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HOPS

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HOPS Evaluation Procedures for Athletic Injuries – PowerPoint PPT presentation

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Title: HOPS


1
HOPS
  • Evaluation Procedures for Athletic Injuries

2
H History
  • The most essential part of the process.
  • Helps the athletic trainer determine what they
    will do during the remainder of the evaluation
    process.
  • Most times a person is able to determine what is
    wrong by getting a good history.
  • Almost like being a detective.

3
H History
  • During the History it is important for the sports
    medicine professional to
  • Be calm and reassuring.
  • Ask open ended questions.
  • Listen carefully to the athlete/patients
    response for possible clues.
  • Maintain eye contact when possible.
  • Obtain the history as soon after the injury as
    possible.

4
H History
  • Start with understanding the mechanism of injury.
  • What is the problem?
  • How did it occur?
  • When did it occur?
  • Did you fall? How did you land?
  • Which direction did your joint or body part move?
  • Did the athlete hear any abnormal sounds or feel
    any abnormal sensations? Key sounds. Sounds
    occurring at the time of injury can provide
    valuable information about the type and severity
    of the injury. Cracks, pops, snaps or tears.

5
H History
  • Next determine pain characteristics.
  • What type of pain is it?
  • Nerve pain is sharp, bright or burning.
  • Bone pain tends to be localized and piercing.
  • Vascular system pain tends to be poorly
    localized, aching and referred from another area.
  • Muscular pain is often dull, aching and referred
    to another area.

6
H History
  • Next determine pain characteristics.
  • Where is the pain? The deeper the injury site,
    the more difficult to match the pain with the
    site of trauma.
  • Does the pain move? Does pain increase at night?
  • Pain the subsides during activity usually
    indicates chronic inflammation
  • Pain that increases throughout the day indicates
    progressive increase in edema.

7
H History
  • Next determine pain characteristics.
  • Does the patient feel sensations other than pain?
  • Pressure on nerve roots can produce a sensation
    of pins and needles (paresthesia)
  • Ask the athlete to quantify the amount of pain
    present using a pain scale of 1 to 10.

8
H History
  • Determine joint responses.
  • If the injury is related to the joint, is there
    instability?
  • Does the joint feel as though it is giving out?
  • Does the joint lock and unlock?

9
H History
  • Evaluate level of function.
  • Were they able to keep playing after the injury
    or did they come out of the game?
  • Are they able to use the injured body part
    normally?
  • Determine if injury is acute or chronic?
  • Acute happened in one action/event
  • Chronic progressed over time

10
H History
  • Find out if there have been any previous injuries
    to the area.
  • Has this ever happened before? When? There may
    be an underlying weakness that caused the injury.

11
O-Observation
  • This is often modified by the complaint of the
    athlete/patient. Here we are looking at the
    athlete and the injury and visually inspecting
    them. Often comparing the injured body part to
    the non-injured side.

12
O-Observation
  • Suggestions
  • Is there obvious deformity?
  • How does the patient move?
  • Is there a limp?
  • Are movements abnormally slow, jerky, and
    asynchronous?
  • Is the patient unable to move a body part?
  • Is the patient holding his or her body stiffly
    to protect against pain?
  • Does the patients facial expression indicate
    pain or lack of sleep?
  • Are there any obvious body asymmetries?

13
O-Observation
  • Suggestions
  • Does soft tissue appear swollen or wasted as
    a result of atrophy?
  • Are there unnatural protrusions or lumps such
    as occur with a dislocation or fracture?
  • Is there a postural malalignment?
  • Are there abnormal sounds such as Crepitus when
    the athlete moves?
  • Does the body area appear inflamed?
  • Is there swelling, heat or redness?
  • Are there any obvious wounds?

14
P - Palpation
  • Both the injured and non-injured sites should be
    palpated (touched) and compared. The athletic
    trainer is looking for an abnormality in
    structures that may not be observed but may be
    felt

15
P - Palpation
  • Evaluate away from the injured area first. This
    helps to gain the athletes confidence and you
    will be less likely to miss secondary areas of
    pain and injury.
  • Bony palpation allows the athletic trainer to
    feel an abnormal gap in the joint, a swelling
    along a structure, a misalignment, or a
    protuberance.

16
P - Palpation
  • Soft tissue palpation allows the athletic trainer
    to detect many things.
  • Swelling, lumps, gaps, and abnormal muscle
    tension
  • Skin temperature variation.
  • Torn ligaments and tendons.
  • Muscle twitching and tremors.
  • Excessive skin dryness or wetness.
  • Abnormal skin sensations
  • Variations in structure shapes, tissue tightness
    and textures

17
S Special Tests
  • Special Tests should be performed by trained
    professionals only.

18
S Special Tests
  • Movement assessment Range of Motion
  • Active Range of Motion (AROM) Done by the
    athlete
  • Depending on where the athlete has pain when
    moving the body part may determine what is wrong
    with them.
  • Passive Range of Motion (PROM) Done by the
    health care professional
  • Depending on where the athlete has pain when
    someone else is moving the body part may
    determine what is wrong with them

19
S Special Tests
  • Movement assessment Range of Motion
  • Muscle strain pain with active contraction and
    passive stretch.
  • Ligament pain with movement and stretching.
  • End Points Normal
  • Cartilage Tear
  • Muscle Spasm
  • Ligament Sprain (ACL)

20
S Special Tests
  • Manual Muscle Testing Strength
  • Done to Test the weakness of specific muscles

21
S Special Tests
  • Neurologic Examination
  • Typically done when there was a head injury.
    Deals with Cerebral function, cranial nerve
    function, and cerebellar function.
  • Sensory Testing - Sometimes done when there is a
    sensory loss in the musculoskeletal system and
    test by dermatome (area of skin innervated by a
    single nerve) or myotome (muscle or groups of
    muscles innervated by a specific motor nerve).
  • Referred pain testing
  • Motor testing like manual muscle testing.

22
S Special Tests
  • Joint Stability Testing
  • Specific tests to determine the integrity
    (strength and stability) of a joint.
  • Determine the severity of an injury or sometimes
    what specifically is wrong.

23
S Special Tests
  • Testing Functional Performance
  • Sometimes done to determine if an athlete can
    immediately return to play.
  • Determines the functional ability of the athlete
    at that immediate time.
  • Can theyrun, cut, plant, back pedal, block,
    hitin short, can they play their sport

24
Medical Referral
  • When immediate diagnosis by a physician is not
    available, the athletic trainer or coach must
    assume responsibility for evaluating the injury.
    Determine if the injury is of a serious or
    non-serious nature. If the injury appears to be
    more serious, referral to a physician is
    indicated.
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