Download Chapter 1 The Injury Evaluation Process

Chapter 1
The Injury
Evaluation Process
Introduction
 Accurate
initial assessment is essential for
successful management and rehabilitation
of an injury
 Evaluation process is ongoing throughout
all phases of recovery
 A systemic and methodical evaluation
model leads to efficiency and consistency
in the evaluation process
Systemic Evaluation Technique
 Figure
1-1, page 2
 The Role of the Noninjured Paired
Structure – Table 1-1, page 3
Clinical Evaluations
 History
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Most Important portion of examination
Communication is key
Cultural Considerations, page 4, Box 1-1
Information that should be obtained:
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Mechanism of injury
Relevant sounds/sensations at time of injury
Location of symptoms
Onset and duration of symptoms (Table 1-2, Pg 5)
Description of symptoms
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Information that should be obtained cont.:
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Changes to symptoms
Previous history
Related history to the opposite body part
General medical health
NCAA Guideline 1B – page 6, Box 1-2
 Inspection
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Gross deformity
Swelling (Girth measurement pg 9, volumetric
measurement pg 10)
Bilateral symmetry
Skin (figure 1-4, page 10)
Infection
 Palpation
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Point tenderness
Trigger points
Change in tissue density
Crepitus
Symmetry
Increased tissue temperature
 Range
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of Motion
Bilateral comparison, normative data
Goniometric evaluation – pg 11, Box 1-4
Planes of the body
Active range of motion (AROM)
Passive range of motion (PROM)
Resisted range of motion (RROM)
• Break tests
• Manual muscle testing
• End -feels
 Ligamentous
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and Capsular Tests
Grading System – pg 15, Table 1-7
Laxity vs. instability
 Special
Tests
 Neurologic Tests
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Sensory Testing
Motor Testing
Reflex Testing
 Activity-Specific
Functional Testing
On-Field Evaluation of Athletic
Injuries

Ambulatory vs. athlete-down
 On-field evaluation must rule out:
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Inhibition of the cardiovascular and respiratory
systems
Life-threatening trauma to the head or spinal column
Profuse bleeding
Fractures
Joint dislocation
Peripheral nerve injury
Other soft tissue trauma
 Disposition
of condition
 Communication plan/emergency action
plan
 Sport specific rules
 On-Field
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Relatively brief
 On-Field
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Inspection
Is athlete moving?
Position of athlete
Primary/secondary survey
 On-Field
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History
Palpation
Findings may warrant transporting athlete to
hospital
 On-Field
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Range of Motion Testing
AROM first
Weight-bearing status
 On-Field
Ligamentous Testing
 On-Field Neurologic Testing
 Removal of Athlete From the Field
Termination of the Evaluation
 Table
1-9, page 25
Standard Precautions Against
Bloodborne Pathogens
Table
1-10, page 26
The Roles of Different Health Care
Professionals
 Athletic
Trainer
 Physical Therapist
 School Nurse
 Emergency Medical Technician
 Physician
Documentation