INJURY EVALUATIONS

Mohd Syrinaz Azli

Akademi Kecergasan Pertahanan
THE INJURY EVALUATION PROCESS
• When evaluating any injury or condition,
diagnostic signs and symptoms are obtained and
interpreted to determine the type and extent of
injury.
• The injury evaluation process must include
several key components:
– taking a history of the current condition
– visually inspecting the area for noticeable
abnormalities
– physically palpating the region for abnormalities
– completing functional and stress tests.
 SIGN
• A diagnostic SIGN is an objective, measurable,
physical finding regarding an individual’s
condition.
• A sign is what the evaluator hears, feels, sees,
or smells when assessing the patient.
 SYMPTOM
• A SYMPTOMS is information provided by the injured
individual regarding his or her perception of the problem.
• Examples of these subjective feelings include blurred
vision, ringing in the ears, fatigue, dizziness, nausea,
headache, pain, weakness, and inability to move a body
part.
• Obtaining information about symptoms can determine if
the individual has an acute injury, resulting from a specific
event (macrotrauma) leading to a sudden onset of
symptoms, or a chronic injury, characterized by a slow,
insidious onset of symptoms (microtrauma) that culminates
in a painful inflammatory condition.
METHODS OF INJURY ASSESMENTS
• Two popular evaluation methods are the
HOPS format and the SOAP note format.
• Each has its advantages, but the SOAP note
format is much more inclusive of the entire
injury management process.
HOPS- History Observation
Palpation Special tests
 HOPS- History
• History: Attitude, mental condition, and
perceived physical state.
– Stated by the athlete.
– Primary Complaint
– Mechanism of Injury
– Characteristics of the Symptoms
– Limitations
– Past History
HOPS- Observation and Inspection
• Observation: Measurable objective signs.
– Appearance
– Symmetry
– General Motor Function
– Posture and Gait
– Deformity, swelling, discoloration, scars, and
general skin condition
 HOPS- Palpation
 Rule out FX (fracture)
 Skin temperature
 Swelling
 Point tenderness
 Crepitus
 Deformity
 Muscle spasm
 Cutaneous Sensation (nail bed refill)
 Pulse
 HOPS- Special Tests
• Functional Tests
– Active Range of Motion (AROM)
– Passive Range of Motion (PROM)
– Resisted Manual Muscle Testing (RROM)
• Stress Tests
– Ligamentous Instability Tests
– Special Tests
 HOPS- Special Tests
• Neurologic Tests
– Dermatomes
– Myotomes
– Reflexes
– Peripheral Nerve Testing
• Sport-Specific Functional Testing
– Proprioception and Motor Coordination
 HOPS- Special Tests

• Sport-Specific Skill Performance

– Throw the football, baseball, softball,
javelin...
– Kick the soccer ball, football, opponent…
– Macarena, Cabbage Patch, Mash Potato
SOAP- Subjective Objective
Assessment Plan
 SOAP- Subjective
• History: Attitude, mental condition, and
perceived physical state.
– Stated by the athlete.
– Primary Complaint
– Mechanism of Injury
– Characteristics of the Symptoms
– Limitations
– Past History
 SOAP- Objective:
• Observation: Measurable objective signs.
– Appearance
– Symmetry
– General Motor Function
– Posture and Gait
– Deformity, swelling, discoloration, scars, and
general skin condition
 SOAP- Objective
 Rule out FX (fracture)
 Cutaneous Sens.
 Skin temperature
 Pulse
 Swelling
 Point tenderness
 Crepitus
 Deformity
 Muscle spasm
 SOAP- Objective
• Functional Tests
– Active Range of Motion (AROM)
– Passive Range of Motion (PROM)
– Resisted Manual Muscle Testing (RROM)
• Stress Tests
– Ligamentous Instability Tests
– Special Tests
 SOAP- Objective
• Neurologic Tests
– Dermatomes
– Myotomes
– Reflexes
– Peripheral Nerve Testing
• Sport-Specific Functional Testing
– Proprioception and Motor Coordination
 SOAP- Objective
• Sport-Specific Skill Performance
– Throw the football, baseball, softball, javelin...
– Kick the soccer ball, football, opponent…
– Macarena, Cabbage Patch, Mash Potato
 SOAP- Assessment
• Analyze and assess the individual’s status and
prognosis
• Suspected injury Site
• Damaged Structures Involved
• Severity of Injury
• Progress Notes
 SOAP- Plan
1. Immediate treatment given
2. Frequency and duration of treatments and
modalities and evaluation
3. On-going patient education
4. Criteria for discharge/return to play
 On The Field Assessment
• History:
– Location of Pain
– Presence of abnormal neurological signs
– Mechanism of Injury
– Associated sounds (snap, crack, pop)
 On The Field Assessment cont.
• Observation:
– Check the surrounding area
– Body positioning
– Movement of the athlete
– Level of responsiveness
– Primary survey
– Inspection for head or neck trauma
– Inspection of the injured body part
 On The Field Assessment cont.
• Palpation
– Joints
– Bones
– Soft tissue
– Skin temperature
 On The Field Assessment cont.
• Functional Testing
– Active Range of Motion (AROM)
– Passive Range of Motion (PROM)
– Resistive Range of Motion (RROM)
– Weight Bearing
 On The Field Assessment cont.
• Stress Testing
– Ligamentous stability

• Neurological Testing
– Cutaneous
– Motor
 On The Field Assessment cont.
• Vital Signs
– Pulse
– Respiratory Rate
– Blood Pressure
– Temperature
– Skin Color
– Pupils
– Disposition
 On The Field Assessment cont.
• Moving the Athlete
– Ambulatory Assist
– Manual Conveyance
– Spine Board
– Pool Extraction
 Physician Ordered Tests
• Blood Test
• Radiographs
• Computed Tomography
• Magnetic Resonance Imaging (MRI)
• Radionuclide Scintigraph (Bone Scan)
• Ultrasonic Imaging
• Electromyography