A sign is something observable and is objectively measured.
A sign can include (but is not limited to) swelling, discoloration, deformity, crepitus, and redness.
A symptom is a subjective complaint and cannot be directly observed.
A symptom can include (but is not limited to) pain, fatigue, nausea, and altered sensation.
Acute refers to a sudden onset with short duration.
Acute injuries typically result from a single event or mechanism.
Chronic refers to a gradual onset with prolonged duration, usually with an unknown cause and time of injury.
A contusion (also known as a bruise) is a direct blow to the tissue in which capillaries are disrupted or damaged.
A 1st degree contusion is superficial with minimal swelling.
A 2nd degree contusion can hemorrhage and has mild-moderate ROM limitations.
A 3rd degree contusion has hematoma with severe ROM limitations.
A sprain is an injury to a ligament or capsule structure.
A 1st degree sprain has mild overstretching with no visual disruptions and mild pain or tenderness.
A 2nd degree sprain has partialtearing and is the broadest range of injury.
A 3rd degree sprain is a complete rupture with a pop, pain, and loss of function.
A strain happens when a muscle or tendon stretches or tears.
A 1st degree strain is microtearing with full AROM and PROM and pain with resisted muscle contraction.
A 2nd degree strain is the briadest range of injury and pain with active muscle contraction and passive muscle stretch.
A 3rd degree strain is completely ruptured with a pop, pain, and loss of function as well as muscle hemorrhage.
A closed fracture is a disruption in continuity of bone with
out a disruption of skin surface.
A traumatic (acute) fracture includes immediate pain, rapid swelling, and bony tenderness.
A stress fracture is often initially dismissed, the onset of pain is gradual, and swelling is minimal and localized.
For a primary survey:
is the injury life or limb threatening
ABC
Tend to any emergency conditions and if none, proceed to secondary survey
For a secondary survey:
examine the seriousness of the injury before the athlete is moved
determine how to remove the athlete from the site
SINS
severity
irritability
nature
stage
Subjective Segment of Examination:
history of the injury
through observation, interviewing patient, questioning observers
review patient records
Objective Segment of Examination:
perform tests to establish severity and nature of injury
do as few tests as possible to determine the injury
only as necessity and level of pain dictate
When taking a history:
chief complaint
mechanism of injury
type of force imposed and surface area impacted
nature of illness or injury
inquire further about signs and symptoms
Essential History:
When dealing with potential life-threatening injury
check for medical ID bracelet
important information about medical history
Focused History:
only investigate major complaint and any problems that are readily apparent
gather information to determine general nature and extent of the injury
Detailed History
Chief complaint
mechanism of injury
associated signs and symptoms
any pre-existing factors
current history and history of previous injury
Mechanisms of Injury is how the injury occurred. It is an ascertain of the direction, location, and velocity of force (compression, tensioning, twisting, and shearing).
Examination of posture must be done anteriorly, laterally, and posteriorly. (Remember plumb line).
Use hearing and vision to examine gait anteriorly, laterally, and posteriorly.
Structures of palpating are skin, fascia, bone, myotendinous unit, joint structure, neurovascular tissue, and lymph nodes.
Palpate systematically, the uninvolved sidefirst to determine a normal reaction, through the layers starting with skin.
Osteokinematics refers to the movements of long bones that produce motion. Motion occurs in an arc around a joint.
Arthrokinematics is the movement of joint surfaces relative to one another. (Roll, glide, spin).
Active ROM is the quality and quantity of motion the individual can produce.
Passive ROM eliminates muscle activity and it’s possible influence.
Soft end feel is when 2 muscle bellies are in contact with one another.