1. Injury Assessment & Evaluation 10/8/20151 http://www.youtube.com/watch?v=VFN90gkKHu4

2. 10/8/20152

3. Objectives Define assessment and determine its role Define terminology used in injury evaluation 10/8/20153

4. Injury classifications Acute, traumatic Overuse, mechanical 10/8/20154

5. Objectives Describe the events of the musculoskeletal evaluation (HOPS) Identify specific components in a history of an injury Describe what is involved in observation & inspection of an injury site Identify principles used in palpation, ROM testing, neurological testing & special tests 10/8/20155

6. Differential Diagnosis Diagnosis: definitive determination of disease, injury, or syndrome a person has or is believed to have Differential diagnosis: Method of diagnosing when unique S/Sx lacking 10/8/20156

7. Assessment Situations On-the-field assessment primary survey render a decision regarding injury severity 1. r/o fracture or dislocation 2. Check for joint stability or muscle rupture 3. Control severe bleeding 4. Test for neurological conditions 10/8/20157

8. Assessment Situations On-the-field assessment is immobilization &/or transportation needed? crowd control: players, coaches, officials 10/8/20158

9. Assessment Situations Off-the-field assessment decisions 1. Extent of injury 2. Immediate treatment (first aid) 3. Playing status 10/8/20159

10. Introduction to Assessment Role of the ATC when emergency care is not required 1. To determine the nature of the illness or injury 2. To determine the need for MD for further exam 3. OR treating the athlete according to routine SO’s 10/8/201510

11. Evaluation Techniques HOPS format 1. Consistent, systematic process 2. Format uses subjective information (history) 3. Also objective information (observation & inspection, palpation, and special tests) 10/8/201511

12. Assessment Terminology Etiology Mechanism of injury (MOI) Pathology Prognosis Sequela Syndrome Signs and symptoms (s/sx) 10/8/201512

13. History MOI – mechanism of injury How did the injury occur? Macrotrauma Microtrauma Identifies structures involved Relevant sounds or sensations 10/8/201513

14. History Symptoms Pain Location Type Referred Radicular Daily pain patterns Provocation and alleviation patterns Other symptoms Limitations 10/8/201514

15. Examination goals Rule out differential diagnosis Determine clinical diagnosis Identify impairments and functional limitations 10/8/201515

16. Observation & Inspection Introduction observing the injury mechanism 10/8/201516

17. Observation & Inspection athlete presents complaining of pain/discomfort assessment begins upon presentation/occurrence use discretion 10/8/201517

18. Observation & Inspection Observation - scan exam assesses general motor function  Gait  Posture  Function  Guarding  Splinting r/o injuries at other joints/areas note willingness & ability to move general posture consistency in motions 10/8/201518

19. Observation & Inspection Inspection of injury site Deformities – subtle or gross Swelling – effusion or edema Discoloration – redness or ecchymosis Infection signs scars general skin condition BILATERAL comparison 10/8/201519

20. 10/8/201520 Palpation Rule out fracture Skin temperature Swelling Point tenderness Vascular pulses Crepitus Muscle spasm Deformity Sensory changes

21. Palpation strategies Sequencing strategy #1 Bones Ligaments Muscles and tendons Sequencing strategy #2 Palpate all structures Begin away from pain site and progress toward suspected injury. 10/8/201521

22. Palpation Procedures Hands Begin proximal to specific injury site Palpate painful area last Begin w/light touch Proceed w/deeper pressure 10/8/201522

23. Palpation Findings Tissue temperature Swelling Changes in tissue density Point tenderness & crepitus Trigger points Cutaneous sensation Peripheral pulses Bone palpation & fracture tests 10/8/201523

24. Peripheral Pulses 10/8/201524