KINE 3P80 Midterm

• Sports Medicine


  Medical and scientific knowledge used to improve sports performance
• Post Game follow-up care


  1. Contact your lead therapist

  2. Arrange to have the athlete go to the BSM Clinic for follow-up

  3. Keep coaching staff informed on athlete’s condition and playing status
• On Field Assessment and follow-up

  1. First goal - Athlete’s Safety - Primary Survey

  2. If injury is non-life threatening not requiring EMS

  3. Question 1: Is the athlete leaving the game or staying in?

  4. If leaving game: Question 2: How to remove safely?

  5. Focus on safe removal - may need to recruit others to help

  6. Must Communicate with Coach regarding athlete’s status
• Primary Survey – Charge Person

  1. Survey the scene (safe to approach?)

  2. Block the head (hand on forehead, “don’t move”)

  3. Check level of consciousness (verbal, painful stimuli) – if unconscious, call 911

  4. Airway - check that it’s clear, remove mouthguard; head tilt, chin lift; jaw thrust if suspect spinal

  5. Breathing - look, listen, feel for 10 seconds - if not breathing, start CPR

  6. Circulation - check carotid pulse, scan body for severe bleeding and medical alert bracelet

  7. Treat for shock (reassure, maintain body temp)
• Secondary Survey

  1. Once you are certain there are no life-threatening injuries, you can begin a secondary survey

  2. Remember - if athlete can be removed safely, remove safely from field first, then begin secondary survey

  3. Interview athlete and/or bystanders

  4. Check vital signs
• Primary Survey

  1. a check for conditions that are an immediate threat to the patient’s life (ie. respiratory & circulatory emergencies)

  2. unwitnessed injury/incident

  3. unconscious athlete

  4. start of every assessment
• Entering the Playing Surface

  1. Know your sports rules regarding entering the field of play

  2. Soccer - wait for ref to call you on

  3. Basketball - player needs to go off if therapists enter the court. Don’t jump the gun unless necessary

  4. Rugby - often no stoppage of play - enter with caution

  5. Wrestling - injury time/blood time - must be efficient

  6. Hockey - ice condition - use care when going on ice
• CPR Overview

  1. If not breathing, (or no carotid pulse), call 911 and administer CPR (cardiopulmonary resuscitation)

  2. 30 compressions/2 breaths

  3. rate of 100 breaths per minute

  4. depth of 1.5 to 2 inches

  5. interrupt CPR if AED becomes available
• Follow-up - Sideline Assessment

  1. Ensure there is a member of your medical staff with the team on the bench or sidelines

  2. Update coaching staff on athlete’s condition and status

  3. Arrange for next level of medical care if needed
• HOPS assessment is a non-emergency on-field assessment done when you have witnessed the injury, and the head/spine are not involved or have been ruled out
• Observations

  • Swelling, Bruising, Bleeding, Deformity, Symmetry, General motor function, Posture and gait abnormalities
• Notification and reporting

  Notify supervisory therapist as soon as possible. Complete Injury Report Form. Follow-up with coaching staff regarding player’s welfare and playing status
• Fracture Test

  • Focus on functional ROM testing and ruling out a fracture: Palpation, Tap test, Compression, Bowing, Functional Tests
• Special Tests


  • Specific Tests that stress the integrity of the joint or muscle, Very injury specific, Performed last to either confirm or rule out the index of suspicion, Limited number of selected tests (maximum of 3)
• Head to toe exam

  Look and palpate thoroughly for bleeding, cuts, bruises and obvious deformities in the following order - head, neck, shoulder, chest, abdomen, pelvis, legs, arms and low back. Note: if there is a specific joint or muscle injury the secondary exam may be more muscle/joint specific
• OPQRST

  1. Onset

  2. Provokes

  3. Quality

  4. Region/Radiating

  5. Severity 1-10

  6. Timing (constant or comes and goes?)
• History


  • Mechanism of Injury (MOI), Signs and Symptoms, Previous History of Injury, New or re-injury
• HOPS assessment

  1. History

  2. Observations

  3. Palpation

  4. Specific/Special Tests
• Secondary survey

  Check vital signs: LOC, Pulse rate - regular or irregular, Breathing - rate and quality, Skin - feel person’s forehead with back of your hand, look at individual’s face and lips, check capillary refill, Pupils - PEARRLA (pupils equal and round, reactive to light and accommodating)
• Always be Prepared: Know your EAP beforehand/practice makes more confident
• Functional Tests

  • Active ROM (AROM), Passive ROM (PROM), Resisted ROM (RROM)
• Palpation


  • Your hands and what you feel can help you determine what tissue is injured - bone, ligament, muscle. Start away from the injury site and work towards it (above and below). Be methodical
• Signs of Shock

  • Agitation
  • Rapid, weak pulse
  • Shallow, irregular breathing
  • Cold, clammy, moist skin
  • Cyanosis
  • Sweating
  • Dilated pupils
  • Eventual unconsciousness
• Primary scan (survey)


  1. Determines level of responsiveness

  2. Recognizes/identifies immediate life-threatening situations

  3. Airway, breathing, circulation

  4. Dictates actions needed
• Secondary scan (survey)


  1. Determines seriousness of injury

  2. Determines type of first aid required

  3. Determines if injury warrants referral

  4. Determines type of transportation needed
• Management

  1. Activate EAP

  2. Monitor airway, breathing, vital signs

  3. Deal with the cause (stop bleeding, splint fractures, ice)

  4. Maintain body temperature

  5. Raise legs 8-12 inches to increase venous return

  6. Do not give fluids
• In light-skinned person, skin will be pale. In dark-skinned person, skin around mouth and nose will be grayish, and tongue, inside mouth, lips, nail bed will be bluish or pale/gray
• Symptoms of Shock

  • Nausea
  • Thirst
  • Anxiety, fear
  • Dizziness
• Hyperthermia

  • Heat cramps
  • Heat exhaustion
  • Heat stroke
• Individuals at risk for heat illness

  • Healthy individuals
  • Age extremes, large muscle or fat mass, poorly acclimatized
  • Those with acute illnesses (Fever, GI illnesses)
  • Those with chronic illnesses (Substance abuse, nutritional supplements, eating disorders, medications, oil or gel-based sunscreens)
  • Wheelchair athletes with spinal cord injury, limiting water intake
• Bee Sting - EpiPen Use

  1. Grasp with orange tip pointing downward

  2. Remove blue safety cap by pulling straight up – do not bend or twist

  3. Place the orange tip against the middle of the outer thigh

  4. Swing and push the auto-injector firmly into the thigh until it “clicks”

  5. Hold firmly in place for 3 seconds – count slowly, “1, 2, 3”

  6. Built-in needle protection: After injection, the orange cover automatically extends to ensure the needle is never exposed

  7. Call 911 after using EpiPen®
• Preventing cold injuries

  1. Acclimatization

  2. Apparel

  3. Replace fluids and calories

  4. Weight records

  5. Avoid alcohol
• Water is important but make sure you dilute electrolytes in water
• Cold-related conditions

  • Raynaud’s syndrome
  • Cold-induced bronchospasm
  • Hypothermia
  • Frostbite
• Preventing heat illness

  1. Gradual acclimatization

  2. Fluid and electrolyte replacement

  3. Identify susceptible individuals

  4. Uniforms

  5. Weight records

  6. Temperature and humidity readings
• Likelihood of Injury

  • Depends on:
  • Size or magnitude of force
  • Direction of application of force
  • Area over which force is applied
  • Material properties of tissues affected
• Types of loading

  1. compress

  2. tensin

  3. shell ord

  4. moreution
• Inflammation

  1. The Healing Process

  2. Inflammatory response phase (1)

  3. Fibroblastic repair phase (proliferation) (2)

  4. Maturation-remodeling phase (3)
• Epiphyseal injuries


  • Growth plate injury caused by acute OR repetitive loading
  • Osgood-Schlatter’s disease at tibial tubercle
  • “Little League elbow” at medial humeral epicondyle
• Skin injuries

  • abrasions
  • blisters
  • contusions
  • incisions, lacerations, avulsions, punctures