1. Chapter 11: Assessment and Evaluation of Sports Injuries

2. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Assessment/Evaluation  An important proficiency for everyone on the athletic care team  Consists of what is thought to be wrong, based on professional knowledge and knowledge of the events occurred.

3. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3 Athletic Injuries  Assessment refers to the orderly collection of objective and subjective data on the athlete’s health status.  Diagnosis uses information from the assessment and physical examination to establish the cause and nature of the athlete’s injury; it may be made only by a physician or licensed health care provider.

4. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4 Factors Influencing Athletic Injuries  Anthropomorphic data, which includes statistics on an athlete’s size, weight, body structure, gender, strength, and maturity level, provides essential information to health care providers.  Where would we find this type of information on athletes?

5. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5 Factors Influencing Athletic Injuries (cont.)  Mechanism of force involves an evaluation of all the forces involved at the time of an impact (direction, intensity, duration, activity, and body/ body part position).  Speed at which the injury occurred affects the extent and severity of the injury.

6. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6 Factors Influencing Athletic Injuries (cont.)  Protective equipment can reduce the severity of injury and prevent injury if properly fitted and used.  The athlete’s skill level may also play a role; beginners are more prone to injury than more advanced athletes.

7. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 7 Primary Injury Survey  The first focus of those on the scene of an injury involves assessment of life-threatening emergencies and management of the airway, breathing, and circulation.  Recognition of Injuries is the process in which the certified athletic trainer determines the probable cause and mechanism of injury.  When evaluating emergencies, it is important to control life-threatening conditions first, an to activiate EMS when needed.

8. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 8 Secondary Injury Survey  A thorough, methodical evaluation of an athlete’s overall health to reveal additional injuries beyond the initial injury.  The HOPS approach is common to the secondary injury survey: History, Observation, Palpation, and Special tests.

9. History  Must be done first!  What happened? Body part injured; description of injury  When did the injury occur?  What factors influcenced the injury.  Was a sound heard? Pop, snap, rip?  Where is the pain located? Location at time of injury? Point to the location Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 9

10. History (cont.)  Pain Characterisitcs: sharp or dull/achy? Stabbing, throbbing? Constant, cramping? Painful at rest or when using?  Numbness, pins and needles, prickling, muscle weakness, paralyisis, burning senation  Instability or is the body part working correctly?  Prior history or injury to affected body part. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 10

11. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 11 Pain Evaluation  A scale can be used to evaluate how much pain the injured athlete is in: 0No pain 1-3Minimal pain 4-6Moderate pain 7-9Severe pain 10Emergency room pain

12. Exposing the Injury  Only if necessary  Cut clothing if needed, using scissors  Use modesty; if possibly cut clothing off in a private area (dressing room, office, etc).  Good practice to have an adult of the same sex as the injured athlete. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 12

13. Observation  Look and compare to the unijured side  Look for deformity, swelling, bleeding, and color changes Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 13

14. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 14 Palpation  Palpation refers to touching the athlete during examination to determine the extent of injury.  Palpation should be firm enough to produce pain if injury is present. Too light a touch may result in overlooking a significant injury.  Observe athlete for facial expressions

15. Special Tests  May be necessary to establish the degree of injury.  Lachman Anterior Drawer Test, Talar Tilt, Empty Can Test, etc can all be utilized. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 15

16. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 16 Active/Passive Motion  Active motion is movement by the athlete through the range of motion during examination.  Passive motion is movement done by the examiner through the range of motion while the athlete relaxes the muscles.

17. Strength and Stability Strength  Begin isometrically without resistance then full range of motion against resistance.  Compare with strength against opposite injured part. Stability  Investigates ligamentous laxity  Degree of looseness in the ligaments of a joint.  Athlete must relax all muscles around injured part.  Stress the ligament at the affected joint line. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17

18. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 18 Activity  Functional activity refers to the level of movement at which the athlete can comfortably work and participate.  Sport-specific activity involves particular types of movement and actions that are needed in or related to a particular sport.

19. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 19 Return-to-Play Criteria  The athlete must exhibit 100% strength in the injured area.  The athlete must be free from pain.  Skill performance tests must be taken to determine the athlete’s ability to return to play.  The athlete must exhibit emotional readiness to return to the chosen activity.

20. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 20 SOAP Notes  This is a particular format for recording information regarding treatment procedures: –Subjective notes include subjective statements made by the injured athlete (history) –Objective notes include the certified athletic trainer’s visual inspection, palpation, and assessment of active, passive, and resistive motion (Inspection, Paplation)

21. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 21 SOAP Notes (cont.) –Assessment of the injury is the certified athletic trainer’s professional judgment and impression as to the nature and extent of injury (Special Test) –Plan refers to First Aid treatment rendered and the sports therapist’s intentions as to disposition (what is to be done next).

22. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 22 Daily Sideline Report  Tracks each athlete who participates in a sport  Tracks injuries, missed practices, and limited practice abilities  May reveal injury patterns that should be addressed with the athlete

23. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 23 Training-Room Treatment Log  Anyone receiving attention from the ACT is logged.  Log data includes name, date, injury, treatment provided, and follow-up care required.

24. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 24 Daily Red Cross List  Documentation used to inform coaches of the status of their athletes’ health and injuries.