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Prevention and Care of Athletic Injuries ATHT 3580
Test One
Name:_______________________________________
Score:________________
Multiple Choice: 3 Points Each
_____
1.
Which of the following is NOT a purpose of the athletic training
room?
A. First Aid
B. Rehabilitation
C. Injury Treatment
D. Team Meeting
_____
2.
Which is not a domain of an athletic trainer?
A. Education and Professional Development
B. Supervision of Post Game Activities
C. Injury Management
D. Injury Prevention
_____
3.
Which is not a part of the national examination?
A. Written Simulation
B. Oral-Practical
C. Written
D. Play-Acting
_____
4.
Which would not belong in a pre-participation exam?
A. HIV/Aids Blood Test
B. Eye Exam
C. Physical History
D. Dental Exam
_____
5.
The inflammation phase of healing does not include what?
A. Loss of Function
B. Return to Active Participation
C. Swelling
D. Increase in Heat
True/False:
2 Points Each
_____
1.
Obtaining a thorough medical history should be one of the first
steps in a physical examination.
_____
2.
A team physician will automatically disqualify an athlete if they
have function in only 1 or a paired organ.
_____
3.
All coaches should have keys to the athletic training room.
_____
4.
The application of heat is the first thing that an athletic trainer
should apply to a new injury.
_____
5.
The American Athletic Trainers Association is the national
group that oversees athletic training.
_____
6.
Volleyball is a high risk sport.
_____
7.
It is the athletic trainer’s responsibility to diagnose an injury
and treat it accordingly.
_____
8.
Competencies are a sub set to the athletic training domains.
_____
9.
The sports medicine team should never include the equipment
manager.
_____
10.
All internships will dissolve in the year 2004 and only
curriculum programs will remain.
Listing:
Points Per Question
List five professionals that you would have on your sports
medicine team. (Do not use peoples names, but professions).
10 Points
1.
2.
3.
4.
5.
List and then define the three phases of the healing process. 1
Point for each listing, and 2 points for each definition.
9 Points Total
1.
2.
3.
Define the letters in the format S.O.A.P. 8 Points
S
O
A
P
Briefly explain what the following words mean in the context of
athletic training competencies. 6 Points
Cognitive –
Psychomotor –
Affective –
Define the letters in the word P.R.I.C.E.S. 6 Points
P
R
I
C
E
S
Short Answer:
How would you distinguish a change of skin color in a dark
skinned athlete? 2 Points
Explain the difference between a high risk sport and a low risk
sport. 2 Points
List any six domains of an athletic trainer. 6 Points
1.
2.
3.
4.
5.
6.
List any eight components of any rehabilitation program. 16
Points
1.
2.
3.
4.
5.
6.
7.
8.
Bonus:
From your reading of the text, tell me in a couple of sentences
the history of the NATA. 5 Points
Biohazardous Issues
There are times when athletic trainers come into contact with
substances that are harmful.
Biohazardous IssuesThe federal government has passed certain
laws that protect workers. This group of laws fall under the
group known as
Occupational Safety and Health Administration.
Biohazardous IssuesOSHAOccupational Safety and Health
Administration
OSHA Regulation 1910.1030Occupational Exposure to
Bloodborne Pathogens
OSHA 1910.1030Scope – who is coveredExposure control
planMethod of ComplianceVaccinations and medical
evaluationsInformation and trainingRecordkeepingSchedule of
implementation
Procedures in Waste ManagementPut on glovesAbsorb fluids
with paper towelsSaturate with bleach solutionScrub the area –
bleach and soapy waterRinse the areaBiohazard bagWash hands
after disposal
Exposures in Athletic TrainingFortunately, there are not too
many times when athletic trainers will come into contact with
needles and other contaminated materials, but open wounds are
one of those exposures that athletic trainers deal with on a
regular basis.
Types of Wound ManagementYou should be able to define each
of the following types of wounds that are typically seen in the
athletic setting:
Wound
ManagementAbrasionsAvulsionsIncisionsLacerationsPunctures
Initial and Follow Up Care
Introduction to Athletic Training
ATHT 3580
NCAA Sport ClassificationsThe National Collegiate Athletic
Association, divides sports into three broad groups, depending
on the rate of injury that you might see in that sport.
The National Athletic Trainers Association, divides the sports
into 2 groups, high and low risk, also depending on the rate of
injury for that sport.
Sports ClassificationsCollision
Contact
Non-Contact
High vs Low Risk Sports
Athletic Training Rules & RegulationsWhatever rules you make
you must enforce!Co-educational facilityStudent-athletes utilize
facilityClean up prior to enteringNo equipment in the athletic
training roomLanguage & noise under controlNot a loungeKeep
area clean – no food nor drinkExceptions to the Rules
Pre-Participation ExaminationThis is a yearly medical
examination to determine whether or not an athlete has the
physical levels necessary to compete without undue risk or
harm.
There are a number of areas that can be included in this exam, I
have listed some of those areas, as well as who can do a better
exam – the family or team physician.
The Pre-Participation ExaminationFamily vs Team Physician
Areas To Include:Medical HistoryFamily HistoryPrevious
InjuriesPrevious SurgeriesVisionDentalBlood Analysis
Areas to Include (Cont):CardiacAllergiesDrug
TestingFlexibilityStrengthOthers
Disqualifications
Protocol to Treat InjuriesThere are guidelines for the treatment
of injuries that will occur in all sports, that protocol is called
PRICES, a word that each letter stands for some aspect of the
treatment protocol.
This should also be referenced in the text to help further explain
what each word means in the treatment protocol.
Treatment of Acute InjuriesP.R.I.C.E.S.P = ProtectionR = RestI
= IceC = CompressionE = ElevationS = Support
Evaluation FormatsH.O.P.S.H = HistoryO = ObservationP =
PalpationS = StressS.O.A.P.S = SubjectiveO = ObjectiveA =
AssessmentP = Plan
Why Document Injuries & Illnesses?
Think about this statement and then read the following slides.
Why Document Injuries?Rehabilitation PlanProgress with
RehabilitationInsurance PaymentLiability IssuesLegal
Ramifications in Future
Basically A Good Idea
Rehabilitation Programs
Regardless of Injury – Many Areas are the Same
Components of Any Rehabilitation ProgramGeneral Body
ConditioningMuscular Strength & EnduranceImproved
FlexibilityIncreased ProprioceptionGood Body
MechanicsCardiovascular ConditioningSport Specific
DemandsPsychological Healing
Therapies for InjuriesBoth heat and cold are utilized in the
treatment protocols for injuries, the next few slides list some of
those therapies, how the modality physiologically effects the
body, and any reasons not to use the modality.
Which are more effective in your mind and why?
Superficial Heat TherapiesMoist Heat PacksWhirlpoolsParaffin
BathsInfrared RadiationContrast BathsChemicalsTopical
Ointments
Physiological Effects of HeatIncrease extensibility of collagen
tissueDecreases joint stiffnessReduces painRelieve muscle
spasmReduces inflammation and edemaIncreases blood flow
Contraindications for Heat ApplicationLoss of
sensationImmediately after injuryDecreased arterial flowTo
eyes or genitalsAbdomen during pregnancy
Cryotherapy ApplicationsIce MassageCold WhirlpoolCold or
Ice Water ImmersionIce Packs – Natural or
ChemicalVapocoolant SpraysIce Cup
Physiological Effects of Cold TherapyVasoconstriction of blood
vesselsDecrease of muscle spasmDecrease nerve ending
excitability
How Do Injuries Happen?Injuries take place when either an
outside force (extrinsic force) comes into contact with the body
– equipment, opponent, or weather. Or, when the body just
wears done (intrinsic force) from overuse or abuse.
Additionally, some injuries occur from inherited factors –
family history.
Mechanisms of InjuriesPrimaryExtrinsic
Opponent
Equipment
EnvironmentalIntrinsic
Sprain
Shin SplintsHereditaryHigh Blood PressureLeg Length
DiscrepancyFlat FeetEtc
Healing Phases of Soft TissueInflammatory Phase3-4 Days
Redness
Heat
Swelling
Pain
Loss of FunctionRepair PhaseUp to 3 Weeks
Initial Healing and Regeneration
Goal – Little Scar Tissue
Remodeling Phase3 Months – 1 Year
Completely New Tissue
Pre-participation ExamPurpose of the Physical Exam
Family versus Team Physician
Areas to Include in the Exam
Pre-participation ExamAreas of Exam:Family HistoryMedical
HistoryPrevious InjuriesPrevious SurgeriesVisionDentalBlood
Analysis
Pre-participation ExamAreas of Exam:Medical
HistoryCardiacStrengthFlexibilityMedical Conditions – ie
AllergiesDrug Testing
Disqualifications
Evaluation FormatsDocumentation – why?
H.O.P.S.HistoryObservationPalpationStress
Evaluation FormatsS.O.A.P.SubjectiveObjectionAssessmentPlan
Either is appropriate
Taping and Wrapping Principles
Prior to taping any body part the following should be
considered for an optimal taping procedure
Taping PreparationRemoval of HairClean the AreaSpecial
ConsiderationsSpray AdherentSkin LubricantsUnderwrap
Taping PreparationShaving the body part:This will allow the
technique to adhere best to the skin and not “float” over the
hair.
Clean the body part:Many times lotion is applied to the body
and this has an oil base and therefore will not allow the taping
procedure to adhere as well.
Taping PreparationSpecial Considerations:Because many
athletes are not good at shaving the ankles and legs, cuts occur
and they must be treated before taping can begin.
Also, once in a great while and athlete will be allergic to the
tape and they must have a protective wrap between the skin and
the tape.
Taping PreparationSpray the body part with adherent:Next, to
insure a good foundation, a tape adherent should be sprayed on
the body part.
Use of heel and lace pads:There are high friction areas, at the
Achilles tendon and on the front of the foot where the laces are,
these need to be protected.
Taping PreparationUse of underwrap:This foam on a roll helps
to hold the heel and lace pads in place prior to taping the ankle.
This product should not cover the entire ankle area (similar to
that of a sock). Too much underwrap is just like taping over a
sock.
Taping PhilosophyBe able to justify every piece of tape you
apply!Use proper terminologyProper body positioning – you and
athleteWhy are you taping?Compression or Support?
Wrapping PhilosophyUse proper size elastic wrap
Apply anatomically correct
Assist the athlete – NOT a cure
Supplies You NeedTypes of Tape AvailableWhiteElastic
ScissorsPadding MaterialEtc.
Terminology
Introduction to Athletic Training
TerminologyAcute – ChronicStrain – SprainLigament –
TendonAbduction – AdductionSuperior – InferiorProximal –
DistalMedial - Lateral
TerminologyPosterior – AnteriorHorizontal – VerticalFlexion –
ExtensionIndicated –
ContraindicatedOppositionCircumductionPronation - Supination
The Healing ProcessInflammatory
PhaseRednessHeatSwellingPainLoss of FunctionLength of
Phase – 3/4 Days
The Healing ProcessRepair PhaseInitial Healing and
Regeneration of TissueGoal – Little Scar TissueLength of Phase
– Up to 3 WeeksRemodeling PhaseFull Repair of TissueLength
of Phase – Up to 1 Year
Rehabilitation ComponentsHealing ConstraintsPain StatusRange
of Motion – ROMStrengthFlexibilityEnduranceBalance
Rehabilitation ComponentsProprioception – Kinesthetic
AwarenessBody MechanicsSport Specific DemandsGeneral
Body ConditioningCardiovascular ConditioningPsychological
FactorsMaintenance Program
Sports ClassificationsFirst ClassificationCollisionContactNon-
Contact
Second ClassificationHigh Risk vs Low Risk
Athletic Training
Athletic Training Domains
Definition of DomainsThese are the 8 broad areas of knowledge
that represent the basis for athletic training curriculum.
The next slides list those 8 domains, please utilize the book to
supplement the information that would be found in each domain.
Domains of Athletic TrainingAcute Care of Injury and
IllnessClinical Examination and DiagnosisEvidence-Based
PracticePrevention and Health Promotion
Domains of Athletic TrainingTherapeutic
InterventionsPsychosocial Strategies and ReferralHealthcare
AdministrationProfessional Development and Responsibility
Domains of Athletic TrainingChanges from Previous
YearsPathology – integrated into all areasRisk
Management/Nutrition – integrated into Prevention and Health
PromotionDiagnosis/Medical Conditions/Disabilities –
integrated into Clinical ExamModalities/Rehab/Pharmacology –
integrated into Therapeutic Interventions
Definition of CompetenciesThese are the objectives that make
up the broad domain areas.
Competencies are then divided into 3 groups that are cognitive,
psycho-motor, and affective.
Competencies in A.T.Three Broad Categories:
Cognitive – book knowledgePsycho-motor – application of
knowledgeAffective – belief system (right vs wrong)
National Athletic Trainers Assoc.The group that oversees the
process to become a certified athletic trainer.
In addition to passing a national exam, many states now have a
licensure process to insure consistency in the applicants
applying to work in that state.
NATA RequirementsNATABOC Approved Curriculum
2004National Certification ExaminationWrittenWritten
SimulationOral-PracticalContinuing Education80 CEU’s Every
Three Years
Sports Medicine TeamThis is an umbrella term that includes a
variety of specialty areas or professions that work in
cooperation with the other groups to provide the best health
care to the student athlete.
These are just some of the areas that you could have on your
team.
Sports Medicine TeamCertified Athletic TrainerPhysiciansList
Various Sub-specialtiesPhysical TherapistNutritionistMassage
TherapistStrength and Conditioning Specialist
Sports Medicine TeamEquipment
ManagerCoachPodiatristPsychologist
Others:
Care of Acute Injuries
What do we do as athletic trainers to care for injuries that occur
on the spot?
Care of Acute InjuriesP.R.I.C.E.S.Protect – the injury from
further harmRest – the injury siteIce – will help control
swellingCompression – also helps control swellingElevation –
keeps swelling to a minimumSupport – if necessary, i.e.,
crutches, cast
Vital Signs and Normal ParametersPulse – number of beats of
the heart per minute, typically taken at the caratoid or radial
artery
Respiration – number of times the average person breathes per
minutes at rest.
Temperature – core temperature of the body, taken orally,
rectally, under the arm, or electronically.
Vital SignsPulseAverage 60-80 Beats Per Minute
RespirationAverage 12 Breathes Per Minute
Temperature98.6 F - Orally
Vital Signs – Blood PressureThe range of the normal person is
120/80.
Upper number is the amount of pressure on the vessel under
pressure
Lower number is the amount of pressure on the vessel under
normal circumstances, more important number.
Treatment ProtocolIce versus Heat – cold therapy is the typical
treatment for an acute injury.
Application of IceReduce Swelling and InflammationReduce
Blood Flow to AreaReduce Pain at Site
Ice ApplicationWays to Apply IceCold PacksIce BagsIce
MassageIce SlushCold WhirlpoolCold Spray
Treatment ProtocolIce versus Heat
Application of HeatIncrease Blood Flow to AreaReduce Muscle
StiffnessMuscular Relaxation
Heat ApplicationWays to Apply HeatHot PacksHot
WhirlpoolModalities - ElectricalTopical Ointment
Application of Ice & HeatContrast Baths
Basic Foot Anatomy
What is the function of the lower extremity? Did you realize
the upper and lower extremity have bony arrangements that are
almost identical?
Basic Foot Anatomy - BonesPhalanges – 14Metatarsals –
5Tarsals –7TalusCalcaneus (heel
bone)NavicularCuboidCuneiform (3)
Bones of the FootThe most commonly fractured bone of the foot
is the 5th metatarsal, at the base where it spreads out at the mid
foot.
The calcaneus is probably the hardest bone of the foot to
fracture.
Basic Anatomy - AnkleBonesTibia – weight bearing boneFibula
– non weight bearing boneTalus
The tibia and fibula articulate with the talus, that is where the
ankle joint is located.
LigamentsThere are more ligaments damaged on the lateral side
of the ankle, since a vast majority of the ankle sprains are
inversion sprains.
Basic Anatomy - AnkleLigamentsLateralMedial
LateralAnterior TalofibularPosterior TalofibularCalcaneofibular
Basic Anatomy - AnkleMedialDeltoid
Arches of FootMedial LongitudinalLateral LongitudinalAnterior
MetatarsalTransverse
Basic Anatomy – Foot & AnkleMovements – these are the major
movements not all the movements at the ankle joint.
InversionEversionDorsi-flexionPlantar flexion
Injuries to the Foot & AnkleSome injuries are relatively minor,
but that does not make them any less important.
We as athletic trainers spend a huge part of our day taping for
ankle sprains, but remember there are other injuries just as
important.
Injuries to the Foot & AnkleAnkle sprainsFirst degreeSecond
degreeThird degreeBlisters on FeetTreatmentCornsHard and
Soft
Injuries to the Foot & AnkleIngrown toenailAthletes
feetCallusHow to preventHow to treatBroken bonesFallen
arches
Injuries to the Foot & AnkleTurf ToeHeel BruiseAchilles
tendon strainAchilles tendon rupture
Special Tests for InjuriesBump TestPreliminary test for fracture
of the ankle
Squeeze TestPreliminary test for fracture of fibula
Thompson TestPreliminary test for rupture to Achilles
RehabilitationRemember – all rehab programs will have
components that are the same, you will just address the
particular injury in a little different fashion.
Rehabilitation for Ankle InjuryStage I – Non Weight Bearing
Stage II – Weight Bearing
Stage III – Sport Specific Work
Rehab Protocol for AnkleTotal Body ConditioningMuscular
Strength & EnduranceFlexibilityProprioceptionBody
MechanicsCardiovascular ConditioningSport Specific Demands
Pre Taping the AnkleThere are a number of steps involved in
getting the ankle ready for taping. The next slide discusses
those steps.
One of the most important things is for you the athletic trainer
to be in good posture to tape the ankle.
Taping An AnkleShave the areaClean the areaSpecial
ConsiderationsAllergies, infections, cuts, etc.Spray
adherentSkin lubricantUnderwrap
Thoracic & Abdomen
This region is where most of the internal organs of the body
reside.
Organs of RegionHollow Organs of Region – define what each
organ does in the body.
StomachIntestinesUrinary BladderTubes and VesselsLungs
Organs of RegionSolid Organs of Region – define what each
organ does in the body.
LiverKidneySpleenGall Bladder
Organs of RegionMixed Organs of Region – define what each
organ does in the body.
HeartMale Reproductive OrgansFemale Reproductive Organs
Injuries to OrgansWhich type of organ – HOLLOW or SOLID is
more prone to injury?
Solid or Hollow Organ Filled with material.
Injuries to the RegionContusionsMuscle StrainsHernia –
protrusion of viscera through the abdominal
wallAcquiredCongenital
Injuries to the RegionStitch in the SideConstipationIntestinal
gasOvereatingDistended spleenFaulty breathingOut of shape
Injuries to the RegionRuptured SpleenFall or direct blow to the
areaInfectious monoSigns of ruptured spleenHistory of severe
blowSigns of shock : abdominal rigidity; nausea,
vomitingKehr’s Sign
Injuries to the RegionLiver Contusion – rareKidney Contusion –
frequentBlood in UrineNausea/VomitingUrinary Bladder
InfectionsScrotal ContusionsIndigestion
Injuries or IllnessesAsthmaInfluenzaBronchitis
HyperventilationRupture of Pectoralis Muscle
Unusual Injuries to AreaMyocardial Infarction – abnormal
rhythmCardiac Contusion – bruising to the heartPneumothorax –
air outside lung spaceHemothorax – blood in lung
spacePulmonary Contusion – bruise to lung
Rib Fractures and Separations
One More IllnessShingles – adult chicken pox
Brought on by stressReduced immune systemNeurological
disorderFollows a dermatome
Extremely Painful
The Hip and Pelvis
Probably the strongest moveable joint of the body.
Basic Anatomy of Hip and PelvisBones of the
AreaPelvisIliumIschiumPubisSacrum – fused vertebraeCoccyx –
tailboneFemur – upper leg bone
Basic Anatomy of Hip and PelvisMuscle Groups of the Region –
some of the largest and strongest muscles of the body
Gluteal Muscle GroupGluteus MediusGluteus MinimusGluteus
MaximusHip extension; internal & external rotation; abduction
Basic Anatomy of Hip and PelvisMuscle Groups of the Region
Hip Flexor MusclesIliopsoasSartoriusPectineusRectus Femoris
Basic Anatomy of Hip and PelvisMuscle Groups of the Region
Hip Adductor MusclesAdductor LongusAdductor
BrevisAdductor Magnus
Basic Anatomy of Hip and PelvisLigaments of the Region
Iliofemoral LigamentPubofemoral LigamentIschiofemoral
Ligament
Probably the strongest joint in the body
Injuries to the HipHip PointerContusion to the attachment sites
of muscles along the crest of the Iliac
Bruised or Broken CoccyxContusion or break to the tailbone,
usually resulting from being knocked on your butt.
The Knee and Upper Leg
Structurally a weak joint.
Basic Anatomy of KneeBones of the Knee JointStructurally
weak jointFemurTibiaFibulaPatella – a sesamoid bone (define)
Anatomy of the KneeBesides the bones of the knee, the
ligaments provide the side to side stability and the front to back
stability.
Basic Anatomy of KneeLigaments of the Knee Joint
Medial Collateral (Tibial)Lateral Collateral (Fibular)Anterior
Cruciate (ACL) LigamentPosterior Cruciate (PCL) Ligament –
least important of the ligaments of the knee.
Anatomy of the KneeIn addition to the bones of the knee, the
next couple of slides show the muscles that surround the knee
joint and actually give the joint most of its stability.
Basic Anatomy of KneeMuscles of the Knee Joint
Quadricep Muscle GroupVastus MedialisVastus LateralisRectus
FemorisVastus Intermedius
Basic Anatomy of KneeMuscles of the Knee Joint – continued
Hamstring Muscle GroupBiceps
FemorisSemitendinosusSemimembranosus
Basic Anatomy of KneeMuscles of the Knee Joint – continued
Flexor MusclesGastrocnemius, lateral headGastrocnemius,
medial head
Anatomy of the KneeNow, besides the bones, ligaments, and
muscles of the knee joint. There are other structures that are
very important to the function of the knee.
Basic Anatomy of KneeOther StructuresMeniscusLateral – “O”
shaped, not connected to LCLMedial – “C” shaped, connected to
MCLFat PadsBursa Sacs – lubricative fluidSynovial Sacs

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  • 1. Prevention and Care of Athletic Injuries ATHT 3580 Test One Name:_______________________________________ Score:________________ Multiple Choice: 3 Points Each _____ 1. Which of the following is NOT a purpose of the athletic training room? A. First Aid B. Rehabilitation C. Injury Treatment D. Team Meeting _____ 2. Which is not a domain of an athletic trainer? A. Education and Professional Development B. Supervision of Post Game Activities C. Injury Management D. Injury Prevention _____
  • 2. 3. Which is not a part of the national examination? A. Written Simulation B. Oral-Practical C. Written D. Play-Acting _____ 4. Which would not belong in a pre-participation exam? A. HIV/Aids Blood Test B. Eye Exam C. Physical History D. Dental Exam _____ 5. The inflammation phase of healing does not include what? A. Loss of Function B. Return to Active Participation C. Swelling D. Increase in Heat True/False: 2 Points Each
  • 3. _____ 1. Obtaining a thorough medical history should be one of the first steps in a physical examination. _____ 2. A team physician will automatically disqualify an athlete if they have function in only 1 or a paired organ. _____ 3. All coaches should have keys to the athletic training room. _____ 4. The application of heat is the first thing that an athletic trainer should apply to a new injury. _____ 5. The American Athletic Trainers Association is the national group that oversees athletic training. _____ 6. Volleyball is a high risk sport. _____ 7. It is the athletic trainer’s responsibility to diagnose an injury and treat it accordingly. _____ 8.
  • 4. Competencies are a sub set to the athletic training domains. _____ 9. The sports medicine team should never include the equipment manager. _____ 10. All internships will dissolve in the year 2004 and only curriculum programs will remain. Listing: Points Per Question List five professionals that you would have on your sports medicine team. (Do not use peoples names, but professions). 10 Points 1. 2. 3. 4. 5. List and then define the three phases of the healing process. 1 Point for each listing, and 2 points for each definition. 9 Points Total 1. 2. 3.
  • 5. Define the letters in the format S.O.A.P. 8 Points S O A P Briefly explain what the following words mean in the context of athletic training competencies. 6 Points Cognitive – Psychomotor – Affective – Define the letters in the word P.R.I.C.E.S. 6 Points P R I C E S Short Answer: How would you distinguish a change of skin color in a dark skinned athlete? 2 Points Explain the difference between a high risk sport and a low risk sport. 2 Points
  • 6. List any six domains of an athletic trainer. 6 Points 1. 2. 3. 4. 5. 6. List any eight components of any rehabilitation program. 16 Points 1. 2. 3. 4. 5. 6. 7. 8. Bonus: From your reading of the text, tell me in a couple of sentences the history of the NATA. 5 Points
  • 7. Biohazardous Issues There are times when athletic trainers come into contact with substances that are harmful. Biohazardous IssuesThe federal government has passed certain laws that protect workers. This group of laws fall under the group known as Occupational Safety and Health Administration. Biohazardous IssuesOSHAOccupational Safety and Health Administration OSHA Regulation 1910.1030Occupational Exposure to Bloodborne Pathogens OSHA 1910.1030Scope – who is coveredExposure control planMethod of ComplianceVaccinations and medical evaluationsInformation and trainingRecordkeepingSchedule of implementation Procedures in Waste ManagementPut on glovesAbsorb fluids with paper towelsSaturate with bleach solutionScrub the area – bleach and soapy waterRinse the areaBiohazard bagWash hands after disposal
  • 8. Exposures in Athletic TrainingFortunately, there are not too many times when athletic trainers will come into contact with needles and other contaminated materials, but open wounds are one of those exposures that athletic trainers deal with on a regular basis. Types of Wound ManagementYou should be able to define each of the following types of wounds that are typically seen in the athletic setting: Wound ManagementAbrasionsAvulsionsIncisionsLacerationsPunctures Initial and Follow Up Care Introduction to Athletic Training ATHT 3580 NCAA Sport ClassificationsThe National Collegiate Athletic Association, divides sports into three broad groups, depending on the rate of injury that you might see in that sport. The National Athletic Trainers Association, divides the sports into 2 groups, high and low risk, also depending on the rate of injury for that sport.
  • 9. Sports ClassificationsCollision Contact Non-Contact High vs Low Risk Sports Athletic Training Rules & RegulationsWhatever rules you make you must enforce!Co-educational facilityStudent-athletes utilize facilityClean up prior to enteringNo equipment in the athletic training roomLanguage & noise under controlNot a loungeKeep area clean – no food nor drinkExceptions to the Rules Pre-Participation ExaminationThis is a yearly medical examination to determine whether or not an athlete has the physical levels necessary to compete without undue risk or harm. There are a number of areas that can be included in this exam, I have listed some of those areas, as well as who can do a better exam – the family or team physician. The Pre-Participation ExaminationFamily vs Team Physician Areas To Include:Medical HistoryFamily HistoryPrevious InjuriesPrevious SurgeriesVisionDentalBlood Analysis Areas to Include (Cont):CardiacAllergiesDrug TestingFlexibilityStrengthOthers Disqualifications
  • 10. Protocol to Treat InjuriesThere are guidelines for the treatment of injuries that will occur in all sports, that protocol is called PRICES, a word that each letter stands for some aspect of the treatment protocol. This should also be referenced in the text to help further explain what each word means in the treatment protocol. Treatment of Acute InjuriesP.R.I.C.E.S.P = ProtectionR = RestI = IceC = CompressionE = ElevationS = Support Evaluation FormatsH.O.P.S.H = HistoryO = ObservationP = PalpationS = StressS.O.A.P.S = SubjectiveO = ObjectiveA = AssessmentP = Plan Why Document Injuries & Illnesses? Think about this statement and then read the following slides. Why Document Injuries?Rehabilitation PlanProgress with RehabilitationInsurance PaymentLiability IssuesLegal Ramifications in Future Basically A Good Idea Rehabilitation Programs Regardless of Injury – Many Areas are the Same
  • 11. Components of Any Rehabilitation ProgramGeneral Body ConditioningMuscular Strength & EnduranceImproved FlexibilityIncreased ProprioceptionGood Body MechanicsCardiovascular ConditioningSport Specific DemandsPsychological Healing Therapies for InjuriesBoth heat and cold are utilized in the treatment protocols for injuries, the next few slides list some of those therapies, how the modality physiologically effects the body, and any reasons not to use the modality. Which are more effective in your mind and why? Superficial Heat TherapiesMoist Heat PacksWhirlpoolsParaffin BathsInfrared RadiationContrast BathsChemicalsTopical Ointments Physiological Effects of HeatIncrease extensibility of collagen tissueDecreases joint stiffnessReduces painRelieve muscle spasmReduces inflammation and edemaIncreases blood flow Contraindications for Heat ApplicationLoss of sensationImmediately after injuryDecreased arterial flowTo eyes or genitalsAbdomen during pregnancy
  • 12. Cryotherapy ApplicationsIce MassageCold WhirlpoolCold or Ice Water ImmersionIce Packs – Natural or ChemicalVapocoolant SpraysIce Cup Physiological Effects of Cold TherapyVasoconstriction of blood vesselsDecrease of muscle spasmDecrease nerve ending excitability How Do Injuries Happen?Injuries take place when either an outside force (extrinsic force) comes into contact with the body – equipment, opponent, or weather. Or, when the body just wears done (intrinsic force) from overuse or abuse. Additionally, some injuries occur from inherited factors – family history. Mechanisms of InjuriesPrimaryExtrinsic Opponent Equipment EnvironmentalIntrinsic Sprain Shin SplintsHereditaryHigh Blood PressureLeg Length DiscrepancyFlat FeetEtc Healing Phases of Soft TissueInflammatory Phase3-4 Days Redness Heat Swelling Pain
  • 13. Loss of FunctionRepair PhaseUp to 3 Weeks Initial Healing and Regeneration Goal – Little Scar Tissue Remodeling Phase3 Months – 1 Year Completely New Tissue Pre-participation ExamPurpose of the Physical Exam Family versus Team Physician Areas to Include in the Exam Pre-participation ExamAreas of Exam:Family HistoryMedical HistoryPrevious InjuriesPrevious SurgeriesVisionDentalBlood Analysis Pre-participation ExamAreas of Exam:Medical HistoryCardiacStrengthFlexibilityMedical Conditions – ie AllergiesDrug Testing Disqualifications Evaluation FormatsDocumentation – why? H.O.P.S.HistoryObservationPalpationStress Evaluation FormatsS.O.A.P.SubjectiveObjectionAssessmentPlan Either is appropriate
  • 14. Taping and Wrapping Principles Prior to taping any body part the following should be considered for an optimal taping procedure Taping PreparationRemoval of HairClean the AreaSpecial ConsiderationsSpray AdherentSkin LubricantsUnderwrap Taping PreparationShaving the body part:This will allow the technique to adhere best to the skin and not “float” over the hair. Clean the body part:Many times lotion is applied to the body and this has an oil base and therefore will not allow the taping procedure to adhere as well. Taping PreparationSpecial Considerations:Because many athletes are not good at shaving the ankles and legs, cuts occur and they must be treated before taping can begin. Also, once in a great while and athlete will be allergic to the tape and they must have a protective wrap between the skin and the tape. Taping PreparationSpray the body part with adherent:Next, to insure a good foundation, a tape adherent should be sprayed on
  • 15. the body part. Use of heel and lace pads:There are high friction areas, at the Achilles tendon and on the front of the foot where the laces are, these need to be protected. Taping PreparationUse of underwrap:This foam on a roll helps to hold the heel and lace pads in place prior to taping the ankle. This product should not cover the entire ankle area (similar to that of a sock). Too much underwrap is just like taping over a sock. Taping PhilosophyBe able to justify every piece of tape you apply!Use proper terminologyProper body positioning – you and athleteWhy are you taping?Compression or Support? Wrapping PhilosophyUse proper size elastic wrap Apply anatomically correct Assist the athlete – NOT a cure Supplies You NeedTypes of Tape AvailableWhiteElastic ScissorsPadding MaterialEtc. Terminology Introduction to Athletic Training
  • 16. TerminologyAcute – ChronicStrain – SprainLigament – TendonAbduction – AdductionSuperior – InferiorProximal – DistalMedial - Lateral TerminologyPosterior – AnteriorHorizontal – VerticalFlexion – ExtensionIndicated – ContraindicatedOppositionCircumductionPronation - Supination The Healing ProcessInflammatory PhaseRednessHeatSwellingPainLoss of FunctionLength of Phase – 3/4 Days The Healing ProcessRepair PhaseInitial Healing and Regeneration of TissueGoal – Little Scar TissueLength of Phase – Up to 3 WeeksRemodeling PhaseFull Repair of TissueLength of Phase – Up to 1 Year Rehabilitation ComponentsHealing ConstraintsPain StatusRange of Motion – ROMStrengthFlexibilityEnduranceBalance Rehabilitation ComponentsProprioception – Kinesthetic AwarenessBody MechanicsSport Specific DemandsGeneral Body ConditioningCardiovascular ConditioningPsychological
  • 17. FactorsMaintenance Program Sports ClassificationsFirst ClassificationCollisionContactNon- Contact Second ClassificationHigh Risk vs Low Risk Athletic Training Athletic Training Domains Definition of DomainsThese are the 8 broad areas of knowledge that represent the basis for athletic training curriculum. The next slides list those 8 domains, please utilize the book to supplement the information that would be found in each domain. Domains of Athletic TrainingAcute Care of Injury and IllnessClinical Examination and DiagnosisEvidence-Based PracticePrevention and Health Promotion Domains of Athletic TrainingTherapeutic InterventionsPsychosocial Strategies and ReferralHealthcare AdministrationProfessional Development and Responsibility
  • 18. Domains of Athletic TrainingChanges from Previous YearsPathology – integrated into all areasRisk Management/Nutrition – integrated into Prevention and Health PromotionDiagnosis/Medical Conditions/Disabilities – integrated into Clinical ExamModalities/Rehab/Pharmacology – integrated into Therapeutic Interventions Definition of CompetenciesThese are the objectives that make up the broad domain areas. Competencies are then divided into 3 groups that are cognitive, psycho-motor, and affective. Competencies in A.T.Three Broad Categories: Cognitive – book knowledgePsycho-motor – application of knowledgeAffective – belief system (right vs wrong) National Athletic Trainers Assoc.The group that oversees the process to become a certified athletic trainer. In addition to passing a national exam, many states now have a licensure process to insure consistency in the applicants applying to work in that state. NATA RequirementsNATABOC Approved Curriculum 2004National Certification ExaminationWrittenWritten SimulationOral-PracticalContinuing Education80 CEU’s Every Three Years
  • 19. Sports Medicine TeamThis is an umbrella term that includes a variety of specialty areas or professions that work in cooperation with the other groups to provide the best health care to the student athlete. These are just some of the areas that you could have on your team. Sports Medicine TeamCertified Athletic TrainerPhysiciansList Various Sub-specialtiesPhysical TherapistNutritionistMassage TherapistStrength and Conditioning Specialist Sports Medicine TeamEquipment ManagerCoachPodiatristPsychologist Others: Care of Acute Injuries What do we do as athletic trainers to care for injuries that occur on the spot? Care of Acute InjuriesP.R.I.C.E.S.Protect – the injury from further harmRest – the injury siteIce – will help control swellingCompression – also helps control swellingElevation – keeps swelling to a minimumSupport – if necessary, i.e., crutches, cast
  • 20. Vital Signs and Normal ParametersPulse – number of beats of the heart per minute, typically taken at the caratoid or radial artery Respiration – number of times the average person breathes per minutes at rest. Temperature – core temperature of the body, taken orally, rectally, under the arm, or electronically. Vital SignsPulseAverage 60-80 Beats Per Minute RespirationAverage 12 Breathes Per Minute Temperature98.6 F - Orally Vital Signs – Blood PressureThe range of the normal person is 120/80. Upper number is the amount of pressure on the vessel under pressure Lower number is the amount of pressure on the vessel under normal circumstances, more important number. Treatment ProtocolIce versus Heat – cold therapy is the typical treatment for an acute injury. Application of IceReduce Swelling and InflammationReduce Blood Flow to AreaReduce Pain at Site Ice ApplicationWays to Apply IceCold PacksIce BagsIce MassageIce SlushCold WhirlpoolCold Spray
  • 21. Treatment ProtocolIce versus Heat Application of HeatIncrease Blood Flow to AreaReduce Muscle StiffnessMuscular Relaxation Heat ApplicationWays to Apply HeatHot PacksHot WhirlpoolModalities - ElectricalTopical Ointment Application of Ice & HeatContrast Baths Basic Foot Anatomy What is the function of the lower extremity? Did you realize the upper and lower extremity have bony arrangements that are almost identical? Basic Foot Anatomy - BonesPhalanges – 14Metatarsals – 5Tarsals –7TalusCalcaneus (heel bone)NavicularCuboidCuneiform (3) Bones of the FootThe most commonly fractured bone of the foot is the 5th metatarsal, at the base where it spreads out at the mid foot. The calcaneus is probably the hardest bone of the foot to fracture.
  • 22. Basic Anatomy - AnkleBonesTibia – weight bearing boneFibula – non weight bearing boneTalus The tibia and fibula articulate with the talus, that is where the ankle joint is located. LigamentsThere are more ligaments damaged on the lateral side of the ankle, since a vast majority of the ankle sprains are inversion sprains. Basic Anatomy - AnkleLigamentsLateralMedial LateralAnterior TalofibularPosterior TalofibularCalcaneofibular Basic Anatomy - AnkleMedialDeltoid Arches of FootMedial LongitudinalLateral LongitudinalAnterior MetatarsalTransverse Basic Anatomy – Foot & AnkleMovements – these are the major movements not all the movements at the ankle joint. InversionEversionDorsi-flexionPlantar flexion Injuries to the Foot & AnkleSome injuries are relatively minor, but that does not make them any less important. We as athletic trainers spend a huge part of our day taping for ankle sprains, but remember there are other injuries just as
  • 23. important. Injuries to the Foot & AnkleAnkle sprainsFirst degreeSecond degreeThird degreeBlisters on FeetTreatmentCornsHard and Soft Injuries to the Foot & AnkleIngrown toenailAthletes feetCallusHow to preventHow to treatBroken bonesFallen arches Injuries to the Foot & AnkleTurf ToeHeel BruiseAchilles tendon strainAchilles tendon rupture Special Tests for InjuriesBump TestPreliminary test for fracture of the ankle Squeeze TestPreliminary test for fracture of fibula Thompson TestPreliminary test for rupture to Achilles RehabilitationRemember – all rehab programs will have components that are the same, you will just address the particular injury in a little different fashion. Rehabilitation for Ankle InjuryStage I – Non Weight Bearing Stage II – Weight Bearing
  • 24. Stage III – Sport Specific Work Rehab Protocol for AnkleTotal Body ConditioningMuscular Strength & EnduranceFlexibilityProprioceptionBody MechanicsCardiovascular ConditioningSport Specific Demands Pre Taping the AnkleThere are a number of steps involved in getting the ankle ready for taping. The next slide discusses those steps. One of the most important things is for you the athletic trainer to be in good posture to tape the ankle. Taping An AnkleShave the areaClean the areaSpecial ConsiderationsAllergies, infections, cuts, etc.Spray adherentSkin lubricantUnderwrap Thoracic & Abdomen This region is where most of the internal organs of the body reside. Organs of RegionHollow Organs of Region – define what each organ does in the body. StomachIntestinesUrinary BladderTubes and VesselsLungs
  • 25. Organs of RegionSolid Organs of Region – define what each organ does in the body. LiverKidneySpleenGall Bladder Organs of RegionMixed Organs of Region – define what each organ does in the body. HeartMale Reproductive OrgansFemale Reproductive Organs Injuries to OrgansWhich type of organ – HOLLOW or SOLID is more prone to injury? Solid or Hollow Organ Filled with material. Injuries to the RegionContusionsMuscle StrainsHernia – protrusion of viscera through the abdominal wallAcquiredCongenital Injuries to the RegionStitch in the SideConstipationIntestinal gasOvereatingDistended spleenFaulty breathingOut of shape Injuries to the RegionRuptured SpleenFall or direct blow to the areaInfectious monoSigns of ruptured spleenHistory of severe blowSigns of shock : abdominal rigidity; nausea, vomitingKehr’s Sign
  • 26. Injuries to the RegionLiver Contusion – rareKidney Contusion – frequentBlood in UrineNausea/VomitingUrinary Bladder InfectionsScrotal ContusionsIndigestion Injuries or IllnessesAsthmaInfluenzaBronchitis HyperventilationRupture of Pectoralis Muscle Unusual Injuries to AreaMyocardial Infarction – abnormal rhythmCardiac Contusion – bruising to the heartPneumothorax – air outside lung spaceHemothorax – blood in lung spacePulmonary Contusion – bruise to lung Rib Fractures and Separations One More IllnessShingles – adult chicken pox Brought on by stressReduced immune systemNeurological disorderFollows a dermatome Extremely Painful The Hip and Pelvis Probably the strongest moveable joint of the body. Basic Anatomy of Hip and PelvisBones of the
  • 27. AreaPelvisIliumIschiumPubisSacrum – fused vertebraeCoccyx – tailboneFemur – upper leg bone Basic Anatomy of Hip and PelvisMuscle Groups of the Region – some of the largest and strongest muscles of the body Gluteal Muscle GroupGluteus MediusGluteus MinimusGluteus MaximusHip extension; internal & external rotation; abduction Basic Anatomy of Hip and PelvisMuscle Groups of the Region Hip Flexor MusclesIliopsoasSartoriusPectineusRectus Femoris Basic Anatomy of Hip and PelvisMuscle Groups of the Region Hip Adductor MusclesAdductor LongusAdductor BrevisAdductor Magnus Basic Anatomy of Hip and PelvisLigaments of the Region Iliofemoral LigamentPubofemoral LigamentIschiofemoral Ligament Probably the strongest joint in the body Injuries to the HipHip PointerContusion to the attachment sites of muscles along the crest of the Iliac Bruised or Broken CoccyxContusion or break to the tailbone, usually resulting from being knocked on your butt.
  • 28. The Knee and Upper Leg Structurally a weak joint. Basic Anatomy of KneeBones of the Knee JointStructurally weak jointFemurTibiaFibulaPatella – a sesamoid bone (define) Anatomy of the KneeBesides the bones of the knee, the ligaments provide the side to side stability and the front to back stability. Basic Anatomy of KneeLigaments of the Knee Joint Medial Collateral (Tibial)Lateral Collateral (Fibular)Anterior Cruciate (ACL) LigamentPosterior Cruciate (PCL) Ligament – least important of the ligaments of the knee. Anatomy of the KneeIn addition to the bones of the knee, the next couple of slides show the muscles that surround the knee joint and actually give the joint most of its stability. Basic Anatomy of KneeMuscles of the Knee Joint Quadricep Muscle GroupVastus MedialisVastus LateralisRectus FemorisVastus Intermedius
  • 29. Basic Anatomy of KneeMuscles of the Knee Joint – continued Hamstring Muscle GroupBiceps FemorisSemitendinosusSemimembranosus Basic Anatomy of KneeMuscles of the Knee Joint – continued Flexor MusclesGastrocnemius, lateral headGastrocnemius, medial head Anatomy of the KneeNow, besides the bones, ligaments, and muscles of the knee joint. There are other structures that are very important to the function of the knee. Basic Anatomy of KneeOther StructuresMeniscusLateral – “O” shaped, not connected to LCLMedial – “C” shaped, connected to MCLFat PadsBursa Sacs – lubricative fluidSynovial Sacs