Comprehensive Off-Field Injury Evaluation: Techniques and Guidelines for Athletic Trainers
This article explores the critical aspects of off-field injury evaluation for athletic trainers (ATCs). It emphasizes that while ATCs cannot formally diagnose injuries, their training enables quick, accurate assessments based on injury history, observation, palpation, and special tests using the HOPS method (History, Observation, Palpation, Special Tests). Key concepts such as etiology, mechanism, pathology, and the importance of thorough documentation through SOAP notes are discussed. It also outlines the use of imaging techniques like X-rays, CT scans, MRIs, and ultrasounds for detailed injury analysis.
Comprehensive Off-Field Injury Evaluation: Techniques and Guidelines for Athletic Trainers
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Presentation Transcript
Evaluation vs. Diagnosis • By law, ATC’s cannot diagnose • Education and training allow them to make quick and accurate judgment calls • i.e. fractures, ligament tears, etc.
Assessment Terms • Etiology – cause of disease • Mechanism – mechanical description of cause • Pathology – structural and functional changes as result of injury • Symptom – change this indicates injury/disease • Sign – indicator of an injury/disease
Off-Field Injury Eval Process HOPS • History • Observation • Palpation • Special Tests
HOPS - History • Past experiences • “Has this ever happened before? If so, when?” • Present • “What’s the problem?” • “How did it happen?” • “When did it happen?” • “Did you hear or feel anything?” • Have them point to where it hurts and describe pain • Acute or chronic?
HOPS - Observation • How do they move? • Is there a limp? • Obvious asymmetries/deformities? • Swelling? • Unnatural lumps? (i.e. fracture or dislocation)
HOPS - Palpation • Bony • Check injured and non-injured sights • Check bilateral • Soft Tissue • Swelling • Lumps • Gaps • Tissue tightness • Check bilateral
HOPS – Special Tests • Movement Assessment • AROM, PROM, RROM • Manual Muscle Testing • Muscle isolation • Neuro Testing • Sensory, reflex, motor • Joint Stability Testing • Sprain grades • Functional Performance Testing • Full strength, joint stability, coordination, and pain free
Progress Evals • Monitors progress of the athlete • History • Pain today vs. yesterday? Did yesterday’s treatment help or make it worse? • Observation • Swelling down? Can athlete move better? • Palpation • Tenderness? Deformities? • Special Tests • More stable? More strength? Better ROM?
Documentation of Injury Evals • Accurate documentation CYA • SOAP Notes: • Subjective – what the athlete tells you • Objective – what ATC finds (palpation, ROM, special tests) • Assessment – ATC’s professional opinion • Plan – treatment, referral, inform parents, etc.
Imaging - Radiography • X-Rays • Used to identify • Fractures • Dislocations • Bone abnormalities
Imaging – Computed Tomography • CT • Like X-ray, but more detail • Allows for views from many angles
Imaging – Magnetic Resonance Imaging • MRI • Expensive • Test of choice for detecting soft-tissue injuries • Ligament tears • Tendon injuries • Muscle injuries
Imaging - Ultrasound • View location, measurement, or delineation of an organ or tissue • Reflection of sound waves • Typically only used in pregnancy
