Musculoskeletal Injuries

• Wrist fractures (Colles' fracture)
• Ankle fractures
• Hip fractures (common in elderly)
• Stress fractures (overuse)

• Ankle sprain (most common joint injury)
• ACL/MCL knee sprain
• Hamstring strain
• Rotator cuff strain (shoulder)

• Shoulder dislocation
• Finger/thumb dislocation
• Patella (kneecap) dislocation

Soft Tissue Injuries

• Contusions (bruises) - direct blunt trauma
• Lacerations - cuts/tears in skin
• Abrasions - skin scraping
• Tendon injuries - Achilles tendon rupture, patellar tendinitis
• Bursitis - inflammation of fluid-filled sacs near joints

Head & Spine Injuries

• Concussion - mild traumatic brain injury
• Whiplash - cervical spine injury from rapid acceleration/deceleration
• Herniated disc - lumbar or cervical spine
• Traumatic brain injury (TBI)

Sports-Specific Common Injuries

Workplace Injuries

• Lower back strain (lifting)
• Carpal tunnel syndrome (repetitive motion)
• Cuts and lacerations
• Falls from height
• Crush injuries

Burns & Thermal Injuries

• First degree - superficial (sunburn)
• Second degree - partial thickness (blistering)
• Third degree - full thickness (deep tissue damage)

By Mechanism

Common Sports Health Injuries

1. Ankle Sprain

• Management: For acute severe sprains, a below-knee cast or Aircast produces faster recovery than compression bandages alone; outcomes are similar at 9 months.
• Return to sport: Guided by functional rehabilitation and proprioceptive training.

Goldman-Cecil Medicine, p. 3848

2. Anterior Cruciate Ligament (ACL) Injury

• Commonly a non-contact injury from sudden deceleration, knee valgus, or rapid change of direction.
• A second blow before full recovery worsens outcomes significantly.
• Recent evidence: balance training programs reduce ACL incidence in soccer players (Su et al., 2025 - Systematic Review & Meta-Analysis, PMID 40051003).

Campbell's Operative Orthopaedics 15th Ed, Block 25

3. Hamstring Strain

• Ranges from mild muscle strain to complete musculotendinous tear.
• Usually occurs at the musculotendinous junction during sudden acceleration/deceleration.
• In adolescents: ischial tuberosity avulsion fracture is more common due to apophyseal weakness.
• Complete recovery can take weeks to months.
• Management: Crutches, protected weight-bearing, sports medicine referral, progressive strengthening.

Gray's Anatomy for Students, p. 3643; Rosen's Emergency Medicine, Table 47.3

4. Quadriceps Strain / Tear

• Ambulation is significantly impaired; patient may be unable to actively extend the knee.
• A palpable depression proximal to the patella suggests a complete tear.
• Ultrasound confirms diagnosis; complete tears require urgent surgical repair.

Rosen's Emergency Medicine, Table 47.3

5. Concussion (Sports-Related TBI)

• Defined as a traumatically induced transient disturbance of brain function.
• More than 90% are NOT associated with loss of consciousness.
• Symptoms: headache, confusion, amnesia, nausea, balance problems, vision changes.
• CT and MRI are normal in concussion.
• Key rule: A player should NEVER return to play while symptomatic.
• Follow stepwise, graded return-to-play protocol when asymptomatic.

Textbook of Family Medicine 9e, p. 1503-1521

6. Rotator Cuff Injury (Shoulder)

• Ranges from impingement to partial/complete rotator cuff tears.
• Recent systematic review found multiple risk factors for shoulder injuries in female overhead athletes (Steele et al., 2025 - PMID 38898813).

Goldman-Cecil Medicine, p. 3520; Rosen's Emergency Medicine, Block 7

7. Muscle Strains - Other Lower Limb

Rosen's Emergency Medicine, Table 47.3

8. Plantar Fasciitis

• Pain is worst in the first steps after waking, improving then worsening later in the day.
• Tenderness at the anteromedial calcaneal tubercle.
• Treatment: rest, NSAIDs, heel cord stretching, insoles, local corticosteroid injection.

Goldman-Cecil Medicine, p. 3853

9. Knee Dislocation

Summary Table

Role of the Sports Health Nurse

1. Injury Assessment and Triage

• Conducts initial injury assessment at the sideline, clinic, or emergency setting
• Evaluates and triages sprains, strains, fractures, dislocations, lacerations, and concussions
• Differentiates between injuries requiring immediate medical transfer and those manageable on-site
• Collaborates with sports medicine physicians to develop individualized treatment plans

CareRev Sports Medicine Nursing Guide

2. Concussion Management

• Recognizes signs and symptoms: headache, confusion, amnesia, balance problems, nausea
• Applies standardized sideline assessment tools (symptom checklists, cognitive and balance tests)
• Enforces the cardinal rule: a player must never return to play while symptomatic
• Oversees a graduated return-to-play protocol progressing through:
  1. No activity
  2. Light aerobic exercise
  3. Sport-specific exercise
  4. Non-contact training drills
  5. Full-contact practice
  6. Return to competition (only when fully symptom-free)
• Monitors for second-impact syndrome - a catastrophic, high-mortality condition where a second head injury occurs before the first has resolved

Swanson's Family Medicine Review, p. 7863-7865; Textbook of Family Medicine 9e, p. 1503-1521

3. Preventive Care and Health Promotion

• Conducts or assists with pre-participation physical examinations (PPE) to screen for conditions that may pose risk during competition
• Identifies risk factors for injury (muscle imbalances, prior injury history, biomechanical issues)
• Educates athletes on:
  • Proper warm-up and cool-down techniques
  • Safe training loads and rest periods
  • Correct sport technique and protective equipment use
  • Nutrition, hydration, and sleep for performance and recovery

Credenza Health Sports Medicine Nursing Guide

4. Emergency Response

• Responds rapidly to cardiac arrest (AED use, CPR), heat stroke, severe fractures, anaphylaxis, and spinal injuries
• Recognizes and acts on exertional heat illness: any athlete showing mental status changes in a hot environment requires immediate removal from play and active cooling (ice-water immersion)
• Facilitates safe transfer to hospital when needed

Textbook of Family Medicine 9e, p. 1706-1712

5. Rehabilitation Support

• Assists in designing and monitoring progressive exercise rehabilitation programs
• Tracks recovery milestones and communicates progress to the medical team
• Coordinates with physiotherapists, strength coaches, and physicians
• Provides wound care, taping, bracing, and post-operative care
• Supports return-to-sport readiness assessments

6. Chronic Condition Management

• Manages conditions such as asthma, diabetes, hypertension, and overuse injuries (tendinopathy, stress fractures)
• Monitors medications (including ensuring compliance with anti-doping regulations)
• Conducts regular health screening and monitoring

7. Mental Health Support

• Identifies signs of anxiety, depression, eating disorders, and overtraining syndrome
• Provides initial support and facilitates referral to sport psychologists
• Supports athletes during periods of injury-related stress or performance pressure

8. Doping Prevention and Ethics

• Educates athletes about prohibited substances (WADA/national anti-doping codes)
• Ensures medications prescribed are compliant with anti-doping rules
• Maintains confidentiality and ethical standards in athlete health management

9. Documentation and Coordination

• Maintains accurate medical records and injury logs
• Coordinates care between physicians, physiotherapists, coaches, and athletic trainers
• Provides medical clearance documentation and liaison with insurance or governing bodies

Where Sports Health Nurses Work

Key Skills Required

• Advanced musculoskeletal assessment
• Emergency and trauma response (BLS, ACLS)
• Knowledge of sports physiology and biomechanics
• Communication with athletes, coaches, and multidisciplinary teams
• Cultural sensitivity (working with diverse athlete populations)
• Familiarity with anti-doping regulations