Transcript Off-the-Field Injury Evaluation - ProvidencePanthersSportsMedicine

Off-the-Field Injury
Evaluation
Overview
• Injury evaluation is an intricate part of sports
injury care. Though on-site injury assessment
is important, often it is necessary to perform a
more detailed assessment at a site other than
where the injury occurred. Each examiner
must become proficient in the off-site, injury
evaluation and the progress
Overview
• The off-field injury assessment concerns the
detailed sequence of procedures that
determine the nature, site, and severity of an
injury. From the off-field evaluation the
examiner can decide whether referral to
another health professional is necessary.
Portions of the off-field evaluation sequence
may be used to determine the progress of a
treatment regimen throughout the
rehabilitative process
Evaluation of Sports Injuries
1. Pre-participation examination
a)
Done prior to start of preseason practice
2. On-the-field injury assessment
a)
Done immediately after acute injury to determine
immediate course of care
3. Off-the-field injury assessment
a)
Done in the athletic training room, clinic, emergency room
or MD’s office after appropriate first aid has been rendered
4. Progress evaluation
a)
Done periodically throughout the rehab process, to
determine the progress and effectiveness of specific
treatment regimen
Basic Knowledge Requirements
1. Normal Human Anatomy
a)
b)
c)
d)
e)
Surface Anatomy
Body planes and anatomical directions
Abdominopelvic quadrants
Musculoskeletal system anatomy
Standard musculoskeletal terminology for bodily positions and
deviations
Body planes
Anatomical Directions
Basic Knowledge (continued)
2. Biomechanics
a) Application of mechanical forces, which may stem
from within or outside the body, to living organisms
b) Pathomechanics: mechanical forces that are applied
to the body because of a structural body deviation,
leading to faulty alignment (overuse syndromes)
3. Understanding the Sport
a) Need to know the correct kinesiological and
biomechanical principles
Basic Knowledge (continued)
4. Descriptive Assessment Terms
a) Etiology: the cause of an injury or disease
(mechanism)
b) Pathology: structural and functional changes that
result from the injury process
c) Symptom: Perceptible change in an athlete’s body or
its functions that indicates an injury or disease
d) Sign: Objective, a definitive and obvious indicator for
a specific
e) Diagnosis: Denotes the name or a specific condition
Basic Knowledge (continued)
a) Prognosis: Prediction of the course of the
condition
b) Sequela: Condition following and resulting from
a disease or injury- development of an
additional condition as a complication of an
existing disease or injury
c) Syndrome: Group of symptoms and signs that
together indicate a particular injury or disease
d) Differential Diagnosis: Systematic method of
diagnosing a disorder that lacks unique
symptoms or signs
Off-the Field Injury Evaluation
1. History
a)
b)
c)
d)
e)
f)
Past history of injury
Present injury
Injury location
Pain characteristics
Joint responses
Determining whether the injury is acute or
chronic
Off-the Field Injury Evaluation
2. Observation
3. Palpation
a) Bony palpation
b) Soft-tissue palpation
Off-the Field Injury Evaluation
4. Special Tests
a) Movement assessment
b) Active ROM
c) Passive ROM
i.
Normal Endpoints (end feels)
Off-the Field Injury Evaluation
I. Abnormal endpoints (endpoints)
a)
b)
c)
Empty feel: movement is definitely beyond the anatomical
limit and pain occurs before the end of the range (ruptured
ligament)
Spasm: involuntary muscles contraction that prevents motion
because of pain
Loose: occurs in extreme hypermobility
Off-the Field Injury Evaluation
4. Special Tests
d) Resisted motions
i.
ii.
iii.
iv.
v.
vi.
Strong and painless- normal muscle
Strong and painful- minor lesion in some part of muscle or
tendon
Weak and painless- complete rupture of muscle or tendon
or some nervous system disorder
Weak and painful- gross lesion of contractile tissue
Pain on repetition- single contraction is strong and
painless, but repetition produces pain as would exist in
some vascular disorder
All muscles painful- serious emotional or psychological
problem
Off-the Field Injury Evaluation
4.
e. Goniometric Measurement of Joint Range
f. Manual Muscle Testing
g. Neurologic Examination
i.
ii.
iii.
iv.
v.
vi.
Cerebral function
Cranial nerve function
Sensory testing: (dermatomes & myotomes)
Reflex testing
Determining projected or referred pain
Motor testing
h. Testing joint stability
Documenting Injury Evaluation
information
1. Soap Notes
a) S (Subjective): Statements provided by the injured
athlete
b) O (objective)
c) A (Assessment): Athletic trainers professional
judgment with regard to the impression and
nature of the injury
d) P (Plan): First aid rendered, and intentions
relative to disposition
Documenting Injury Evaluation
information
2. Progress Notes
a)
Routinely written after each progress evaluation
done throughout the course of the rehabilitation
program
b) Follow the S.O.A.P. format
Additional Diagnostic Tests
used by a Physician
1. Imaging Techniques
i.
Plain film radiography (X-rays)
a) Show bones
Diagnosis Tests
• Arthroscopy
– a surgical procedure that
allows your doctor to
look at the inside of
a joint in your body
through a thin viewing
instrument
Diagnosis Tests
• Bone Scanning
– Shows new
areas of bone
growth &
breakdown
Diagnosis Tests
• Magnetic Resonance Imaging
– Shows structural
abnormalities of the body