New Haven Athletics &
Sports Medicine, LLC
A Group Dedicated to the Health
and Wellness of Student Athletes
Presented By:
Dr. Bryan W. Barry
Director of Sports Medicine
Michele T. Cormier
Director of Athletic Training
Table of Contents





Head Injuries
Neck Injuries
Common Orthopedic Sports
Injuries: Shoulder, Knee and Ankle
Hydration for the Athlete
Orthopedic taping
Head Trauma:
Concussion




What is a concussion?
A concussion is an injury to the head caused by a
direct or indirect blow to the head.
It is defined as a complex pathophysiological
process affecting the brain, induced by traumatic
biomechanical forces.
Concussion is an injury to the brain caused by
impact against the skull. It can often involve a loss
of consciousness but does not in all cases.
Concussion can be mild, moderate or severe.
Introduction


On-Field Evaluation of Head Injury
Common signs of mild-to-moderate head
injury are confusion, disorientation,
headache, dizziness, nausea and vomiting.
Following a head injury during a game, a
coach or trainer can make an on-field headto-toe assessment:
On-Field Assessment







Orientation: ask the child who he is, where he is, how old
he is, etc.
Memory: have athlete recall the names of three objects; do
this right after the injury and then five minutes later
Concentration: have athlete count backwards from 100 by
3s or 7s, or repeat a series of three numbers (3, 1, 5, for
example), months of the year, colors of fruits, etc.
Speech: check for slurred speech; it is often helpful to have a
parent or someone familiar with the child s usual speech to
help assess the normalcy of speech after a head injury
Neurologic: perform a fast check of pupil reaction,
coordination and sensory (bring finger to nose with eyes open
and closed)
Exertion or motor function: have the athlete
run back and forth 30-40 yards, and do up to five push-ups
and sit-ups
Medical Clearance
If the athlete demonstrates any symptoms of
head injury or if mental status cannot be
cleared, he or she definitely should not be
allowed to go back into the game and
should be further observed for progression
or resolution of symptoms.
The Bottom line: If you’re not sure- remove
athlete from play! Follow-up with physician
Symptoms of a
Mild Concussion



A mild concussion may involve no loss
of consciousness (being "dazed") after
athlete
Symptoms should clear within 5
minutes, including headache
May return to play if cleared by
physician or trainer
Symptoms of a
Moderate Concussion








What are the symptoms of a moderate
concussion?
Mental confusion.
Post traumatic memory loss.
Moderate tinitus (ringing in the ears).
Moderate dizziness or headache.
Moderate balance disturbance.
Possible nausea and vomiting.
Loss of consciousness.
Symptoms of a Severe
Concussion






What are the symptoms of a severe
concussion?
Mental confusion lasting 5 minutes or more.
Severe tinitus, dizziness or headache.
Prolonged retrograde amnesia (memory loss
of events before the accident).
Loss of consciousness longer than 5
minutes.
Possible increase in blood pressure with
decrease in heart rate.
What should be done?

The athlete should be removed from the competition immediately.

Notify parents immediately

The athlete should not be left alone.

Professional medical advice and evaluation should be done that day.

Avoid contact or collision sports for at least 1 week without symptoms.

Rest is the best recovery technique. Healing takes time. For headaches,
acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) can be
used as well as ice.

Avoid aspirin and alcohol as they can increase the risk of bleeding.

Repeated concussions may indicate retirement from contact sports altogether.
INITIAL ON-FIELD
EVALUATION for Cervical
Trauma





During on-field evaluation, the golden rule is to assume that a cervical spinal cord injury
has occurred until proved otherwise.
Immediately Call the Doctor, Athletic Trainer,
or Ambulance onto the field
The first step is to immobilize the player's head and neck by holding them in a neutral
position. Keep helmut on!
Check for the ABCs--Airway, Breathing, Circulation, and Consciousness.

If the athlete is breathing and has a pulse, maintain his or her current position until
transportation is available or until the athlete regains consciousness.

(4) Simply remove the mouth guard, if present, and maintain an unobstructed airway.
Shoulder Injuries


Sprain vs Strain
Separation vs Dislocation / Subluxation
Strain-Rotator Cuff Injury
Supraspinatus
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Infraspinatus
Subscapularis
Sprain-Acromioclavicular

Grade 1 A/C Sprain
Grade 2 A/C Sprain
Grade 3 A/C Separation
Shoulder Instability /
Subluxation





What is shoulder instability?
Multiple structures involved
Glenoid Labrum
Shoulder Capsule
Rotator cuff involvement
Shoulder Dislocation
What are the symptoms of a dislocated
shoulder?
Acute, caused by direct or indirect trauma
Sudden onset of severe pain, and often a feeling of
the shoulder 'popping out'.
The shoulder will often look obviously different to the
other side
If there is any nerve damage there may also be pins
and needles or numbness through the arm to the
hand
There is usually quite severe pain associated with a
dislocation.
What should the athlete do
about their dislocated shoulder?


Call 911
Stabilize to prevent further
complications which may arise due to
nerve and/or blood vessel entrapment
The dislocated shoulder should be
relocated as soon as possible by an
orthopedic physician
Brachial Plexus Injury
“Stinger” or “Burners”
Numbness and weakness in the
shoulder or arm.
Symptoms usually come on
immediately but only last a few
minutes depending on severity.
Treatment may involve improving
the strength and flexibility of the
neck
Knee injuries
Knee Anatomy: MCL, LCL , ACL, PCL
Medial Meniscus
Lateral Meniscus
Ankle Sprains
Treatment
ACUTE INJURY ADVICE
For immediate self care of simple sprains and strains, what appears
to be the most simple intervention is often the most effective:
P ROTECTION of the injured area from further injury
R EST - avoid any activities that cause pain, swelling or discomfort.
I CE for 15 minutes every 2-3 hours for the first 48 hours.
C OMPRESSION using an elastic bandage - take off if increased
pain, numbness or swelling below the bandage
E LEVATION above the level of your heart to reduce swelling
Hydration
But Seriously,
it’s important!
Water is the most essential ingredient to a
healthy life and optimal sports performance.
Important in all physiological functions
It’s not just about thirst.
If the athlete is thirsty, it’s too lateDehydration has already taken place
Symptoms of Dehydration
when the total fluid loss reaches 5%










Fatigue
Muscle cramps
Headaches
Nausea
Loss of concentration
Increased heart rate
Increased respiration
Decreased sweating
Decreased urination
Increased body temperature
Guidelines to Proper
Hydration Levels

Guidelines for proper hydration
Most athletes can use the following guidelines to replace fluid losses
and modify accordingly, if needed.
Hydration before exercise
•
•
Drink 15-20 fl oz 2-3 hours before exercise
Drink 8-10 fl oz 10-15 minutes before exercise
Hydration during exercise
• Drink 8 fl oz of sports drink (1:3 ratio of sports drink to water)
every 15 -20 minutes of exercise
Rehydration after exercise- Fluid replacement
• Drink 20 fl oz of water for every 1 lb lost (weigh yourself before
and after exercise to determine the number of pounds lost)
Thank you!