2HIPSSpecific injury assessment to evaluate the extent of musculoskeletal injuriesPerformed in an ordered sequence to assess the nature, site and severity of an injuryBy following a consistent pattern, you are less likely to forget a procedureHIPSHistoryInspectionPalpationSpecial Test
3PPE /BSIBefore you start the injury assessment you must take precautions to prevent disease transmissionAvoid contact with body fluidsWear GlovesCover cutsWear protective coveringsUse breathing devicesWash hands after treatmentRemove athlete from activity if bleeding and blood on uniformUse a solution of bleach and water or hydogen peroxide to get blood off uniform
4History One of most important steps Collecting as much information as possibleAsk athlete questionsAsk bystanders questionsProvide clues in determining structures that are injuredWhere does it hurt?What happened?How did it happen?How long has it hurt?Does the joint give away?Does the joint lock?Did you hear or feel a pop, crack, snap…?
5Inspection This step is purely observational Always compare bilaterallyNote if holding body partNote holding body partNote functional abilitiesLimping?Grimacing?Look forBleedingDeformitySwellingDiscolorationAny sign of injury
6Palpation Palpation means to feel or touch Increase palpation pressure as toleratedBegin away from injury siteVisualize structures as examineCompare bilaterallyPalpateBonesMusclesSoft tissueLigamentsTendons
7Special Tests There are five areas of special tests Range of Motion Stress TestsNeurologicalCirculatoryFunctional
8Special Tests Range of Motion Active Passive Resistive Assess in proper sequence-Active-Passive-ResistiveCompare bilaterallyActiveMovement is performed solely by athletePassiveMovement is performed completely by the examinerResistiveAthlete is asked to perform movement while the examiner provides resistanceNote any restriction or limitationUsed to determine status of muscle/muscle groupFindings:Weak and PainlessPossible 3rd degree strainWeak and PainfulPossible fracture at joint siteStrong and PainfulPossible tear of muscle/tendonStrong and Pain freeNo muscle injury
9Special Tests Stress Tests Neurological Exam Designed for almost every body regionUsed to determine:Ligament stabilityMuscle imbalanceMuscle tightnessJoint functionIntegrity of structuresNeurological ExamDetermine sensory functionRun fingers over area of skin on affected and unaffected areaApply sharp and dull points to affected and unaffected areaDoes it feel the same on both sides?
10Special Tests Circulatory Functional Tests Check pulse distal to injuryWhen appropriate take pulse, blood pressure and nail bed perfusionFunctional TestsDetermine if athlete can return to sport participationDone only if no findings were found during special testsEvaluate motor control and proprioceptionWalk, jog, run in straight line, figure 8 and zig-zagSquatThrowStand on one leg
11Make a DecisionAfter completing a HIPS evaluation, a decision of action can be made dependant on:Extent of injuryType of care neededPlan of actionReturn to play, re-valuate for follow-through treatmentCan not return to play, ice and re-evaluateCall 911Physical referral