Critical question 1: How are sports injuries classified and managed?
Assessment of Injuries
The TOTAPS method (Talk, Observe, Touch, Active movement, Passive Movement, Skills Test) is an effective way to assess the nature and extent of an injury to a player and make a decision as to whether or not the athlete who is injured can resume playing.
Talk: The athlete should be asked a range of questions to establish what happened and how they were feeling. Potential questions include: Where is the pain? Did you hear anything? What happened to cause it? Is this the first time this has happened?
Observe: The injured site must be carefully inspected identify any signs of swelling and deformity. It can help to compare the injured site to the other side of the body. (E.g., compare one ankle to the other, to assess an ankle injury). Signs of deformity or swelling are an indication of either soft or hard tissue damage, which means further assessment and treatment from a professional is required.
Touch: If observation fails to yield results the next step involves feeling around the injured site to identify any deformity or swelling. Gentle pressure should be applied from the outside of the injury before slowly working in.
Active Movement: The athlete will need to test movement around the injured site by performing actions such as flexion, extension and rotation to determine whether the mobility of the joint has been affected. If there is no pain whilst the athlete is performing the movement by themselves then they need to complete an isometric contraction before the athlete can move ahead to the last step. If the assessor feels that the athlete does not have a full range of movement, they should progress to the next stage.
Passive Movement: If full range of movement is not evident, the assessor or sports trainer needs to physically mobilise the joint to test the range of motion and identify any instability and painful areas. The athlete must be watched to see if they exhibit signs of discomfort.
Skills Test: The final stage requires the athlete to complete sport specific movements that mimic those which are performed during the game. For example, walking, jogging, side stepping, changing direction and jumping. If the athlete can complete these and the assessor is satisfied, then they can return to play. During this test the assessor must watch the athlete for any signs of discomfort or favour towards one side. At this stage, strapping may be used to reinforce the injured site.
The athlete must complete and pass all assessment procedures in order to be considered fit enough to return to the playing field.
If the athlete is unable to complete any of the requirements from TOTAPS, then they should be referred to a medical professional for further treatment. The assessment of the injury can be stopped at any time if it is evident that the athlete is feeling pain and cannot return to the field.