Assessment of Inuries Soft and Hard

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Sports Medicine Case Study Matthew Cerato

Sports MedicineCase Study

Outline the procedures that you would have followed when Glenn collapsed on thefield in severe pain

In all first aid situations a primary survey should be used to make a quick assessment of the

overall scene prior to becoming involved with the situation. The acronym DRABCD should be

used but firstly the people involved with the scene should immediately call emergency services

(000).

Dangerdangers such as fire, traffic and chemicals immediately surrounding the patientshould be assessed then removed because first aid will not be able to be done. Eg In

Glenn McGraths (GM) case rubber gloves may be used to reduce the risk of infection to

the assessor.

Responseassessment of the victims response by Squeeze and Shout; speaking to thepatient loudly if they are unconscious then squeeze the victim by the shoulders if there is

no response. Eg. Ask GM questions such as what is your name and where are you? Due

to the low intensity of this case GM would have been conscious and been able to be

responsive to the practitioner, this would be the end of the DRABCD primary survey for

GMs situation due to his responsiveness and the dismissal of danger.

Airwayopen the airway and look for signs of life Breathlook, listen and feel for signs of normal breathing Compression two breaths, thirty compressions (Repeat C until signs of life appear or

the ambulance comes)

Defibrillation This is used after CPR to get the patients heart beat to start pumpingagain.

Figure 1.1 shows a resuscitation chart that should be used as a guideline when doing a

primary survey.

F igure 1.1


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When injuries occur an assessment of the injury needs to take place which will result in whether

the individual is able to return to the field. TOTAPS is a nationally recognised regime for

assessing sports injuries. The following steps should be taken:

Talk talk to the injured player and ask them what exac tly happened. In GMs case heshould have been asked specific questions including:- How did you sustain this injury?- How painful is the injury?- What area is the injury in?

These questions will allow the qualified practitioner to find out important information about the

nature of the injury; this will enable a direct assessment of the injured area for further

assessment.

Observe involves looking at the injured area to see if there are any obvious signs ofdeformity or swelling. In GMs case his ankle should have been compared his other one.This is done to show the differentiation of the ankles and the substantiation of the injury.

TouchFurther from observing the area the practitioner should gently touch the injury tofeel for deformities and swelling. In GMs case this would be done by feeling the ankle

region and comparing the ankle with his other ankle and also if obvious signs of pain

inhabit Glenn. This act is done to try and pinpoint the main area of pain which will allow

effective management of the area.

Active MovementThe patient should then be asked to perform joint movements such asflexion, extension and rotation. GM would be asked to perform these actions with his

ankle to establish the immediate severity of the injury; rotating, bending and extending his

ankle. GM probably would feel pain during the performance of these movements and

therefore the assessment of his injury wouldnt have proceeded under the TOTAPS

regime because it might have increased injury. If these movements can be done pain free,

then the final stages of TOTAPS should be attended to.

Passive MovementThe assessor would then physically mobilise the joint using a rangeof movements previously stated. If GMs examination preceded this would involve theassessor physically handling the ankle and moving it through movements such as flexion,

extension and rotation. This is done to identify painful areas and the instability in the joint

which would allow better management of the painful areas.


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Skills Test This phase involves the patient performing a skill directly relating to thegame. In GMs case this wouldnt have been done because Glenn was involved in an

enjoyable game of touch-rugby, but if it was sustained during a cricket match he would be

asked to perform things such as running, bowling and appropriate left and right

movements to show that he was able to return to the field with adequate movement and no

further major risks; if it was a minor injury then GM could possibly return to the field.

Stop assessment if damage is apparent and pain is felt.

After the TOTAPS assessment has taken place injuries should be classified according to their

cause; injuries frequently occur in sports such as football and cricket by common movements

including jogging and jumping. These injuries are classified directly relating to their cause;

common classifications to identify and manage them successfully include:

Directcaused by an external force applied to the body (Ron Ruskin, 2007). Commoninjuries include fractures, dislocations, sprains and bruises which can stem from

collisions which other individuals or a force driven tackle. Eg. A sprain caused by a

collision of two soccer players.

Indirect caused by an intrinsic force that is, a force within the body (Ron Ruskin,2007). Inadequate warm-ups, ballistic movements, excessive movement and execution

faults are all common causes for indirect injuries due to the excessive stress on the

muscles and joints. Common injuries include tearing muscles or placing stress on tendons

and ligaments which will lead to possible damage and irritation. Eg. A hurdler tearing a

calf muscle during an event.

Overuse caused by overuse of specific body regions over long periods of time (RonRuskin, 2007). Common exercises such as jogging and stepping can cause overuseinjuries if they are repetitive and low-impact. The repetition of these exercises can cause

shin splits and tendinitis which can be become inflamed and painful. Eg. Getting stress

fractures due to excessive running.

From these classifications they may also be categorised into: Inflammatory response

Soft tissue injuriesinjuries to all tissue other than bones and teeth (Ron Ruskin, 2007).There are numerous soft tissue injuries and some common areas for these injuries to

occur include damage to muscle, tendons, ligaments, cartilage, skin, blood vessels,

organs and nerves. These injuries can be categorised two ways:

- Acutesudden occurring injuries such as:- Sprains stretching or tearing a ligament (strong, rigid and inelastic tissue).

When ligaments are stretched or torn there is an insurmountable pain and swelling of

the injury area an there will be a tendency for the joint to not perform normal

movements due to the role of the ligaments to connect bone to bone. When a sprain


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For the rehabilitation to be successful the individual needs to ensure that it is

effective. It important to remember:

Rest needs to be active Ice should be put on skin injuries Ice should be left on 20min

To prevent futher damage to injuries specific techniques and substances

need to be avoided. The HARM acronym should be used and remembered

accordingly, it involves no heat, alcohol, running and massage.

o Heato Alcoholo Runningo Massage

Further reading


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Describe the injury management procedures you would put in place, followinginitial treatment and diagnosis, which would ensure his safe return to play (include

examples of physical and skill related tests)

Rehab:

Progressive mobalisation

Stretching

Conditioning

Total Body fitness

Taping

Use of heat and cold

Specific programs

Return to competitive sport:

Indicators

Monitoring progress

Taping

Specific warm-ups

Progressive involvement

Figure 13.35


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Provide a brief discussion regarding the ethics associated with pressure to return toplay that could be placed on Glenn by the Coach/match committee, sponsors and/or

supporters. What role would you, as sports injury specialist, and Glenn play in

deciding when he would be fit to return to play.

Ethics

Playing with injury

Pressure to participate

Role of coach and sports medicine

Use of drugs:

- For strength- For aerobic performance- To mask other drugs- Drug testing


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Bibliography(n.d.). Retrieved September Tuesday, 2009, from ESPN Cricinfo:

http:ww.cricinfo.,com/engvaus/content/current/story/215050.html

Ankle Sprains: Healing and Preventing Injury. (n.d.). Retrieved September 8, 2009, from Family Doctor:

http://familydoctor.org/online/famdocen/home/healthy/physical/injuries/010.html

Ron Ruskin, K. P. (2007). Outcomes 2 HSC Course(Third ed.). Milton, QLD, Australia: John Wiley & Sons

Australia, Ltd.

Appendix 1


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England v Australia, 2nd Test, Edgbaston, 1st day

McGrath ruled out with ankle injuryCricinfo staff

August 4, 2005

Glenn McGrath was ruled out of the second Test shortly before the start of

play on Thursday, after suffering a freak injury during Australia's pre-match

warm-up. He is now a major doubt for next week's third Test at OId

Trafford as well, having sustained a grade two tear to the lateral ligaments

of his right ankle.

McGrath, 35, trod on a stray cricket ball during a game of touch-rugby and

had to be helped into a groundsman's buggy by his team-mates. His place

in the side was taken by fellow seamer Michael Kasprowicz, who picked up

five wickets in the drawn warm-up match against Worcestershire this week.

"Glenn rolled his ankle during the early stages of training," Errol Alcott, the

team physiotherapist, told AFP. "There's nothing obvious in the X-rays regarding bone abnormalities but

we are awaiting further expert reports from a radiologist this [Thursday] afternoon." McGrath returned to

the dressing-room where his foot was elevated while the injury was iced.

Australia's captain, Ricky Ponting, won the toss and chose to bowl first even though his spearhead was

sidelined. "I guess the good thing about it is that Kasper took five wickets in the tour game during the

week so he's in pretty good touch as well and I'm looking forward to seeing him bowl."

This is the first Ashes Test McGrath has missed since Sydney in 2003 where England won by 225 runs. At

Lord's, where Australia won the first Test by 239 runs, McGrath became only the fourth bowler to take

500 Test wickets, as Australia went 1-0 up in the five-Test series.

http://www.cricinfo.com/engvaus/content/story/215050.html

Appendix 2

Glenn McGrath goes down inpain during the warm-up Getty Images
http://www.cricinfo.com/engvaus/content/story/215050.htmlhttp://www.cricinfo.com/engvaus/content/story/215050.htmlhttp://www.cricinfo.com/engvaus/content/story/215050.html


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S t M di i C St d M tth C t

Appendix 3

Documents

Assessment of Inuries Soft and Hard