HPR 010 Lecture Notes - Lecture 18: Tennis Elbow, Ankle, Ulna
12 Jun 2018
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Chapter 15 – Extremity Injuries
- Injuries to the extremities are common because people are involved in active lifestyles that
include sports and wilderness activities.
Extremity Injury Assessment
- Look for signs and symptoms of fractures and dislocations.
- Examine the extremities using DOTS.
- Use the rule of thirds.
- Consider the cause of injury.
- Use CSM (circulation, sensation, movement).
Types of Extremity Injuries
- Contusions—tissue is bruised
- Strains—muscles are stretched or torn
- Sprains—tearing or stretching of joints
- Tendinitis—inflammation of a tendon caused by overuse
- Dislocations—bones are displaced from their normal joint alignment, out of their sockets, or out
of their normal positions
- Fractures—breaks in bones that may or may not be accompanied by open wounds
RICE Procedure
- Rest, ice, compression, and elevation
o R=rest; do not use of move injured part, crutches may be used
o I – ice; apply for 20 minutes every 3 to 4 hours during the first 48 hours, never apply
directly to skin, when skin becomes numb – remove.
o C = compression; Apply elastic bandage to injury, Should be worn continuously for first
18 to 24 hours, Use horseshoe-shaped pad for ankle injury.
o E = Elevation; Limits circulation to injured area, Do not elevate a suspected fracture until
it has been stabilized.
o
- Recommended immediate treatment for bone, joint, and muscle injuries
- The first 48 to 72 hours after an injury can do a lot to relieve—even prevent—aches and pains.
Shoulder and Upper Area Injuries
- Shoulder Dislocation:
o What to Look For
▪ Person holds upper arm away from body, Arm cannot be brought across chest,
Extreme pain, Squared off appearance, Complete loss of function, History of
dislocations, Numbness or paralysis
o What to Do
▪ Do not force, twist, or pull back in place.
▪ Place a folded or rolled blanket or pillow between upper arm and chest.
▪ Apply an arm sling and swathe.
▪ Apply an ice pack for 20 minutes.
▪ Seek immediate medical care.
find more resources at oneclass.com
find more resources at oneclass.com
- Clavicle Fracture
o What to Look For:
▪ Fall on outstretched arm, Direct blow to clavicle or shoulder, Severe pain over
injured area, Holding injured arm against chest, No movement because of pain,
Swelling, Deformity, Tenderness, Dropped or drooped shoulder, Bruising
o What to Do:
▪ Treat for shock.
▪ Apply arm sling and swathe.
▪ Apply ice pack for 20 minutes, three to four times during 24 hours.
▪ Seek immediate medical care.
- Contusions
o What to Look For:
▪ Swelling, Pain at the injury site, Firmness when pressed, Tenderness,
Discolorations
o What to Do:
▪ Apply an ice pack for 20 minutes, three to four times during first 24 hours.
▪ Place arm in sling and swathe.
- Tendinitis
o What to Look for:
▪ Constant pain or pain with motion of the shoulder, Limited motion of shoulder,
Crakling sound, Tenderness over the area
o What to Do
▪ Use an ice massage for 10 minutes before and after exercise.
▪ Use a sling and swathe.
▪ Use pain medication.
▪ Seek medical advice.
- Humerus Fracture
o What to Look for
▪ Direct blow to the area, Twist or fall on the outstretched arm, Severe pain,
swelling, deformity, Tender if touched, Inability to move the arm, Holds arm
against chest
o What to Do
▪ Assess and treat for shock.
▪ Apply an ice pack for 20 minutes.
▪ Stabilize the arm.
▪ Seek immediate medical care.
Elbow Injuries
- Should be considered serious
- Treat with extreme care.
- Elbow Fractures and Dislocations
o What to Look For
▪ Immediate swelling, Severe pain, Possible visible deformity, Restricted, painful
motion, Numbness or coldness of the hand and fingers below the elbow
o What to Do:
▪ Do not move the elbow.
▪ Treat for shock.
find more resources at oneclass.com
find more resources at oneclass.com
▪ Splint the elbow in the position found.
▪ Apply an ice pack for 20 minutes.
▪ Seek immediate medical care.
- Tennis elbow
o What to look for
▪ Pain that increases while using the arm, Gradual grip weakness, Injured elbow
that fatigues quicker than normal, Very tender on outer protrusion
o What to Do
▪ Apply heat before an activity.
▪ Apply ice pack for 20 minutes after activity.
▪ Seek medical advice.
- Golfer’s Elow
o What to Look for
▪ Pain increases while using the arm, Gradual grip weakness, Injured elbow
fatigues quicker than normal.
o What to Do
▪ Apply heat before an activity.
▪ Apply an ice pack for 20 minutes after activity.
▪ Seek medical advice.
- Radius and Ulna Fractures
o The radius and ulna are the two large bones in the forearm.
▪ When one bone is broken, the other acts as a splint.
▪ When both are broken, the arm usually appears deformed.
o What to Look For
▪ Pain in the forearm or wrist, Deformity, Severe pain radiating up and down,
Inability to move the wrist or painful when moved
o What to Do
▪ Assess and treat for shock if indicated.
▪ Apply an ice pack for 20 minutes.
▪ Stabilize against motion.
▪ Place the arm in a sling and swathe.
▪ Seek medical care.
Wrist Fractures
- What to Look For:
o Snapping or popping sensation, Pain aggravated by movement, Tenderness, swelling,
Inability or unwillingness to move wrist, Lumplike deformity
- What to Do
o Use the RICE procedure.
o Stabilize the wrist with a splint.
o Seek medical care.
Hand Injuries
o May be fractured by Direct flow or Crushing injuries
- Crushed Hand
o What to Look for
▪ Pain, Swelling, Loss of motion, Open wounds, Broken bones
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Injuries to the extremities are common because people are involved in active lifestyles that include sports and wilderness activities. Look for signs and symptoms of fractures and dislocations. Dislocations bones are displaced from their normal joint alignment, out of their sockets, or out. Tendinitis inflammation of a tendon caused by overuse of their normal positions. Fractures breaks in bones that may or may not be accompanied by open wounds. Rest, ice, compression, and elevation: r=rest; do not use of move injured part, crutches may be used. 18 to 24 hours, use horseshoe-shaped pad for ankle injury: e = elevation; limits circulation to injured area, do not elevate a suspected fracture until it has been stabilized. Recommended immediate treatment for bone, joint, and muscle injuries. The first 48 to 72 hours after an injury can do a lot to relieve even prevent aches and pains.
