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ITP 201:Basic Injury Care,[object Object],Brandi Smith-Young, PT,[object Object],Perfect 10.0 Physical Therapy,[object Object],Perfect10PT@gmail.com,[object Object]
Brandi Smith-Young,[object Object],Competitive gymnast,[object Object],2 time USAG Collegiate National Champions at TWU,[object Object],Bachelors in Kinesiology at TWU,[object Object],Masters in Physical Therapy at Tx St,[object Object],Fellowship trained in Orthopedic manual physical therapy,[object Object],Board certified orthopedic specialist in PT,[object Object],Specialize in treating gymnast,[object Object]
Injury prevention,[object Object]
Risk management,[object Object],Make sure the gym is a safe environment,[object Object],Account for injuries before they happen,[object Object],Make sure every area is covered with mats (no gaps in mats),[object Object],Move all unused equipment close to the walls or in designated areas,[object Object],Have designated walking areas,[object Object],Update old unsafe equipment,[object Object],Keep the younger kids separate from the team when possible,[object Object],Keep coaches always conscious of safety,[object Object],All coaches CPR & first aide certified annually or biannually ,[object Object]
Safety is #1,[object Object]
Proper biomechanics- upper,[object Object],Push up position,[object Object],Push up,[object Object],When taking off or landing on the wrist it is imperative to have good mechanics.,[object Object]
Improper mechanics lead to repetitive abnormal stress,[object Object],Leads to inefficient performance,[object Object],Leads to injury,[object Object]
Proper Loading mechanics,[object Object],Fingers facing fwd,[object Object],Maintain palmar arches,[object Object],Antecubitalfossa (“Smiley face”) points inward (“kiss each other),[object Object],Elbows straight but not locked out,[object Object],Shoulder blades cinched up to the rib cage (no winging),[object Object]
Proper biomechanics-Lower,[object Object],Single leg standing,[object Object],Single leg ¼ squat,[object Object],When taking off or landing it is imperative to have good mechanics.,[object Object]
Improper mechanics lead to repetitive abnormal stress,[object Object],Leads to inefficient performance,[object Object],Leads to injury,[object Object]
Proper jump/landing mechanics,[object Object],Straight back,[object Object],Hips square,[object Object],Hip inline with the knee,[object Object],Knee inline with the 2nd toe,[object Object],Hips slightly flexed,[object Object],Knees bent with the knee falling over the midfoot,[object Object]
Proper jump/squat mechanics,[object Object]
Proper skill progression,[object Object],Drills,[object Object],Drills,[object Object],Drills,[object Object],More…..drills,[object Object],Make sure an athlete is strong enough, flexible enough, done the proper progressions and done the skill safely in a safe place before progressing,[object Object],Do NOT let an overzealous athlete convince you to let them chunk things,[object Object]
NO more…one mores,[object Object],Give a specific number of trials for a skill,[object Object],Especially at the end of practice,[object Object],Do NOT let an athlete say….I just want to do one more at the end of practice or after they have done a ton of bad or unsuccessful attempts,[object Object],When an athlete is physically and mentally tired…one more turns into a nightmare real quick!,[object Object]
First Aid kit,[object Object],Adhesive Bandages-large,[object Object],Standard Band-Aides,[object Object],Knuckle Bandages,[object Object],Fingertip Bandages,[object Object],Iodine Swabs,[object Object],Alcohol Pads,[object Object],Burn Ointment,[object Object],Antibiotic Ointments,[object Object],Eye Patches,[object Object],Eye Wash,[object Object],Gauze Pads-4x4 and 2x2,[object Object],[object Object]
Ace Wrap- 6 in, 4 in, & 2 in
Scissors
Tape
Tweezers
Tylenol-*DO NOT administer medication with acetaminophen
First Aid Guide
*Hepacleanse- 4-10 drops in     about 1/2 cup of water till the water is tinted a light pink.,[object Object]
Other emergency supplies,[object Object],Ice Pack,[object Object],Splinting Supplies-air splint, SAM splint, Vacuum Immobilizers,[object Object],Arm Sling,[object Object],Crutches,[object Object],CPR Mask,[object Object],CPR guide,[object Object],AED machine ,[object Object],                 (Cardiac Rescue Systems www.cardiacrescue.com),[object Object],www.henryschein.com ,[object Object]
CARDIAC	,[object Object],   RESCUE	 ,[object Object],SYSTEMS, INC. 	,[object Object],Please contact: Bert Cattoni,[object Object],Phone: (630) 541-5469 ,[object Object],Cell: (630) 854-5150,[object Object],bcattfway@aol.com  www.cardiacrescue.com,[object Object],PO Box 5522  Woodridge IL, 60517,[object Object]
Hands-on Only CPRFor adult who collapses only,[object Object]
Conventional CPR for children is still recommended,[object Object],CAB- Chest compression, Airway, Breathing,[object Object],30 chest compressions,[object Object],Clear air way,[object Object],2 breaths,[object Object],30:2 until help arrives,[object Object],www.heart.org,[object Object]
Medical resources,[object Object],Orthopedic Surgeon,[object Object],Doctors who specializes or fellowship trained  (ie fellowship trained ankle, knee or board certified spine specialist),[object Object],Specialize in sport injuries,[object Object],Specialize in pediatric sport injuries,[object Object],Physical Therapist,[object Object],Board certified orthopedic specialist ,[object Object],Fellowship trained manual physical therapy, sports PT, movement dysfunction ,[object Object],www.apta.org or www.aaompt.org,[object Object],911,[object Object],Do not hesitate to call if uncomfortable with broken bone, concussion, seizure, or any other emergency,[object Object]
Develop relationship with PT,[object Object],Have PT come every week or every other week to the gym,[object Object],Triage,[object Object],Screen for injury prevention/wellness once every quarter lower levels or more frequent for elites (once every 4-6 wks),[object Object],Assess conditioning program for areas of weakness or overtraining,[object Object],Implement injury prevention program,[object Object],Help come up with Active Recovery program for injured athletes,[object Object],Provide educational talks for staff or parents,[object Object],Get to the doctor more rapidly,[object Object]
Emergency action plan,[object Object],Have an emergency action plan,[object Object],Train your staff annually on the action plan,[object Object],Who goes to the aide of the injured athlete,[object Object],When to call 911,[object Object],Who calls 911,[object Object],What the other coaches do to assist the primary provider or with other athletes or parents,[object Object],Who waits for the ambulance if needed,[object Object],What first aid is administered,[object Object]
EAP cont’d,[object Object],Have plans for various incidences which may arise,[object Object],What to do if an athlete is unconscious after landing on their head,[object Object],What to do in the event of a fracture or dislocation,[object Object],Practice Pit extractions with local fire department,[object Object]
Traumatic injuries & care,[object Object]
Sprain/Strains,[object Object],Minor injury no obvious deformity or serious injury,[object Object],Rest,[object Object],Ice,[object Object],Elevation (above the heart),[object Object],Compression,[object Object],Call the therapist or team medical provider have gymnast assessed to decide need for further medical care.,[object Object],Small sprains & strains untreated can lead to more serious injuries or troubles,[object Object],Care within 24-48 hrs dec recovery time & inc success full recovery,[object Object]
Possible Broken bone-no obvious deformity,[object Object],Apply splint to immobilize,[object Object],Apply ice,[object Object],Elevate above heart,[object Object],Contact doctor to get an appointment or have parent take the gymnast to Urgent care or ER if the gymnast excessive pain an unable to wait until the next,[object Object]
Dislocation or severe fracture-obvious deformity,[object Object],DO NOT move the gymnast from the area,[object Object],Call 911,[object Object],If profuse bleeding occurs apply direct compression with gauze over wound,[object Object],DO NOT try to relocate a dislocated joint or set a bone. You can do MORE harm and permanent damage to the athlete,[object Object]
Possible concussion,[object Object],Use the SCAT 2 for assessment,[object Object]
ITP 201 basic injury care
Concussion grading,[object Object],-Grade I- Dazed look; patient completely lucid (no amnesia, confusion) in 0-5 minutes,[object Object],-Grade II-Slight Confusion: mild posttraumatic amnesia that last less than 60 min; possible ringing in the ears: headache; may develop post concussion syndrome that can last several weeks to several years,[object Object],-Grade III- Symptoms listed above in addition to retrograde amnesia in which events prior to the concussion are forgotten,[object Object],-Grade IV- Loss of consciousness for less than 5 minutes followed by stupor, confusion, automatism and finally full alertness,[object Object],-Grade V- Unconsciousness for greater than 5 min; symptoms listed above but more severe, nausea, and vomiting; possible permanent neurological deficits,[object Object]
*Any gymnast with a head injury needs to be seen by a doctor as soon as possible.  If Grade IV or V concussion occurs call 911.,[object Object]
Deep laceration,[object Object],-Apply direct pressure with gauze to control bleeding.,[object Object],-Send gymnast to Urgent Care or ER for sutures,[object Object]
Non-traumatic injuries &care,[object Object]
Causes of non-traumatic injuries,[object Object],-Improper technique,[object Object],-Improper warm-up,[object Object],-Lack of flexibility (typically true shoulder, hip flexibility) or range of motion,[object Object],-Improper conditioning,[object Object],-Overuse,[object Object],*Muscle imbalances ,[object Object]
prevention,[object Object],-Emphasize technique from the beginning,[object Object],-Focus on all muscle groups,[object Object],-Build core strength early on (true internal/external abdominals, transverse abdominus…not just the “6 pack muscles” rectus) ,[object Object],-Do not forget to train the shoulder blade stabilizer and the hip stabilizers,[object Object],-Be specific and meticulous with conditioning, a stickler for form,[object Object],-Cross train/selectively train,[object Object],-Prevent overtraining by taking advantage of soft landings,[object Object],-Wrist guards (Tiger paw) for gymnast doing yerchenko vaults,[object Object],-Regular medical screenings with a therapist or doctor,[object Object],-Treat aches and pains before they become full blown injuries,[object Object],-Deal with the minor injuries to prevent recurring injury, domino affect, or worsening of injuries,[object Object]
treatment,[object Object],*A therapist can help with all the below and closely guide modified workouts along with progressive return to full workouts based on tissue healing.,[object Object],-Identify the cause,[object Object],-Eliminate the cause,[object Object],-Allow inflammation or acuteness of the injury to subside,[object Object]
Treatment cont’d,[object Object],-Strengthen weak muscles, stretch tight muscles, and retrain muscle firing patterns when a muscle is dominant,[object Object],-Maintain strength and endurance while treating an injury,[object Object],-Progressive loading to return to gymnastics without further injury (i.e. start with less numbers, low impact and progress slowly to full numbers and high impact),[object Object]
Ankle Sprains,[object Object],-First 24-48 hours R.I.C.E.,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Normalize ROM and strength,[object Object],-Normalize proprioception,[object Object],-Ankle taping/bracing during the protective phase where ankle is subject to re-injury.,[object Object]
spondylolesthesis,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Assess possible hypermobility L5-S1, if positive; brace with simple back brace/wrap during painful activities for up to 300 days (collagen fibers replenish; tissue healing),[object Object],-Proper lumbar stabilization (using blood pressure cuff; 40-50 with flexion bias),[object Object],-Avoid hyperextension (no backbends, bridges, back walkovers),[object Object],-Insure shoulder and hip ranges of motion are normal,[object Object]
Back pain,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Assess possible hypermobility L5-S1, if positive; brace with simple back brace/wrap during painful activities for up to 300 days (collagen fibers replenish; tissue healing),[object Object],-Proper lumbar stabilization (using blood pressure cuff; 40-50 with flexion bias),[object Object],-Avoid hyperextension (no backbends, bridges, back walkovers),[object Object],-Insure shoulder and hip ranges of motion are normal,[object Object],- Stretch hip flexors (iliopsoas and quads),[object Object],-Strengthen hip abductors, extensors, flexors, and external rotators (glut med, glut max, iliopsoas, superior/inferior gemelli),[object Object]
Shoulder pain,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Assess resting position of the shoulder (Anterior medial glide syndrome),[object Object],-Assess cervical and scapular strength,[object Object],-Stretch pecs and lats,[object Object],-Neck (deep cervical flexors) and shoulder blade (Upper trap, middle trap, lower trap, serratus anterior) strengthening,[object Object],-Rotator cuff strengthening ,[object Object],-Make sure rhomboid not doing all the work with shoulder external rotation (re-train if it is),[object Object]
Wrist pain,[object Object],-Technique,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Scapular and deep cervical strengthening,[object Object],-Make treat shoulder and elbow issues to,[object Object],-Wrist extension strengthening (make sure move wrist straight back, not inward) (ECRB tends to dominate),[object Object],-Finger flexor strength/grip strength,[object Object],-Proper loading of the wrist in plank, pushup, handstand, etc),[object Object],-Wrist guards (Lion Paws, tiger paws),[object Object]
Tendonitis/tendonopathy,[object Object],*There is no such thing as tendonitis in most cases.  They have found there is no inflammatory response.  It is tendonopathy which translates to micro-tearing of the tendon, which if goes untreated can truly rupture the tendon.,[object Object],-Technique,[object Object],-Normalize joint mechanics (See manual physical therapist),[object Object],-Normalize muscle imbalances affecting the tendon and loading response,[object Object]

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