Field Strategies
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- Fitting Football Shoulder Pads
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1) Determine chest girth measurements. Slect pads based on the player's postition. Place pad on shoulders and tighten all straps and laces. The entire clavicle should be covered.
2) Anterior View -> Laces should be centered over the sternum w/ no gap b/t the two halves. Should be full coverage of the AC joint, clavicular and pectoral muscles. Caps should cover the upper portion of the arch and entire deltoid muscles
3) Posterior view -> Entire scapula and trapezius should be covered w/ lower pad arch extending below the inferior angle of scapula to protect the latissimus dorsi
4) Arms abducted -> neck opening should not be uncomfortable or pinch the neck. Place pads w/ helment and jersey to ensure no impingement of cervical region - Musculoskeletal Examination
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Obseve:
Postural symmetry -> unusual swelling, pelvic tilting, hamstring and calf atrophy
Back and spine -> look for scoliosis, kiphosis, lordosis
Lower extermities -> quad. symmetry, genu valgus or varus, pes cavus or pes planus, pronation or supination of feet
Squatting and duck walk -> functional movement of hip, knee and ankle
Heel standing and toe standing -> strength and ROM in dorsiflexion and plantar flexion - Proper Fitting of a Football Helmet
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1) Hair cut in style that will be worn during competition and wet hair -> measure the circumference of head above ears w/ given measureing tape
2) Select proper sized shell and adjust the front and back sizers and jaw pads for proper fit
3) Inflate air bladder by holding the bulb w/ an arch in the hose; deflate the hose is in straight position
4) Helmet fits snugly around players head and covers base of skull -> not impinge the cervical spine in neck extension; ear holes should match up with external auditory ear canal
5) Check -> 4pt chin strp is = tension and length on both sides and the chin pad is = distance from each side of helmet
Check -> facemask allows for complete vision and is 1 to 2 finger width above eyebrows and 2 fingers width away from forehead and nose
Check -> helmet does not move when pressed forward from rear or straight down when pressed on top
Check -> helmet does not slip when the athlete is asked to "bull" their neck when grasping the facesmask pulling left then right
- Fitting Mouth-Formed Mouthguards
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1) Submerge mouthguard in boiling H2o for 20 to 25 sec. Shake off excess water .
2) Place mouthguard directly in mouth over the upper dental arch. Center the mouthguard w/ thumbs using loop strap as guide
3) Close the mouth but do not bite down. Place the tongue on roof of mouth and suck as hard as possible for 15 to 25 sec.
4) Rinse mouthguard in cold water. Check the finished product. If any imperfections do not reheat and start over - Injury Assesment Protocol
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History of the Injury:
Primary Complaint; MOI; CHCaracteristics of symptoms; Disapbility resulting from injury; related medical history
Observation:
Observe overall appearance; body aymmetry; general motor function; posture and gait
Inspect deformity, swelling, discoloration, scars and general skin condition
Palpation:
Body structures to determine possible fracture
Soft tissue structures: Skin temp, swelling, PT, crepitus, deformity, muscle spasm, pulse
Functional tests:
Active, Passive, Resisted
Stress tests:
ligamentous instability tests and special tests
Neurologic tests:
Dermatomes, myotomes, reflexes, peripheral nerve testing
Sport specific function testing:
Proprioception and motor coordination
Sport specific skill performance
- Knee Braces
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Prophylactic Knee braces
Protect MCL -> redirecting a lateral valgus force away from joint
Functional Knee braces
Protect ACL injuries ->control tibial translation and rotational stress relative to femur and extension limitations
Rehabilitative braces
Provide absolute immobilization at selected angle after surgery, controlls ROM and prevents accidental loading
Patellofemoral Protection
dissipate force, maintain patellar alignment and umprove patellar tracking
Horseshoe type pad
patellofemoral subluxation or dislocation
Relieves anterior knee pain syndrome
Strap worn over infropatellar ligament
Relieves patellar pain
- Measuring Blood Pressure
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General Guidelines:
No caffeine 1hr prior to testing; calibrate gauges every 6 months
Techniques:
Inflate to about 200 mmhg; Place stethoscope over brachial artery ; Sound 1st appears is systolic and the last sound is diastolic (s/d)
Normal BP:
Adults -> 120/80 mmhg
Children -> 105/70 mmhg
- Standardized Description of Skinfold Sites and Procedures
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General Guidelines:
Measurements made on right side of body
Men and Women athletes should fall b/t 12 to 17%
Men: Biceps, chest, thigh, abdominal
Women: Triceps, Suprailiac, thigh - Care of Open Wound (Incisions and Lacerations)
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1) Clean both the wound site and area around the wound w/ antiseptic solution
2) Spray tape adherent on a cotton-tipped applicator and apply above and below the wound
3) Beginning in the middle of wound, bring the edges together and secure the steristrip below the wound
4) Start from the middle and work out by alternating sides
5) Dress the wound w/ an nonstick sterile dressing
6) Sutures may be desirable for any depth of laceration; sutured w/in 10 hrs of injury
7) Refer for medical care if more than 5 years since a tetanus booster or signs of infection - Care of Open Wounds (Abrasions)
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1) Clean and remove visible contaminants with a fluid flush w/ water and sweeps of gauze
2) Clean the wound site and area around the wound w/ antiseptic solution
3) Dress and bandage the wound securely for continued play
4) For dirty abrasions or when it has been at least 5 years since a tetanys booster, refer for medical care - Care of Open Wound (Blisters)
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1) Clean both the wound site and area around the wound w/ antiseptic solution
2) Leave the roof of the blister intact for at least 24 hrs and cover area w/ a topical antibiotic and dry sterile dressing
3) If blister is large, use a small needle to aspirate the clear fluid
4) once the fluid is removed, cleanse the area again w/ an antiseptic solution
5) Pad the nontender skin around the blister w/ soft foam, new skin or 2nd skin
6) Dress and bandage the wound site securely for cont' play - Determining the History of Injury and Level of Responsiveness
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Stabilize the head and neck
If nonresponsive:
Call the persons name and tap the sternum or arm. If no response, rap sternum more forcibly w/ knuckles or pinch the soft tissue in the armpit.
If ABCs are adequate, gather history of injury
If conscious, ask:
What happened? Are you in pain? where is the pain? Is it localized or radiating? Did you hear any sounds or unusual sensations when the injury occurred? Any previous injuiry? Do you have a headach? Are you nauseous? Are you dizzy? Are you taking any meds?
- General Guidelines for Preventing Spread of Bloodborne Pathogens
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Latex gloves should always be worn; Other equipment that should be worn include -> eye wear, masks and gowns
Following any exposure to infectious material immediately wash and disinfect hands and other skin surfaces
Clean large spills by flooding the contaminated area w/ disinfectant prior to removing the spill
Disinfect all horizontal surfaces regularly
Disinfect w/ a cleaning solution of 1:10 to 1:100 solution (bleach to water)
Soiled towels should be separated from regular laundry
All items should be washed w/ detergent and water for 25 minutes at a min of 106F
All disposable contaminated products should be handled w/ gloves and placed in biohazard bags
Sharp containers should be placed in a leak proof, puncture resistant, red color container
Disposal of contaminated items and sharps should be in compliance w/ OSHA - Factors in the Selection and Fit of Atheltic Shoes
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1) Fit shoes after workout with socks typically worn
2) Fit shoes to longest toe of largest foot w/ one thumbs width to the end of the toe box
3) Make sure the shoe is as wide as the widest part of the foot
4) The sole of shoe should provide moderate support
5) The midsole may be compsed of EVA, polyurethane or both. EVA -> provides cushioning, Polyurethane -> provides good durability and stability
6) Thermoplastic hell counter maintains shap and firmness
7) Running shoes -> heel at least 1/2 inch above outsole to min. stretch on achilles tendon
8) Runners w/ normal feet -> more forefoot & toe flexibility
Overpronation -> greater control on medial side
Achilles tendinitis -> at least a 15 mm heel wedge
Court sports -> added side to side stability
High arches -> soft midsoles, curved lasts and low hindfoot stability
Normal arches -> firm midsole, semicurved last and moderate hindfoot stability
Flexible low arch -> very firm midsole, straight last and strong hindfoot stabililty
9) Avid runners should replace shoes every 3 months, recreational runners every 6 months