KEY KNOWLEDGEKEY SKILLS Why, what and how do sporting injuries occur? The duty of care that must...

KEY KNOWLEDGE KEY SKILLS

Why, what and how do sporting injuries occur?

The duty of care that must be undertaken by administrators, coaches, team managers, teachers and / or students participating in sports

Various strategies using sports medicine to improve performance and any associated ethical considerations

Policies developed by Sports medicine Australia

How is pre-participation screening used to prevent injuries to those involved in physical activities?

The ability to specify if sports injuries are caused direct, indirect or overuse factors

The application of duty of care in various sport and physical activity programs

Apply and analyse any ethical considerations associated with sports medicine practices

Understand and appreciate Sports Medicine Australia policies

Construct and apply pre-activity screening documentation to performers and sports participants

© Cengage Learning Australia 2011

Sports injury risk management systems that should be considered before, during and after sporting events

Reducing the risk of injury by considering various preventative measures such as policies, training, warm ups and cool downs, mandatory wearing of protective equipment, appropriate footwear and taping/strapping of joints.

Consideration of multiple rehabilitation strategies used to assist recovery from injury and management strategies used to assist players getting back to competition or pre-injury levels.

The role allied health professionals play in promoting safe play, injury prevention and rehabilitation.

Analyse and discuss various risk management systems that can be applied to training and recovery

Identify and discuss various sports injury preventative strategies used in a variety of physical activities.

Discuss similarities and differences in a variety of contemporary rehabilitation strategies

Consider the role physiotherapists, occupational therapists, dieticians, masseurs and other allied health professionals play in injury prevention, rehabilitation and eventual return to sport of lifestyle.


Direct injuries are caused by an external force and can be caused by:• a collision with another person, either intentional or unintentional, such as beingtackled in Australian Rules football or simply running into another person on a sporting field• a direct blow from an implement such as a Hockey stick, or being struck by a projectile such as a cricket ball.These injuries may cause minor damage such as a bruise, or major damage such as a broken bone

Direct injuries


Indirect injuries are usually caused by a sudden change in either direction or intensity. Examples include sprained ligaments and strained muscles.

Indirect injuries can also be caused by simply losing balance and tripping over, resulting in minimal injury such as a bruise, or major trauma such as a broken bone or the loss of consciousness.

Indirect injuries

Overuse injuriesOveruse injuries result from the continualperformance of some type of movement such as ‘shin splints’ from running or elbow tendonitis from tennis. A variety of factors can lead to overuse injuries including:• the repetitive nature of the activity• insufficient recovery time between training sessions• inappropriate increase in training load• inadequate footwear• inappropriate training surface.


Ethics are the shared beliefs and principles that a society lives by. They are the moral values of a society. The Australian Sports Commission has developed ‘The essence of Australian sport’, guidelines that define the core principles that our sporting culture has been built on. Unfortunately, there can be increased pressure for those involved in sport to sometimes act in an unethical manner. Reasons include –

Ethical considerations for sports medicine practices

• a ‘win at all costs’ mentality• financial gain• insufficient recovery time• prestige and fame• ongoing dissatisfaction with performance levels• psychological dependence• lack of confidence• pressure to win from family, coach or sponsors• the influence of role models.


At a community level, Sports Medicine Australia is responsible for creating a safe playing field in which all Australians can actively and freely participate. The delivery of the Safer Sport message throughout Australia is achieved through the development and design of courses and educational resources for coaches, trainers, teachers and participants.

Sports Medicine Australia works to ensure the safety of all active Australians, and the continued professional development of persons interested in sports science, sports medicine and healthy activity.

Sports Medicine Australia draws together all sports science and sports medicine professionals. These groups include:

• orthopaedic surgeons • physicians • doctors • physiotherapists • optometrists • dentists •podiatrists• dieticians • psychologists • sports scientists • nurses • teachers • exercise physiologists • academics • population health specialists


The purpose of pre-activity screening is to minimise the risk of injury from physical activity, including fitness testing. Pre-activity screening is highly recommended for older adults and those with health concerns. In reality, anyone who is involved in, or intends to commence, some form of physical activity should complete some form of pre-activity screening every 12 months.

Pre-activity screening should include information on: • current health issues such as asthma and diabetes.• musculo-skeletal conditions such as Osgood-Schlatter disease• previous injuries that may impact on participation in some activities such as a knee reconstruction• information on current intake of any prescription medication• family and personal medical history. (In some circumstances it may be more appropriate to obtain a separate medical history.)

Pre-activity screening


Participating in training and physical activity can pose a risk to a participant. Risk management is the process of measuring or assessing risk and then developing strategies to manage the risk. Risk is the chance of something happening. It can be measured in terms of likelihood and consequences. Some suggested steps in the risk-management process are:• identification and assessment of risks• identification of possible actions available• risk avoidance• risk reduction• creating a plan• implementing the plan• ongoing monitoring and evaluation of the planSuch approaches can assist in identifying the hazards and evaluating and controlling the risk. A number of key questions could be posed when determining risk-management procedures.Possible questions to consider for all circumstances include –• What could possibly go wrong? (Consider all risks you face.)• What protections do you have in place to prevent these likely occurrences?• What will you do if it happens?

Risk management and prevention


Inadequate pre-participation screeningThe entry point for the individual along with assessment of the existing fitness level must be factored in when designing a suitable training program and there should be sufficient provision for recovery, to avoid training loads being set too high for the given skill and fitness level of the participant

Coaching conduct and practicesIf an injury occurs, unsafe coaching practices and unqualified people developing training programs or administering first aid, as well as poor immediate management procedures, could result in an injury becoming more serious.

What can go wrong in training and recovery?


Program designOvertraining, sprains, strains and particularly back injuries can result from poorly designed training programs, such as programs based on an unsound application of training principles and inappropriate choices of training methods.

Activities and equipmentInappropriate activities for players of a particular age, size, body shape, sex, skill level and psychological and physical maturity should not be included in a program.

Equipment can contribute to injury in training and recovery if –• it is used incorrectly; not cared for maintained properly• it is not used for the purposes for which it was designed• safety dress codes are not observed during training and competition• inspections of facility and equipment are not regularly and routinely undertaken• uneven and poorly maintained playing surfaces are not repaired.


Inability to get immediate medical assistance or the required first aid equipment can result in an injury not being treated correctly. If an injury occurs in training, many factors could increase the risk consequences:

• Incorrect first aid and immediate injury and management procedures (e.g. not supplying a wheelchair or a stretcher)

• Qualified sports first aiders not being present at competition events and training sessions• Ice not being available at training and competition• Emergency plans, procedures and phone numbers not being readily accessible at the site of trainingPerforming a functional assessment for a safe return to physical activity after rehabilitation is important in reducing the potential risk for a further injury.Insufficient recoveryHaving to train or compete without adequate recovery may expose an athlete to a greater risk of injury. It is during the recovery process that many important physiological responses occur.Environmental conditionsConducting training and competition in inclement weather such as storms, lightning, extreme heat, extreme cold or peak ultraviolet times without regard for the accepted guidelines and thereby failing to implement prevention and treatment of environmental stress factors could also result in injury or illness.

Inability to get medical assistance


To assist in the area of development of policy, procedures and practices, Sports Medicine Australia (SMA) Smartplay program has developed Guidelines for Clubs, Associations and Facilities. The guidelines offer advice on the development of a sport safety plan in the following areas:

• medical history forms• injury records• injury referral• modified sports• health policies and guidelines including hydration, infectious diseases, children in sport,• sports first aid and sports trainers• physical preparation• coaches and officials• equipment, including protective equipment• playing environment and facilities.

Sports safety guidelines


In addition to the development of policy, the development of procedures in a range of areas is also a useful action to take. Such areas could include –• screening pre-participation prior to an individual undertaking training• athlete preparation − outlining appropriate practices for planning, physical conditioning, recovery, skill training and supervision• injury management, including first aid plans, first aid resources, emergency treatment, injury referral, administration of treatment, return to sport after injury, record keeping and data collection on injuries (VicSport)• facility and equipment use − these procedures could address issues such as regular inspections (major inspections and pre-activity inspections), compliance with standards, signage, lighting, fire safety, evacuation/ emergency plans, disabled access, security, equipment positioning, hygiene, use of protective equipment and use of barriers (VicSport)• prevention and treatment of environmental stress factors.

Risk-management procedures


Tremendous gains have been made over the past 20 years in the area of injury rehabilitation.Rehabilitation focuses on a combination of the following four areas –• Reducing inflammation and promoting increased healing• Promoting an increased range of motion (which may have decreased due to inactivity or immobilisation while injured)• Increasing strength of the injured area; particularly as muscle wasting may have resulted due to inactivity, and is particularly pronounced with immobilisation injuries such as a broken limb• Improving proprioception of the injured area, i.e. improve joint awareness

Rehabilitation techniques and healthcare professionals


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