures can be open/compound fracture or a closed/ simple fracture.
• Severity of the fracture varies from a mild crack in the bone to the severe shattering of the bone into many pieces.

7.5.5.1  Fractures

A fracture is a break in a bone. Fractures are caused by a direct impact, such as a fall or a severe tackle. Stress fractures develop over time and are caused by overuse.

7.5.5.2  Stress fracture

Stress fractures may occur because of overuse injuries and the failure to have adequate equipment to protect the body.

Causes : Stress fractures often result from increasing the amount or intensity of an activity too quickly.

Prevention : Low impact activities added to exercise regimen to avoid repetitively stressing a particular part of the body.

Treatment : Rest, cold therapy ice packs, cold compresses, apply ice to the injured area, anti- inflammatory medications such as Ibuprofen, aspirin etc and a recovery time of 6 to 8 weeks is required for healing.

7.5.5.3  Greenstick

A fracture in a young, soft bone, in which the bone bends.

Causes : These fractures most commonly occur with a fall.

Prevention : Promotion of regular exercise, ensuring the child’s safety by providing proper safety equipment and adequate calcium in the child’s diet can also help to prevent this kind of fracture.

Treatment : Removable splints result in better outcomes than casting in children with – Torus fractures of the distal radius.

7.5.5.4  Comminuted

A fracture in which a bone is broken, splinted, or crushed into number of pieces.

Causes : Direct and indirect trauma or violence can be causes for commutated fracture.

Prevention : Maintaining strong bones by eating food that is rich in calcium and regular exercise can help in the prevention of this type of fracture.

Treatment : An X-ray is important for diagnosing of the condition. An open reduction when the bone fragments are jammed-together using surgical nails, wire plates etc. is required for comminuted fracture.

7.5.5.5  Transverse

Transverse fracture is when there is a straight break right across a bone.

Causes : When a large amount of force is transmitted directly i.e., perpendicularly to the bone.

Prevention : Physical activity and weight bearing exercises will make the bones stronger and denser. Bones can also be strengthened by eating foods rich in calcium and taking regular exercise.

Treatment : Can be treated at home along with rest and medicine. A back brace (called TSL) or abdominal binder may be prescribed to reduce the pain by limiting motion at the fracture site.

7.5.5.6  Oblique

Oblique fracture is one in which the bone breaks diagonally.

Causes : This fracture is usually caused by an injury to the bone as the result of a fall, accident, or other trauma.

Prevention : Bones can be strengthened by eating food rich in calcium and exercising regularly to help prevent this type of fracture.

Treatment : It depends upon the severity of the crack or break. Anti- inflammatory medication, reduction (Resetting the bone) can also help to some extent.

7.5.5.7  Impacted

This type of fracture occurs when the broken ends of the bones are jammed together by the force of the injury.

Causes : It is caused mainly when someone falls from height with a great impact.

Prevention : Increased physical activity, weight bearing exercises and maintaining good intake of calcium in food can help in preventing this type of fracture.

Treatment : In an impacted fracture the bones get broken into fragments. Therefore, a sling or a splint may be required to keep the broken bones in place, so that movement of the sharp ends of the broken bone is prevented. This is essential to prevent further damage to the bone.

Preventive Measure of Sports Injuries :

• Proper warm up
• Proper conditioning
• Balanced diet
• Adequate knowledge about the sport skills
• Use of protective equipments
• Good sports facilities
• Unbiased officiating
• Avoid over training
• Proper Techniques
• Obeying the rules
• Proper cooling down
• Levelled ground

Management of Fracture : First-aid for closed and open fracture.

The injured part can be immobilized with the help of sling in closed fracture. During open fracture the open wound must be covered by sterile gauze or dressing. The compression and elevation is given to stop the bleeding. The sling is used to immobilize the injured part.

For transporting the injured person to the hospital, sitting position is desirable but in complicated cases person can be transported in a lying position on a stretcher.

Sports-Injuries :

Personal causes :

• Improper warm up .and cool-down
• Not following the rules and regulation.
• Protective clothing and equipment
• Knowing the limits
• Improper rest and relaxation
• Healing previous injury or inadequate rehabilitation
• Lack of conditioning
• Drug abuse

Environmental/External causes :

• Improper ground or poorly maintained facilities
• Extreme cold or heat
• Inadequate first-aid care
• Expectation of spectators
• Lack of medical check-up
• Improper diet

Training causes :

• Without considering individual differences
• Lack of proper supervision
• Wrong method of training/poor coaching
• Lack of systematic and scientific training
• Lack of psychological preparation
• Improper load and recovery

Prevention of Sports Injuries :

• Overall conditioning
• Pre-participation physical examination/medical check-up
• Coaching under expert trainer/physio/coach
• Stress on proper physical fitness
• Balance diet
• Acclimatisation with environment/coaching according to climatic conditions
• Training according to periodisation
• Intake of sufficient fluid
• Adequate clothing and equipments
• Standardised play field/court
• Documentation of injuries
• Knowledge of first-aid
• Protective sport gears