The Human Body: An Orientation

Overview of Anatomy and Physiology

Anatomy – the study of the structure of body parts and their relationships to one another

• Gross or macroscopic
• Microscopic
• Developmental

Physiology – the study of the function of the body’s structural machinery

Gross Anatomy

• Regional – all structures in one part of the body (such as the abdomen or leg)
• Systemic – gross anatomy of the body studied by system
• Surface – study of internal structures as they relate to the overlying skin

Microscopic Anatomy

• Cytology – study of the cell
• Histology – study of tissues

Developmental Anatomy

• Traces structural changes throughout life
• Embryology – study of developmental changes of the body before birth

Specialized Branches of Anatomy

• Pathological anatomy – study of structural changes caused by disease
• Radiographic anatomy – study of internal structures visualized by X ray
• Molecular biology – study of anatomical structures at a subcellular level

Physiology

Considers the operation of specific organ systems

• Renal – kidney function
• Neurophysiology – workings of the nervous system
• Cardiovascular – operation of the heart and blood vessels

Focuses on the functions of the body, often at the cellular or molecular level

Understanding physiology also requires a knowledge of physics, which explains electrical currents, blood pressure, and the way muscle uses bone for movement

Principle of Complementarity

• Function always reflects structure
• What a structure can do depends on its specific form

Levels of Structural Organization

• Chemical – atoms combined to form molecules
• Cellular – cells are made of molecules
• Tissue – consists of similar types of cells
• Organ – made up of different types of tissues
• Organ system – consists of different organs that work closely together
• Organismal – made up of the organ systems

Levels of Structural Organization

Organ Systems of the Body

Integumentary system

• Forms the external body covering
• Composed of the skin, sweat glands, oil glands, hair, and nails
• Protects deep tissues from injury and synthesizes vitamin D

Skeletal system

• Composed of bone, cartilage, and ligaments
• Protects and supports body organs
• Provides the framework for muscles
• Site of blood cell formation
• Stores minerals

Muscular system

• Composed of muscles and tendons
• Allows manipulation of the environment, locomotion, and facial expression
• Maintains posture
• Produces heat

Nervous system

• Composed of the brain, spinal column, and nerves
• Is the fast-acting control system of the body
• Responds to stimuli by activating muscles and glands

Cardiovascular system

• Composed of the heart and blood vessels
• The heart pumps blood
• The blood vessels transport blood throughout the body

Lymphatic system

• Composed of red bone marrow, thymus, spleen, lymph nodes, and lymphatic vessels
• Picks up fluid leaked from blood vessels and returns it to blood
• Disposes of debris in the lymphatic stream
• Houses white blood cells involved with immunity

Respiratory system

1. Composed of the nasal cavity, pharynx, trachea, bronchi, and lungs
2. Keeps blood supplied with oxygen and removes carbon dioxide

Digestive system

• Composed of the oral cavity, esophagus, stomach, small intestine, large intestine, rectum, anus, and liver
• Breaks down food into absorbable units that enter the blood
• Eliminates indigestible foodstuffs as feces

Urinary system

• Composed of kidneys, ureters, urinary bladder, and urethra
• Eliminates nitrogenous wastes from the body
• Regulates water, electrolyte, and pH balance of the blood

Male reproductive system

• Composed of prostate gland, penis, testes, scrotum, and ductus deferens
• Main function is the production of offspring
• Testes produce sperm and male sex hormones
• Ducts and glands deliver sperm to the female reproductive tract

Female reproductive system

• Composed of mammary glands, ovaries, uterine tubes, uterus, and vagina
• Main function is the production of offspring
• Ovaries produce eggs and female sex hormones
• Remaining structures serve as sites for fertilization and development of the fetus
• Mammary glands produce milk to nourish the newborn

Organ Systems Interrelationships

• The integumentary system protects the body from the external environment
• Digestive and respiratory systems, in contact with the external environment, take in nutrients and oxygen

Necessary Life Functions I

Maintaining boundaries – the internal environment remains distinct from the external

• Cellular level – accomplished by plasma membranes
• Organismal level – accomplished by the skin

Movement – locomotion, propulsion (peristalsis), and contractility.

Responsiveness – ability to sense changes in the environment and respond to them.

Digestion – breakdown of ingested foodstuffs.

Necessary Life Functions II

Metabolism – all the chemical reactions that occur in the body.

Excretion – removal of wastes from the body.

Reproduction – cellular and organismal levels.

• Cellular – an original cell divides and produces two identical daughter cells
• Organismal – sperm and egg unite to make a whole new person

Growth – increase in size of a body part or of the organism.

Survival Needs

• Nutrients – chemical substances used for energy and cell building
• Oxygen – needed for metabolic reactions
• Water – provides the necessary environment for chemical reactions
• Maintaining normal body temperature – necessary for chemical reactions to occur at life-sustaining rates
• Atmospheric pressure – required for proper breathing and gas exchange in the lungs

Homeostasis

• Homeostasis is the ability to maintain a relatively stable internal environment in an ever-changing outside world
• The internal environment of the body is in a dynamic state of equilibrium
• Chemical, thermal, and neural factors interact to maintain homeostasis

Homeostatic Control Mechanisms

The variable produces a change in the body.

The three interdependent components of control mechanisms are:

• Receptor – monitors the environments and responds to changes (stimuli)
• Control center – determines the set point at which the variable is maintained
• Effector – provides the means to respond to the stimulus

Homeostatic Control Mechanisms

Negative Feedback

• In negative feedback systems, the output shuts off the original stimulus
• Example:  Regulation of blood glucose levels

Positive Feedback

Homeostatic Imbalance

• Disturbance of homeostasis or the body’s normal equilibrium
• Overwhelming of negative feedback mechanisms allowing destructive positive feedback mechanisms to take over

Aerobic Endurance Training

There are several different types of aerobic endurance training - each with a different, specific outcome and suitable for different events and sports.

The duration, frequency and intensity of sessions varies with each form of training leading to different physiological adaptations within the body. The table below summarizes the main types of aerobic endurance training and suggested parameters:

Long Slow Distance Training

As you would expect this type of training is typical of a long distance runner. Intensity is usually less than 70% VO2max, or equivalent to about 80% maximum heart rate. Duration should be near to race distance or at least 30 minutes to 2 hours long (1). Intensity for long, slow distance endurance training is often gauged using the "talk" test whereby the athlete can hold a conversation without being too winded.

Adaptations to this form of aerobic endurance training include improved cardiovascular and thermoregulatory function, improved mitochondrial energy production, increased oxidative capacity of skeletal muscle and increased utilization as fat for fuel (which spares muscle glycogen) (2,3,4,5,6,7). Anaerobic or lactate threshold is also likely to improve with a body better able to remove lactate.

Because long distance training is low intensity (lower than competition) too great a reliance on this form of endurance running in the athlete's training program can be disadvantageous. Here is a sample training program for a marathon runner:

Sample Half Marathon Training Plan
Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Rest	Fartlek Run (45 min)	Long Slow Distance Run (60 min)	Interval Training (45 min)	Pace/Tempo Run (60 min)	Repetition Run (45 min)	Long Slow Distance Run (120 min)

Notice how the two long distance runs are split up with plenty of rest between? Only one run per week that approaches half marathon distance. The other types of training are covered below.

Pace/Tempo Training      

Also referred to as lactate threshold training, pace/tempo training is designed to improve energy production from both aerobic and anaerobic energy pathways. Intensity is slightly higher than race pace and corresponds to thelactate threshold. Duration is usually 20-30 minutes at a steady pace. lactate threshold

Tempo/pace training can also be performed intermittently or in intervals (1). Intensity is the same as steady state tempo/pace training except the session consists of a series of shorter bouts with brief recovery periods. It is important to keep intensity at or slightly higher than competition pace for either type of pace/tempo training. Progression should be in the form of increased duration rather than a faster running/cycling/swimming ect. 

Interval Training

Interval training allows the athlete to work close to their aerobic limit (VO2max) for a longer duration compared to a continuous type session. Short bouts of 3-5 minutes at an intensity close to VO2max are interspersed by periods of active recovery. Work to rest ratio should be 1:1 so a 3 minute run should be followed by 3 minutes of rest (8).

Because this type of aerobic endurance training is very demanding, sessions should be limited both in duration and in frequency each week. Duration is usually 30-45 minutes and frequency is one or two sessions per week, with ample rest days between. Below is a sample program for a 10k runner:

Sample 10K Training Plan
Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Rest	10 x 0.5km	10km run (easy)	Long Slow Distance Run (45 min)	5 x 1km	Long Slow Distance Run (45 min)	Fartlek Run (45 min)

Taking the time for each 0.5km interval, allocate the same amount of time for the rest periods between. Rest should be in the form of active recovery such as brisk walking or very light jogging. 

Repetition Training

This is the most intense form of aerobic endurance training. Performed at a pace greater than VO2max it places a high demand on the anaerobic energy systems. Work intervals are usually only 60-90 seconds separated by rest intervals of 5 minutes or more. Typically work to rest ratio is 1:5 (8). Repetition training helps to improve running speed, running economy and builds a greater tolerance to lactic acid. Endurance athletes often use repetition training to help in the final kick of a race. Due to the high intensity nature, only one session per week is required.

Fartlek Training

Fartlek training combines some or all of the above aerobic endurance training techniques. A long slow run/cycle (at about 70% VO2max) form the foundation of the session and is combined with short bursts of higher intensity work. There is no set format for a Fartlek session although there are some standard sessions that have been developed by coaches over the years. Fartlek endurance training will improve VO2max, exercise economy and lactate threshold. It also adds a nice change of pace to the more monotonous steady-state training. The table below outlines a sample program for an amateur Cross Country Runner:

Sample Cross Country Training Plan
Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Rest	Long slow distance run (60 min)	Fartlek run (45 min)	Pace/Tempo Run (25 min)	Long Slow Distance Run (45 min)	25 min Long Slow Distance Run	Race Day

There are literally dozens of fartlek sessions that can be adopted into an aerobic endurance training program. 

References

1) Daniels J. Training Distance Runners - a Primer. Gatorade Sports Sci. Exch. 1:1-5. 1989
2) Costill DL, Fink WJ, Pollock ML. Muscle fibre composition and enzyme activities of elite distance runners. Med Sci Sports. 1979,8:96-102
3) Costill DL, Thomas R, Robergs RA, Pascoe D, Lambert C, Barr S, Fink WJ. Adaptations to swimming training: influence of training volume. Med Sci Sports Exerc. 1991 Mar;23(3):371-7
4) Dudley GA, Abraham WM, Terjung RL. Influence of exercise intensity and duration on biochemical adaptations in skeletal muscle. J Appl Physiol. 1982 Oct;53(4):844-50
5) Foster C, Hector LL, Welsh R, Schrager M, Green MA, Snyder AC. Effects of specific versus cross-training on running performance. Eur J Appl Physiol Occup Physiol. 1995;70(4):367-72
6) Holloszy JO, Coyle EF. Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. J Appl Physiol. 1984 Apr;56(4):831-8
7) Hawley JA. Adaptations of skeletal muscle to prolonged, intense endurance training. Clin Exp Pharmacol Physiol. 2002 Mar;29(3):218-22
8) Baechle TR and Earle RW. (2000) Essentials of Strength Training and Conditioning: 2nd Edition. Champaign, IL: Human Kinetics

A Comparison of Muscle Fiber Types

 

Skeletal muscle fibers are grouped to biochemical performance characteristic into three different categories : fast-twitch fibers, intermediate fibers and slow-twitch fibers.

Each muscle contains a genetically determined percentage of fiber types. For example, one person may have more fast-twitch fiber in a particular muscle than another person.

The effect that muscle conditioning has on changing the profile of muscle types is uncertain. The percentages of fiber types, however, greatly influence muscular power and endurance.

Anaerobic fast-twitch fibers 9also call fast-glycolytic or Type IIb fibers) are able to contract very forcefully and rapidly. They are used primarily for power and speed.

Aerobic sloe-twitch fibers (also called slow-oxidative or Type I fibers) are highly resistant to fatigue. They are used primarily for endurance.

The characteristics of intermediate fibers differ somewhat from fiber to fiber, but lie on the continuum between fast-twitch and slow-twitch fibers.

A Comparison of Muscle Fiber Types

Fiber characteristic	Fast-twitch fiber	Intermediate fiber	Slow-twitch fiber
Fiber size	Large	Intermediate	Small
Glycogen content	High	Intermediate	Low
Myosin ATPase	High	High	Low
Myoglobin content	Low	High	High
Energy system	Anaerobic	Combination	Aerobic
Twitch	Fast	Fast	Slow
Primary use	Speed and power	Moderate	Endurance

Perubatan Kecemasan Kecederaan Sukan

Definisi

Kecederaan yang dialami oleh ahli sukan semasa bersukan atau akibat daripada aktiviti yang berlebihan tanpa latihan yang sempurna.

Sebab-sebab atlet mendapatkan rawatan

• Pencapaian menurun
• Kecederaan
• Kesakitan & ketenderaan
• Penyakit yg menganggu pencapaian.

GARIS PANDUAN MELAKUKAN LATIHAN F.I.T.T

• F - Frequency ( Kekerapan) 3 – 5 /52
• I - Intensity ( ketahanan kegiatan)

          -  Mula dgn 60 % - 75 % MHR

          -  Target 70% - 85 %

• T - Type of activity ( Jenis aktiviti)

          -  Aerobic , joging dlln.

• T - Time/ duration ( Jangka masa)

               - Mula dgn 5 – 15 minit / sesi

           - Target 30 – 60 minit / sesi

Klasifikasi Kecederaan Sukan

(a) Kecederaan ringan atau 1st degree injury

• Kecederaan ringan dengan koyakan mikroskopik.
• Gejala – rasa tidak selesa yang minima dan tidak mempengaruhi pencapaian     ahli sukan.
• Contoh kecederaan – luka abrasi, kontusi (lebam), mild sprain

(b) Kecederaan sederhana atau 2nd degree injury

• Kecederaan yang menyebabkan kerosakan tisu yang ketara.
• Tanda & gejala – luka, sakit, bengkak, kemerahan atau panas.
• Menyebabkan hilang fungsi dan mempengaruhi pencapaian ahli sukan.
• Contoh kecederaan – Hematoma, muscle tear atau sprain, ligament tear atau   sprain.

(c) Kecederaan Teruk atau 3rd degree injuries

• Kecederaan otot atau ligament – koyakan hampir putus atau putus  keseluruhannya.
• Kepatahan tulang.
• Ahli sukan perlu berehat sepenuhnya, rawatan perubatan intensif dan pembedahan.

(d) Kecederaan sukan akut

• Kecederaan yang tiba-tiba, disebabkan oleh overstress atau over-exertion.
• Jangkamasa kecederaan kurang daripada seminggu. 

(e) Kecederaan sukan kronik

• Kecederaan akibat pergerakan yang berulang-ulang, berlebihan dan teknik tak betul.
• Gejala – sakit sikit-sikit atau lenguh dan berulang-ulang.
• Jangkamasa kecederaan atau gejala mungkin beberapa minggu bulan atau tahun.

(f) Kecederaan sukan acute-on-chronic

• Kecederaan sukan kronik yang mengalami kecederaan baru akibat penggunaan otot yang berlebihan (overstress).

(g) Kecederaan sukan ekstrinsik

• Kecederaan akibat berlanggar atau kontek fizikal dengan athlit lain atau benda.
• Contoh kecederaan – lebam (contusion), hematoma atau luka.

(h) Kecederaan sukan intrinsik

• Kecederaan yang terjadi secara dalaman akibat dari penggunaan otot yang berlebihan (overuse atau overstress).
• Contoh kecederaan – koyakan otot atau ligament semasa memecut.

Jenis Kecederaan Sukan

• Abrasi, melepuh (blister) dan luka.
• Kontusi & Hematoma
• Cramps & Muscle Strains
• Joint sprains, dislocations & Fractures
• Masalah kepala, leher dan tulang belakang
• Masalah dada dan abdomen
• Kecederaan anggota atas (tangan)
• Kecederaan anggota bawah (kaki)
• Pengsan dan sawan.
• Heat stress disorders. 

Abrassion, lepuh & luka

Definisi

• Hilang kesinambungan pada kulit dan tisu berdekatan yang menyebabkan pendarahan serta boleh mengalami jangkitan.       

Jenis luka dalam kecederaan sukan

• Abrasi - kulit tercalar.
• Lepuh (Blister) - kulit tergeser
• Luka laserasi - kecederaan akibat benda tajam spt kaca, batu atau tiles.
• Luka tembus (puncture) – kecederaan akibat benda tajam seperti spikes, paku, wayar.

Rawatan

(a) Luka & Abrasi - Dressing

• Untuk hentikan pendarahan dan elakkan jangkitan.
• Menghadkan pergerakan – elakkan kecederaan lebih teruk.
•  Menyerap sekresi dan menutup bahagian luka.

(b) Lepuh

• Lepuh pecah – dressing dan potong lebihan kulit.
• Lepuh tak pecah dan tidak sakit – pastikan ianya bersih dan biarkan surut sendiri.
• Lepuh tidak pecah tetapi sakit – guna jarum steril untuk pecahkannya dan dressing.

Kontusi dan Hematoma

Definisi

• Kontusi – terjadi akibat hentaman secara terus pada kulit dan menyebabkan lebam (tanda biru kehitaman) pada kulit atau tisu berdekatan (otot)
• Definisi - Hematoma –  Terjadi akibat hentaman secara terus pada kulit dan menyebabkan pengumpulan darah dibawah kulit atau antara otot.
• Kecederaan jenis ini terjadi akibat perlanggaran tiba-tiba dengan ahli sukan lain atau objek keras. Kontusi pada otot akan menyebabkan kekejangan pada otot tersebut. Hematoma akan menyebabkan bengkak pada bahagian terlibat.

Pencegahan

Kontusi dan Hematoma

• Gunakan alat perlindungan seperti knee & elbow pad (volleyball), shinguard (hockey),faceguard (penjaga gol hoki).

 Rawatan Kontusi dan Hematoma

• Pertolongan cemas - terapi ”RICE”
• Bengkak besar – compression bandage.
• Rujuk hospital – kontusi pada abdomen atau dada.

Kejang otot (Cramps) dan strain otot 

Kejang otot (Cramps)

Definisi

• Merupakan kontraksi otot luar kawalan dan berpanjangan.

Deskripsi

• Otot yang mengalami kekejangan menjadi pendek, keras dan amat sakit.
• Akibat dari kontusi atau sprain pada otot.
• Otot yang biasanya terlibat – calf, quadriceps, harmstring, otot dibahagian lumbar.
• Warm up & streching.
• Meningkatkan kekuatan otot dan fitness fizikal.
• Memastikan pengambilan air yang cukup dan pengantian semula eletrolit yang hilang melalui peluh. (untuk elak heat stroke)
• Memastikan peredaran darah ke otot tidak terganggu. (elakkan bandage yang terlampau ketat.

Rawatan Kejang otot (Cramps) dan strain otot

• Lakukan kontraksi pada otot yang bertentangan dengan otot terlibat. (Cth Otot harmstring terlibat, lakukan kontraksi manual pada otot Quadriceps) 
• Regang otot terlibat perlahan-lahan cth untuk labu betis (calf), lakukan dorsiflexion pada pergelangan kaki (ankle) 90º dengan lutut diluruskan. Jangan ”jerk” atau tolak dengan cepat, kerana ianya menyebabkan kecederaan otot yang lebih teruk.
• Selepas kejang lega buat urutan dengan lembut arah jantung untuk peredaran darah yang lebih baik.
• “Acupinch” – picit otot terbabit dengan menggunakan ibujari dan jari telunjuk sehingga kejang berkurangan.

Strain Otot

Definisi

• Kerosakan sebahagian otot atau tendon ( termasuk tempat perlekatan otot-tendon) yang disebabkan oleh penggunaan otot berlebihan (overuse) atau regangan otot terlampau (overstress). Biasanya berlaku koyakan tisu secara makroskopik atau mikroskopik.

Pencegahan

• Senaman mengikut had kebolehan dan fitness.
• Meningkatkan kekuatan otot secara berperingkat (gradual).
• Sentiasa amalkan warm-up, cool down dan senaman regangan.

Rawatan

Terapi ”RICE”. 

• Sprain Sendi,Dislokasi dan Kepatahan

Sprain Sendi

Definisi

• Merupakan kecederaan pada sendi yang melibatkan koyakan pada ligamen (biasanya separa) akibat daripada regangan terlampau (overstress) secara tiba-tiba atau penggunaan otot yang berlebihan (overuse) secara berulang. 

Pencegahan

• Pastikan persekitaran tidak merbahayakan.
• Ikut peraturan permainan yang ditetapkan.
• Sentiasa berlatih untuk tingkatkan ketahanan anggota yang terlibat.Amalkan senaman ”agility” untuk persediaan kepada tindakan atau reaksi pergerakan yang pantas.

Sprain Sendi

Rawatan

• Terapi ”RICE”.
• Sendi kecil (jari, pergelangan kaki) – lakukan ”taping”.

Dislokasi Sendi

Definisi

• Peralihan permukaan tulang yang membentuk sendi dan menyebabkan kedua-dua permukaan tulang tidak bertemu.
• Subluxation – merupakan dislokasi separa. 

Pencegahan

• Sama seperti sprain. 

Rawatan

• Immobilisasi sendi terlibat.
• Rujuk hospital.

Kepatahan

Definisi

• Hilang kesinambungan pada tulang.

Jenis Kepatahan

• Simple / Closed.
• Compound / Open

Tanda & gejala

• Sakit yang kuat bila bahagian terlibat digerakkan
• Deformiti & bengkak.
• Pergerakan abnormal (false joint).
• Crepitus 

Rawatan Kepatahan

• Immobilisasi sendi terlibat.
• Dressing
• Rujuk hospital.

Kesan Lokasi Kecederaan Sukan dengan Kadar Penyembuhan

• Kawasan kecederaan yang banyak bekalan darah seperti kepala dan leher akan mengalami pendarahan yang banyak tetapi sembuh lebih cepat.
• Kecederaan bahagian badan yang kurang bekalan darah mengambil masa yang lama untuk sembuh. Contoh, kecederaan tendon (golfer’s elbow & tennis elbow) dan kecederaan lutut seperti hondromalacia patella (runner’s knee or jumper’s knee)
• Bahagian yang banyak pergerakan seperti kulit di bahagian lutut juga mengambil masa lama untuk sembuh.

Peringkat Kecederaan

• Inflamasi (inflammation)
• Pemulihan (repair)
• Konsolidasi (consolidation)

Prinsip Rawatan Kecederaan Sukan

R .I. C. E

• Rawatan pertolongan cemas yang dicadangkan terutama 24 ke 48 jam yang pertama.

Rest

• Rehatkan bahagian yang terlibat dan buat dressing jika ada luka. Tujuan merehatkan atau immobilisasi adalah untuk mengelakkan kecederaan semakin teruk dan mengurangkan inflamasi.

Ice pack

• Demah sejuk dengan menggunakan ais pada bahagian terlibat selama 15 – 30 minit. Ulang setiap 2 – 3 jam jika perlu.

Compress

• Balut bahagian terlibat dengan bandage(crepe) terutama jika ada pendarahan atau bengkak.

Elevate

• Tinggikan anggota yang tercedera melebihi paras jantung untuk mengurangkan kongesi darah dan mencegah berlakunya venous pooling oleh gravity.

Tujuan terapi R.I.C.E

• Menghentikan pendarahan atau mengurangkan bengkak.
• Mengurangkan sakit.
• Mengelakkan kecederaan menjadi lebih teruk.
• Mengurangkan inflamasi.

Prosidur terapi demahan sejuk

• Lapik bahagian tercedera dengan sapu tangan atau tuala kecil sebelum meletakkan ice pack – elakkan frost-bite pada kulit.
• Balut dengan bandage (crepe) – pressure bandage.
• Biarkan selama 15 – 30 minit.
• Ulang kaedah rawatan ini setiap 2 – 3 jam, jika perlu. 

Tindakbalas pesakit dengan demahan sejuk

• 3 minit pertama – rasa sejuk
• Dalam 8 minit – rasa panas (burning)
• Dalam 10 minit – rasa mencucuk
• Selepas 10 minit – rasa kebas dan kesakitan berkurangan. 

Jenis-jenis demahan sejuk

• Reusable synthetic cold pack.
• Ketul ais dalam plastik.
• Ethyl chloride spray.
• Tuala kecil yang direndam dalam ais.
• Air yang mengandungi ais (sejuk).

Kontraindikasi demahan sejuk

• Alahan sejuk – terjadi ruam dan gatal kulit selepas demahan sejuk.
• Frost-bite
• Thrombosis atau darah beku dalam salur darah.
• Masalah sirkulasi darah setempat spt Raynaud’s phenomenon, Buerger’s disease.

Ubat-Ubatan

Ubatan Oral

• Anti inflammatory – NSAIDS
• ndocid 25 – 50mg tds
• oltaren 25mg bd
• Mefenamic Acid 250mg tds
• Analgesik – kurangkan sakit.
• Paracetamol 1mg tds
• Enzyme preparation – kurangkan bengkak.
• Papase/ Prolase
• Muscle relaxant – rawat kekejangan otot.
• Valium

Ubat topikal

• Liniment Methyl Salicylate
• Ethyl chloride spray
• Suntikan
• Kortikosteroid – kenacort, methylprednisolone.

Pembedahan

• Pembedahan dilakukan jika itulah satu-satunya cara untuk penyembuhan.

Jenis kecederaan

• 3rd degree muscle strains & complete ruptures of tendon (eg archilles tendon)
• 3rd degree ligament sprains (eg the medial or inner ligament of knee)
• Meniscus injuries – locked knee.

Kepatahan

Kecederaan kronik – tennis elbow.

 Rawatan

• Fisioterapi
• Heat therapy 
• Electrotheraphy eg TENS
• Exercise therapy - rehabilitasi
• Manual therapy eg massage
• Taping

Jenis Kecederaan Sukan Spesifik Kepala hingga Kaki

Kepala

Kecederaan kepala dan leher mungkin serius jika terdpt tanda & gejala;

• Kebas & rasa mencucuk di bahagian tangan dan kaki.
• Tangan atau kaki atau keduanya tak boleh bergerak.
• Keluar cecair jernih (CSF) atau darah melalui ENT – skull fracture.

Knockout, KO, Konkusi

Tanda dan gejala

• Glazed eyes
• Confused
• Amnesia – tidak ingat/sedar apa yang berlaku.
• Tidak sedar diri walaupun beberapa saat
• Pening 

Mata lebam

Rawatan

• Buat demahan sejuk 

Pendarahan hidung

Penyebab

• Tumbukan di kepala.