Explain The Physiological And Psychological Responses To Injury

Physiological and Psychological responses to injury

In this report I will be describing and explaining the physiological and psychological responses to injury. If you injure yourself while playing sport the injury is a sports injury. They can occur from a complete accident, or some can result from poor equipment or insufficient training. You can also get a sports injury if you don’t warm up or stretch enough before exercise or playing sport.

Physiological Responses

Damaged tissue

Primary damage responses to injury

When you sustain a sports injury, inflammation begins almost immediately. It is the body’s attempt to eliminate harm and to begin the healing process. The body is trying to dispose of the dead tissue and trying to promote the renewal of new, healthy tissue.

There are 5 main primary signs

that inflammation is occurring; these consist of redness due to vasodilatation (widening of blood vessels and bleeding in the area of injury, see figure1), soreness/pain (this is from the release of chemicals from the damaged cells), swelling (this is due to a large arrival of fluid toward the damaged area), heat (from an increased blood flow to the damaged area), and loss of function (from both pain and swelling).

Figure 1
A normal ankle on the left compared to a reddened, swollen ankle on the right.

Healing response
Following this are the three main stages of inflammation; starting with the tissue damage, this could be anything from a graze to severe tissue damage in either soft or hard tissue, and can come from a collision, awkward fall or even just overuse. Next is the release of chemicals, just some of these chemical names are; Kinins, Prostaglandin and Histamine. These three chemicals co-exist to aid with vasodilatation within the capillaries. While the release of chemicals is indefinitely beneficial for the body’s defence, it can also be painful as some of the chemicals increase the sensitivity of the fibres in the area. Lastly the Leukocyte cells (white blood cells) rush to the area of injury. There are two types of Leukocyte cells- macrophages and neutrophills. Neutrophills are the first ones to the area of damage and the neutralize harmful bacteria. Macrophages help to benefit the healing process by engulfing all the bacteria and dead cells, thus making the area clear for new cells to grow. Macrophages can stay in the area for weeks after the injury has occurred.

The clotting mechanism
When you sustain an injury, you will begin to bleed.

Our body has little pieces of blood cells called platelets that will begin to gather at the site of the injury and begin the clotting process. These platelets will form a plug-like structure that will close over the opening in the blood vessel and stop the bleeding. See figure 2. Clotting is also known as coagulation. It begins almost instantly after a blood vessel is injured/damaged. In coagulation blood changes from its natural liquid form to a gel-like form therefore resulting in haemostasis.

What is Haemostasis? Haemostasis is the cessation of blood from leaving a damaged/injured blood vessel, and then followed by repair.

There are three stages of coagulation:

1) The formation of Prothrombinase. When liquid blood comes into contact with certain molecules the formation of an enzyme called Prothrombinase is stimulated.

2) Prothrombinase converts prothrombin (a plasma protein which is created within the liver) into another enzyme called Thrombin.

3) Thrombin converts Fibrinogen is converted into Fibrin which forms the scaffolding-like structures that forms a clot and eventually a

scab.

Figure 2
A Blood clot

Extra information on clotting:
Aspirin thins your blood and makes clotting more difficult. It does however also lower the chances of unwanted blood clots within the body.
Some babies are born with vitamin K deficiencies (Vitamin K is paramount for clotting the blood), so in the UK all babies are routinely vaccinated with Vitamin K at birth.
If you have a blood transfusion in hospital, the blood you are receiving does not contain any white blood cells or plasma, only red blood cells. This therefore makes clotting extremely difficult.
Von Willebrand disease is when the body is unable to make blood clots. The treatment for people with Von Willebrand disease can cost up to £32,000.

Tissue Damage (Hard and Soft)
Hard and soft tissue damage will heal in different ways.
Soft tissue is harm or damage to any biological tissue excluding bone tissue. Muscles, tendons and ligaments are all soft tissue. The injuries that soft tissues can sustain will either be open or closed wounds. Open wounds bleed externally, while closed wounds do not involve external bleeding however they may be bleeding internally. Open wounds include; cuts, grazes. See figure 3. Closed wounds include; bruises, damage to muscle, ligament or muscle. The healing process should have begun within the first day or two from sustaining the injury and depending on the state of the injury, the healing process can last from anything from 3 days to around a month. Hard tissue damage is cracked or broken bones. See figure 4. Breaks or fractures can come in 4 types; closed fracture, open fracture, complicated fracture or stress fracture. The healing process for hard tissue is typically much longer than it is for soft tissue. Most broken bones need to go in a protective cast and can take up to six months to fully repair a broken bone- or even longer if you are unhealthy.