Assessment Techniques in Sports Injuries

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Assessment Techniques in Sports Injuries
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Learning Objectives

• Have a clear understanding of specialist tests
  and investigations that may be used in sports
  injury assessment

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Assessment Areas

• Intrinsic risk factors
• Extrinsic risk factors
• History of the injury mechanism, pain profile,
  previous treatment, etc
• Specialist tests
• Specialist investigations

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Making The Diagnosis
Physical Examination
Clinical History
Working Diagnosis
Specialist test(s)
DEFINITIVE DIAGNOSIS
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Specialist tests

• Standard orthopaedic tests for that joint,
  muscle, tendon, ligament, etc
• Identify injured structure
• Isolate the injured structure
• Stress the injured structure in a controlled
  progressive manner

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Specialist investigations

• Imaging techniques
• Exercise physiology tests
• Sports psychology tests/ profiles
• Biomechanical analysis of function and performance

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Neural Tests

• Neural symptoms/ functions
• Dermatome symptoms
• Straight Leg Raise (SLR)
• SLR with modifications
• Slump test
• Resisted muscle testing for nerve root lesions

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STRAIGHT LEG RAISE
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SLUMP TEST
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Proximal Muscle Imbalance

• Upper limb dominance
• Shoulder drop
• Sit and reach test
• Thomas test for hip flexor tightness (iliopsoas,
  rectus femoris)

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THOMAS TEST
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Sacroiliac Tests

• FABER test
• Gapping test
• Hip flexion and adduction test
• Sit up and reach test
• Pelvic compression test

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GAPPING TEST
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SIT UP REACH TEST
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JOINT SCOURING TEST
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Hip Joint Tests

• Piriformis test
• Joint scouring (Quadrant) test
• Inferior glide
• Posterior glide
• Anterior glide

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PELVIC COMPRESSION TEST
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PIRIFORMIS TEST
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HIP GLIDES
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Standard Knee Tests

• Menisci
• Cruciate ligaments
• Collateral ligaments
• Joint capsule

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Apleys Compression Test
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McMurrays Test
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McMurrays Test
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Anterior drawer test
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Modified drawer test
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Valgus Stress Test
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Specialist Knee Tests

• Resisted extension
• Q angle
• Clarks test
• Patella tracking
• 5050 test
• Squat test

• Patella apprehension
• Patellofemoral compression test
• Hoffa test
• Plica test
• Obers test
• Noble test

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Resisted Extension
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Clarks Test
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Direct Palpation
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5050 Test
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Patella Tracking
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Patella Tracking (dynamic)
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Q Angle
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Thumb roll test
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Obers Test
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Noble Test
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Ankle Tests

• Ligament stability
• ROM
• Anterior drawer
• Inversion stress test
• Compression test
• External rotation test
• Retinacular stability

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Lateral Collateral Ligaments
Lateral Collateral Ligaments
ATFL
CFL
PTFL
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RANGE OF MOTION
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DIRECT PALPATION
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ANTERIOR DRAWER TEST(ATFL pathology)
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X-ray Views- ? Instability

• Anterior drawer stress view- for ATFL
  instability. gt10mm diagnostic (or gt3mm from
  contra-lateral side).
• Talar tilt stress view- for ATFL and CFL
  instability. Tilt gt10 degrees from contra-lateral
  side.

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B
A
Inversion stress of the normal (A) and injured
(B) ankle
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PERONEAL SUBLUXATION
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SYNDESMOSIS COMPRESSION TEST
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DORSIFLEXION AND EXTERNAL ROTATION TEST
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QUESTIONS ?