Study Notes

Assessment of Injuries

– TOTAPS (Talk, Observe, Touch, Active movement, Passive Movement, Skills Test)

TOTAPS is used 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.The athlete needs to complete all assessment procedures to determine if they can return to the playing field.

If the athlete is unable to complete any of the requirements from TOTAPS, then the athlete should be not be allowed to return to play. 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.

T – Talk: You need to talk to the athlete to ask a range of questions to generate an understanding of what happened. Questions can include – Where is the pain? Did you hear anything? What happened to cause it? Is this the first time this has happened?

These questions are designed to do a quick assessment of what actually happened.

O – Observe: As part of your assessment, you need to view the injured site to look for signs of swelling and deformity. You should also look to compare the injured site to the other side of the body. (E.g., compare one ankle to the other for reports of an ankle injury).

If any signs of deformity or swelling are evident then you can assume that either soft or hard tissue injury has occurred which means you need to seek further assessment and treatment from a professional.

T – Touch: The next step is to gently feel around the injured site, feeling and looking for signs of discomfort and or deformity and swelling. Start away from the injured site and slowly make your way towards where the injury has been reported.

A – Active Movement: This step is to determine to mobility of the joint. The athlete needs to be asked to move the injured site by performing actions such as flexion, extension and rotation. 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 skip to the last step. If you as the assessor feel that the athlete does not have a full range of movement, progress onto the next stage.

P – Passive Movement: If there is not a full range of movement 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 needs to be watched for signs of discomfort.

S – Skills Test: This is the final stage where the athlete needs to complete sport specific movements that are required during the game. You would typically ask the athlete to walk, jog, side step, change direction, jump etc. If the athlete can complete these and the assessor is satisfied, then they are able to return to play. Again, you are looking for signs of discomfort, or the athlete possibly favouring one side. At this stage, strapping may be used to reinforce the injured site.

Full Written Notes

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.