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Injuries to Epithelial Tissue Injuries to Epithelial Tissues • Epithelial tissue makes up the layers of our skin • Many types of epithelial injuries in sports • Superficial epithelial tissue injuries follow a 3 step healing process – Response – Repair – Remodeling Superficial Injuries to Epithelial Tissue • Abrasions – outer layer of skin has been scraped off – turf burns, sliding in baseball and softball, falling while running xc or track • Laceration – jagged tear in the flesh – head wounds – usually will need stitches Superficial Injuries to Epithelial Tissue • Puncture Wound – penetration of a sharp object deep in skin – rare in sports • Incision – clean, straight cut – cut usually made by a very sharp object – usually needs stitches Superficial Injuries to Epithelial Tissues • Callus – thickened area of skin – usually not painful – caused by friction against the skin over time – common areas • • • • side of big toe heel “ball of foot” palm of hands Superficial Injuries to Epithelial Tissues • Blister – build-up of fluid under skin – caused by friction against the skin – occurs rapidly and not over time – very painful once they develop – common areas • heel • palm • “ball of foot” Superficial Injuries to Epithelial Tissues • Hematomas – a blood-filled swollen area – goose-egg – areas where no muscle present between skin and bone – cranium, shin, under nail beds Superficial Injuries to Epithelial Tissues • Contusions – injury received by a blow to area – a bruise – bleeding spreads out into surrounding tissue – extremely common in all sports Treatment and Care – Contusions & Hematomas Immediate Treatment (RICER) • Rest • Ice – applied for 20 minutes • Compression – ace bandage • Elevation • Range of Motion Treatment and Care – Contusions & Hematomas Follow-up Treatment • Continue to ice • Mild stretching • Protect area – donut-shaped pad over injury Skin Infections • Skin always has some amount of bacteria, fungus, and viruses living on it • Skin infections occur when: – there are breaks in the skin – organisms have uncontrolled growth When worry about skin lesions? • Lesions are bright red • Lesions that are warmer compared to other skin • Inflammation and irritation around the skin lesions • Prior history of infectious skin lesions • Skin abrasions increase the risk of skin infection Expertise • Experienced person with skin lesions, the better the medical evaluation • The best situation is qualified physicians, trainers and referees working together for the benefit of the athletes Skin Infections - Highlights • Bacteria (can be cured) – Staphylococcus including MRSA – Streptococcus bacteria causing Impetigo • Fungal (can be cured) – Ringworm – Athlete’s foot • Viral (can’t be cured but can be treated) – Herpes – Warts – Molluscum contagiosum Skin Infections - Bacteria • Right antibiotics is required to cure a bacterial skin infection • Antibiotics will not cure fungal or viral infections • Can be the fastest growing infections • Most easily spread among athletes Staphylococcus Infections • Staph Aureus bacteria commonly cause skin infections • 20 to 30% of healthy people have Staph on their skin. • Staph are resistant to some antibiotics • all Staph infections can be treated with one or more antibiotics Staphylococcus Infections • Athletes, military recruits, children, and prisoners are at higher risk of Staph infections. • Risk of infection increased when there are: – – – – – cuts in the skin close skin-to-skin contact crowded living conditions poor hygiene contaminated items and surfaces Typical Staph Skin Lesions Typical Staph Skin Lesions MRSA • MRSA – Methicillin-resistant Staphylococcus aureus bacteria – Does NOT respond to some antibiotics used to treat regular Staph – MRSA skin infections are on rise in high school athletes MRSA • MRSA – Appears on skin as sores or boils – Looks much like a regular Staph infection – Spreads through direct contact with people or equipment/surfaces contaminated with MRSA MRSA • Treatment – Don’t ignore infected areas – Don’t drain sore yourself – Seek medical attention – Doctor will drain sore, bandage and may prescribe antibiotics – Keep sore covered at all times to reduce infecting others Staph and MRSA • Staphlycoccus Infections Impetigo • Impetigo – Highly contagious bacterial skin infection – Caused by Group A Streptococcus (GAS) bacteria – Not common in adults but occurs in close contact athletes (rugby, football and wrestling) – Video Impetigo • Impetigo – Appears first as small blisters – Blisters evolve to yellowish, honey colored crusted blisters – Can be treated with topical antibiotic – Can’t participate until all blisters are cleared up – Refer athlete to doctor for correct diagnosis Staph vs. Strep • Strep bacteria • Staph bacteria Ringworm • Ringworm – Caused by a fungus (not worm) called Tinea Corporis – Appears as ring-shaped lesions on skin – Spreads through direct contact with infected individuals Ringworm • Ringworm – Fungus thrives on warm, moist skin – Athletes at greatest risk are wrestlers and football – Accounts for approx 84% of skin infections in wrestlers – Treat with antifungal creams and avoid contact with others Ringworm Tips to prevent ringworm 1. Shower after playing sports 2. Dry thoroughly after bathing or swimming 3. Wash clothes and yourself after each workout 4. Avoid contact with individuals who are infected 5. Don’t share towels or clothing with others Athlete’s Foot • Athlete’s foot – Caused by fungus called Tinea Pedis – Fungus thrives in warm, moist areas – Contagious and spreads through person to person contact – Also spreads by walking barefoot across contaminated floors Athlete’s Foot • Athlete’s foot – Symptoms are burning, itching and scaling of the skin – Treated by many antifungal topical medications – Keep feet dry as possible, don’t walk barefoot across locker rooms or weight rooms Herpes • Herpes – Viral infection – Most common in athletes is Herpes gladiatorum (mat herpes) – Caused Herpes Simplex Virus type I – Same virus that causes cold sores Herpes • Herpes – Once infected, can treat symptoms but have the virus inside body for life – Lesions usually appear on face or upper body – Contagious during outbreaks – Seek medical attention – No practice or play until no longer contagious Warts • Warts – Most common in athletes is plantar warts – Caused by human papilloma virus (HPV) – Virus enters skin through cuts or cracks – Usually occur on soles of feet and can spread by walking barefoot Warts • Warts – Usually not a health risk – Can be treated easily with freezing kits or cauterization – Treat immediately to avoid spreading virus to others Molluscum Contagiosum • Molluscum Conagiosum – Caused by the pox virus – Lesions are contagious and should be treated immediately to avoid spreading – Most common in wrestlers – Video • Wrestling Mats - Haven for Bacteria