The Systematic Evaluation Process in Athletic Training

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The Systematic Evaluation Process in Athletic
Training

• By
• John Smaniotto

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History

• The history is the first and most important step
• You find out what happened
• Should ask simple questions
• Listening and good communication skills are
  important

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History Cont.

• Some important questions to ask are
• Mechanism of injury
• Did they hear any sounds
• Have they had any previous injury
• Where and how bad does it hurt

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Inspection

• This begins as soon as the athlete comes into the
  athletic training room
• You are looking for the athletes gait and posture
• You are looking for any deformities
• You are looking for facial expressions

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Inspection Cont.

• You are looking for any discolorations
• Looking for signs of previous injury, such as
  scars
• You are looking for differences bilaterally
• You are looking for any swelling
• Effusion- localized within the joint capsule
• Edema- more diffuse and not as localized

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Palpation

• You are actually feeling different landmarks on
  the body
• You want to do this bilaterally as well
• You want to start away from the injury and work
  you way towards it

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Range of Motion

• You are seeing if they have full range of motion
  and how painful the movements are
• You would not do this if you suspect a fracture
  or if there is a deformity
• Check bilaterally

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Palpation Cont.

• Different things that you should be looking for
  are
• Any point tenderness
• Any swelling or effusion
• Any deformities
• Any signs of inflammation
• Any muscle spasm or guarding

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Range of Motion Cont.

• Passive range of motion
• You move the athlete through the motion yourself
• Active range of motion
• The athlete moves through motion on his own

• Resistive range of motion
• You add resistance as athlete moves through
  entire range of motion
• Want to check to how how much this hurts and how
  strong they are when moving through the motion

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Manual Muscle Testing

• You have athlete do motion of certain muscles as
  you add resistance to test their strength
• Grading scale
• 5/5-can resist against full pressure
• 4/5-can resist against moderate pressure
• 3/5-can resist against gravity but not any
  pressure
• 2/5-can resist against a gravity eliminated
  environment
• 1/5-cannot move but has a contraction
• 0/5-no contraction

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Special or Ligmentous Tests

• Special tests are tests that you do to rule out
  specific pathologies
• They are used to check the extent of the injury
• These are useful to rule out fractures
• Percussion or compression tests

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Special/Ligamentous Tests Cont.

• They can also be used to check the integrity of
  different ligaments
• Lachman test which tests integrity of ACL
• Valgus stress test of the knee which tests the
  integrity of the MCL

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Neurological testing

• This step of the evaluation is to make sure that
  there was no nerve damage due to the injury
• You want to check this when there is a fracture,
  when there is a head or neck injury, and when the
  athlete is complaining of numbness or radiating
  pain

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Neurological Testing Cont.

• Each nerve level has a certain function and
  sensory area
• You would check there dermatomes and myotomes
• Dermatomes-sensory area
• Myotomes-motor function of the nerve

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The End