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HMS,TIP 2018 HSC 30a

An athlete running a 400-metre race experiences a hamstring strain in the sprint towards the finish line.

Explain the classification and management of the athlete’s injury.   (8 marks)

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  • The hamstring strain is classified as an indirect, soft tissue, acute injury because the damage occurs from internal forces within the athlete’s body. This occurs because the hamstring muscle experiences excessive tension during the high-intensity sprint phase. The reason for this is the muscle cannot cope with the explosive demands, resulting in muscle fibres tearing. This demonstrates an indirect injury pattern where no external contact causes the damage.
  • Immediate management follows the RICER protocol because this approach minimises secondary tissue damage and inflammation. For example, rest involves immediately stopping activity to prevent further muscle tearing. Ice application for 15-20 minutes every hour helps to reduce pain, swelling and metabolic demands of damaged tissues. This leads to vasoconstriction that limits bleeding within the muscle. Compression using elastic bandaging creates external pressure that supports damaged tissues and reduces swelling. Consequently, elevation of the injured leg above heart level facilitates venous return and reduces fluid accumulation.
  • Referral to medical professionals is essential because accurate diagnosis determines appropriate treatment progression. This process ensures that the severity of the strain is properly assessed using clinical tests or imaging. For instance, a physiotherapist can determine if the injury is Grade 1 (mild), Grade 2 (moderate) or Grade 3 (severe) which then guides rehabilitation timeframes and return-to-play decisions. Therefore, proper medical assessment prevents complications and ensures safe recovery.

Show Worked Solution

  • The hamstring strain is classified as an indirect, soft tissue, acute injury because the damage occurs from internal forces within the athlete’s body. This occurs because the hamstring muscle experiences excessive tension during the high-intensity sprint phase. The reason for this is the muscle cannot cope with the explosive demands, resulting in muscle fibres tearing. This demonstrates an indirect injury pattern where no external contact causes the damage.
  • Immediate management follows the RICER protocol because this approach minimises secondary tissue damage and inflammation. For example, rest involves immediately stopping activity to prevent further muscle tearing. Ice application for 15-20 minutes every hour helps to reduce pain, swelling and metabolic demands of damaged tissues. This leads to vasoconstriction that limits bleeding within the muscle. Compression using elastic bandaging creates external pressure that supports damaged tissues and reduces swelling. Consequently, elevation of the injured leg above heart level facilitates venous return and reduces fluid accumulation.
  • Referral to medical professionals is essential because accurate diagnosis determines appropriate treatment progression. This process ensures that the severity of the strain is properly assessed using clinical tests or imaging. For instance, a physiotherapist can determine if the injury is Grade 1 (mild), Grade 2 (moderate) or Grade 3 (severe) which then guides rehabilitation timeframes and return-to-play decisions. Therefore, proper medical assessment prevents complications and ensures safe recovery.

♦♦ Mean mark 55%.

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.

  1. Outline TWO classifications of this injury.   (3 marks)

  2. 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%.