HMS, TIP 2023 HSC 30a

Refer to the following scenario to answer BOTH Questions 30 (a) (i) and (ii).

An athlete tries to change direction quickly to evade an opponent during a basketball game. They hear a loud snap and feel their knee give way beneath them, sustaining knee ligament damage.

Outline TWO classifications of this injury. (3 marks)

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Explain the process for determining the nature and extent of this injury. (5 marks)

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Sample answer

i. Injury classifications

An indirect injury as it resulted from internal forces when the athlete tried to change direction, rather than from direct external impact.
A soft tissue injury since ligaments are connective tissue rather than bone, with damage occurring to the structural components that stabilize the knee joint.

ii. Assessment of nature and extent of the injury – TOTAPS

The TOTAPS assessment begins by talking with the athlete about injury mechanism and symptoms. This communication reveals critical information about the snap sound and knee instability because these details indicate potential ligament rupture severity. Questioning establishes pain location and movement limitations which helps identify specific structures involved.
Observation follows because visual indicators reveal injury extent through swelling, bruising, or deformity patterns. These signs demonstrate ligament damage severity and guide subsequent assessment steps. Touch assessment then occurs to pinpoint specific pain sites along knee ligament pathways. This palpation process identifies which structures like ACL or MCL are damaged because tenderness patterns correspond to anatomical locations.
Active movement testing enables the athlete to attempt limited knee flexion and extension. Range restrictions occur due to ligament injury and muscle guarding which indicates functional limitations. Passive movement assessment involves careful knee manipulation including anterior drawer tests. These specialised tests determine ligament stability because abnormal movement patterns reveal structural compromise. Skills testing becomes contraindicated because obvious instability creates risk for further damage to compromised ligaments.

Show Worked Solution

Sample answer

i. Injury classifications

An indirect injury as it resulted from internal forces when the athlete tried to change direction, rather than from direct external impact.
A soft tissue injury since ligaments are connective tissue rather than bone, with damage occurring to the structural components that stabilize the knee joint.

ii. Assessment of nature and extent of the injury – TOTAPS

The TOTAPS assessment begins by talking with the athlete about injury mechanism and symptoms. This communication reveals critical information about the snap sound and knee instability because these details indicate potential ligament rupture severity. Questioning establishes pain location and movement limitations which helps identify specific structures involved.
Observation follows because visual indicators reveal injury extent through swelling, bruising, or deformity patterns. These signs demonstrate ligament damage severity and guide subsequent assessment steps. Touch assessment then occurs to pinpoint specific pain sites along knee ligament pathways. This palpation process identifies which structures like ACL or MCL are damaged because tenderness patterns correspond to anatomical locations.
Active movement testing enables the athlete to attempt limited knee flexion and extension. Range restrictions occur due to ligament injury and muscle guarding which indicates functional limitations. Passive movement assessment involves careful knee manipulation including anterior drawer tests. These specialised tests determine ligament stability because abnormal movement patterns reveal structural compromise. Skills testing becomes contraindicated because obvious instability creates risk for further damage to compromised ligaments.

♦ (ii) Mean mark 51%.