Off-Field Injury Evaluation

Evaluation vs. Diagnosis

OBy law, ATC’s cannot diagnoseOEducation and training allow

them to make quick and accurate judgment calls

Oi.e. fractures, ligament tears, etc.

Assessment TermsO Etiology – cause of diseaseO Mechanism – mechanical description

of causeO Pathology – structural and functional

changes as result of injuryO Symptom – change this indicates

injury/diseaseO Sign – indicator of an injury/disease

Off-Field Injury Eval Process

HOPS

OHistory OObservationOPalpationOSpecial Tests

HOPS - HistoryO Past experiences

O “Has this ever happened before? If so, when?”

O PresentO “What’s the problem?”O “How did it happen?”O “When did it happen?”O “Did you hear or feel anything?”O Have them point to where it hurts and

describe painO Acute or chronic?

HOPS - ObservationO How do they move?O Is there a limp?O Obvious asymmetries/deformities?O Swelling?O Unnatural lumps? (i.e. fracture or

dislocation)

HOPS - PalpationO Bony

O Check injured and non-injured sightsO Check bilateral

O Soft TissueO SwellingO LumpsO GapsO Tissue tightnessO Check bilateral

HOPS – Special TestsO Movement Assessment

O AROM, PROM, RROMO Manual Muscle Testing

O Muscle isolationO Neuro Testing

O Sensory, reflex, motorO Joint Stability Testing

O Sprain gradesO Functional Performance Testing

O Full strength, joint stability, coordination, and pain free

Progress EvalsO Monitors progress of the athleteO History

O Pain today vs. yesterday? Did yesterday’s treatment help or make it worse?

O ObservationO Swelling down? Can athlete move better?

O PalpationO Tenderness? Deformities?

O Special TestsO More stable? More strength? Better ROM?

Documentation of Injury Evals

O Accurate documentation CYAO SOAP Notes:

O Subjective – what the athlete tells you

O Objective – what ATC finds (palpation, ROM, special tests)

O Assessment – ATC’s professional opinion

O Plan – treatment, referral, inform parents, etc.

Imaging - Radiography

OX-RaysOUsed to identify

O FracturesO DislocationsO Bone abnormalities

X-Ray

Imaging – Computed Tomography

OCTOLike X-ray, but more detailOAllows for views from many

angles

CT

Imaging – Magnetic Resonance Imaging

OMRIOExpensiveOTest of choice for detecting

soft-tissue injuriesO Ligament tearsO Tendon injuriesO Muscle injuries

MRI

Imaging - Ultrasound

OView location, measurement, or delineation of an organ or tissue

OReflection of sound wavesOTypically only used in

pregnancy

Ultrasound