Chapter 1 The Injury Evaluation Process

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Chapter 1 The Injury Evaluation Process
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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

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Systemic Evaluation Technique

• Figure 1-1, page 2
• The Role of the Noninjured Paired Structure
  Table 1-1, page 3

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Clinical Evaluations

• History
• Most Important portion of examination
• Communication is key
• Cultural Considerations, page 4, Box 1-1
• Information that should be obtained
• 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.
• Changes to symptoms
• Previous history
• Related history to the opposite body part
• General medical health
• NCAA Guideline 1B page 6, Box 1-2

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• Inspection
• Gross deformity
• Swelling (Girth measurement pg 9, volumetric
  measurement pg 10)
• Bilateral symmetry
• Skin (figure 1-4, page 10)
• Infection

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• Palpation
• Point tenderness
• Trigger points
• Change in tissue density
• Crepitus
• Symmetry
• Increased tissue temperature

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• Range 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

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• Ligamentous and Capsular Tests
• Grading System pg 15, Table 1-7
• Laxity vs. instability
• Special Tests
• Neurologic Tests
• Sensory Testing
• Motor Testing
• Reflex Testing
• Activity-Specific Functional Testing

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On-Field Evaluation of Athletic Injuries

• Ambulatory vs. athlete-down
• On-field evaluation must rule out
• 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

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• Disposition of condition
• Communication plan/emergency action plan
• Sport specific rules

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• On-Field History
• Relatively brief
• On-Field Inspection
• Is athlete moving?
• Position of athlete
• Primary/secondary survey
• On-Field Palpation
• Findings may warrant transporting athlete to
  hospital

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• On-Field Range of Motion Testing
• AROM first
• Weight-bearing status
• On-Field Ligamentous Testing
• On-Field Neurologic Testing
• Removal of Athlete From the Field

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Termination of the Evaluation

• Table 1-9, page 25

Standard Precautions Against Bloodborne Pathogens

• Table 1-10, page 26

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The Roles of Different Health Care Professionals

• Athletic Trainer
• Physical Therapist
• School Nurse
• Emergency Medical Technician
• Physician

Documentation