MANAGEMENT

TOTAPS

TALK:

Ask the injured athlete the following questions:

What happened?
Where does it hurt?
Did you hear a sound upon impact (a snap, crack or pop)?
On a scale of 1 – 10, how would you rate your pain?

It is imperative to communicate with the injured athlete in order to take the appropriate steps to treat and support the injury.

T

O

OBSERVE:

Look for obvious signs surrounding the injury:

Look for any sign of deformity, swelling or contusions
Compare the injured site to the opposing part of the body
Look for signs of pain or discomfort by observing the athlete’s facial expressions and movement
Note their mental state (relaxed, panicked, stressed, incoherent etc.)

T

TOUCH:

We may then touch the injury to determine where the injury is:

Touch around the injured site to determine the exact location of the injury
Touch may also help to determine the severity
Feel for any swelling or deformity

A

ACTIVE MOVEMENT:

Ask the athlete to move the injured limb themselves:

Are they able to move through their full range of motion?
Is there pain at any point?

P

PASSIVE MOVEMENT:

If the athlete is unable to comfortably move the limb/joint through their full range of motion, it is unnecessary to take any of these further steps and professional help should immediately be sought.

Passive movement is performed only by a physio or trainer
They will gently move the joint through its full range of motion, noting any pain or difficulty
They may also need to feel for any instability

S

SKILLS TEST:

If the athlete manages to pass the steps outlined above as part of the assessment procedure, they are required to complete a skills test.

The skills test may involve moves involved in the game/sport/activity or may simply be a test to see whether the athlete is able to stand and comfortably place weight on the injured site
The skills test may include activities such as jumping, hopping, running or making side steps

Important things to remember:

If at any one of the steps the athlete experiences severe pain or inability to move, you should:

Not go further with the assessment
Remove the player from the game/competition
Begin initial treatment (RICER)
Refer them to further treatment

RICER

Reduces further damage. It is imperative to avoid as much movement as possible and keep weight off the injured site.

Apply a cold pack to the injured site for 20 minutes every 2 hours. Ice cools the tissue and can reduce pain, swelling and bleeding. If using ice, wrap a towel around the pack as ice should never be applied directly to the skin. Ice is used to reduce swelling as the cold restricts blood vessels and decreases the circulation to the area. (Vasoconstriction)

Apply a compression bandage to the injured site. Compression assists in reducing both bleeding and swelling. Always apply a bandage to clean and dry skin. Overlap the bandage by a half to two thirds in a spiral bandaging technique formation. To secure the bandage, do not apply pressure on the last 10cm of application. Ensure the bandage is not too tight.

Elevate the injured area to stop any bleeding or swelling. You may want to place the limb on a pillow to provide comfort. Elevation encourages the blood to move away from the injured area, hence assisting in the process of reducing swelling and bruising.

Refer the injured person to a qualified professional (doctor or physio) for a diagnosis, care and treatment.

Scar tissue is weakened tissue. Returning to play with weak muscles increases the likelihood of a reoccurring injury. If we do not immediately carry out RICER, scar tissue will build up in the body’s natural response to injury.

REST

ICE

COMPRESSION

ELEVATION

REFERRAL

IMMEDIATE MANAGEMENT OF AN ACL INJURY

IMMEDIATE MANAGEMENT OF A SHOULDER DISLOCATION

FOOTNOTES

RICER 2020, Elastoplast, viewed 16 November 2020, <https://www.elastoplast.com.au/strapping-and-injuries/injury-management-and-prevention/ricer>.