As an athletic trainer one of the most important tools we have for ANY injury is our eyes. In school we take a lot of classes on rehabilitation, taping, evaluation, etc., however the most important classes in my opinion are the ones that help us identify mechanism of injury (MOI). Those classes would be; anatomy, physics, biomechanics and the variations of kinesiology.
I am not speaking of getting up close to the injured individual to begin an initial evaluation, that is a different part of the job, I am speaking of watching the injury unfold in real-time. Taking the MOI classes allows us to understand what most bodies can handle and how they should be functioning. Knowing what each ligament in the body is designed to do (restrict certain movements) or where each tendon/muscle originates and inserts and what type of lever movement it provides can tell a lot when forces are applied. In the cases of unsuspected or unnatural forces are applied and from where (Physics) in that exact time in body motion (biomechanics) as compared to normal movement (kinesiology) will tell athletic trainers what kind of injury they are going to deal with. This not only allows for a better “filtering” system for evaluation, but it saves time in making critical decisions.
Yes, we do not see every injury occur, that is why the interview of the athlete and anyone who saw it is very important. Either seeing it or getting the information after the fact constructs what was happening at the moment of injury, and allows athletic trainer to call upon all the evaluation techniques and special tests learned to perform a comprehensive physical exam.
There are times that I find myself (probably every time) watching a sporting event and upon seeing an incident occur trying to identify the exact injury before it is announced on TV. I actually think this is good practice for me, and this weekend there is not a more rich environment for sudden injury than the X Games.
Those athletes are on the brink of injury in everything they do, the speed and risks taken just predispose this sport to many more sudden injuries. I am actually amazed that more do not get hurt more often. A perfect example of this happened while I was watching the BMX Freestyle Big Air as Chad Kagy took a big fall and signaled for the medical team. I rewound the video multiple times trying to see the injury and ID it before they did on TV, lo and behold after about one second I saw the injury. Below is a video of the wreck, it is of horrible quality, but you can see the injury occur in slow-motion (forward to the 1:06 mark);
Falling from about 40 feet will cause some major damage to anyone, even with protective equipment on, and all the variables of vector and landing angles provide a myriad of possibilities, but if you see in the video there is a body part not reacting like it should be after the contact with the ramp. If you watched or have read about it you will know the injury, I challenge all the AT’s out there to look a the video and try to come up with a possible injury before reading on…………..
If you notice his right leg reacts differently than his left, and appears to be “dead” at the bottom of the ramp. Knowing that go back to the fall and you will see his right leg take the brunt of the force. That with the initial eval of his disposition at the end, made me think upper leg/hip injury, which in fact was the case as Kagy broke his femur.
As you watch sports we as athletic trainers are getting practice in ID’ing injuries. In the realm of concussions this is A VERY important factor as well. If you watch the X Games you will see plenty of those as head bounce of concrete, dirt, and wood all weekend long. Take some time and see if you can find the injuries.