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Sports Medicine Primer for Sports Medicine Primer for the Soccer Coachthe Soccer Coach
Sports Medicine Primer for Sports Medicine Primer for the Soccer Coachthe Soccer Coach
Scott Hamill, ATC, PTADominican Hospital
Sports Medicine Center
Scott Hamill, ATC, PTADominican Hospital
Sports Medicine Center
The risk of injury is inherent in sports
Coaches are first responders and may need to deal with injuries from abrasions to concussions
Three million kids play high school and youth soccer in the U.S.
Approx. 450,000 injuries occur yearly
The risk of injury is inherent in sports
Coaches are first responders and may need to deal with injuries from abrasions to concussions
Three million kids play high school and youth soccer in the U.S.
Approx. 450,000 injuries occur yearly
Injury PreventionInjury Prevention
Proper conditioning Proper warm up/stretching Equipment: well fitting cleats, shin guards,
synthetic balls, fixed goals, field conditions Hydrate Avoid overtraining: stress followed by
REST and the body grows stronger Encourage athletes to talk about injuries.
Injuries addressed early resolve more quickly
Proper conditioning Proper warm up/stretching Equipment: well fitting cleats, shin guards,
synthetic balls, fixed goals, field conditions Hydrate Avoid overtraining: stress followed by
REST and the body grows stronger Encourage athletes to talk about injuries.
Injuries addressed early resolve more quickly
Sports Injury TreatmentSports Injury Treatment
Soft Tissue Injury PRICE: Protection, Rest, Ice, Compression,
Elevation Contusion
Ice, compression, protection Deep thigh contusion: flex knee and ice to
prevent hematoma Abrasion
Clean, disinfect, dress Laceration
Clean,disinfect, dress. Suture if too wide or deep to close. Location
• Blister Puncture with sterilized needle and drain Apply antibiotic and cover with gauze or bandaid
Callus
Soft Tissue Injury PRICE: Protection, Rest, Ice, Compression,
Elevation Contusion
Ice, compression, protection Deep thigh contusion: flex knee and ice to
prevent hematoma Abrasion
Clean, disinfect, dress Laceration
Clean,disinfect, dress. Suture if too wide or deep to close. Location
• Blister Puncture with sterilized needle and drain Apply antibiotic and cover with gauze or bandaid
Callus
SprainLigaments connect bone to boneSeverity: mild moderate severe Ice, support, compression, crutchesSend for xray if unable to walk on the
ankle, significant swelling, symptoms don’t
improve after a few days, pain in foot or above ankle
SprainLigaments connect bone to boneSeverity: mild moderate severe Ice, support, compression, crutchesSend for xray if unable to walk on the
ankle, significant swelling, symptoms don’t
improve after a few days, pain in foot or above ankle
Strain Muscle/tendon Ice, compression, crutches No massage or stretching first 48
hours No heat for 72 hours Gentle stretching after light warm up Strength exercises if no localized pain Progress to full go gradually
Strain Muscle/tendon Ice, compression, crutches No massage or stretching first 48
hours No heat for 72 hours Gentle stretching after light warm up Strength exercises if no localized pain Progress to full go gradually
Fracture/Dislocation Management
Fracture/Dislocation Management
Finger Splint, ice, send to
ER
Finger Splint, ice, send to
ER
Ankle Do not move
athlete if obvious fracture/dislocation call 911
Ankle Do not move
athlete if obvious fracture/dislocation call 911
Patella Usually dislocates
laterally Do not move
athlete Call 911
Patella Usually dislocates
laterally Do not move
athlete Call 911
Shoulder Usually dislocates
anteriorly Sling, ice,
transport immediately
If parent or coach can’t transport call 911
Shoulder Usually dislocates
anteriorly Sling, ice,
transport immediately
If parent or coach can’t transport call 911
Head and Face InjuriesHead and Face Injuries
Teeth Assess for
concussion Put tooth in
container with saline, milk, saliva
Get to Dentist or ER Can be saved if
treated in 2-3 hours
Teeth Assess for
concussion Put tooth in
container with saline, milk, saliva
Get to Dentist or ER Can be saved if
treated in 2-3 hours
Eye Foreign body
Wash out with athlete side lying
If object cannot be removed or eye is punctured cover eye with gauze and send to ER. Do not remove impaled object
Eye Foreign body
Wash out with athlete side lying
If object cannot be removed or eye is punctured cover eye with gauze and send to ER. Do not remove impaled object
Nose Bleeding
Assess for concussionPinch nostrils and hold one minuteRolled gauze under bottom lipRolled gauze in nostrils for return to play
Nose Bleeding
Assess for concussionPinch nostrils and hold one minuteRolled gauze under bottom lipRolled gauze in nostrils for return to play
Nose fracture Suspect concussion/neck injury Crepitus/cracking at bridge of nose Obvious deformity Rolled gauze on each side of nose taped
down on cheeks Ice and send to doctor
Nose fracture Suspect concussion/neck injury Crepitus/cracking at bridge of nose Obvious deformity Rolled gauze on each side of nose taped
down on cheeks Ice and send to doctor
Abdominal InjuriesAbdominal Injuries
Organ injuries Wind knocked out. Calm athlete and hands
on head to open rib cage Testicular spasm. If athlete is on back bring
both knees to the chest and hold 20 seconds. Internal bleeding. Rebound tenderness: pain
when pressing on abdomen is released. Watch athlete for dizziness, lethargy, fainting, vomiting. Call 911 and put into shock position on back with legs elevated and cover for warmth.
Organ injuries Wind knocked out. Calm athlete and hands
on head to open rib cage Testicular spasm. If athlete is on back bring
both knees to the chest and hold 20 seconds. Internal bleeding. Rebound tenderness: pain
when pressing on abdomen is released. Watch athlete for dizziness, lethargy, fainting, vomiting. Call 911 and put into shock position on back with legs elevated and cover for warmth.
Concussion MangementConcussion Mangement
No return to play same day. When in doubt sit them out Progressive exertional return to contact Any return of symptoms and process
begins again at day one Impact baseline test Cumulative traumatic encephalopathy
No return to play same day. When in doubt sit them out Progressive exertional return to contact Any return of symptoms and process
begins again at day one Impact baseline test Cumulative traumatic encephalopathy
Cervical InjuriesCervical Injuries
Do not move athlete! Other athletes should be told to never try to help injured athlete to their feet!
Symptoms: Numbness, tingling, burning in extremities Loss of motor control. Can’t move arms,
legs, hands, feet. Neck pain
Do not move athlete! Other athletes should be told to never try to help injured athlete to their feet!
Symptoms: Numbness, tingling, burning in extremities Loss of motor control. Can’t move arms,
legs, hands, feet. Neck pain
Treatment Stabilize head/spine Calm athlete Activate EMS Assess and maintain ABCs
Treatment Stabilize head/spine Calm athlete Activate EMS Assess and maintain ABCs
Heat InjuriesHeat Injuries
Signs and Symptoms Chills Dark colored urine Dizziness Dry mouth Headaches Thirst Weakness
Signs and Symptoms Chills Dark colored urine Dizziness Dry mouth Headaches Thirst Weakness
Prevention
• Proper training for the heat• Fluid replacement before, during and after
exertion. 16 oz one hour before exercise, 4-8 oz during.
• Appropriate clothing—light colored, loose fitting and limited to one layer
Early recognition via direct monitoring of athletes by other players, coaches and medical staff
Monitoring the intensity of physical activity appropriate for fitness and the athlete's acclimatization status
Prevention
• Proper training for the heat• Fluid replacement before, during and after
exertion. 16 oz one hour before exercise, 4-8 oz during.
• Appropriate clothing—light colored, loose fitting and limited to one layer
Early recognition via direct monitoring of athletes by other players, coaches and medical staff
Monitoring the intensity of physical activity appropriate for fitness and the athlete's acclimatization status
Treatment Get athlete to shaded area Cool rapidly with ice packs cold water
from hose or water bottles Water soaked towels over body Provide cold beverages if able to
drink Activate EMS
Treatment Get athlete to shaded area Cool rapidly with ice packs cold water
from hose or water bottles Water soaked towels over body Provide cold beverages if able to
drink Activate EMS
When can the Athlete Return to Play?
When can the Athlete Return to Play?
Lower body Full ROM, Full strength Two legged hop X 10 Injured leg hop X 10 Jog in place Jog straight ahead Run straight ahead Back pedal Carioka both directions Stop progression if pain or limp develops
Lower body Full ROM, Full strength Two legged hop X 10 Injured leg hop X 10 Jog in place Jog straight ahead Run straight ahead Back pedal Carioka both directions Stop progression if pain or limp develops
Upper body Full ROM, Full strength Push up x 10 Sport specific movements
Upper body Full ROM, Full strength Push up x 10 Sport specific movements
Emergency PlanEmergency Plan
Make sure someone has cell phone coverage
Know where EMS will access field Appoint coach or parent to direct
EMS to injured athlete
Make sure someone has cell phone coverage
Know where EMS will access field Appoint coach or parent to direct
EMS to injured athlete
Internet ResourcesInternet Resources
stopsportsinjuries.org Nata.org childrensmemorial.org Smsmf.org (ACL Injury Prevention) www.cdc.gov/concussion (concussion info) www.soccerinteractive.com (dynamic ex) http://www.youtube.com/watch?v=snPo9om
B4wA&feature=related (Ankle taping video)
stopsportsinjuries.org Nata.org childrensmemorial.org Smsmf.org (ACL Injury Prevention) www.cdc.gov/concussion (concussion info) www.soccerinteractive.com (dynamic ex) http://www.youtube.com/watch?v=snPo9om
B4wA&feature=related (Ankle taping video)