Types and Causes of Sports Injuries
Acute vs Chronic Injuries
Sports injuries fall into two fundamental categories. Acute injuries are caused by a single sudden traumatic event — a collision, a fall, a missed landing. They have an immediate onset, with pain typically felt instantly. Chronic injuries, by contrast, develop gradually through repetitive movement and overuse; the athlete may notice a dull ache that worsens over weeks or months rather than a sharp pain at a defined moment. Distinguishing these two categories is a foundation of this unit, and the distinction comes up in both short-answer and extended-response exam questions.
Soft Tissue vs Hard Tissue Injuries
Injuries are also classified by which type of body tissue is damaged. Soft-tissue injuries involve muscles, tendons, ligaments, cartilage or skin. Hard-tissue injuries involve bone, including fractures and dislocations. This classification helps to determine treatment: hard-tissue injuries typically require imaging (X-ray) and immobilisation, while soft-tissue injuries may be managed with PRICE therapy and physiotherapy.
Acute Soft-Tissue Injuries: Strains and Sprains
A strain is a tear or overstretching of a muscle or tendon. Strains occur when a muscle is asked to generate force it cannot sustain — for example, a sprinter pulling their hamstring during maximum acceleration, or a weightlifter straining their lower back. Strains are soft-tissue injuries. A sprain, by contrast, is a tear of a ligament — the fibrous tissue that connects bone to bone and stabilises joints. Sprains most commonly affect the ankle, knee and wrist. The most clinically significant ligament in sport is the Anterior Cruciate Ligament (ACL), located in the knee: ACL injuries typically occur during sudden direction changes, landing from a jump, or deceleration — making them particularly common in football, netball and basketball. Both strains and sprains are acute soft-tissue injuries.
A strain is a torn or overstretched muscle or tendon (soft tissue). A sprain is a torn ligament (soft tissue). The Anterior Cruciate Ligament (ACL) in the knee is the most clinically important ligament in sport science and is commonly injured through sudden twisting or deceleration movements.
Acute Skin Damage: Abrasions, Contusions and Blisters
Skin damage encompasses four types in the specification. Abrasions (grazes) occur when the skin surface is scraped against a hard surface — a rugby player sliding on an artificial pitch or a cyclist falling on a road. Cuts and lacerations involve a break in the skin caused by sharp contact with an implement, a surface or an opponent. Contusions (bruises) result from a direct blow that damages blood vessels beneath the skin without breaking the surface — the bleeding is internal, causing the characteristic discolouration. Blisters are fluid-filled pockets beneath the skin caused by repetitive friction — a rower's hands, a runner's heels and a tennis player's fingers are all common sites. All of these are soft-tissue injuries. They vary in severity: lacerations and contusions can occasionally be serious (a deep laceration may require suturing; a contusion on the head may mask a more serious injury), while abrasions and blisters are typically minor but can become infected if poorly managed.
Acute Hard-Tissue Injuries: Fractures and Dislocations
A fracture is a break in a bone. The specification distinguishes two types. An open (compound) fracture is where the broken bone penetrates through the skin — highly visible, carries a serious infection risk and always requires emergency medical attention. A closed (simple) fracture is where the bone breaks internally without breaking the skin, identified by pain, swelling, deformity and loss of function. A dislocation occurs when the bones of a joint are forced out of their normal anatomical alignment — the shoulder (glenohumeral joint) and fingers are the most commonly dislocated joints in sport. Dislocations are hard-tissue injuries. They typically cause immediate severe pain, a visible deformity and complete loss of normal joint function. Fractures and dislocations must not be manipulated in the field without medical expertise — a suspected fracture or dislocation should be immobilised and the athlete referred immediately to emergency services.
Hard-tissue injuries are limited to fractures (open and closed), stress fractures and dislocations. Every other named injury in the specification — strains, sprains, abrasions, contusions, blisters, concussion, tendonitis, epicondylitis and shin splints — is a soft-tissue injury.
Concussion is a traumatic brain injury caused by a blow or jolt to the head that temporarily disrupts normal brain function. Symptoms include headache, confusion, dizziness, nausea, memory problems and sensitivity to light. The specification requires you to know the possible link between repeated head injuries and the onset of dementia and Alzheimer's disease. This link has become a major safeguarding concern in contact sports, particularly rugby union and American football. Chronic Traumatic Encephalopathy (CTE) — a degenerative brain condition found post-mortem in former contact sport athletes — is now associated with a history of repeated concussive and sub-concussive blows. As a result, national governing bodies (NGBs) have introduced strict return-to-play protocols: no athlete with suspected concussion should return to play in the same session. Concussion is a soft-tissue injury (brain tissue, not bone).
Chronic injuries develop gradually from repetitive overuse. Tendonitis is inflammation of a tendon caused by repetitive stress. The three named sites are: Achilles tendonitis (posterior heel — common in runners and jumpers); rotator cuff tendonitis (shoulder — common in swimmers, throwers and racket sport players); and patellar tendonitis (knee — common in basketball players and high jumpers, nicknamed "jumper's knee"). Epicondylitis is a condition affecting the tendons at the epicondyle of the humerus (the bony projection at the elbow). Lateral epicondylitis (tennis elbow) causes pain on the outside of the elbow through overuse of the wrist extensor muscles — common in racket sports and repetitive manual tasks. Medial epicondylitis (golfer's elbow) causes pain on the inside of the elbow through overuse of the wrist flexors — common in golf, throwing sports and rock climbing. Shin splints (medial tibial stress syndrome) cause pain along the inner shin, typically in runners who rapidly increase their training mileage, run on hard surfaces or have poor footwear. Stress fractures are tiny cracks in bone from repetitive loading — unlike other chronic injuries, they are hard-tissue injuries. All tendonitis, epicondylitis and shin splints are soft-tissue injuries.