Transcript Sports Medicine Primer for the Soccer Coach

Sports Medicine Primer for the
Soccer Coach
Scott Hamill, ATC, PTA
Dominican 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
Injury 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
Sports 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
 Sprain
 Ligaments connect bone to bone
 Severity: mild moderate severe
 Ice, support, compression, crutches
 Send 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
Fracture/Dislocation
Management
 Finger
 Splint, ice, send to
ER
 Ankle
 Do not move athlete
if obvious
fracture/dislocation
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
Head 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
 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 concussion
 Pinch nostrils and hold one minute
 Rolled gauze under bottom lip
 Rolled 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
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Abdominal 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.
Concussion 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
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Cervical 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
 Treatment
 Stabilize head/spine
 Calm athlete
 Activate EMS
 Assess and maintain ABCs
Heat Injuries
 Signs and Symptoms
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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
 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?
 Lower body
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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
Emergency Plan
 Make sure someone has cell phone
coverage
 Know where EMS will access field
 Appoint coach or parent to direct EMS
to injured athlete
Internet Resources
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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=snPo9omB4wA
&feature=related (Ankle taping video)