Sports-related Injuries and Mechanisms

Evaluations

Mechanism: Learning to run hurdles on a track practice, both lower legs

started a couple of weeks ago 

S and S

Medial lower shin pain with running

Decreased ankle flexibility

Walks on side of feet

1 training shoes= 1 year old

Pin point on posterior tibialis 

Mechanism: learning to hurdle for the first time

at track practice. Pain on both lower legs that

started a couple of weeks ago at practice.

S&S: medial lower shin pain with running and

hurdling

-decreased ankle dorsiflexion

- walks on inside of feet, decreased medial arch

-training shoes over 1 year old

-pin point pain on lower medial border of tibia

Medial tibial stress syndrome (shin splints)

Mechanism: softball outfielder steps on edge of grass at warning track

going after a fly ball. Felt a pop in their 

R

 foot. 

S and S

Lateral mid-foot pain

Pin point at the head of the 5th metatarsal

Mid pain and maxity awoth the talar tilt and anterior drawer test

Unable to bear weight on R foot

R foot jones fracture

Mechanism: Lacrosse player falls and has their R ankle stepped on the

lateral side

S and S

Both lateral and medial ankle pain

Medial swelling at medial malleolus

Pain with bump and compression test

Pin point pain at medial malleolus

Medial Malleolar Fracture

New track athlete just started training 3 weeks ago 

S and S 

Pain after running with both achilles

Point tender just above ca

lcaneus

Goes away the next day

Comes back after running

New running shoes

No previous problem with achilles

Achilles Tendonitis

Mechanism: athlete’s R ankle landed on another athlete’s foot

S and S

Felt a crunch

Immediate pain and swelling (lateral)

Unable to bear weight

Pain with compression test

Laxity and no end point with talar tilt and anterior drawer test

Inversion ankle sprain

Mechanism: Basketball player came down on another player’s foot while

attempting to rebound the  ball

S and S

Limps into the training room

Felt a crunch in the L ankle

Has injured this ankle 2x before

Immediate lateral pain and swelling

Unable to bear weight 

Pain with compression test, Anterior drawer test and talar tilt test, no end

point

L ankle inversion ankle sprain

Mechanism: rounding 2nd base making inside cut on the bag L ankle 

S and S

Medial and lateral ankle pain

Able to bear weight but painful

Paint with bump test

Pin point pain on deltoid ligament

All other ankle test negative

Eversion ankle sprain

Mechanism: x-country runner stepped into a hole on a trail run. Severe R

ankle pain, happened about a hour ago

S and S

Athlete is limping noticeably

Immediate severe pain R ankle with swelling

Heard a pop

Point tender on lateral distal fibula

Pain with all ankle special tests

Limited weight bearing but painful

R lateral Malleolar Fracture

Learning to hurdle for the 1st time at track practice. Pain on both lower

legs that started a couple of weeks ago after practice

S and S 

Medial lower shi

n

 pain with running and hurdling 

Decreased ankle dorsiflexion

Walks on inside of feet, decreased medial arch

Training shoes over 1 year old

Pin point pain on lower medial border of tibia

Medial tibial stress syndrome ( shin splints)

Soccer player suddenly sprinting to get ball… L achilles pain

S and S

Sharp pain then went away

Felt a “sharp” felt like I got kicked

Hard to push off

Positive Thompson test

Pin point at calcaneal insertion 

Previous history of achilles 

tendonitis

Achilles tendon rupture

Mechanism: outfielder stepped on edge of grass at warning track going

for fly ball- R ankle/foot

S and S 

Lateral Mid-foot pain 

Pain @ head of 5th metatarsal

Some pain & laxity with talar tilt & anterior drawer test 

Felt a pop, can’t weight bear in R foot/ankle

Jones fracture

Mechanism: started hurting after basketball practice 3

weeks ago

S and S                                                                                                                 

Pain with squatting, landing, jumping

Pain with up and down stairs 

Anterior drawer test hurts

Patella Tendonitis

Mechanism: playing lacrosse, lateral blow to L knee 

S and S 

swelling , medial knee pain 

Point tender along MCL 

Pain with valgus stress test only 

Feels loose and unstable

MCL sprain- grade 2

Mechanism: throwing discus at track practice

S and S 

Obvious deformity L knee, patella is on lateral aspect

of distal femur 

Prior history of dislocation 

Can’t walk or place weight on L leg

L leg muscle guarding and lots of medial and lateral L

leg pain

L Patellar Dislocation

Mechanism: Basketball player gets hit on the outside of the L knee while

going after a loose ball 

S and S 

Felt a pop

Medial knee pain

Unable to extend knee fully

Point tenderness along medial aspect of L knee 

Feels unstable 

Positive valgus stress test only with end point

MCL Sprain

Mechanism: playing catcher, blocking the plate making a play the day

before

S and S 

R knee hurts everywhere 

Can’t bend or straighten knee 

Pain with 

apley's

 compression 

No previous knee issues 

Noticeable limp, can only walk on toes

Meniscus Tear

Mechanism: jumping and landing hard 

S and S 

Started over a week ago

No one particular day, just started

Pain with resisted knee extension

Pain with up and down stairs 

Pain under Patella

Patellofemoral Syndrome Chondromalacia

Patella

Mechanism:Soccer player suddenly sprinting to get a

ball , L rear lower leg/ankle pain.

S&S felt a sharp pain then a dull ache

Heard a “snap”,  “felt like I got kicked in the back of my lower leg” 

Hard to push off the L foot

+ Positive Thompson test

Increased pain at the Achilles insertion at the calcaneus

Previous history of Achilles tendonitis

Diagnosis Achilles Tendon Rupture

Mechanism: Catcher blocking plate at

practice the day before. R foot got pinned

under base runner  while trying to tag him

out.

S&S 

Noticeable limp walking in

Felt a pop in R knee during play

R knee hurts everywhere, swollen

Can’t bend or straighten R knee

No previous knee injury 

+

Appley’s compression test, specifically medially

Diagnosis: R knee medial meniscus tear

Mechanism: throwing discuss at track

practice

S&S

Obvious deformity of L knee - Patella is on lateral

aspect of femur

Prior history of dislocation

Can’t bear weight

Muscle guarding, lots of medial & lateral knee pain

Patella dislocation

Mechanism: Basketball player making a move to the

basket planted on the R foot while going left, then felt

immediate severe pain in the R knee, then fell to the

floor. 

S&S

Immediate swelling R knee

Medial joint line pain

Unable to bear weight 

Feels unstable

Pain with knee flexion and extension

+

Lachman’s Drawer with no end point and pain

Diagnosis: R ACL sprain, grade III

Mechanism: Basketball player doing an increased

amounts of jumping and hard landings.

S&S 

Started over a week ago 

Can’t remember a particular time, just noticed it started hurting

Pain with resisted knee extension under the patella

Pain going up and down stairs

Pain with squatting

Diagnosis: Patella Femoral Syndrome

Mechanism: Playing Basketball R knee R foot

planted while pivoting making  move to the

basket.

S&S

Immediate pain and swelling

Medial joint line pain 

Unable to bear weight, unstable

Pain with knee flexion & extension 

Positive anterior drawer test, No end point & pain

Diagnosis: ACL Sprain Grade III

Mechanism: Anterior L knee pain, started

hurting after basketball practice over 3 weeks

ago.

S&S

Pain with squatting, landing, jumping

Pain with going up and down stairs 

Pain along the patella tendon 

Pain with Lachman’s Anterior Drawer test on anterior

knee but solid end point

Diagnosis: L Knee patellar tendonitis

Mechanism: R Foot Planted While Pivoting

Making A Move To Basket 

Immediate Pain And Swelling 

Medial Joint Line Pain 

Unable To Bear Weight, Unstable 

Pain With Knee Flexion And Extension 

Positive Anterior Drawer Test, No End Point And

Pain 

Diagnosis: ACL Sprain - Grade 3

Mechanism: Basketball player doing increased

amounts of jumping and hard landings 

Started over a week ago

Can’t remember a particular time, just noticed it

started hurting 

Pain with resisted knee extension under the

patella

Pain going up and down stairs

Pain with squatting

Diagnosis: Patella Femoral Syndrome 

Mechanism: Basketball player making a move to

the basket planted on R foot while going left, then

felt immediate severe pain in the R knee, then fell

to the floor. (just happened)

Immediate swelling R knee 

Medial joint line pain 

Unable to bear weight 

Feels unstable 

Pain with knee flexion and extension 

+Lachman’s Drawer with no end point and pain

Diagnosis: R ACL Sprain, Grade 3

Mechanism: Throwing Discuss At Track Practice 

Obvious deformity of L knee

-

Patella is on lateral aspect of femur 

Prior history of dislocation 

Can’t bear weight 

Muscle guarding, lots of medial and lateral knee

pain

Diagnosis: Patella Dislocation

Mechanism: Catcher blocking plate at practice

the day before. R foot got pinned under base

runner while trying to tag him out 

Noticeable limp walking in 

Felt a pop in R knee during the play 

R knee hurts everywhere, swollen

Can’t bend or straighten R knee 

No previous knee injury 

+Apley's Compression test, specifically medially

Diagnosis: R knee medial meniscus tear

Mechanism: Soccer player suddenly sprinting to

get a ball, L rear lower leg/ankle pain 

Felt a sharp pain then a dull ache 

Heard a “snap”, “felt like I got kicked in the back of

my lower leg” 

Hard to walk and push off the L foot 

+

Positive Thompson Test 

Increased pain at the Achilles insertion at the

calcaneus  

Previous history of Achilles tendonitis

Diagnosis: Achilles Tendon Rupture

Mechanism:  Running Sprint workout for football

off season conditioning yesterday.

S&S:

Athlete limps into training room 

Felt a pop in the back of my R thigh

Difficulty squatting, getting in and out of chair 

Pain with knee flexion and extension

R hamstring strain

Mechanism: doing step back lunges after doing

heavy squats 

S&S:

Pain @ mid front thigh

Difficulty getting in and out of chair or car 

Pain with running

Limited R knee flexion

Pain with terminal knee extension 

R Quadriceps Strain

Mechanism: Running Sprint workout @ Track

Practice 

S&S:

Pain @ middle portion of Left Hamstring 

Difficulty with squatting 

Noticeable limp, can’t run

Painful knee flexion and extension

Hamstring Strain

Mechanism: Doing step back lunges in weights,

after doing heavy squats 

S&S:

Pain @ mid right thigh

Difficulty sitting down and getting up

Pain with running

Limited R knee flexion

Pain with terminal knee extension

Quadriceps Strain

Mechanism: stunting while cheerleading doing a

backhandspring, felt a pop in my left shoulder

when my hands hit the ground.  I hit the ground

and had immediate severe pain  (8/10) and could

not move my arm.

S&S:

Obvious flattening deltoid 

Protecting arm, head to left side

Weakness, numbing, tingling in left arm

Humeral head in armpit 

Glenohumeral dislocation

Mechanism: Basketball player is knocked to the

ground while driving to the basket.  As they put

their right arm out to break the fall, another player

lands on their upper arm.  The athlete hears a

snap.

S&S:

Obvious upper arm deformity 

Swelling

Cannot flex or extend elbow

Weakness with right upper extremity 

Can’t do any special tests = painful

Fracture of the humerus

Mechanism: Lacrosse player gets a hard cross

check on his L anterior shoulder that knocks him

to the ground., felt a crunch.

Obvious deformity along lateral ⅓ of clavicle 

Pain (8/10) / Can’t lift arm 

Pain with impingement test with movements 

Weakness with IR/ER MMT

Diagnosis: Clavicle Fracture

Baseball pitcher threw 120 pitches 2 days ago

and the last pitch really hurt in my R shoulder,

stopped right away and iced my shoulder 

Difficulty raising or lifting arm 

Pain (7/10) with shoulder flex/ext

Pain (8/10) with ER 

Positive empty can test 

Positive impingement tests with movements

Diagnosis: Rotator Cuff Strain

Mechanism: Baseball catcher notices R shoulder

pain that started about 3 weeks ago. 

S&S: 

Only hurts when I throw 

Hurts more when I throw from my catchers

stance

Pain with IR/ER (4/10) 

Pain with shoulder flex (6/10) 

Pain with impingement tests

Diagnosis: Biceps Tenosynovitis

Mechanism: Lacrosse player diving to make a

shot and got pushed to the ground, landing on the

tip of his right shoulder and he felt a pop 

S&S: 

Deformity at AC joint 

Point tenderness at AC joint and distal end of the

clavicle 

Pain with C1 C2 C3 movements 

+

Impingement with movements

Diagnosis: Acromioclavicular Sprain

Mechanism: Softball catcher notices left shoulder

pain about 3 weeks ago and slowly getting worse,

hurts especially when throwing back to pitcher

from catcher's stance and throwing back to

second base, hurts with hitting too 

S&S: 

Pain 4/10 incocking to throw position 

MMT ER/IR = ER is weaker than IR 

Pain 7/10 with both impingement tests 

Left shoulder weakens with empty can test

Diagnosis: Impingement Syndrome

Mechanism: softball player sliding head first into 2nd base, landing hard while getting tagged on the top of the

L shoulder. 

Felt it slip out of the joint

Sts: 

-limited shoulder range of motion

- mild pain (3/10) in shoulder joint

- some pain (2/10) with flex & exit

- weakness with IR/ER

- positive apprehension sign (feels like it’s going to slip out)

- no visual deformity

Glenohumeral sublaxation

Mechanism

Softball catcher noticed L shoulder pain about 3 weeks ago

and slowly getting worse. Hurts especially throwing back to

pitcher from catcher's stance and throwing to 2nd base. Hurts

with hitting too.

S&S

pain (4/10) in cocking to throw position 

MMT ER/IR ER is weaker than IR

Pain 7/10 with both impingement test

L shoulder weakness with empty can test

IMPINGEMENT SYNDROME

MECHANISM: LACROSSE PLAYER DIVING TO

MAKE A SHOT AND GOT PUSHED TO THE

GROUND, LANDING ON THE TIP OF HIS R

SHOULDER FELT A “POP”

S&S: DEFORMITY AT AC JOINT

POINT TENDERNESS AT AC JOINT & DISTAL

END OF CLAVICLE

PAIN WITH C1,C2,C3 MOVEMENTS

POSITIVE IMPINGEMENTS WITH MOVEMENTS

ACROMIOCLAVICULAR SPRAIN

MECHANISM: BASEBALL CATCHER NOTICES R

SHOULDER PAIN THAT STARTED ABOUT 3

WEEKS AGO

S&S: ONLY HURTS WHEN THROWING

HURTS MORE WHEN THROWING FROM

CATCHER'S STANCE

PAIN WITH IR/ER (4/10)

PAIN WITH SHOULDER FLEX (6/10)

PAIN WITH IMPINGEMENT TEST

BICEPS TENOSYNOVITIS

MECHANISM: BASEBALL PITCHER THREW 120

PITCHES 2 DAYS AND THE LAST PITCH REALLY

HURT IN R SHOULDER STOPPED RIGHT AWAY &

ICED SHOULDER

S&S DIFFICULTY RAISING OR LIFTING ARM

PAIN (7/10) WITH SHOULDER FLEX/EXT

PAIN (8/10) WITH ER

POSITIVE EMPTY CAN TEST

POSITIVE IMPINGEMENT TEST WITH

MOVEMENTS

ROTATOR CUFF STRAIN

Mechanism: softball player sliding head first into

second base, landing hard while getting tagged on

the top of the 

L 

shoulder felt is slip out of the joint

S&S: limited shoulder range of motion 

-mild pain (3/10) in shoulder joint

-some pain(2/10) with flexion and extension

-weakness with IR/ER

-positive apprehension sign (feels like it is going to

slip out

-no visual disformation

Glenohumeral Subluxation

Mechanism: Football Running Back hit several

times in R biceps while carrying the ball

S&S:- pain in R lateral bicep with palpation(6/10

pain) (8/10 with bicep contraction)

-

Difficulty with elbow extension

-

Painful with elbow flexion & shoulder forward

flexion

-

X-ray shows calcium deposit in bicep

Myositis Ossificans of the bicep

Mechanism:2nd baseman hit by a baseball 3

times during a game in the L upper arm

S&S: - Pain (6/10) with elbow flexion & extension

-

Pain (8/10) with resisted elbow flexion

-

Pain (7/10) with palpation of mid- biceps

Doctor visit: X-ray is clear , no fracture or Bone

formation

Upper Arm/ Biceps Contusion

Mechanism: Lacrosse player gets a hard cross

check on the L anterior shoulder that knocks him

to the ground. Felt a crunch.

S&S:

-obvious deformity along lateral ⅓ of clavicle

-pain (8/10) cant lift arm

-pain with impingement test with movements 

-weakness with IR/ER MMT

Clavicle Fracture

Mechanism: Basketball player is knocked to the ground while

driving to the basket as they put their R arm out to break their

fall, another player lands on their upper arm. The athlete heard

a snap

S&S: - Swelling

-

Cannot flex or extend elbow

-

Weakness R arm upper extremity

-

Can’t do any special test (painful)

Fracture of the humerus

Mechanism: stunting while cheerleading doing a

backhandspring, felt a pop in my L shoulder when

my hands hit the ground. I hit the ground and had

an immediate severe pain (8/10) and could not

move my arm:

S&S:

-obvious flattened deltoid

-protecting arm, head to L side

-weakness, numbing, tingling L arm

-humeral head in arm pit

Glenohumeral Dislocation