HOPSHOPS

HOPSHOPS

Systematic and standardized procedure Systematic and standardized procedure used to evaluate injuries.used to evaluate injuries.

Why?Why?– Reduces risk of “missing something”Reduces risk of “missing something”– Allows easy communication of findings to all Allows easy communication of findings to all

medical personnelmedical personnel

HOPSHOPS

HHistoryistory

OObservationbservation

PPalpationalpation

SSpecial Testspecial Tests

Sometime it is referred to as HIPS (history, Sometime it is referred to as HIPS (history, inspection, palpation and special tests)inspection, palpation and special tests)

HISTORYHISTORY

First stepFirst stepDone before you ever touch the athleteDone before you ever touch the athleteUse information gained during this phase to guide the Use information gained during this phase to guide the rest of the evaluationrest of the evaluationQuestions should answer the following:Questions should answer the following:– How did injury occurHow did injury occur– When did injury occurWhen did injury occur– Did you hear anything: pops, grating, etc.Did you hear anything: pops, grating, etc.– Did you feel anything: give out, pop out, burning, numbness, etc.Did you feel anything: give out, pop out, burning, numbness, etc.– What have you done for it: ice, heat, NSAIDsWhat have you done for it: ice, heat, NSAIDs– Type and location of painType and location of pain

INSPECTIONINSPECTION

Second part of the evaluationSecond part of the evaluationYou still have not touched the athleteYou still have not touched the athlete– Why do you think that the athletic trainer still has not Why do you think that the athletic trainer still has not

touched the injured athlete? touched the injured athlete?

This phase can be done as soon as you see the This phase can be done as soon as you see the athlete walk in the door, or as you walk onto the athlete walk in the door, or as you walk onto the field, and can be partially done while taking the field, and can be partially done while taking the history.history.Compare everything bilaterallyCompare everything bilaterally– Why?Why?

INSPECTIONINSPECTIONDuring the inspection you are LOOKING During the inspection you are LOOKING for clues that tell you about the injuryfor clues that tell you about the injury– Swelling (type, location, amount)Swelling (type, location, amount)– DiscolorationDiscoloration– DeformitiesDeformities– Gait/weight-bearingGait/weight-bearing– PosturePosture– Scars from previous injuriesScars from previous injuries– BleedingBleeding

What should you do if you see bleeding?What should you do if you see bleeding?

PalpationPalpation

This is the first time you actually touch the This is the first time you actually touch the athleteathleteYou use the information you gained during the You use the information you gained during the history and inspection to guide youhistory and inspection to guide youNow you are FEELING for clues about the injuryNow you are FEELING for clues about the injuryYou always palpate the uninjured side firstYou always palpate the uninjured side first– Why?Why?

Then you palpate the injured side starting away Then you palpate the injured side starting away from the area of most pain.from the area of most pain.– Why?Why?

PalpationPalpation

Remember to observe universal precautions if Remember to observe universal precautions if your inspection revealed blood or body fluidsyour inspection revealed blood or body fluids

Things you are looking for during palpationThings you are looking for during palpation– Temperature changes: hot or coldTemperature changes: hot or cold– DeformitiesDeformities– Point tendernessPoint tenderness– CrepiticeCrepitice– Swelling (wet diaper vs. water balloon)Swelling (wet diaper vs. water balloon)– Rule out fracturesRule out fractures

SPECIAL TESTSSPECIAL TESTS

The tests used in this section will be The tests used in this section will be different for each body part that we coverdifferent for each body part that we cover

Remember to perform each test bilaterallyRemember to perform each test bilaterally

In general the tests are used to determineIn general the tests are used to determine– Joint range of motionJoint range of motion– Muscle strength and functionMuscle strength and function– Ligament stabilityLigament stability– Nervous function/integrityNervous function/integrity

ROM & Muscle TestingROM & Muscle Testing

Used to determine if the range of motion of a Used to determine if the range of motion of a joint is within normal limitsjoint is within normal limits

Always test bilaterallyAlways test bilaterally

Three ways to test range of motion– test them in Three ways to test range of motion– test them in this orderthis order– Active—the athlete move the joint themselvesActive—the athlete move the joint themselves– Passive– the athlete is relaxed and you move the joint Passive– the athlete is relaxed and you move the joint

through the ROMthrough the ROM– Resistive-- you apply resistance while the athlete Resistive-- you apply resistance while the athlete

moves the jointmoves the joint

Ligamentous TestsLigamentous Tests

Tests used to determine the integrity of Tests used to determine the integrity of specific ligamentsspecific ligaments

We will learn specific tests during future We will learn specific tests during future unitsunits

Results of these tests, along with the Results of these tests, along with the history, inspection and palpation will allow history, inspection and palpation will allow you to “grade” sprainsyou to “grade” sprains

Grades of SprainsGrades of Sprains

Grade IGrade I– Ligament testing reveals solid endpoint (rope)Ligament testing reveals solid endpoint (rope)

Grade IIGrade II– Ligament testing reveals soft endpoint Ligament testing reveals soft endpoint

(bungee)(bungee)

Grade IIIGrade III– Ligament testing reveals no endpoint Ligament testing reveals no endpoint

(nothing)(nothing)

Neurologic TestingNeurologic Testing

Dermatomes: an area of skin mainly Dermatomes: an area of skin mainly supplied by a single spinal nervesupplied by a single spinal nerve

Myotomes: a group of muscle mainly Myotomes: a group of muscle mainly supplied by a single spinal nervesupplied by a single spinal nerve

ReflexesReflexes

Peripheral nerve testingPeripheral nerve testing

DocumentationDocumentation

Document, document, document!Document, document, document!

Remember that one of the most important Remember that one of the most important things an athletic trainer can do is to have things an athletic trainer can do is to have accurate documentation of everything they accurate documentation of everything they do to and for an athletedo to and for an athlete

Be sure when performing a HOPS Be sure when performing a HOPS evaluation that you document evaluation that you document EVERYTHING!EVERYTHING!

DOCUMENTATIONDOCUMENTATION

What were their answers to any questions that you What were their answers to any questions that you asked themasked themWhat did you find during the observation and palpationWhat did you find during the observation and palpationWhat tests were performed and what was the resultWhat tests were performed and what was the resultWhat do you suspect may be wrongWhat do you suspect may be wrong– REMEMBER ATHLETIC TRAINERS CAN ONLY EVALUATE, REMEMBER ATHLETIC TRAINERS CAN ONLY EVALUATE,

THEY NEVER DIAGNOSE!THEY NEVER DIAGNOSE!

What is your planWhat is your plan– Do you recommend they see a doctorDo you recommend they see a doctor– Are you calling 911Are you calling 911– Are you sending them to the ERAre you sending them to the ER– Are you continuing treatment in the training roomAre you continuing treatment in the training room– What specific directions did you give themWhat specific directions did you give them

CommunicationCommunication

Remember to respect the athlete’s privacy Remember to respect the athlete’s privacy and HIPAA and HIPAA – Only communicate with people directly Only communicate with people directly

involved with the athlete– parents, coach, involved with the athlete– parents, coach, team doctor, etc.team doctor, etc.

– Do not give specific information to the mediaDo not give specific information to the media– Store your evaluation in a secure place – Store your evaluation in a secure place –

athlete’s secured file, secured computerathlete’s secured file, secured computer