KIN 188 – Prevention and Care of

Athletic Injuries

Injury Evaluation Procedures

Clinical Evaluations

• Generally occur in controlled environment with access to evaluation tools, records, references (text and/or personnel) and time

• HIPS/HOPS process– History

– Inspection/Observation

– Palpation

– Special Tests (ROM, stress tests (ligaments and joint capsules), neurovascular)

Subjective vs. Objective Information

• Subjective– History information is subjective

– What the injured person tells you

– Best evaluated with open-ended questions vs. yes/no

• Objective– Inspection/observation, palpation and special tests are

objective

– What the evaluator sees, feels, etc.

History

• Primary/chief complaint• Etiology/mechanism of injury• Unusual sounds/sensations• Location of symptoms• Onset/duration of symptoms• Description/nature of symptoms• Prior history• General health

Inspection/Observation

• Gait, posture, movement patterns

• Gross deformity/asymmetry

• Swelling

• Discoloration

• Scars

• Skin/infection

• Compare bilaterally

Palpation

• Point tenderness

• Muscle spasm/trigger points

• Change in tissue density, swelling

• Crepitus

• Asymmetry

• Tissue temperature

• Compare bilaterally

Range of Motion

• Compare bilaterally for all – measured with goniometer and compared to statistical norms

• Active range of motion• Passive range of motion

– End feels: pathologic vs. physiologic

• Resisted range of motion– Strength test vs. MME

• Cardinal planes– Frontal/coronal, transverse, sagittal

Stress Tests

• Primarily used to assess integrity of ligaments and/or joint capsules, some do muscle/tendon or impingement evaluation

• Special (named) tests common• Laxity

– Describes the amount of “give” in a joint’s supportive connective tissue

• Instability– Joint’s inability to function under stresses encountered

during functional activities

Neurovascular Tests

• Neurological evaluation– Nerve roots vs. peripheral nerves

– Sensory function

– Motor function

– Reflex testing

• Circulatory evaluation– Pulse points - palpation

– Capillary refill

– Skin color/temperature

Field Evaluations

• Primary survey– ABCD’s, equipment considerations (helmet, shoulder pads, etc.)– Activation of EMS/emergency plan

• Triage– Consideration if more than one person injured, attend to most

significant injury/condition first

• Secondary survey– Abbreviated HIPS/HOPS process

• Vital signs monitoring

– Removal from field considerations• Spine board, manual transportation, ambulatory assistance

Level of Care

• Basic life support (BLS)– Primary concern is stabilization and transportation of

the injured person

– EMT, ATC, PT, school nurse, etc.

• Advanced life support (ALS)– Ability to administer medications, advanced cardiac

and/or respiratory care, etc.

– Paramedics, physicians, etc.