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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 2019 HSC 30a

An athlete dives towards the ground in an attempt to score a try in a game of touch football. The athlete hears a loud crack and remains on the ground, clutching the injured shoulder.

  1. Explain the assessment procedures that should be used to determine the nature and extent of this injury.   (4 marks)

  2. Describe the management of fractures and dislocations.   (4 marks)

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i.    TOTAPS assessment

  • TOTAPS assessment provides systematic evaluation of the shoulder injury. Talk involves questioning the athlete about pain location, intensity, and mechanism of injury. This determines initial severity and helps identify potential fracture or dislocation.
  • Observe compares the injured shoulder to the uninjured side for deformity, swelling, or abnormal positioning. This reveals obvious structural damage or displacement indicating serious injury requiring immediate medical attention.
  • Touch assesses tenderness, heat, and structural abnormalities through gentle palpation. This identifies specific injury location and severity. However, if significant deformity or severe pain exists, assessment should stop immediately.
  • Active and passive movement testing would not proceed due to suspected hard tissue injury. This occurs because movement attempts could worsen fracture displacement or joint damage, requiring immediate medical intervention instead.

ii.   Management of fractures and dislocations

  • Fractures require immediate immobilisation to prevent further tissue damage and reduce pain.
  • Support the injured area using splints, slings or bandages without attempting realignment.
  • Monitor for shock symptoms including pale skin, rapid pulse and decreased consciousness.
  • Transport to medical facilities immediately for professional treatment including X-rays and surgical intervention if required.
  • Dislocations involve joint displacement requiring professional medical reduction.
  • Never attempt to relocate the joint as this may cause additional nerve or blood vessel damage.
  • Immobilise the joint in the position found using appropriate supports.
  • Apply ice to reduce swelling and pain while monitoring circulation below the injury site.
  • Arrange immediate medical evacuation for proper diagnosis and professional joint reduction procedures.

Show Worked Solution

i.    TOTAPS assessment

  • TOTAPS assessment provides systematic evaluation of the shoulder injury. Talk involves questioning the athlete about pain location, intensity, and mechanism of injury. This determines initial severity and helps identify potential fracture or dislocation.
  • Observe compares the injured shoulder to the uninjured side for deformity, swelling, or abnormal positioning. This reveals obvious structural damage or displacement indicating serious injury requiring immediate medical attention.
  • Touch assesses tenderness, heat, and structural abnormalities through gentle palpation. This identifies specific injury location and severity. However, if significant deformity or severe pain exists, assessment should stop immediately.
  • Active and passive movement testing would not proceed due to suspected hard tissue injury. This occurs because movement attempts could worsen fracture displacement or joint damage, requiring immediate medical intervention instead.

ii.   Management of fractures and dislocations

  • Fractures require immediate immobilisation to prevent further tissue damage and reduce pain.
  • Support the injured area using splints, slings or bandages without attempting realignment.
  • Monitor for shock symptoms including pale skin, rapid pulse and decreased consciousness.
  • Transport to medical facilities immediately for professional treatment including X-rays and surgical intervention if required.
  • Dislocations involve joint displacement requiring professional medical reduction.
  • Never attempt to relocate the joint as this may cause additional nerve or blood vessel damage.
  • Immobilise the joint in the position found using appropriate supports.
  • Apply ice to reduce swelling and pain while monitoring circulation below the injury site.
  • Arrange immediate medical evacuation for proper diagnosis and professional joint reduction procedures.

♦♦♦ Mean mark (ii) 48%.

HMS, TIP 2020 HSC 30ai

Outline how the indicators of readiness to return to play are used following an ankle injury.   (3 marks)

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  • Return-to-play indicators ensure safe progression following ankle injury rehabilitation.
  • Athletes must demonstrate pain-free movement during sport-specific activities like running, jumping and directional changes.
  • Range of motion must equal or exceed pre-injury levels, assessed through ankle flexibility tests.
  • Functional strength testing compares injured ankle performance to the uninjured side.
  • Athletes complete balance and proprioception assessments to ensure joint stability during dynamic movements.
  • Medical clearance confirms tissue healing and structural integrity.
  • These indicators prevent re-injury and ensure athletes can perform at competitive levels without compromising long-term ankle health.
Show Worked Solution
  • Return-to-play indicators ensure safe progression following ankle injury rehabilitation.
  • Athletes must demonstrate pain-free movement during sport-specific activities like running, jumping and directional changes.
  • Range of motion must equal or exceed pre-injury levels, assessed through ankle flexibility tests.
  • Functional strength testing compares injured ankle performance to the uninjured side.
  • Athletes complete balance and proprioception assessments to ensure joint stability during dynamic movements.
  • Medical clearance confirms tissue healing and structural integrity.
  • These indicators prevent re-injury and ensure athletes can perform at competitive levels without compromising long-term ankle health.