Sport Injury Classification

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Introduction

Sport injuries are diverse in terms of the mechanism of injury, how they present in individuals, and how the injury should be managed. Defining exactly what a sports injury is can be problematic and definitions are not consistent. According to Engebretsen et al (2012) a sports injury may be defined as "damage to the tissues of the body that occurs as a result of sport or exercise" .  While There are many ways to classify sports injuries based on the time taken for the tissues to become injured, tissue type affected, severity of the injury, and which injury the individual presents with.

Injury Classification 

Time

This is one of the most common methods of classifying sports injuries, and relies on the sports therapist knowing the mechanism of injury and the onset of the symptoms.

Acute

Injury occurs suddenly to previously normal tissue. Acute injuries occur due to sudden trauma to the tissue, with the symptoms of acute injuries presenting themselves almost immediately. The principle in this instance is that the force exerted at the time of injury on the tissue (ie. muscle, tendon, ligament, and bone) exceeds the strength of that tissue.Forces commonly involved in acute injury are either a direct or indirect.

Direct / Contact Injury

A direct injury is caused by an external blow or force.

• A collision with another person (for example, during a tackle in rugby union)
• Being struck with an object (for example, a cricket ball or hockey stick).

Indirect / Non-Contact Injury An indirect injury can occur in two ways:

• The actual injury can occur some distance from the impact site. For example, falling on an outstretched hand can result in a dislocated shoulder.
• The injury does not result from physical contact with an object or person, but from internal forces built up by the actions of the performer, such as may be caused by over-stretching, poor technique, fatigue and lack of tness. 

Overuse

Any repetitive activity can lead to an overuse injury. Overuse injuries occur over a period of time, usually due to excessive and repetitive loading of the tissue, with symptoms presenting gradually. Little or no pain might be experienced in the early stages of these injuries and the athlete might continue to place pressure on the injured site.This prevents the site being given the necessary time to heal. Eventually the damage accumulates, and the injured site becomes in amed, and therefore painful. In contrast to acute injuries, the cause of overuse injuries is often much less obvious. The principle in overuse injury is that repetitive microtrauma overloads the capacity of the tissue to repair itself.

To better understand overuse injury it helps to think in terms of what is happening at the microscopic level to the tissue that has been “stressed” during the repetitive workouts. During exercise the tissues (muscles, tendons, bones, ligaments, etc) experience excessive physiological stress. When the activity is over the tissues undergo adaptation so as to be stronger to be able to withstand a similar stress in the future if required. Overuse injury occurs when the adaptive capability of the tissue is exceeded and tissue injury then develops. That is, in the over- zealous athlete there is not enough time for adaptation to occur before the next work out and the cumulative tissue damage eventually exceeds a threshold for that tissue causing pain and tissue dysfunction. The adaptive capability of the tissue may be exceeded secondary to excessive repetitive forces attributable to one or more commonly a combination of risk factors including;

• Intrinsic 

Age

Size/Body Composition

Bone Health

Poor Biomechanics

Lack of Flexibility

Muscle Imbalance

Muscle Weakness

• Extrinsic

Training Errors e.g. Excessive Volume, Excessive Frequency, Excessive Intensity

Equipment e.g. Damaged, Inappropriate, Worn Out

Playing Surfaces e.g. Uneven v Even, Grass v Concrete

The cause of overuse injury is most often MULTIFACTORIAL and can involve both extrinsic and intrinsic factors.

Tissue Type

Soft Tissue

Ligament

Tendon

Muscle

Skin

Hard Tissue

Bone

References 

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