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Sterner Notes
 

Sterner Notes

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    Sterner Notes Sterner Notes Presentation Transcript

    • Systematic Evaluation Process
    • Systematic Evaluation Process
      • What need to know for successful evaluation and impression?
        • ANATOMY
        • Pathomechanics
        • Biomechanics of Sport
        • Pathologies
    • Systematic Evaluation Process
      • Many different ways
      • Must be Sequential Process
      • Types of Evaluations
        • Clinical
        • On-field
    • Systematic Evaluation Process
      • History
        • Most important part of evaluation
        • Communication skills
        • Simple Open-ended Questions
          • Mechanism
          • Sounds
          • Pain Location
          • Onset of Symptoms
          • Description of Symptoms
            • When
            • Joint Position
            • How
          • Previous Injury
    • Systematic Evaluation Process
      • Tips for taking a good history
        • LISTEN
        • Verbal vs Nonverbal Communication
        • Avoid slang and jargon language
        • Maintain eye contact
        • Be Calm and reassuring
    • Systematic Evaluation Process
      • Inspection (Observation)
        • Really begins when patient enters athletic training room
          • Gait
          • Posture
          • Functional movement
    • Systematic Evaluation Process
      • Inspection cont.
        • Deformities
    • Systematic Evaluation Process
      • Inspection cont.
        • Deformities
    • Systematic Evaluation Process
      • Inspection cont.
        • Deformities
        • Ecchymosis
    • Systematic Evaluation Process
      • Inspection cont .
        • Deformities
        • Ecchymosis
        • Swelling
          • Effusion vs edema
          • Localized vs diffuse
    • Systematic Evaluation Process
      • Inspection cont .
        • Deformities
        • Ecchymosis
        • Swelling
          • Effusion vs edema
          • Localized vs diffuse
        • Bilateral Symmetry
    • Systematic Evaluation Process
      • Inspection cont.
        • Deformities
        • Ecchymosis
        • Swelling
          • Effusion vs edema
          • Localized vs diffuse
        • Bilateral Symmetry
        • Skin
          • Scars, ecchymosis, temp, color
    • Systematic Evaluation Process
      • Palpation
        • Feeling for:
          • Point tenderness
          • Deformities
          • Crepitus
          • Gapping
          • Muscle tension/spasm
          • Temperature
          • Swelling (edema/effusion)
    • Systematic Evaluation Process
      • Palpation Procedures
        • Injured vs non-injured side
        • Start away from injured part
        • Bony Tissue First
    • Systematic Evaluation Process
      • Palpation Procedures
        • Injured vs non-injured side
        • Start away from injured part
        • Bony Tissue First
        • Ligament Structures Second
    • Systematic Evaluation Process
      • Palpation Procedures
        • Injured vs non-injured side
        • Start away from injured part
        • Bony Tissue First
        • Ligament Structures Second
        • Muscle Tissue Third
    • Systematic Evaluation Process
      • Range-of-Motion (ROM)
        • Active ROM (AROM)
          • Contraindications
          • Willingness to move
    • Systematic Evaluation Process
      • Range-of-Motion (ROM)
        • Active ROM (AROM)
          • Contraindications
          • Willingness to move
        • Passive ROM (PROM)
          • Quantity of movement
          • Endfeels
            • Normal vs abnormal
    • Endfeels (Normal vs Abnormal) No endfeel, Ex fracture, severe sprain, acute inflammation Empty Loose bodies, fracture Hard Spasm, soft tissue shortening Firm Boggy feeling, Ex edema Soft Abnormal Bone-on-bone Hard Muscle, capsular, ligament stretch Firm Soft Tissue approximation Soft Normal
    • Systematic Evaluation Process
      • Range-of-Motion (ROM)
        • Active ROM (AROM)
          • Contraindications
          • Willingness to move
        • Passive ROM (PROM)
          • Quantity of movement
          • Endfeels
            • Normal vs abnormal
        • Resistive ROM (RROM)
          • Break test vs manual muscle test
          • Grading System
    • Grading Scale for RROM No contraction felt Gone (0/5) Cannot prodce movement, but feel muscle contration Trace (1/5) Move through full ROM in gravity eliminated position Poor (2/5) Move through full ROM against gravity Fair (3/5) Resist against moderate pressure Good (4/5) Resist against maximal pressure Normal (5/5)
    • Systematic Evaluation Process
      • Ligament and Capsular Tests
        • Structural integrity of non-contractile tissue
        • Bilateral comparison
    • Systematic Evaluation Process
      • Special Tests
        • Bilateral comparison
        • Specific to a structure, joint or body part
    • Systematic Evaluation Process
      • Neurological Tests
        • Sensory
          • Dermatome
          • Myotome
          • Reflex Testing
    • Systematic Evaluation Process
      • Neurological Tests
        • Sensory
          • Dermatome
          • Myotome
          • Reflex Testing
    • Systematic Evaluation Process
      • Neurological Tests
        • Sensory
          • Dermatome
          • Myotome
          • Reflex Testing
    • Systematic Evaluation Process
      • Functional Tests
        • Coordinated movements specific to sport or position
    • On-field Evaluation
    • On-field Evaluation
      • Must rule out
        • Cardiovascular or respiratory failure
        • Life-threatening head or spinal injury
        • Profuse bleeding
        • Fractures
        • Joint dislocation
        • Peripheral nerve injury
        • Other
    • On-field Evaluation -- History
      • Clear Communication
      • Briefer than Clinical
      • Mechanism
      • Pain location
      • Noises
      • Signs and symptoms
    • On-field Evaluation --- Inspection
      • When does this begin?
      • Is the athlete moving?
      • Position of Athlete?
      • Conscious or unconscious?
      • Observe as soon as walk on the field
    • On-field Evaluation --- Palpation
      • Bone alignment
      • Crepitus
      • Joint alignment
      • Swelling
      • Pain
      • Deficits in muscle or tendons
    • On-field evaluation – ROM Testing
      • AROM, PROM, RROM
      • Contraindications
    • On-field evaluation --- Ligamentous and Special Tests
      • Usually single plane tests
      • Gives immediate impression
    • On-field evaluation --- Neurological Tests
      • Very important if suspect head or spine injury
      • Also with fractures and dislocation
    • Removal of Athlete from Field
      • DECISIONS, DECISIONS. WHAT SHOULD YOU DO?
      • Fractures, dislocations, gross joint instability, spinal injury
      • Ways to remove athlete once make the decision