Sport Injuries

Jade and Hannah

Introduction to contusions

Contusion (bruises) are acute sport injuries that are caused when your body collides with a solid object. When this occurs, the soft tissue under your skin (muscle fibres and connective tissue) are crushed but the skin doesn't break or rupture. When soft tissue is damaged, the ruptured capillaries cause blood to leak out under the skin which results in the area swelling and forming a red/purple mark that is tender to touch. Bruises are usually graded into three categories and these are referred to as: first, second or third degree depending on their severity.

Contusion - First degree

A first degree bruise is an acute injury and is the least severe and it is only a minor rupture of the capillaries. The sign for first degree bruises is minimal swelling. The symptoms are mild pain and localised stiffness/tenderness of the area. It doesn't cause any limitations in strength or range of motion. From this, there is very little loss of function.

An example is when Rafael Nadal hit Novak Djokovic in the face with a tennis ball during their semifinal match in Canada. This would have caused a first degree contusion, as Djokovic will have gained minimal swelling and pain from this. This however won't have affected his performance vastly as a first degree contusion doesn't cause limitations in strength or motion.

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Contusion - Second degree

A second degree bruise is an acute injury and is due to a moderate rupture of the capillaries and increased bleeding. Signs can include bleeding and moderate swelling. Symptoms include increased pain, moderate loss of movement, muscle function or both.

An example is if a sprinter tripped and fell over then landed on their knees. The big impact when their knees hit the floor will cause moderate rupture of the capillaries which will cause bruising and increase bleeding.

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Contusion - Third degree

A third degree bruise is a severe tissue compression. It's due to a major rupture of the capillaries. Signs include massive swelling around the injury site. The symptoms of this are severe pain, significant haemorrhage, hematoma formation, and severe limitations in range of motion/ muscle function. As a result of these bruises, deeper structures like bones and muscles may have damaged but this could be masked by the signs and symptoms associated with superficial soft tissue damage.

An example is a basketball player going over on their ankle (spraining ligaments) after landing badly from a high jump. This would cause massive swelling and bruising around the ankle.

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Introduction to sprains

Sprains are also acute sport injuries which occur when one or more ligaments have been stretched, twisted or torn. (Ligaments are strong bands of fibrous tissue around joints that connect bones to one another). This is damage to one or more ligaments in a joint. Sprains are often caused by trauma or by the joint being taken beyond its possible range of motion. The severity of a sprain ranges from minor injury which will resolve in a few days, to a major rupture of one or more ligaments, requiring surgery and a long period of rest. Sprains can occur in any joint but are most common in the wrist, knee and ankle.

Sprain - First degree

A first degree sprain is where the fibres of the ligaments are stretched but still intact, or mild tearing of the ligament. Little or no function loss, the joint can still function and bear some weight. A sign includes minor swelling. The symptoms are mild pain and some joint stiffness.

An example is in diving. A diver could sustain a first degree sprain because of the amount of force of the diver puts on their wrist when they enter the water. When divers lock their elbows into extension and hyperextended both wrists before hitting the water it subjects the worst to a lot of force which can cause ligaments to stretch or even mildly tear.

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Sprain - Second degree

A second degree sprain is a tear of part of a ligament, from a third to almost all of its fibres. Its more severe tearing of the ligament compared to a first degree sprain. A sign includes swelling bruising. Symptoms include moderate to severe pain, weight bearing is very painful.

An example is a Wayne Rooney getting accidentally colliding with Gomez. By colliding with an opponent, this would cause impact to the ankle which could then lead to tearing of part of a ligament. He had to be carried off the pitches he was unable to bear weight on the floor at the time and left the stadium in crutches and a protective boot in order to reduce weight put onto the ankle.

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Sprain - Third degree

A third degree sprain is a complete rupture of a ligament, sometimes avulsing (when a fragment of a bone tears away from the main mass) a piece of bone. There is loss of motion as joint function is lost. Signs are severe swelling and bruising. Symptoms are severe pain and loss of movement at that joint.

An example is in gymnastics when doing stunts. If someone who is threw up in the air as a stunt (known as the 'flyer') but is dropped and lands on an outstretched arm, this will most likely rupture many ligaments as they have fallen from a height greater than themselves. The 'flyer' would have severe swelling and bruising and a loss of movement.

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