Sports Medicine Primer for Sports Medicine Primer for the Soccer Coachthe Soccer Coach

Sports Medicine Primer for Sports Medicine Primer for the Soccer Coachthe Soccer Coach

Scott Hamill, ATC, PTADominican Hospital

Sports Medicine Center

Scott Hamill, ATC, PTADominican Hospital

Sports Medicine Center

The risk of injury is inherent in sports

Coaches are first responders and may need to deal with injuries from abrasions to concussions

Three million kids play high school and youth soccer in the U.S.

Approx. 450,000 injuries occur yearly

The risk of injury is inherent in sports

Coaches are first responders and may need to deal with injuries from abrasions to concussions

Three million kids play high school and youth soccer in the U.S.

Approx. 450,000 injuries occur yearly

Injury PreventionInjury Prevention

Proper conditioning Proper warm up/stretching Equipment: well fitting cleats, shin guards,

synthetic balls, fixed goals, field conditions Hydrate Avoid overtraining: stress followed by

REST and the body grows stronger Encourage athletes to talk about injuries.

Injuries addressed early resolve more quickly

Proper conditioning Proper warm up/stretching Equipment: well fitting cleats, shin guards,

synthetic balls, fixed goals, field conditions Hydrate Avoid overtraining: stress followed by

REST and the body grows stronger Encourage athletes to talk about injuries.

Injuries addressed early resolve more quickly

Sports Injury TreatmentSports Injury Treatment

Soft Tissue Injury PRICE: Protection, Rest, Ice, Compression,

Elevation Contusion

Ice, compression, protection Deep thigh contusion: flex knee and ice to

prevent hematoma Abrasion

Clean, disinfect, dress Laceration

Clean,disinfect, dress. Suture if too wide or deep to close. Location

• Blister Puncture with sterilized needle and drain Apply antibiotic and cover with gauze or bandaid

Callus

Soft Tissue Injury PRICE: Protection, Rest, Ice, Compression,

Elevation Contusion

Ice, compression, protection Deep thigh contusion: flex knee and ice to

prevent hematoma Abrasion

Clean, disinfect, dress Laceration

Clean,disinfect, dress. Suture if too wide or deep to close. Location

• Blister Puncture with sterilized needle and drain Apply antibiotic and cover with gauze or bandaid

Callus

SprainLigaments connect bone to boneSeverity: mild moderate severe Ice, support, compression, crutchesSend for xray if unable to walk on the

ankle, significant swelling, symptoms don’t

improve after a few days, pain in foot or above ankle

SprainLigaments connect bone to boneSeverity: mild moderate severe Ice, support, compression, crutchesSend for xray if unable to walk on the

ankle, significant swelling, symptoms don’t

improve after a few days, pain in foot or above ankle

Strain Muscle/tendon Ice, compression, crutches No massage or stretching first 48

hours No heat for 72 hours Gentle stretching after light warm up Strength exercises if no localized pain Progress to full go gradually

Strain Muscle/tendon Ice, compression, crutches No massage or stretching first 48

hours No heat for 72 hours Gentle stretching after light warm up Strength exercises if no localized pain Progress to full go gradually

Fracture/Dislocation Management

Fracture/Dislocation Management

Finger Splint, ice, send to

ER

Finger Splint, ice, send to

ER

Ankle Do not move

athlete if obvious fracture/dislocation call 911

Ankle Do not move

athlete if obvious fracture/dislocation call 911

Patella Usually dislocates

laterally Do not move

athlete Call 911

Patella Usually dislocates

laterally Do not move

athlete Call 911

Shoulder Usually dislocates

anteriorly Sling, ice,

transport immediately

If parent or coach can’t transport call 911

Shoulder Usually dislocates

anteriorly Sling, ice,

transport immediately

If parent or coach can’t transport call 911

Head and Face InjuriesHead and Face Injuries

Teeth Assess for

concussion Put tooth in

container with saline, milk, saliva

Get to Dentist or ER Can be saved if

treated in 2-3 hours

Teeth Assess for

concussion Put tooth in

container with saline, milk, saliva

Get to Dentist or ER Can be saved if

treated in 2-3 hours

Eye Foreign body

Wash out with athlete side lying

If object cannot be removed or eye is punctured cover eye with gauze and send to ER. Do not remove impaled object

Eye Foreign body

Wash out with athlete side lying

If object cannot be removed or eye is punctured cover eye with gauze and send to ER. Do not remove impaled object

Nose Bleeding

Assess for concussionPinch nostrils and hold one minuteRolled gauze under bottom lipRolled gauze in nostrils for return to play

Nose Bleeding

Assess for concussionPinch nostrils and hold one minuteRolled gauze under bottom lipRolled gauze in nostrils for return to play

Nose fracture Suspect concussion/neck injury Crepitus/cracking at bridge of nose Obvious deformity Rolled gauze on each side of nose taped

down on cheeks Ice and send to doctor

Nose fracture Suspect concussion/neck injury Crepitus/cracking at bridge of nose Obvious deformity Rolled gauze on each side of nose taped

down on cheeks Ice and send to doctor

Abdominal InjuriesAbdominal Injuries

Organ injuries Wind knocked out. Calm athlete and hands

on head to open rib cage Testicular spasm. If athlete is on back bring

both knees to the chest and hold 20 seconds. Internal bleeding. Rebound tenderness: pain

when pressing on abdomen is released. Watch athlete for dizziness, lethargy, fainting, vomiting. Call 911 and put into shock position on back with legs elevated and cover for warmth.

Organ injuries Wind knocked out. Calm athlete and hands

on head to open rib cage Testicular spasm. If athlete is on back bring

both knees to the chest and hold 20 seconds. Internal bleeding. Rebound tenderness: pain

when pressing on abdomen is released. Watch athlete for dizziness, lethargy, fainting, vomiting. Call 911 and put into shock position on back with legs elevated and cover for warmth.

Concussion MangementConcussion Mangement

No return to play same day. When in doubt sit them out Progressive exertional return to contact Any return of symptoms and process

begins again at day one Impact baseline test Cumulative traumatic encephalopathy

No return to play same day. When in doubt sit them out Progressive exertional return to contact Any return of symptoms and process

begins again at day one Impact baseline test Cumulative traumatic encephalopathy

Cervical InjuriesCervical Injuries

Do not move athlete! Other athletes should be told to never try to help injured athlete to their feet!

Symptoms: Numbness, tingling, burning in extremities Loss of motor control. Can’t move arms,

legs, hands, feet. Neck pain

Do not move athlete! Other athletes should be told to never try to help injured athlete to their feet!

Symptoms: Numbness, tingling, burning in extremities Loss of motor control. Can’t move arms,

legs, hands, feet. Neck pain

Treatment Stabilize head/spine Calm athlete Activate EMS Assess and maintain ABCs

Treatment Stabilize head/spine Calm athlete Activate EMS Assess and maintain ABCs

Heat InjuriesHeat Injuries

Signs and Symptoms Chills Dark colored urine Dizziness Dry mouth Headaches Thirst Weakness

Signs and Symptoms Chills Dark colored urine Dizziness Dry mouth Headaches Thirst Weakness

Prevention

• Proper training for the heat• Fluid replacement before, during and after

exertion. 16 oz one hour before exercise, 4-8 oz during.

• Appropriate clothing—light colored, loose fitting and limited to one layer

Early recognition via direct monitoring of athletes by other players, coaches and medical staff

Monitoring the intensity of physical activity appropriate for fitness and the athlete's acclimatization status

Prevention

• Proper training for the heat• Fluid replacement before, during and after

exertion. 16 oz one hour before exercise, 4-8 oz during.

• Appropriate clothing—light colored, loose fitting and limited to one layer

Early recognition via direct monitoring of athletes by other players, coaches and medical staff

Monitoring the intensity of physical activity appropriate for fitness and the athlete's acclimatization status

Treatment Get athlete to shaded area Cool rapidly with ice packs cold water

from hose or water bottles Water soaked towels over body Provide cold beverages if able to

drink Activate EMS

Treatment Get athlete to shaded area Cool rapidly with ice packs cold water

from hose or water bottles Water soaked towels over body Provide cold beverages if able to

drink Activate EMS

When can the Athlete Return to Play?

When can the Athlete Return to Play?

Lower body Full ROM, Full strength Two legged hop X 10 Injured leg hop X 10 Jog in place Jog straight ahead Run straight ahead Back pedal Carioka both directions Stop progression if pain or limp develops

Lower body Full ROM, Full strength Two legged hop X 10 Injured leg hop X 10 Jog in place Jog straight ahead Run straight ahead Back pedal Carioka both directions Stop progression if pain or limp develops

Upper body Full ROM, Full strength Push up x 10 Sport specific movements

Upper body Full ROM, Full strength Push up x 10 Sport specific movements

Emergency PlanEmergency Plan

Make sure someone has cell phone coverage

Know where EMS will access field Appoint coach or parent to direct

EMS to injured athlete

Make sure someone has cell phone coverage

Know where EMS will access field Appoint coach or parent to direct

EMS to injured athlete

Internet ResourcesInternet Resources

stopsportsinjuries.org Nata.org childrensmemorial.org Smsmf.org (ACL Injury Prevention) www.cdc.gov/concussion (concussion info) www.soccerinteractive.com (dynamic ex) http://www.youtube.com/watch?v=snPo9om

B4wA&feature=related (Ankle taping video)

stopsportsinjuries.org Nata.org childrensmemorial.org Smsmf.org (ACL Injury Prevention) www.cdc.gov/concussion (concussion info) www.soccerinteractive.com (dynamic ex) http://www.youtube.com/watch?v=snPo9om

B4wA&feature=related (Ankle taping video)