Create an account
1. primary evaluation: on field
2. secondary evaluation: off-field
3. follow up:
- post game
- later... refer... wait & see
Severity: 1st degree or Grade I
mild/ slight stretching of tissue
little loss of ROM & strength
Severity: 2nd degree or Grade II
ROM loss up to 50%
strength loss up to 50%
Severity: 3rd degree or Grade III
rupture of tissue
strength loss > 50%
intense pain initially, then subsides
-can "see"/touch, asses (directly)
when you arrive on the scene...
-calm tyself and the crowd around you
-calm athlete: touch and talk
-stabilize injury (leg, arm, head/neck, etc.): assume "bad at this point
-acute or chronic condition?
-hear, feel snap, crack or pop?
-how happened? establish MOI
-where does it hurt? can you point with 1 finger?
-has it happened before?
-what activities are limited?
-life/limb threatening? Fx or dislocation?
-athlete condition? panic, fear, altered consciousness
-obvious deformity? Fx or dislocation/ laceration?
-bleeding? internal or external
-guarding (holding arm) or limping? protecting?
-light -> firm
-start away; move towards
-abnormalities? Fxs or dislocations
-pain? pinpoint or diffuse? inside or outside? type; sharp, burning, dull ache?
-maybe most important part; often overlook
-full ROM & strength do not guarantee full function
-ask athlete to demonstrate functional, sport activities
-for example, after an ankle injury:
bilateral toe raises
unilateral toe raises
injury evaluation review
primary survey always 1st
H = Hx
-What happened? (MOI)
-How? When? Previous history?
-Type of pain, feel/hear anything
-Hurts more when you...?
O = Observation
-Gait, ROM, facial expression, guarding
-Deformity, discoloration, swelling
P = Palpation
-Bony + soft tissue landmarks
-Light to firm
-Start away & more toward pain
S = Structural Integrity/ Special Tests
-AROM & PROM
-Strength tests/ MMT
Basic ortho assessment/ decision tree: -see injury, calm, stabilize
-see injury, calm, stabilize
-ask "snap, crackle, pop"? (Hx)
--Yes -> assume Fx/Disl/Ligament rupture
*unlikely to show "willingness to move" (AROM)
*may observe abnormal anatomy (bilateral view)
*stabilize, refer, activate EAP/911
--No -> breathe easier, safe to proceed
*no deformity (observed)
*willingness to move? (AROM): yes, proceed to palpate
Basic ortho assessment/ decision tree: observation
-"as they lay"
-carrying self: protecting? favoring?
Basic ortho assessment/ decision tree: palpation
Rules of palpation:
-away -> towards
-soft -> deep
Deformity, deficit, void, gap?
-grade 3 tissue damage, Fx?
Pain level 1-10
≥7 = significant/ concerned
Pinpoint or diffuse pain?
Sharp, lancing pain?
Basic ortho assessment/ decision tree: initial management decision
remove from field
- after follow-up and get info a 2nd time
Basic ortho assessment/ decision tree: sideline assessment
-gradual, Fnxl testing
-when do you refer to play?
Evaluation Process Overview
-immediate care protocols:
*PRICE (first 72 hours most important
-follow-up as necessary
-following initial evaluation and throughout the process
-it not written down, it didn't happen
Tissue Properties: yield point
elasticity reaches max. limits -> mechanical failure
-the point you straign
-pulling it to its max. end range
injuries to skin: soft tissue and skin
effected tissues & injuries: skeletal muscle injuries
-muscle tissues & tendons
-muscle soreness (DOMS) & stiffness
effected tissues & injuries: chronic MT injuries
-myositis/fascitis: inflammation & degeneration of the MT
-"tendinitis": inflammation, irritation, and swelling of a tendon
-atrophy: loss of muscle
effected tissues & injuries: connective tissue
effected tissues & injuries: joint injuries
-subluxations & dislocations
-chronic joint injurie
-reservoir for calcium
-formation of blood cells
types of bone injuries
-periostitis: "shin splints" ulna & medial shin
-depressed Fx: flat bone
-greenstick Fx: divit
-impacted Fx: crushed
-longitudinal Fx: long
-spiral Fx: up & around
-transverse Fx: sideways
-comminuted Fx: blown
-blowout Fx: eye socket
-avulsion Fx: something pulled off
-stress Fx: overuse
-direct flow to nerve
- temporary loss of motor and sensory function due to blockage of nerve conduction
signs: prolonged neuritis can lead to paralysis
microtrauma & overuse syndrome
-caused by repetitive stress to tissue
-friction, pressure, volume of activity, biomechanics
microtrauma & overuse syndrome examples
*apophyseal avulsion: little leaguer's elbow and shoulder
*rotators cuff tendonitits
*low back pain
Please allow access to your computer’s microphone to use Voice Recording.
Having trouble? Click here for help.
We can’t access your microphone!
Click the icon above to update your browser permissions and try again
Reload the page to try again!Reload
Press Cmd-0 to reset your zoom
Press Ctrl-0 to reset your zoom
It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.
Please upgrade Flash or install Chrome
to use Voice Recording.
For more help, see our troubleshooting page.
Your microphone is muted
For help fixing this issue, see this FAQ.
Star this term
You can study starred terms together