Evaluation of an Injury Chapter 13 Principles of Athletic Training

Evaluation History: History: –Be calm and reassuring –Express ?’s that are simple and not leading –Listen carefully to athlete’s complaints –Maintain eye contact –Record exactly what the athlete says without interpretation

Past History Questions Has this ever happened before? If so when and how severe. Has this ever happened before? If so when and how severe. Have you ever injured the other extremity before? Have you ever injured the other extremity before?

Present History Questions What is the problem or your chief complaint? What is the problem or your chief complaint? How did it occur? How did it occur? When did it occur When did it occur Did you fall? How did you land? Did you fall? How did you land? Which direction did your joint move? Which direction did your joint move? Did you hear or feel anything when it occurred? Did you hear or feel anything when it occurred? *If the athlete can’t answer any of the above questions ask teammate or someone who observe the injury.* *If the athlete can’t answer any of the above questions ask teammate or someone who observe the injury.*

Present History Continue Injury location Injury location –Point to the exact location of pain with one finger  If yes they can then injury is localized if not then injury may be generalized and nonspecific

Present History Continue Pain characteristics Pain characteristics –What type of pain is it?  Nerve pain=sharp, bright, or burning  Bone pain= localized and piercing  Vascular pain= poorly localized, aching, and referred from another area  Muscle pain= dull, aching, and referred to another area

Present History Continue Pain characteristics Pain characteristics –Where is the pain –Does the pain change at different times?  Pain that subsides during activity usually indicates a chronic inflammation  Pain that increases in a joint throughout the day indicates a progressive increase in edema

Present History Continue Pain characteristics –D–D–D–Does the athlete feel sensations other that pain? PPPPressure TTTTingling PPPPins and needles

Joint responses Joint responses –Is there instability –Does it feel as though it will give way? –Does the joint lock and unlock Determine whether the injury is acute or chronic. Determine whether the injury is acute or chronic.

Observation How does the athlete move? How does the athlete move? Is there a limp Is there a limp Are movements abnormally slow or jerky Are movements abnormally slow or jerky Is the athlete unable to move a body part? Is the athlete unable to move a body part? Is the athlete holding his/her body stiffly to protect against pain? Is the athlete holding his/her body stiffly to protect against pain? Does the athlete’s facial expression indicate pain or lack of sleep? Does the athlete’s facial expression indicate pain or lack of sleep?

Observation Continued Are there any obvious body asymmetries? Are there any obvious body asymmetries? Is there an obvious deformity? Is there an obvious deformity? Does soft tissue appear swollen or has atrophy Does soft tissue appear swollen or has atrophy Are there unnatural protrusions or lumps? Are there unnatural protrusions or lumps? Is there a postural malalignment? Is there a postural malalignment? Are there abnormal sounds such as crepitus? Are there abnormal sounds such as crepitus? Does a body area appear inflamed? Does a body area appear inflamed? Is there swelling, heat, or redness? Is there swelling, heat, or redness?

Palpation You can use palpation in the beginning or when you identify the specific injury. You can use palpation in the beginning or when you identify the specific injury. Start with light pressure Start with light pressure Followed by gradual deeper pressure Followed by gradual deeper pressure Usually begin away from the site of complaint and gradually move towards it. Usually begin away from the site of complaint and gradually move towards it.

Palpation Continued Bony palpation: Bony palpation: –Palpate bilateral –Feel for abnormal gap at a joint.  Swelling on a bone  Misaligned joints  Abnormal protuberances

Palpation Continued Soft-Tissue Palpation –A–A–A–Athlete is relaxed –P–P–P–Palpate for SSSSwelling LLLLumps GGGGaps AAAAbnormal muscle tension TTTTemperature MMMMuscle twitching or tremors SSSSkin dryness or moisture BBBBecome aware of dysesthesia, anesthesia, hyperesthesia