Off-the-Field Injury Evaluation

Overview Injury evaluation is an intricate part of sports injury care. Though on-site injury assessment is important, often it is necessary to perform a more detailed assessment at a site other than where the injury occurred. Each examiner must become proficient in the off-site, injury evaluation and the progress

Overview The off-field injury assessment concerns the detailed sequence of procedures that determine the nature, site, and severity of an injury. From the off-field evaluation the examiner can decide whether referral to another health professional is necessary. Portions of the off-field evaluation sequence may be used to determine the progress of a treatment regimen throughout the rehabilitative process

Evaluation of Sports Injuries 1.Pre-participation examination a)Done prior to start of preseason practice 2.On-the-field injury assessment a)Done immediately after acute injury to determine immediate course of care 3.Off-the-field injury assessment a)Done in the athletic training room, clinic, emergency room or MD’s office after appropriate first aid has been rendered 4.Progress evaluation a)Done periodically throughout the rehab process, to determine the progress and effectiveness of specific treatment regimen

Basic Knowledge Requirements 1.Normal Human Anatomy a)Surface Anatomy b)Body planes and anatomical directions c)Abdominopelvic quadrants d)Musculoskeletal system anatomy e)Standard musculoskeletal terminology for bodily positions and deviations

Body planes

Anatomical Directions

Basic Knowledge (continued) 2. Biomechanics a)Application of mechanical forces, which may stem from within or outside the body, to living organisms b)Pathomechanics: mechanical forces that are applied to the body because of a structural body deviation, leading to faulty alignment (overuse syndromes) 3. Understanding the Sport a)Need to know the correct kinesiological and biomechanical principles

Basic Knowledge (continued) 4. Descriptive Assessment Terms a)Etiology: the cause of an injury or disease (mechanism) b)Pathology: structural and functional changes that result from the injury process c)Symptom: Perceptible change in an athlete’s body or its functions that indicates an injury or disease d)Sign: Objective, a definitive and obvious indicator for a specific e)Diagnosis: Denotes the name or a specific condition

Basic Knowledge (continued) a)Prognosis: Prediction of the course of the condition b)Sequela: Condition following and resulting from a disease or injury- development of an additional condition as a complication of an existing disease or injury c)Syndrome: Group of symptoms and signs that together indicate a particular injury or disease d)Differential Diagnosis: Systematic method of diagnosing a disorder that lacks unique symptoms or signs

Off-the Field Injury Evaluation 1.History a)Past history of injury b)Present injury c)Injury location d)Pain characteristics e)Joint responses f)Determining whether the injury is acute or chronic

Off-the Field Injury Evaluation 2. Observation 3. Palpation a)Bony palpation b)Soft-tissue palpation

Off-the Field Injury Evaluation 4. Special Tests a)Movement assessment b)Active ROM c)Passive ROM i.Normal Endpoints (end feels)

Off-the Field Injury Evaluation I. Abnormal endpoints (endpoints) a)Empty feel: movement is definitely beyond the anatomical limit and pain occurs before the end of the range (ruptured ligament) b)Spasm: involuntary muscles contraction that prevents motion because of pain c)Loose: occurs in extreme hypermobility

Off-the Field Injury Evaluation 4. Special Tests d) Resisted motions i.Strong and painless- normal muscle ii.Strong and painful- minor lesion in some part of muscle or tendon iii.Weak and painless- complete rupture of muscle or tendon or some nervous system disorder iv.Weak and painful- gross lesion of contractile tissue v.Pain on repetition- single contraction is strong and painless, but repetition produces pain as would exist in some vascular disorder vi.All muscles painful- serious emotional or psychological problem

Off-the Field Injury Evaluation 4. e. Goniometric Measurement of Joint Range f. Manual Muscle Testing g. Neurologic Examination i.Cerebral function ii.Cranial nerve function iii.Sensory testing: (dermatomes & myotomes) iv.Reflex testing v.Determining projected or referred pain vi.Motor testing h. Testing joint stability

Documenting Injury Evaluation information 1.Soap Notes a)S (Subjective): Statements provided by the injured athlete b)O (objective) c)A (Assessment): Athletic trainers professional judgment with regard to the impression and nature of the injury d)P (Plan): First aid rendered, and intentions relative to disposition

Documenting Injury Evaluation information 2. Progress Notes a)Routinely written after each progress evaluation done throughout the course of the rehabilitation program b)Follow the S.O.A.P. format

Additional Diagnostic Tests used by a Physician 1.Imaging Techniques i.Plain film radiography (X-rays) a)Show bones

Diagnosis Tests Arthroscopy – a surgical procedure that allows your doctor to look at the inside of a joint in your body through a thin viewing instrument

Diagnosis Tests Bone Scanning – Shows new areas of bone growth & breakdown

Diagnosis Tests Magnetic Resonance Imaging – Shows structural abnormalities of the body