sports injury sports injury sports injuries are injuries that occur during sport, athletic activities, or exercising. in the united states, there are approximately 30 million teenagers and children who participate in some form of organized sport. of those, about three million athletes age 14 years and under experience a sports injury annually. according to a study performed at stanford university, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the knee, lower leg, ankle, or foot. in addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck occurrences. player getting ankle taped at an american football game in mexico a tennis injury tackles like this one in women's australian rules football can cause injuries. ryan miller of the buffalo sabres suffers an ankle sprain.when an athlete complains of pain, injury, or distress, the key to diagnosis is a detailed history and examination. an example of a format used to guide an examination and treatment plan is a s.o.a.p note or, subjective, objective, assessment, plan. another important aspect of sport injury is prevention, which helps to reduce potential sport injuries. it is important to establish sport-specific dynamic warm-ups, stretching, and exercises that can help prevent injuries common to each individual sport. an injury prevention program also consists of education on hydration, nutrition, monitoring team members "at risk", monitoring at-risk behaviors, and improving technique. in addition, season analysis reviews, preseason screenings, and pre-participation examinations are essential in recognizing pre-existing conditions or previous injuries that could cause further illness or injury. one technique that can be used in the process of preseason screening is the functional movement screen. the functional movement screen can assess movement patterns in athletes in order to find players who are at risk of certain injuries. in addition, prevention for adolescent athletes should be considered and may need to be applied differently than adult athletes. lastly, following various research about sport injury, it is shown that levels of anxiety, stress, and depression are elevated when an athlete experiences an injury depending on the type and severity of the injury. types of sport injury nearly two million people every year suffer sports-related injuries and receive treatment in emergency departments. fatigue is a large contributing factor that results in many sport injuries. there are times where an athlete may participate on low energy leading to the deterioration in technique or form, resulting in a slower reaction time, loss in stability of muscle joints, and allowing an injury to occur. for both sexes the most common areas injured are the knee and ankle, with sprains/strains being the most common areas for injury. injuries involving the patellofemoral articulation are significantly more frequent among females. the sport with the highest injury rate in the united states is american football, with greater than 12 times the number of injuries seen in the next most common sport. soft tissue injuries main article: soft tissue injury when soft tissue experiences trauma the dead and damaged cells release chemicals, which initiate an inflammatory response. the small blood vessels that are damaged become dilated which produce bleeding within the tissue. the body's normal response includes forming a small blood clot in order to stop the bleeding and allows a clot of special cells, called fibroblasts, to form. this begins the healing process by laying down scar tissue. therefore, the inflammatory stage is the first phase of healing. however, too much of an inflammatory response in the early stage can indicate that the healing process takes longer and a return to activity is delayed. sports injury treatments are intended to minimize the inflammatory phase of an injury, so that the overall healing process is accelerated. intrinsic and extrinsic factors are determinant for the healing process. soft tissue injuries can be generally grouped into three categories: contusions, abrasions and lacerations. contusions or bruises are the simplest and most common soft tissue injury and is usually a result of blunt force trauma. severe contusions may involve deeper structures and can include nerve or vascular injury. abrasions are superficial injuries to the skin no deeper than the epidermis tissue layer, and bleeding, if present, is minimal. minor abrasions generally do not scar, but deeper abrasions generally bleed and may scar. lastly, sports-related lacerations are caused by blunt trauma and result in burst-type open wounds, often with jagged irregular edges. facial lacerations are the most variable of the soft tissue injuries that athletes can sustain. they can occur intraorally and extraorally, vary from a superficial skin nick to a through and through lip laceration, or involve significant vascular disruption or injury to collateral vital structures. hard tissue injuries types of hard tissue injuries can include dental and bone injuries and are less frequent than soft tissue injuries in sport, but are often more serious. hard tissue injuries to teeth and bones can occur with contusions, such as battle sign, which indicates basilar skull fracture, and so-called raccoon eyes, which indicate mid-face fractures. however, tooth fractures are the most common type of tooth injury, and can be categorized as crown infractions, enamel-only fracture, enamel-dentin fractures, and fractures that extend through the enamel and dentin into the pulp which are defined below. crown infractions are characterized by a disruption of the enamel prisms from a traumatic force, these injuries typically present as small cracks that affect only the enamel. enamel-only fractures are mild and often appear as roughness along the edge of the tooth crown. these injuries typically can go unnoticed by the athlete as they are usually not sensitive to the touch or to temperature changes. enamel-only fractures are not considered dental emergencies and immediate care is not needed. enamel-dentin crown fractures typically present as a tooth fracture confined to enamel and dentin with loss of tooth structure, but not exposing the pulp. the athlete often will report sensitivity to air, cold or touch, but the athlete can return to play as tolerated and referral can be delayed up to 24 hours. enamel-dentin-pulp fractures extend through the enamel and dentin and into the pulp. if the pulp is vital, a focal spot of hemorrhage will be noticeable within the yellow dentin layer and the athlete may report acute pain. referral to a trauma-ready dentist should occur as soon as possible. in addition to tooth fractures, there are several types of bone fractures as well. these types being closed or simple, open or compound, greenstick, hairline, complicated, comminuted, avulsion, and compression. a complicated fracture is when the structures surrounding the fracture are injured, such as blood vessels, organs, nerves, etc. overuse injuries overuse injuries can be defined as injuries that result from a mechanism of repetitive and cumulative micro-trauma, without a specific onset incident. rapid changes in physical growth can make children vulnerable to overuse injuries, and these types of injuries are increasing among youth populations. overuse injuries can usually be classified into 4 types/stages, these include: pain in the affected area during activity (which does not affect performance) pain in the affected area during activity (which does restrict performance) pain in the affected area after activity chronic pain in the affected area, even after resting predictive indicators of overuse injuries in adolescent endurance athletes, runners seem to account for the majority of injuries (up to 80 percent) with the majority of these injuries (more than two-thirds), occurring in the lower extremity and being of an overuse nature. although incidence rates in senior athletics has been reported as 3.9 injuries/1000 hours of practice, specific injury incidence in youth track and field varies among disciplines; whereas an overall incidence of 0.89 injuries/1000 hours has been reported for high school track and field athletes. in addition, long-distance runners have showed a 19 times higher incidence (17 injuries/1000 hours) than other disciplines. head and neck injuries head and neck injuries can include a variety of pathologies from sprains, strains and fractures to traumatic brain injuries and spinal cord injuries. sprains and strains can occur from an abrupt rotation or whipping motion, such as whiplash. stress injuries (stress fractures and stress reactions) of the lumbosacral region are one of the causes of sports-related lower back pain in young individuals. the onset of the observed cervical fractures in sports injury were likely due to continued momentum that transferred loads superiorly through the neck, which likely exacerbated the injuries to the occipital condyles and the upper cervical vertebrae. researchers have reported that 3-25% of cervical spine injuries actually occur after the initial traumatic event and are caused or exacerbated by improper handling during early stages of management or patient transport. one of the more common head or neck injuries that occurs in sports is a concussion. a concussion is a type of mild traumatic brain injury resulting in a chemical change in the brain and has potential to cause damage to brain tissue. this can occur when a person sustains a hit or blow that cause the head and brain to move quickly, causing the brain to bounce in the skull. according to an epidemiological study published in the journal of athletic training, the incidence of concussions from 27 high school sports was 3.89 sports-related concussions per 10,000 athlete exposures. sports related musculoskeletal injuries subacromial impingement syndrome is a shoulder joint injury. baseball players are prone to get affected with subacromial impingement syndrome, as the sport requires an overhead movement of the arms to make a throw. injury causes mechanical inflammation in the subacromial space – the space above the shoulder's ball and socket joint and the top most shoulder bone. muscular strength imbalances, poor scapula, and rotator cuff tears are the main causes of subacromial impingement syndrome. overhead movement of the arms instigates pain. falling on an outstretched arm and pulling on the shoulder, repetitive lifting of heavy loads or overhead movement cause rotator cuff tears. anterior cruciate ligament injury: common in skiing, soccer, football, and basketball. immediately after injury the subject will fall to the ground, acute swelling sets in, knee is destabilized, and bearing weight becomes a difficulty. knee injury in contact sports, and jumping, deceleration, and pivoting in non-contact sports and activities cause anterior cruciate ligament injury. collateral ligament injury: an injury to a partially flexed knee can damage the medial collateral ligament – the ligament stretching along the inner edge of the knee. a forceful medial blow to the knee can cause collateral ligament injury. a reduction in range-of-motion and pain are symptoms of collateral ligament injury. meniscus injuries: acute or repeated injury to the meniscus – the shock absorber of the knee – causes meniscus injuries. a person with meniscus injuries experience difficulty squatting and walking instigates pain. runner's knee (patellofemoral pain): knee joint pain affecting the patellofemoral joint. pain is a direct consequence of the kneecap rubbing against the end of the thigh bone – "patella" means kneecap and "femur" means a thigh bone. the force the patellafemoral joint has to sustain can be as much as five times the body weight when the knee is fully flexed – when squatting – and three times body weight when the knee flexes to 90 degrees – when climbing stairs. this makes the cartilage that makes up the patellafemoral joint susceptible to wear and tear. the typical pain is also associated with muscle strength and joint flexibility. repetitive physical activity such as running can trigger pain. tight hamstrings, tight achilles tendons, and weak thigh muscles, which are required to stabilize the knee, cause runner's knee. inversion ankle sprain: landing on an uneven surface sprains the ankle. swelling, localized pain, difficulty bearing weight, and limping are signs of inversion ankle sprain. eversion ankle sprain: injury related to the ankle turning outward or rotating externally. a typical symptom of eversion ankle sprain is excruciating pain that worsens with weight bearing. risk factors there are several factors that may put an athlete more at risk for certain injuries than others. intrinsic or personal factors that could put an athlete at higher risk for injury could be gender. for example, female athletes are typically more prone to injuries such as acl tears. there are approximately 1.6-fold greater rate of acl tears per athletic exposure in high school female athletes than