Chapter 11 Assessment and Evaluation of Sports Injuries

1. Chapter 11 Assessment and Evaluation of Sports Injuries

2. Objectives • Explain the difference between assessment, evaluation, and diagnosis of an injury. • Describe the various factors that influence the type and severity of athletic injuries. • Evaluate an athletic injury using the systematic approach. • Explain the different methods and reasons for documenting injuries

3. Assessment • Assessment: orderly collection of objective and subjective data on the athlete’s health status • Collect medical history • Objective vs Subjective • Palpation • ROM • Special Tests

4. Diagnosis • Diagnosis: Using information from assessment and physical examination findings to establish the cause and nature of the athlete’s injury or disease • Made only by physician or other licensed health care provider • Must remember to work in scope of practice

5. Influencing Factors • Anthropomorphic Data: size, weight, body structure, gender, strength, and maturity level • College vs High School • Mechanism of Force: all forces involved at the time of impact • Direction, intensity, duration, position of body

6. Influencing Factors • Speed: influence type and severity of injury • Greater speed usually equals greater chance of injury • Athletes should compete against athletes of similar level

7. Influencing Factors • Protective Equipment: better equipment has helped keep number of injuries down. • Make sure equipment is worn properly • Skill Level: beginners are at a greater risk for injury due to being unfamiliar with basic techniques

8. Primary Injury Survey • Check for serious, life-threatening injuries • Activate EMS if needed • CAB’s • Circulation: Check for pulse, coughing, movement • Airway: Open airway using head tilt/chin lift or jaw thrust • Breathing: Listen, look and feel for signs of breathing

9. Head tilt, chin-lift is used to open airway of an unconscious person Jaw thrust opens the airway when a spinal injury is suspected Head Tilt vs Jaw Thrust

10. Secondary Injury Survey • Secondary injury survey is a thorough, methodical evaluation of an athlete’s overall health to reveal additional injuries beyond the initial injury • HOPS • History • Observation • Palpation • Special Tests

11. History • What happened? • When did injury occur? • Did you hear a sound? • Where is the pain? • What type of pain? Pain Scale? • Neurological function? • Prior history?

12. Observation • What do you see? • Compare injured to uninjured side • Deformity? • Swelling? • Bleeding? • Bruising or ecchymoses?

13. Palpation • Palpation is the touching of the injured athlete • Examine uninjured side first • Palpate firmly enough to produce pain if present • Watch for facial expressions or wincing • Palpate one joint above and below injury

14. Special Tests • Active range of motion: athlete moves body part through range • Passive ROM: examiner moves body part through range • Strength: isometric and through ROM • Stability: ligament laxity tests • Special Tests

15. Activity • Functional activity: level of movement the athlete can comfortably participate in • Run, hop, sprint, cut, twist • Sport-specific activity: movements related to a particular sport • Volleyball spike • Basketball shot • Soccer kick

16. Return to Play • 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.

17. Abrasions: occurs when several layers of skin are torn loose Laceration: tear in the skin Stitches if more than ¼ inch deep and ½ inch long Soft Tissue Injury

18. Avulsion: injury where skin is torn off Keep skin flap if possible Puncture: caused by sharp, pointed objects High risk of infection Soft Tissue Injury

19. Care of Soft Tissue Injuries • Clean wound • Make sure it is free of dirt and debris • Apply antibiotic ointment • Help prevent infection and keeps dressing from sticking to wound • Apply bandages or non-adherent pad • Check for signs of infection

20. Signs of Infection • Swelling • Heat • Angry • Redness • Pus • Streaks

21. Injury to Muscle • Strain: caused by twisting or pulling a muscle • Overuse or acute • Signs and symptoms: pain, spasm, weakness • May feel deficit in severe strains • RICE • Rehab to increase flexibility and strength

22. Injury to Ligaments • Sprain: results from a fall, sudden twist, or blow to the body that forces a joint out of its normal position • S/S: pain, swelling, bruising, loss of ROM • Severity is classified by grades • Grade I: Mild • Grade II: Moderate • Grade III: Severe

23. Tendonitis • Tendon: fibrous tissue that connects muscle to bone • Tendonitis: inflammation of the tendon • Typically worse after activity and at night • Caused by overuse • Treat with rest, ice, NSAIDs, ultrasound, rehab

24. Bursa: located throughout the body to decrease friction between two surfaces Bursitis: inflammation of a bursa Joint pain with movement and at night Bursitis

25. Contusions • Direct blow that does not break the skin • Usually includes ecchymosis or bruising • Myositis Ossificans

26. Documentation of Injuries • SOAP note • Subjective, Objective, Assessment, Plan • Daily Injury Report • Communication between coaches on status of athletes • AT room treatment log • Athletes receiving treatments should be logged in