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EPHE 344 LOG BOOKVELOX VALHALLIAN RUGBY FOOTBALL CLUB DIVISION 3Simone BeattieV00713699EPHE 344 Training Log Simone BeattieBrad CurryValhallian Velox Rugby Club V00713699TOTAL HOURS: 51.5Date: January 12th Training session6 - 8pmThis was our first practice where we met our senior trainers and met everyone from or class who was working with Velox for the semester. We learned the basics of what the teams were like; the divisions, practice times and the proposed game schedule. We were taught how to tape an ankle in a few slight variations, how to effectively rip tape and had some time to practice this on each other. Personal reflection: I am excited to be working with the third division men’s team this semester on Sunday games; I am learning that they are a very broad group of players ranging teenagers to mid-aged people and coming from a number of different backgrounds. Since the third division is not a high level of competition, everyone is there to have fun and just try their best. Since thirds do not practice often in the weeks, I will be assisting the 1st and 2nd division men’s teams and 1st and 2nd women’s teams on Tuesdays where ever I am needed. I think that I did well in taping the ankle and remembering all of the steps and turns in the heel locks, but I would like to become neater at my heel locks.Date: January 17th Training session6 - 8pm Today we worked with the senior trainers again, learning the basics before we begin working with the team. We went over concussions; how to deal with them in an emergency situation and how to assess an athlete using a SCAT card. We practiced a few scenarios of a c-spine emergency situation; how to stabilize the person and log roll them if necessary. We learned the taping methods for the wrist and thumb and practiced taping each other for the rest of the time.Personal refection: The senior trainers are very good at teaching us and are helpful in guiding us in the scenarios. I am glad to be learning these very important emergency protocols, but I want to practice them a bit more so I will be confident if I ever need to use them. I caught on quickly to taping the wrist neatly and correctly, but I would like to get better at taping the thumb neatly; especially the breast cancer strips. Date: January 19thTraining session6 - 8pmToday we worked with the senior trainers again learning the basics of handling blood injuries and the rules of blood subbing in a game. We were taught the basics of massage, the three main components of it: effleurage, tapotement and petrissage, and the differences between a pre-game and post-game massage. We were taught the taping methods for an Achilles tendon strain and for plantar fasciitis and had time to practice on each other.Personal reflection: I feel that I learned a lot from today and feel more comfortable knowing the proper methods of dealing with blood to avoid contamination as well as protect myself. Massage has always been a great interest of mine so I was glad to be learning some specific techniques to use. I had heard of plantar fasciitis before, but never knew quite what it was until today. I think since athletes are constantly changing their workouts, wearing out their shoes and getting new ones, they are highly susceptible to getting this injury. I feel that I am good at taping for plantar fasciitis and now that I understand the main causes and treatments for it, I think I will be able to help anyone who has this issue. I would like to get some practice with the massage techniques to be sure I am doing them correctly.Date: January 24thPractice6 - 9pmPlayer: Q.T.P: This player has on-going symptoms of muscle spasming in the upper right hamstring region, perhaps due to over stretching or twisting when playing.Q: achy muscle painR: does not radiateS: 3T: flexion at the hip; stretching the hamstringP: Gave a pre-game massage of the right hamstring for 5 minutes to release any tightness in the muscle and reduce pain and spasming; this included effleurage to warm up and tapotement methods to stimulate the muscle. This is a preventative measure to ensure the muscle is warmed up well and will not re-injure or increase the injury.For exercises to begin strengthening the muscles, the player spoke with the head trainers.Player: S.C.S: Player has tight hamstrings post-practice and benefits from PNF stretching.5 cycles of 30 seconds passive stretching and 30 seconds of agonist muscle contraction, they reported, helped loosen up the muscles and reduce tightness later on.Prevention techniques: The field was inspected prior to practice and portions of the field were “out of bounds” for the night, due to pooling water. The conditions were very cold outside; therefore, practice was kept short to prevent players from experiencing hypothermia. Every Tuesday, the trainers bleach the water bottles to ensure that are clean and well kept for the athletes.Personal reflection: Before practice, a speaker from Popeye’s Supplement (Victoria) came to speak to us about proper nutrition and use of supplements. I learned a lot about the types of products the athletes at Velox are presently using and how they are using them to meet their goals of weight gain, weight loss, increased energy and better health. I feel this is an important thing to know about the athletes and proper guidance should be provided in achieving these goals to prevent unhealthy or mislead remedies.For pre and post game care of the athletes, I felt it went well for the first official night our hands on experience. I felt confident in helping the athletes with massage and stretching as I am familiar with this from sports I have done and having been to a massage therapist. I would like to become more experienced in these areas, learn about exercises that I can give to players after they have injured a muscle or joint and I am looking forward to using my new taping skills next week.Date: January 31st Practice6 - 9pmPlayer: J.R.S: Player reported that he feels pain when he moves his wrist to one side… [ulnar deviation]History: He hurt his wrist when using a hand drill the week before; the drill handle spun around and wrenched the wrist in a twisting motion. He has no previous injury to the area.Pain location: On the medial side of the wrist; superficiallyQuality: localized discomfortRadiation: NoneSeverity: 2 (mild)Timing: Pain when the wrist is in ulnar deviationO: No Swelling is observed at this point in time. The pain has remitted since the incident and no medications/bandaging has been used for it.ROM: Active – Ulnar deviation is painful Passive- Ulnar deviation is painful Resistant- No pain from an direction Normal bony end feel (pain at the appropriate end point). No pain was perceived in other directions of motion.A: There is a suspected inert tissue sprain of the wrist that does not seem to be intra-capsular. The wrist is vulnerable to further damage if hit incorrectly during practice or a game.P: Taping the wrist to resist ulnar deviation will help to support the area, relieving pain and helping to prevent re-injury. The player is expected to recover normally. They are to report back if pain persists the next week or worsens.Player: T.P.Wrist AssessmentS- The player tells me he has constant pain in his wrist and it is painful to rotate.History- No history of injury, just aware of the pain after practicesP- localized to the wrist jointQ- weakness and dull constant painR- does not radiateS- 2 to 4 (mild/moderate)T- any motion of the wristO- No obvious swelling or discolouration of the wrist was present. The player managed to achieve all normal range of motion with passive, active and resistant movements with relatively little pain. With some manipulation of the wrist, there seemed to be something obstructing or resisting the motion of the wrist more than normal. A- Seeing as the player was able to move the wrist in all normal ranges of motion and he did not have an acute injury to the wrist that could be the cause of the pain, it is not likely a fracture or strain/sprain. This may be a micro-trauma of overuse in the wrist that can create this inflammation and discomfort. It is also possible that the bursae in the wrist are irritated causing pain or a cyst may be developing in the wrist causing the slight resistance in the wrist. P- The player was informed of these possibilities and told to keep an eye on it; if the pain worsens, persists or any other symptoms arise (e.g. swelling) he should report back or see a doctor.The player should avoid overusing the wrists such as in manipulating heavy objects, by twisting the wrist or typing on a keyboard for long periods of time. The symptoms should decrease and if a cyst develops it likely will recover without treatment, but it is a good idea to get it checked by a doctor.Preventative techniques: The fields were inspected prior to practice and half of the field was closed for the night due to more puddles.Personal Reflection: Today I learned how to tape a wrist to prevent ulnar deviation, as opposed to the standard extension/flexion prevention. The wrist assessment brought in a lot of the new knowledge that I am learning in class. I would like to become more confident in my assessments by learning more about the symptoms of an injury and becoming more familiar with other areas of common injury, including knees, ankles and wrists.February 5thAway game in Cowichan Bay9:45am - 2:45pmPlayer: J.M.S: The player says he does not have pain right now, but would like his knees taped for preventative measures. He has chronic knee pain from playing rugby.O: He has been assessed before by the senior trainers and the taping seems to help with support and reduce pain post-game. Active, passive and resisted ROMs were tested and the knees ROM is not compromised by the weakness or pain. No obstruction or critical injury has been found.A: The player’s knees weakness/pain may be from micro-trauma in rugby alone or be due to other life stresses depending on his job and extra activities. P: The player should continue to be taped prior to games to support the weak joints. The areas should get iced after practice if the knees are painful to decrease inflammation and pain. Strengthening exercises that load the joints with an appropriate weight may be beneficial to the supporting muscles and bones around the joints (e.g. Squats, plyometrics). If the pain becomes worse or symptoms change, report back.Player: T.F.S: Player says he has a weak left ankle and usually has it taped before games. He has a history of ankle injuries: twisted and sprained this ankle on one or more occasion. The area does not currently hurt prior to the game.O: Going through the ROM for active, passive and resisted (dorsiflexion, plantar flexion, invertion, evertion), he does not have an abnormal end feels and does not have much pain in any direction. There is a bit of greater laxity in the lateral tendons of the injured ankle when he inverts the foot, compared to the right uninjured ankle. A: Player has a weak ankle that is susceptible to re-injury from playing. He has been assessed before by the senior trainers, who suggest taping it.P: Player is taped prior to the game in neutral position and a slight pull to prevent inversion due to the greater range of motion in inversion. Applying ice after games and at anytime can help with any pain that comes from playing.Player: S.C.S: No pain was reported.O: Player scratched his head during play and had some blood that needed cleaning up before he could continue playing.A: No pain or abnormal symptoms are seen from the player and no heavy impact was seen or reported by the player; the injury is likely a simple cut.P: Non-sterile gauze is used to clean up the visible blood/ dirt and stop the area from bleeding. Skin lube is applied to prevent bleeding from persisting. Player should be reassessed after the game and area well cleaned to prevent staph. infections.Player: A.MMid-play injury: Opposing team wrenched the player's right pinky finger during a scrum. The game was called just after half time, due to dirty play and Cowichan was forced to forfeit.S: Player reported not being able to move his finger and felt that he had broken it. History: the player has dislocated and fractured the same finger previously and the feeling of pain is similar.P: Localized pain to the pinky mid regionQ: sharp, aching painR: the pain does not radiate much from the pinkyS: 6 pain, bearable, but very uncomfortableT: Painful to move at allO: The pinky was swollen within moments of the accident. The swelling was localized to the 1st metacarpal region which reduces the likeliness that the injury is a dislocation. Obvious deformity of the finger is seen and so no movement assessment is done.A: Based on the player's symptoms, the injury is likely a fractured metacarpal bone. No other injury is immediately apparent.P: The player is instructed to stabilize the finger (not move or reset) and gently rest it on ice to reduce the swelling and help with the pain. They are told to go to the emergency room for a physician assessment. The player asked for pain medication, but we refrained, because if he were to need surgery, he would not be allowed to have medication in his system with the anesthetic. Unfortunately this will likely be his last game of the season.Preventative measures: The field was inspected prior to the game, the EAP was reviewed, emergency roles were allocated and we talked to the referee. to ensure we were properly posted. After the game, each player was checked for cuts and sores and cleaned to prevent infection.Personal Reflections: I enjoyed my first game with the thirds team this semester. I learned firsthand how the games are run, how we follow the game very closely up and down the field and when we run water bottles out after the 3 pt kick. The minor cut that one player got was well taken care of, with little time off of the field due to a quick assessment and treatment. I would like to become more confident in my treatment skills. I feel the more I become comfortable at the games, the better I will feel about running out to an injured athlete when it happens. The suspected broken finger of one of our players was also handled well considering the circumstances. It was an unfortunate early end to the game, but we gained experience with a minor emergency that will aid us in the next game.February 7thPractice6- 9:30pmPlayer: S.C S: Player says she previously rolled her ankle, twisting her foot inwards (inversion) from practiceHistory: The player has had no previous injury to her ankle, but has always had weak ankles.P: lateral side of the ankleQ: achy and sharp when rotatedR: the pain does not radiate far from the lateral ankleS: 5 (moderate)T: painful when inverted at the ankle or runningO: There is minimal swelling seen in the area.Passive ROM: painful when invertedActive ROM: painful when invertedResisted ROM: no pain when muscles contract and foot is in neutralNo pain in the other directions of motion; each end field/feel is compared to the none in injured side.A: The player seems to have damaged inert tissue in the lateral side of her ankle; a ligament, perhaps the calcaneofibular ligament or posterior talofibular ligament on the lateral side of the foot. In any case the ankle will be weak as a result of the injury and require some time to heal. P: To prevent further injury, the area will be taped to prevent inversion of the foot at the ankle. The player is told not to push through pain in the ankle during practice and to let it rest and heal as much as possible when not at practice. Icing and elevating the area will help with the pain and reduce inflammation. Put ice on the area until numb (~15mins) then remove and reapply when sensation has fully returned. As a future recommendation, the athlete should look into strengthening exercises such as using the resistance bands for the ankle once it has had time to heal a bit.Player: T.BS: Player reports jamming his wrist when going into a scrum.History: There is no history of injury to this wristP: The pain is on the posterior side (back) of the handQ: Achy and more painful when it is movedR: The pain does not radiate from the wristT: Area of wrist hurts when the hand is flexed at the wristO: There is no immediate swelling of the wrist, but it does begin to swell as time passes. A quick assessment of his ROM and palpation is done before the swelling increases too much.Active ROM: Painful when in flexion Passive ROM: Painful when extended Resisted ROM: Painful when trying to flex at the wristNo obstruction is found in the wrist and no heightened pain is felt from palpation. The wrist reaches all of its normal end ranges for all directions of movement. ROM is compared to the non- injured side.A: The player has likely damaged a tendon in the wrist and will be in pain until it heals. Since there are no other signs or symptoms suggesting a secondary injury, the player can treat the wrist solely for the tendon.P: The area needs to be iced immediately to reduce swelling and prevent poor circulation around the hand. Also the hand should be held above the heart to decrease blood pooling as well. The player should not return to play for this practice, but in a few days/week, when the swelling and pain goes down, they can be taped to prevent flexion, at practice. After practice, a few of the players had ice baths to help with painful muscles and relieve stress on the body from practice. Each player who chose to go in the ice bath was timed for 15 minutes in the tub and checked on every 5 minutes to catch any preceding signs of hypothermia.Preventative Measures: The field was inspected as usual, looking for any obstructions, holes or dips in the field. It was a cold and rainy night, so the players were told to be careful of the slippery grass and to alert the trainers if they are getting too cold.Personal Reflection: At today’s practice, I gained the experience of assessing two different joints, one already in its stage of healing and the other; an acute injury from practice. I felt that I properly handled their injuries, but would to learn a bit more about other injuries that could result from a ‘jammed’ wrist. I feel that I would have felt an abnormal bone or the player would be in pain when I palpated if there was a fracture, but I am not entirely sure. I am looking forward to the next practice, so I can become more familiar and more comfortable with each tape job and assessment I do.February 13th- Reading BreakFebruary 22nd Inclass Discussion of Risk Factors, Safety and Personal ExperiencesIn class today, we got together in groups and discussed our experiences with our teams so far. Erin - Vike's Rugby TeamRisk Factors: extrinsic - field conditions, level of competition,Safety precautions used: trainers educating athletes properly to prevent injury. intrinsic - players not getting enough restCommon injury: shin splints and ankle sprainsExperiences: Dealt with player who injured their knee during a game.What they did right: knew the proper treatment steps: assessment, rest, ice, compress and elevate.Rule for prevention: give advice to the players on how to avoid injuriesWhat to improve: She would like to get more confident at taping.Mike- Velox Rugby Club 1st DivisionRisk Factors: extrinsic- caps that they wear are for minimal protection and not protect against concussionsintrinsic- players are not keeping their fitness levels up for their sport's level of intensity. (i.e. Poor diets and drinking often, little strength training)Common Injuries: concussions and anklesExperiences: Dealt with a shoulder dislocation in a gameWhat they did right: went through their history, and did not pop it back in to be safe and sent them to the hospitalRule for prevention: Draining the fields to prevent soggy grass and related injuriesWhat to improve: He wants to become more confident in assessmentsAdrian- Saanich Peninsula Soccer Team 3rd Division Risk Factors: extrinisic: field conditions sometimes poor and incongruency for vvvvvvvvvvvvcompetition levels of opposing teams; play too experienced or ccccccccccccccinexperienced teamsintrinsic: players do not seem to care about their overall wellbeing ( i.e.play when they have injuries, eat/sleep poorly)Common injuries: ankle sprains and twistsExperiences: Dealt with a player who took a blow to their ACL in a gamewhat they did right: he iced the knee and referred them to a doctor. A different situation, a player had trouble breathing and had history of pnemonia. what they did right: he had the player relax and drink some water to deactivate the sympathetic nervous system.Rules for preventions: Always check the med forms to get a background of the athlete's injuries and health conditionsWhat to improve: he wants to remember to consider their past injuries in assessments.February 28thPractice: Assisted the women's rugby team.6- 9pmPlayer: S.CPlayer is taped again (assessment on February 7th) for inversion injury on the ankles. Pain has reduced since first assessment and taping is more of a preventative measure now. Player had a game on the weekend and was taped too tightly with ‘tough skin’ spray on. The tape was removed to re-tape the ankle, but because the tough skin was very new, the tape adhered to the skin and pulled some skin off with it! I think this is a very important issue to note as re-taping is likely a common thing, especially with new student trainers. We should be cautious with the tough skin spray and be aware that removing tape directly after can damage the skin, cause pain and make the area susceptible to infection or further injury. The area is being kept clean and watched closely to avoid any further issues.Players: R.C and S.MTwo players on the women's team are currently on a 'Return to play' program guided by one of the senior trainers, after suffering a grade 2 concussion. Both have rested for one week without activity. On Thursday they began light activity at practice, doing 20 minutes of jogging/ walking around the field. Today they progress to slightly heavier activity, doing a full 20 minute run. A and P: No symptoms are reported from the players after their run and if they continue to be asymptomatic until tomorrow they can progress to higher heart rate activities such as sprints and plyometrics ( sports specific training). If the program goes as planned the players will progress to non-contact drills during practice on Thursday (increase cognitive processing during activity) and then return to full contact and games on the following Tuesday practice.Player: L.D.S: Player says she has pain in the posterior region of her arm. She finds it painful to lift heavy objects with that one arm.History: No previous injury to the area.P: Superficial pain in the triceps region Q: Aching pain and tendernessR: The pain is localized to the back of the arm S: 3 (mild/moderate)T: Painful even without contraction or change in positionO: There is no visible swelling or bruising. The player finds it tender to palpate and there is some tightness found in the muscle from gentle palpation. With passive ROM, the player feels pain when the arm goes into flexion, and with active ROM the player feels pain when the arm goes into extension. It is painful to resist the flexion (contracting triceps muscle). Pain is dull when arm is resting passively.A: Since the player has normal range of motion and pain in opposing directions for active and passive range of motion and painful during isometric contraction, this injury is likely a pull or a strain of one of the triceps heads. The pain with no motion could be due to inflammation in the area.P: The player should ice the area after practice to reduce the pain and reduce edema in the tissue. Resting the arm will allow it to heal faster and working it back into full contraction again once the arm begins to feel better.Player: C.M.Mid-practice injury: jammed thumb during the scrum drills S: The player reports that she jammed her finger and she is not sure that she can move it. She does not think she broke it.P: In the thumb joint socketQ: spasming, sharp pain R: the pain is localizedS: 6 (moderate pain)T: the thumb is painful to move O: The player is in a lot of pain and attempts to wiggle her thumb, but cannot. Swelling begins to show in the area minutes after the incident. As the spasm wears off, she is able to move her thumb again with some dull achy pains in the joint. A: This injury is likely a common jam from direct force onto the tip of the thumb, forcing it back into the joint capsule. This causes the surrounding pollicis muscles to contract and prevent movement in the joint as a protective mechanism. P: To reduce the swelling, the player should ice the area and sit off until the swelling and pain subsides. The area will likely be tender for a few days, but should heal up fully. Icing in the next few days will help and the player should report back if any symptoms persist or worsen.Preventative Techniques: The field was checked for obstacles before practice started, ice bags were prepped for the sidelines and players were told to be careful of the wet grass. Personal Reflection: I didn’t get a lot of hands on learning for this practice due to my own injury of breaking my clavicle over reading break. I did, however, get a chance to shadow a number of assessments, such as the progress of the ‘Return to Play’ program that two girls on the women’s team were currently in. One of the girls was not happy with the fact that she wasn’t allowed to play at the next weekend game due to her concussion, but it was necessary get back to playing, slowly to avoid further injury and prevent delaying her healing time any longer. The senior trainer was very good in explaining the entire program to the two girls and why it was important that they go through each step. Proper education is a preventative measure even after an injury has occurred as some athletes do not know how bad a concussion is until it is explained. I feel that I learned a lot from that experience and I think I will be more confident in explaining the process to other athletes if the issue arises. I think the assessments of the sore arm and jammed thumb were handled well. I hope to learn more about the shoulder and arm region so that I can be more specific with my assessments in the future.March 6th Practice6- 9:30pmPlayer: R.GS: The player reported previously rolling their ankle (eversion) about 1.5 weeks ago and have had their ankle taped for stability at practices since then. History: They have a history of rolling the same ankle before within the past year.P: Pain is minimal, but feels somewhat unstable when they runQ: Dull pain and only when they are moving the ankleR: The pain does not radiateS: 6 when it happened; now a 2T: Pain is felt when the foot reaches end point of eversionO: There is no swelling in the area or abnormalities visible or felt by palpation. No pain is particular to the malleolar zone and the player is able to weight bare without much discomfort.Active ROM: 2/10 pain when evertedPassive ROM: pain when evertedResisted ROM: no painNo pain is felt in the other directions of motionA: Since the pain has diminished considerably since the injury, it is likely that the area is healing up properly. The injury was likely inert tissue on the medial side of the foot; perhaps the deltoid ligament that attaches just above the arch.P: The player should continue to watch that the pain does not persist or worsen. For taping pre-game, the ankle should be taped in neutral position as taping to only prevent eversion can predispose an inversion ankle roll. Player: Q.T S: Player experiences pain on the bottom of their foot when they first step out of bed, when they stand up from sitting for a while and the area is tender to touch. They recently just bought new cleats. They have been previously assessed by a senior trainer to have plantar fasciitis.History: They have a history of plantar fasciitis and have been treated for them before.P: area beneath the arch to the heelQ: sharp when they stand up and achy for a while then it goes awayR: the pain radiates within the regions of the bottom footS: 2-6 dependingT: Pain when in plantar flexionO: The player has no abnormalities visible or felt and can weight bear without feeling weakness or instability. So as not to rule out other possible injuries, the ankle is tested for ROM.Active ROM: No painPassive ROM: No painResisted ROM: No painThe player was also followed up on their hamstring tightness from January (24th). They still get a pre-game massage every so often, but have gotten into the habit of stretching well after a game or practice.A: The symptoms support the belief that the player has plantar fasciitis. Since they just recently changed their cleats, the support is likely very different than their old, worn out ones. This sudden change could put a change in stress on the fascia and lead to plantar fasciitis. P: The player is taped for plantar fasciitis. For treatment, the player is encouraged to have their foot taped into dorsiflexion or sleep in a ski boot to prevent re-stretching the fascia every morning; delaying the healing process. Ice will also help to minimize pain in the area and can be applied frequently (15 mins on; 45 mins off).A number of athletes reported at the end of practice, having sore calves, feeling as if they were pulled or strained. The assumption was that the ground was very spongy from the rain a few days before and was causing the player’s heels to sink into the ground and over stretch their gastrocnemius or soleus muscles. As a future consideration, the players should play in the least muddiest area of the field in the best effort to prevent calf injuries.Preventative measures: The field was inspected for obstacles or unfit conditions, although perhaps the field was not in the best shape for playing on, seeing as a few players had calf pain following the practice. Personal Reflection: I was glad to be able to use my knowledge of plantar fasciitis as we just recently learned how to assess it in the lab. I feel that all the signs and symptoms lead to that conclusion and I was happy with my assessment and treatment. I also gained experience with an eversion ankle roll, which I know is not as common. Seeing how the field can really be a cause of injury for the athletes emphasizes to me, how important it is to check the field before practice and games and mark off areas that are too wet or spongy. Even if the athletes do not roll their ankles, running on an inconsistence surface like that can put them back in their training.March 11thAway game in Powell River6am- 11:30pmPlayer: J.BS: The player reported, having previously injured his medial cruciate ligament in rugby. It is not currently injured, but it is weak when he plays.O: Flexion and Extension Range of motion is tested for active, passive and resisted and is normal in the knee and no pain is experienced. No difference is seen between each knee.A: As the player said, they have a previously injured MCL and it will be weaker and more susceptible to re-injury in rugby.P: The player should be taped to reduce any unnatural medial deviation and reduce the strain on that ligament. This is a preventative measure, if injury does occur the player is instructed to report back to the trainers.Player: B.W.S: The player reported having tight calves from the game and would like them massaged. Player also said they have shin splints from street running earlier that week and wants to know how to treat/ prevent getting them.O: No contraindications exist for massaging this player (no acute injury, open wounds, or irritated areas).A: Tightness on the lateral gastrocnemius muscle supported the suspicion that the pain is only muscular and massage will help to relieve the tension.P: The player is massaged for 10 minutes on each side starting with effleurage to warm up for a minute then petrissage and tapotement alternating to loosen up the tight muscle and target pressure points. Massage is always directed in the proximal to distal direction to encourage the flow of blood back to the heart and reduce edema. Massaging the shins internally against the fibularis longis muscle helps to relieve the pain of the player's lateral shin splints. They are told to ice and stretch after running and do exercises to strengthen the anterior muscles of the lower leg. Tight calves can also cause strain on the fibula and tibia and anterior muscles so stretching and massaging that region will also help. The player is taped for shin splints and told to report back any change in symptoms and whether treatment/prevention is beneficial.Player: A.L.Mid-game injury: Compression in the spinal column.S: The player experienced spasming pains in his lower back after a scrum and got up and walked to the sidelines without assistance. He reported tightness in his lower back that prevented him from straightening his back without pain. He said they were okay to walk and nowhere else hurt.History: Player has a history of back pain, especially during rugby.P: Lower backQ: spasming, achyR: the pain is just at the lower back (Lumar Spine)S: 5/6 pain that is mostly just uncomfortable and restrictingT: bending back at the lumar spine aggravates the spasmO: The player is in obvious discomfort and is arching their lower back to decrease the pain in the area. Range of Motion would not be an appropriate test right now as the area is highly aggravated and movement will only cause greater discomfort.Feeling test: He has not lost feeling in any limbs or any area of the back as observed by asking “where am I touching?” when his eyes are closed and hand is on different areas of the body, such as the right foot.Motion test: He has not lost any ability to move, only in the back due to the pain. This is tested by asking questions such as, “Can you wiggle your toes?”A: Since the player can move himself and does not report any sharp (nerve-like) pains, has no loss of feeling or movement, and the pain reported is achy and spasming, it is likely the muscles surrounding the vertebrae that are causing the pain. If the vertebrae were compressed in the scrum, the muscles would protectively stop him from causing injury to the area by spasming up. P: The best treatment is to massage and relax the transversospinalis and erector spinalis muscles in the area to allow the vertebrae to decompress. Post game deep tissue massage will prevent prolonged spasming and decrease the pain time.Preventative Measures: The field was inspected prior to the game, the EAP was reviewed, emergency roles were allocated and the trainers were split up to cover both sides of the field to better observe the athletes and spot injuries quicker.Personal Reflection: I really enjoyed this game as both teams were ultimately there for the fun of it. Both teams were fair and no dirty play occurred; I was happy to see not many injuries from this game. The long trip allowed me to get to know the players much better and truly appreciate their team bond; when they are playing, they must trust each other a lot in order to play well and win as well as they did. I felt confident in my recommendations for shin splints, as I have personally experienced that and am very familiar with the different types of treatment options. Speaking to the touch judge at the game, I was able to learn more about the game of rugby than I have already come to know and felt more engaged in the workings of the game. For future games, I hope to understand why particular plays are made and not just how.March 25th Home Game vs. Comox12pm – 4pmPlayer: J.MThe player is taped on his left knee to support the LCL. I have previously taped his knee before (February 5th) due to chronic pain in the knee from Rugby. The senior trainer instructed me on a new method of taping his knee that involves a figure of eight anchor with the stretchy athletic tape, reinforced with the cotton athletic tape on each side, and electrical tape to secure the anchors. The player finds this tape job much more supportive than the standard fan taping. P: The player should continue to be taped by the new method before practices and games to resist instability in the joint. Strength training the supporting muscles and tendons will increase the stability and hopefully lead to a decrease in pain.Player: J.H. (Comox player) The opposing team did not have trainers and so we assisted the other team in a few pre-game treatments. S: The player reported rolling his ankle inverted 4 days ago and feels unstable when he runs. He can weight bear and walk normally; the pain only arises when playing.History: The player has rolled their ankle before and did completely heal.P: Lateral side of the footQ: superficial pain, dullR: the pain doesn’t radiateS: 3 or 4 T: painful when the foot is invertedO: Minimal swelling and no abnormalities are seen on the injured foot compared to the other. Testing the ROM:Active: Painful when invertedPassive: Painful when invertedResisted: No pain, just slightly weakerA: The player seems to have sprained their ankle, pulling the lateral ligaments of the ankle (calcaneofibular ligament or posterior talofibular ligament). No other injury is detected. P: Tape the ankle to prevent inversion and ice the area after practice to relieve any pain and swelling.Player: A.RMid-game injury: MOI: Player hit their head on the ground when their teammate was in a ruck; they were pushing again the opposing team who drew back and he went head first into a roll. Situation: He did not get up for ~30 seconds (we could see he was conscious) so two of us ran out when it was safe and assessed the situation. He was conscious and responsive and sitting up when we reached him. S: He was slightly dazed and when asked what happened, he told us he did hit his head and he feels a little shaken up. We checked to see if he had any pain in his neck or spine and did a quick palpation test. Before we could assess, the player got up and ran back to join the game. O: Observing their jog, there was no obvious sway or imbalance. To be safe, we asked the coach to sub out the player for another so they could be properly assessed.S: He was asked for symptoms (listed on SCAT card) and did not report any of them besides the slight dizziness at the time of the fall. He was asked our venue, what half it was and who scored last: all of which he answered correctly. He was asked to remember ‘pencil, horse, rock, nail, cup’ and recite immediately and at the end of the game. He managed to remember all 5 still asymptomatic at the end of the game. O: Focusing on the tip of a pencil, he was able to follow its path with no pupil deviation.Player seems to be completely asymptomatic during the sideline assessment and reported that the dizziness was gone with the minute after the fall. A: Since the signs do not point towards any serious injury, the player returns to play at their own discretion. They are cautioned that any headache, pain, nausea or dizziness could be a sign of a concussion and returning to play if these are present could predispose them to a very serious injury. The player insisted they felt fine and could return to the game. P: Following the game, they were watched closely for any delayed signs and symptoms; none arose in the 2 hours after and he did not report any abnormal feelings.A note is taken by the coach and the trainers as reference if any signs arise later or appear at the next practice. The player is instructed to report any changes in behaviour or arising symptoms; take the night and next day easy as well.Preventative Measures: The field was inspected prior to the game, the EAP was reviewed, emergency roles were allocated and the trainers were split up to cover both sides of the field to better observe the athletes and spot injuries quicker.Personal Reflection: I thought this game was a very enjoyable game to be at as a trainer. Velox and Comox are considered to be two of the top teams in the league, so they are good competition for each other and play fairly. At the away game to Comox Valley, Comox won and today when the Comox came to Velox, Velox won! They are in hopes for a finals game together to settle the score. For taping I feel I am getting better at assessing and taping neatly and quickly without much hesitation. I am glad to be continually learning new and better ways to support our athletes with taping and individualize each tape job to the specifics of each player. The injuries were minimal, but I did not hesitate when A.R. went down. I saw the fall so I knew he would be shaken up, but before he hit he was not far from the ground, making the fact that his symptoms were few and short-lived, more likely. I alerted the senior trainer and the moment there was a safe path to the player we made our way out there to assess the player and watch that we were not in danger of getting caught in the game. It was a bit of a heightened point in the game as I was nervous that it may be more serious than it was, but I knew the steps in my head for the EAP and felt confident that I would have performed well if it were an emergency situation. I am glad for the experience and happy to see the player recover so quickly. March 27th Practice6-9pmPlayer: G.GS: The player reported rolling his left ankle (inversion) 4 days ago. The swelling was worse when it happened, but it has gone down since then; the pain has decreased as well. History: They have a history of rolling the same ankle at least 2 times this season.P: Pain is on the lateral side of the ankle and slightly on the posterior side of the medial malleolusQ: Achy pain that is worse when they move the ankleR: The pain does not radiateS: 4T: Pain is felt when the foot reaches end point of eversionO: There is some swelling in the area superior to the lateral malleolus, but nothing abnormal for observing or palpating. The player is able to weight bare and gait is normal.Active ROM: everted slight pain medially, inverted painful on the lateral side.Passive ROM: pain is less, but noticeable on the lateral sideResisted ROM: no painThe other directions of motion do not cause him pain.A: The player probably sprained his ankle and it likely happened, because the injury of a previous roll did not have time to heal before the impact. P: The player should ice and elevate the existing swelling on the foot to bring down the edema and decrease the pain. I recommended that he take care of this injury and rest it often; do not try to run on it or play without proper taping and assessment before-hand. If he does not let this heal it will continue to get injured and possibly develop into a chronic injury that is much harder to treat. After the area has had time to heal, building up strength in the ligaments and tendons with exercise bands will help to keep the ankle stable when playing.Player: T.BS: Player reported falling on his right wrist at practice a week ago and has had it taped at the last practice.History: There is no history of injury to this wristP: The pain is on the anterior side of the handQ: Achy R: The pain does not radiate from the wristT: Area of wrist hurts when the hand is extended at the wristO: There is no swelling remaining in the wrist from the injury. Active ROM: Painful when in extension Passive ROM: Painful when extended Resisted ROM: No painNo obstruction is found in the wrist and no heightened pain is felt from palpation. The wrist reaches all of its normal end ranges for all directions of movement. ROM is compared to the non- injured side.A: The player has likely damaged a tendon in the wrist of the anterior side and will be in pain until it heals. There are no other signs or symptoms suggesting a secondary injury.P: The player would like to play today, so he should have the injured wrist taped up to prevent extension into the range of motion that is painful. He is told that icing will help the injury in recover by decreasing inflammation and pain in the area. He should rest it as much as possible and avoid leaning on the hand with full weight until it heals.Player: K.J.Post-game massage: S: The player has their lower back iced after practice by one of the senior trainers and reports that they have tightness in the muscles surround their right scapula. The senior trainers inform me that they often massage the area with baby oil after practices, so this would be an appropriate treatment for today.History: often has tightness and soreness in the muscles of the upper back after practiceP: located over the scapula/ thoracic spine on the right side.Q: tight and uncomfortableR: The pain does not radiateS: 2/3 not a severe painT: when the muscles are stretchedO: There are no open wounds, or other contraindication for massage. A: From initial palpation, there are no abnormalities, but there are a lot of knots in the muscles along the medial border of the scapula. P: I began the massage with effleurage to warm up the muscles and get the blood flowing (5 minutes) then I proceeded to work at the tight muscles with techniques of petrassage to release tension in the muscle fibers and aim to break down the tight contractions that have formed in the muscle. I do this for 10 to 15 minutes checking often that the pressure is right and then finish off with another few minutes of effleurage to flush out an accumulation of fluid. I recommended that they see a massage therapist if the tightness is causing them pain on a daily basis and/or affecting their ability to move. Preventative Techniques: The field was checked for obstacles before practice started and ice bags were prepped for the sidelines. Personal Reflection: I think that today’s practice went really well for me as I felt really confident in my assessments and treatments. I feel that the knowledge and practice over the semester has started to really pay off and I can start to see what I am capable of when I believe in my abilities and know that with practice I will only get better.Overall Personal Reflection:I feel that I have gained a lot from my practicum with the Velox Rugby team these past three months. I was a bit nervous when I started, because I did not know what being an athletic trainer was really like and I had not learned a lot about assessing, treating and preventing injuries yet. I was pleased to find that the senior trainers at Velox had all gone through the same class that we are now, and were once in our position as junior trainers. I think that the practical experience is such an asset to the course as much as it is a necessity for learning how to work with athletes. I felt that my placement gave me a lot of opportunities to use the knowledge that I was learning in the lecture and in the lab in a practical way. Not only was I learning the foundations of how to assess, treat and prevent, but I was able to make that transition to the real world and see how I am able to make a difference for these athletes when they get hurt and help them in the best ways to prevent these injuries. When I first began at Velox, I was not a big rugby fan, mostly because I had never learned the complete rules of the game and I had often heard of it as a rough and high contact sport where players get hurt a lot. I am glad that I have had a chance to gain a true appreciation for the sport with my experience. As an athletic trainer I have seen how hard players practice and put everything they have into this sport; they have the competitive drive and a true love for the game that expresses a good quality of their character. I now know that the game is more than just players running at each other and dog-piling for the ball; the game contains many sub-components from the scrum- to the rucks- to the lineouts and each component has specific rules that the players must abide by. The team must work together and trust each other with every play to get the ball where they want it to go and strategically beat their opponents. I am glad that I was able to gain the experience I did at Velox, because I could fully imagine what it would be like to be an athletic trainer as a career. I was able to see that it is much more than just knowing your injuries and treatments, but actually knowing your athletes and their specific needs. Beyond the theory, I was able to work on my confidence in assessing athletes and getting to know them and their injuries; developing a profession relationship with the athletes where they can trust their athletic trainer is important in providing the best care possible.I am very pleased with my placement experience, but I think that it would have been a bit better if there was more guidance at the start of the placement. I felt that we were given a lot of the knowledge to deal with injuries, but when it came to approaching the athletes, whom we had never met before, I personally felt intimidated by the situation. I often did not feel that I had the ability to handle a situation where an athlete was injured, because I had not done it before. I think that having the senior trainers guide us through our first few assessments and introduce us to the players would have eased the tension a little bit and made it more comfortable for us to step up and practice the skills that we were learning. The trainers at Velox care a lot about their athletes and truly want the best for them in their games and always enforce the rules when it comes to “return to play” protocols. Even so, I think that there are some ways that the trainers could improve their risk management and better prevent their athletes from getting injured. I think that there need to be more caution when letting players practice on the fields, especially when they are wet. One practice in particular (March 6th), a significant number of athletes came off the field during the evening with some form of a calf or lower leg pain that we could easily see coming from running on the soggy ground. Another important area to be concerned about is the health and wellbeing of the athletes in their daily lives. Rugby is a tough sport that requires a lot from the players; if they do not take care to eat well, rest well and strength train, they will likely be more susceptible to injuries on the field. I understand that there are a lot of players to keep up with, but even having informative meetings where they discuss these types of things could encourage them to really consider their lifestyles and feel that they can ask questions about these topics to be sure they are not putting themselves at risk for injury. I did not find any issues with communication during my experience at Velox. The only concern I may have is, like I said earlier, that the senior trainers should communicate with the junior trainers for the first few assessments to ensure that the methods and techniques are correct. This would help the junior trainers build confidence much quicker.I learned a lot from this experience including myself. I now know that injury care is really interesting to me, because it applies to me and my activities as and to the people I know. I like that it challenges my logic when I assess athletes and gets me to think critically about the entire situation, from the individual to the specifics of the event. As much as I enjoy working with the team, I learned quickly that I am not the first to jump at an opportunity when I am not confident in my skills. I think this is a really important discovery for me, because I know that I have to work on this. My ultimate goal is to one day be working in a job where I am dealing with people who are injured and require my help and I need to be confident in that position so that I can provide the best care possible. This is not a limitation for me, because I know that I will overcome it and my training with Velox has been an important step in that process. Overall I have had an excellent learning experience this semester in the class and with the practicum that has helped me to discover other interests of mine and helped me to build a clearer image of where I want to be one day in my career. ................
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