Question

Name: Injury Date: Athletic Training Injury Evaluation Form Sport: Today's Date: Location: Student ID#: Description of how injury occurred: Type of Injury New Body Part Aggravated (Location of Injury): Recurrent Illness Concussion Other: Previous trouble with this injury? YES NO Cause of Injury Collision with fixed object Collision with another player Fall from height/awkward landing Jumping to shoot or defend Hyperextension Overuse Slip/trip/fall/stumble Struck by ball/object Struck by other player Temperature related Non-athletic related Other: If yes please explain: Evaluation Observation Palpation: Range of Motion/Strength: Neurological: Special Tests: Clinical Impression: Initial Treatment: Referral Return to Play Remove from Play Call Emergency Services Emergency Room Walk in Clinic Physician Visit Other: Notes:
An athlete lands on another player’s foot coming down from a rebound and inverts their ankle. They felt a pop, they have moderate swelling, can’t put weight on ankle and pain on the lateral side.

Answer 1

Name:Mr.X Sport: Football (as example) Today's Date:09/19/2019

Injury Date: 09/19/2019 Location: Ground Student ID #1234

Description of how injury occurred:landing of an athlete on foot from a rebound and injuring the ankle

Type of injury: New Body part: Ankle (mention right or left)

Previous trouble with this injury:No

Cause of injury: Collision with another player

Evaluation

Observations/Palpation:

• Pop on the ankle
• Swelling (moderate)
• Pain on palpation
• No redness,scars

Range of motion /strength: Restricted movement or limited movement in the ankle

Neurological:conscious,oriented to time, place and person, stable

Special test:X ray ankle joint (mention right or left ankle)

Clinical impression: Ligament tear (unable to put weight on ankle,moderate swelling on lateral sides, pain makes to suspect for this impression)

Initial treatment:Rest,Ice application, Elevation ,mild pain killers

Referral:Physician visit to rule out the diagnosis and initiate treatment

Notes:Not resuming to play till the injury or pain subsides