PENCEGAHAN KECEDERAAN DAN KESELAMATAN DALAM SUKAN

Dr. Amirullah Mohd Arshad

SPORT INJURY MANAGEMENT

Dr. Amirullah Mohd Arshad

OBJEKTIF

Jurulatih akan memahami jenis-jenis kecederaan dalam sukan Jurulatih akan sedar tentang keadaan-keadaan yang mungkin menimbulkan kecederaan dalam bersukan dan bersenam Jurulatih akan memahami cara mengelakkan berlakunya kecederaan

Jenis-jenis Kecederaan
1.

2.

3.

Intrinsik (kecederaan tidak langsung) Ekstrinsik (kecederaan langsung) Kecederaan lebih guna

Jenis-Jenis Kecederaan
Intrinsik -kecederaan yang disebabkan oleh atlit sendiri -melibatkan otot, tendon, ligamen -kecederaan seperti overstretching
1.

Jenis-Jenis Kecederaan
2. Ekstrinsik (kecederaan langsung) -kecederaan yang disebabkan oleh pukulan atau hempapan ke badan. contoh: perlanggaran dengan lawan, terkena objek seperti bola, reket atau kayu pemukul.

Jenis-Jenis Kecederaan
3.Kecederaan lebih guna (overuse) -kecederaan yang biasanya disebabkan oleh tekanan berterusan keatas tisu tertentu umpamanya tulang, ligamen atau tendon. (patah, terseliuh, kecederaan teruk pada ligamen dan tendon dan juga kerosakkan otot)

JENIS KECEDERAAN
Kecederaan tisu lembut Kekejangan otot (penguncupan otot-otot yang amat laju dan jangka masa lama disebabkan -dehidrasi -kelesuan -hentakan atau pukulan ke atas otot-otot) Ketegangan otot (strain) (fiber otot mengalami kecederaan)

JENIS KECEDERAAN
Luka Melibatkan kecederaan dari luar kulit dan juga dari dalam. -abrasi (cakaran pada permukaan kulit) -potongan (terkena objek tajam) -tebukan (ditebuk oleh objek tajam)

JENIS KECEDERAAN

Lebam akibat kontusi (akibat hentakan terus keatas permukaan luas atau tisu lembut)

JENIS KECEDERAAN
Kecederaan tisu keras Melibatkan semua tulang -tulang patah akibat stres yang tinggi keatas tulang -tulang panjang (femur atau humerus) mengambil masa 6 minggu untuk sembuh.

JENIS KECEDERAAN
Dislokasi -berlaku apabila hujung tulang yang membentuk sendi tercabut atau terkeluar dari tempat lekatnya. -sering berlaku dibahagian sendi bahu

Mencegah Kecederaan
1.

Pakaian dan peralatan sukan

Pakaian Peralatan Peralatan Keselamatan Padang dan gelanggang

Mencegah Kecederaan 2.

Memanaskan Badan
Meningkatkan suhu dalam badan dan otot Mengurangkan ketegangan otot Mengurangkan risiko kecederaan Penyesuaian paru-paru dan dan saluran darah terhadap peningkatan kerja

Kenapa Memanaskan Badan

Untuk meningkatkan suhu badan dan otot Meningkatkan perjalanan darah & oksigen ke otot-otot

(otot-otot,sendi tisu bersedia untuk gerakkerja dan mengurangkan kemungkinan tercedera)

Mencegah Kecederaan 3. Menyejukkan badan

Untuk mengembalikan fungsi secara progresif Membantu penguraian asid laktik dalam otot dan lain-lain organ Mengelakkan pengumpulan darah dikaki bagi sesi sukan berintensiti tinggi.

Bagaimana dan bila untuk memanaskan badan

Program Latihan dan Aktiviti Fizikal

4 fasa Fasa Fasa Fasa Fasa Memanaskan badan Aerobik Pemantapan Otot (Conditioning) Menyejukkan badan

Program Latihan dan Aktiviti Fizikal

Fasa memanaskan badan Menyediakan otot dan sendi

Meningkatkan pengaliran darah Mencegah kecederaan Aktiviti senaman kelonggaran senaman regangan kalistenik

Program Latihan dan Aktiviti Fizikal

Fasa Aerobik yang menggunakan otot-otot besar Senaman

secara berulang untuk suatu jangka masa yang lama dan melibatkan penggunaan oksigen. Berjalan pantas Joging Berbasikal Lompat tali Tarirobik Naik tangga Berenang Bermain bola sepak

Program Latihan dan Aktiviti Fizikal

Fasa Pemantapan Otot (Muscular Conditioning) Memantapkan daya tahan dan kekuatan otot. Contoh: tekan tubi bangun tubi

Program Latihan dan Aktiviti Fizikal

Fasa Menyejukkan badan

Menurunkan kadar nadi kembali kepada keadaan biasa dan mengembalikan otot kepada keadaan rehat. Senaman tidak boleh dihentikan serta merta.

FAEDAH REGANGAN
1.Sendi-sendi bergerak dengan licin tanpa rintangan. 2.Mengurangkan/mengelakkan penyakit Muskulo Skeletal 3.Mengelakkan kecederaan pada otot tendon,ligamen. 4.Cepatkan peredaran darah. 5.Benarkan pergerakkan maksima. 6.Cepatkan pembuangan kumuh supaya tidak terasa sakit/tegang otot. 7.Rehatkan otot-otot yang tegang oleh kerana terasa sakit/tegang otot. 8.Darah tidak terkumpul dibahagian tertentu. 9.Mengekalkan kelembutan.

Mencegah Kecederaan
4. Keperluan Cecair Badan kehilangan cecair 2-3 liter bagi setiap jam aktiviti intensiti tinggi (6-10% berat badan) Penurunan kandungan air dalam plasma darah

mengakibatkan penurunan tekanan darah Peningkatan suhu badan dan mengakibatkan stress haba

Mencegah Kecederaan
Stres haba Akibat dari pendedahan kepada bahang matahari dan cuaca lembab -kekejangan otot ketidak seimbangan antara air dan electrolit -pucat,pening dan loya (heat exhaustion) -strok haba (pengsan, suhu meningkat hingga 41 darjah, badan tidak dapat mengeluarkan peluh)

Mencegah Kecederaan
6. Kesediaan Kesihatan

Mencegah Kecederaan
7.Mempunyai kecergasan untuk bersukan
-Stamina -Kepantasan -Kekuatan -Kuasa kuat dan pantas -Kesesuaian -Kelenturan -Kemahiran

Mencegah Kecederaan
8. Berlatih tetapi jangan keterlaluan 9.Dapatkan rehat yang cukup 10.Latihan perlaziman 11.Patuhi peraturan dan arahan sukan yang diceburi. .

Pengurusan kecederaan bantu mula

RICE

RICE

R rest I ice C compression E - elevation

KEY WORDS

Tissue organization of many similar cells Tendon connective tissue structure which connect muscle to bone Ligament strong connective tissue bond which connects bone to bone at a joint

Soft Tissue Injury

Most commonly injured :skin, muscle, tendons and ligament

Signs and symtoms of muscle fibre damage (strains)

Decreased function Pain on contraction Pain on stretching Sharp pain on injury Extreme point tenderness Spasm Loss of continuity (if complete rupture)

Sign & symptoms of ligament injuries (sprain)

Swelling Pain and point tenderness Later discoloration Decreased range of movement

Soft Tissue Injury

Less frequently involved :those contained with in the abdomen,brain,lungs,genitals, etc may be vulnerable in certain activities

Treatment - Aims

To prevent further tissue damage Initially to reduce swelling and later assist in removal of swelling To ease pain To prevent loss of range of motion To prevent muscle wasting To maintain players in fitness while injured region is healing To regain full power and function To restore confidence in the affected part or limb To return player to sport as soon as possible To prevent recurrence by education and training

Pathology of Injury

In general terms muscle, tendons and ligaments pass through three phases of repair

Phase 1- Acute Inflammatory Phase

Up to 72 hours after injury Increase blood flow If blood vessel damaged, blood escaped in the wound Increase in secretions and fluid Cause swelling,pain,redness, loss normal function Clotting begins

0 hours Immediate post injury ligament rupture

24 hours No RICE Uncontrolled bleeding & oedema

PAIN

Repair Phase

Anything between 72 hours to 6 weeks, depending on injuries Removal of damage tissues Formation of new fibres which is not fully alligned Gradual reintroduction to normal function

Remodelling phase

3 to 6 weeks up to 6 months Does overlap with the repair phase Reoriented and alligned to its original position Supervised original exercise would expedite the recovery

3-6 weeks No RICE & early exercise Bulky, painful scar collagen with adhesion

3-6 weeks With RICE Repair without adhesion

Factors to consider before an athlete returns to sport following an injury

1. 2. 3. 4. 5.

6.

Pain-free/intact structure Flexibility Cardiovascular fitness Strength Self confidence Skills needed in his or her sport

Kaedah pengurusan kecederaan sukan

For effective assessment of an injury remember T.O.T.A.P.S!

TOTAPS

Talk Ask the player what happened Where does it hurt? What kind of pain is it?

T O TA P S

Observe Look at the affected area for redness or swelling Is the injured side different from the other side?

TOTAPS

Touch

Touch will indicate warmth for inflammation - touch also assesses pain.

TOTAPS

Active movement

Ask the injured player to move the injured part without any help.

TOTAPS

Passive movement If the player cant move the injured part, carefully try to move it yourself through its full range of motion.

TOTAPS

Skill test / Stand

Did the active and passive movement produce pain? If no, can the player stand and demonstrate some of the skills from the game carefully? If an injury is identified, remove the player from the activity immediately.

Treating the injury An injury identified using T.O.T.A.P.S. should immediately be treated with the R.I.C.E.D. procedure

Injury management involves identifying, treating and recovering from an injury. Its important that injured players dont suffer unnecessary additional pain and discomfort and affect their recovery from their injury. Remember, the sooner you rest and treat the injury, the less time the player will be in pain or discomfort and the sooner they will be able to return to their activity.

Avoid H.A.R.M-ful factors

Once the injury has been diagnosed and treated, avoid the H.A.R.M-ful factors for 72 hours:

HARM

Heat Heat increases the bleeding in the injured tissues. Avoid hot baths and showers, saunas, hot water bottles, heat packs and liniments.

HARM

Alcohol Alcohol must be avoided as it increases the bleeding and swelling around soft tissue injuries and delays healing. It can also mask the injurys pain and possible severity, which may delay treatment.

HARM

Running
Running or any form of exercise will cause further damage. A medical providers assessment and approval should be given before resuming activity within 72 hours of the injury.

HARM

Massage Massage causes an increase in bleeding and swelling and will prolong the rehabilitation process when done within 72 hours of the injury.