SAN JOSÉ STATE UNIVERSITY
CAATE ACCREDITED
UNDERGADUATE
PROFESSIONAL PROGRAM
ATHLETIC TRAINING PROGRAM
(ATP)
CLINICAL EDUCATION
MODULES
ATHLETIC TRAINING STUDENT GUIDE TO COMPETENCY
COMPLETION IN
KIN 197A, 197B, 197C, 197D and
ALL REQUIRED ATHLETIC TRAINING COURSES
2
SAN JOSÉ STATE UNIVERSITY
UNDERGRADUATE
ATHLETIC TRAINING PROGRAM
CLINICAL EDUCATION MODULES
The Undergraduate Athletic Training Program (ATP) at San José State University requires a
series of clinical experiences consisting of competencies and proficiencies. Competencies and
proficiencies will be obtained through a number of experiences in the classroom, lab, and
clinical/practicum setting. This manual is divided into 4 sections related to internship courses:
197A, 197B, 197C and 197D. In order to complete the Athletic Training Program, each student
will need to have each competency evaluated in all 4 sections of this manual. Preceptors are the
only individuals who can evaluate competence in each skill. Skill evaluation will include practice
in labs, demonstration of competence and either an experience in the field or a scenario. Students
are responsible to spend time outside classroom and internship experiences to ensure skill
competence.
Students may advance through the manual at their own rate. Successful practice and then
competence of each task must be demonstrated prior to skill performance in the clinical setting.
Demonstration of skill performance should coincide with course completion. In order to progress
through the practicum process (197A to 197B, etc.) students must complete the required (labeled
REQUIRED) skills in each section. Although it is preferred that students complete all
proficiencies for each course, it is understood that some field/scenario proficiencies may be
difficult to obtain. Thus, students have 4 semesters (197A, 197B, 197C and 197D) to complete
these sections of the proficiencies.
Progress to program completion requires that all evaluations be completed by Preceptors and
recorded by the Program Director as an exit requirement.
DEFINITIONS:
Practice: Skill taught in class or lab and practiced either 1-on-1 with a preceptor or peer, or in
small peer groups.
Competence: Student demonstration of skill proficiency in an oral practical setting. This may
occur in class, lab or practicum with a preceptor.
Field/Scenario Competence: Demonstration of skill proficiency in a field setting or during
practicum through a scenario oral practical with a Preceptor only.
Required: Proficiencies labeled required must be completed during the specified practicum
course (i.e. 197A, 197B, 197C and 197D) in order to receive a grade and progress to the next
course.
NR: Proficiencies labeled NR required completion by the end of KIN 197D in order to receive
endorsement for the Board of Certification (BOC) examination. It is strongly recommended that
students complete these during the specified practicum course (i.e. 197A, 197B, 197C and 197D),
but it is not required to receive a grade and progress to the next course.
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Student Name
_____________________________________________
Program Entry Year _____________________________________________
Program Completion _____________________________________________
Program Director
Clinical Education
Coordinator
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Signature
Date
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Preceptor
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Preceptor
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CLINICAL PROFICIENCIES
KIN 197A:
KIN 188 and KIN 189
5
KIN 197A - Practicum in Athletic Training I
Competency Evaluation Sheet
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Separate sheets are provided for evaluation skills of head injuries. Each evaluation should be
completed for practice, competence, and field/scenario elements. You must have a rating of 4 or
above on the competence and field/scenario elements to pass
Competency
TAPING and WRAPPING
 Medial Longitudinal Arch Support
 Great Toe
- Hyperextension/flexion
 Ankle
- Closed Basketweave
- Open Basketweave
- Basic preventative –inversion/eversion
- Compression wrap with horseshoes
- Achilles
 MTSS (Shin Splint)
- Circumferential taping
 Quadriceps/Hamstring wrapping
 Adductor/Groin wrapping
 Hip Flexor wrapping
 Knee
- Valgus support (MCL)
- Varus support (LCL)
- Hyperextension
- Compression wrap
 Thumb
- Hyperextension
 Fingers
- Buddy taping
- Hyperextension/Hyperflexion
 Elbow
- Hyperextension
- Varus/valgus
- Hyperflexion
- Compression wrap
 Wrist/Hand Taping
- Hyperflexion/Hyperextension
- Wrist/Hand combination
- General compression taping
Practice
REQUIRED
Competence
Field/Scenario
6
 Shoulder
- Glenohumeral Spica wrap
- Acromioclavicular joint
 Lumbar support/bracing
 Cervical support/bracing
 Rib/Thorax support/bracing
REQUIRED
PADDING/SPLINTING
 Materials (foams, felts, etc.)
 Friction pad
 Bony prominence/donut pad
 Muscle contusion
 Soft playing cast (silicone,
thermofoam)
 Hard immobilization splint or cast
(thermoplastics, plaster, fiberglass)
 Pre-fabricated splints
NR
7
REQUIRED
RISK MANAGEMENT
 Use and interpret weight charts
ENVIRONMENTAL CONDITIONS
 Assess the following conditions and make
participation recommendations
 Heat/Cold Temperature
 Lightning
 Wind
 Humidity (Sling-psychrometer)
REQUIRED
EMERGENCY ASSESSMENT
 Emergency Plan understanding
- Demonstration of proper preparation
- Knowledge of procedures
- Proper blood borne pathogen disease
prevention and disposal
 CPR certification
 First Aid certification
 Check surroundings for physical and/or
environmental hazards
 Triage
 Patient Assessment
- Primary survey (ABCD)
- Control of bleeding
- Vital signs (HR/RR/BP)
- Level of consciousness (oriented x 4)
 Shock
 Pulse: Identify the signs and symptoms of
the following cardiac rhythms
- Tachycardia
- Bradycardia
- Arrhythmia
 Respirations: Identify signs and symptoms
of the following breathing patterns
- Apnea
- Tachypnea
- Dyspnea
- Bradypnea
- Hyperventilation
- Obstructed airway – conscious
- Obstructed airway – unconscious
 Temperature
- Oral
- Axillary
- Tympanic
NR
8
 Skin
- Color
- Temperature
 Diabetic Emergencies
- Diabetic Coma
- Insulin Shock
 Fractures/Dislocations
- Proper “packaging” for transportation
- Guidelines for splint application
 Spinal Cord Injury
- Proper spine board techniques
- Proper stretcher/sport chair use
- Proper stabilization techniques
 Splint
- Vacuum splint
- Moldable splint (Sam splint)
 Transportation of injured individual using
- Spine board
- Manual techniques
 Open Wound Management
- Open vs. closed wound
- Control bleeding
- Wound cleansing principles
- Apply superficial skin closures
- Apply appropriate dressings
- Apply and remove gloves and other
protective equipment
- Properly dispose of biohazardous
waste
 Environmental Conditions – Identify signs
and symptoms of the following:
- Heat syncope
- Heat cramps
- Heat exhaustion
- Heat stroke
- Hypothermia
- Frostbite
9
REQUIRED
PHYSICAL EVALUATION
 Snellen eye chart
 Height
 Weight
 Skin (blemishes, rashes, moles, etc.)
EQUIPMENT, PADDING & BRACING
 Crutch Fitting
- Instruct patient on use of crutches
 Cane Fitting
- Instruct patient on use of cane
GENERAL MEDICINE
 Personal hygiene and health principles and
guidelines
 Infectious disease transmission and
prevention principles and guidelines
You must have a rating of 4 or above on the competence and field/scenario elements to pass
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
10
KIN 197A - Practicum in Athletic Training I
FIELD DECISIONS - UNCONSCIOUS ATHLETE
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Evaluate scene for safety
Summon Help - activate EMS
History
What was the mechanism of injury?
Was the person unconscious? For how long?
Prior history of CNS injuries or difficulty?
Suspect/Assume Cervical Spine Injury
· Immobilize head/cervical spine
· Check ABCDs (primary survey)
- Begin rescue breathing/CPR if necessary
- Transport to hospital
· If primary survey benign, move to
abbreviated secondary survey
· Vital signs to establish baseline
- Pulse/Respirations/Blood Pressure
- Serial evaluations
· Pupil response
- PEARL
· Attempt to arouse victim – will awaken to:
- Name
- Patting/tapping
- Pain (pinch, rub, etc.)
· Nonverbal reaction to pain
- Appropriate
- Inappropriate
- None
· Decerebrate/Decorticate Posturing
REQUIRED
Practice
Competence
NR
Field/Scenario
11
REQUIRED
Further evaluation if awakens
· Conscious and
- Oriented x four
- Disoriented
- Restless (inability to stay still)
· Speech
- Clear
- Rambling
- Garbled
- Combative
- None
· Sensory/motor evaluation
- Distal upper extremities
- Distal lower extremities
You must have a rating of 4 or above on the competence and field/scenario elements to pass
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
12
KIN 197A: Practicum in Athletic Training I
FIELD DECISIONS - CONSCIOUS ATHLETE REMOVED TO
ATHLETIC TRAINING ROOM
All skills must be viewed, dated, and initialed. Peers can evaluate Practice elements, while a
preceptor must evaluate Competence and Field/Scenario elements.
Competency
History
What was the mechanism of injury?
Was the person unconscious? For how long?
Prior history of CNS injuries or difficulty?
Baseline Information
· Monitor vital signs
- Normal values for vital signs and exercise
considerations
- Increasing pulse, decreasing BP = shock
- Increasing systolic/decreasing diastolic BP =
increasing intercranial pressure
· Pain anywhere else/cervical spine injury?
· Orientation x 4 (time, place, person, self)
· Pupil response (PEARL)
· Headache
· Dizziness or vertigo
· Facial expression (dazed, blank, etc.)
· Nystagmus
· Tinnitus
· Amnesia
- Retrograde defined/evaluated
- Anterograde defined/evaluated
· Cognitive function evaluation
REQUIRED
Practice
Competence
NR
Field/Scenario
13
REQUIRED
Cranial Nerves
1. Olfactory - identify scent from each nostril
2. Optic - visual acuity
3. Occulomotor - constriction of pupil,
opening eyelid, eye adduction/downward
roll
4. Trochlear – upward roll of eyes
5. Trigmenial - clench teeth, palpate masseters,
facial sensation sharp vs. dull
6. Abducens – lateral ocular movement
7. Facial - raise eyebrows, close eyes tightly,
show teeth, frown, smiled, puff out cheeks
8. Acoustic/Vestibulocochlear - test unilateral
hearing and balance
9. Glossopharangeal - say “ah”, swallow and
watch for coordinated “curtain movement”
of pharynx
10. Vagus - “gag” reflex
11. Spinal accessory - upper trapezius/resisted
shoulder shrug, sternomastoid/turn head
against resistance
12. Hypoglossal - stick out tongue, look for
asymmetry, deviation or atrophy
Palpation
· Mastoid processes
· Cervical spinous/transverse processes
· Supraspinous ligament
· Sternomastoids
· Trapezius – upper/middle/lower fibers
· Compare bilaterally
Ranges of Motion – Active, Passive and Resistive
· Cervical flexion – chin to chest
· Cervical extension – look straight above head
· Lateral cervical flexion – approx. 45 degrees
· Cervical rotation – chin/nose over acromion
process
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
NR
14
REQUIRED
Neurological Evaluation
· Myotomes – C5-T1
- C5 - Shoulder abduction
- C6 - Biceps curl/wrist extension
- C7 - Triceps extension/wrist flexion
- C8 - Finger flexion/grip strength
- T1 - Finger abduction/adduction
· Dermatomes – C5-T1
- C5 – Lateral arm
- C6 – Lateral forearm, thumb, index finger
- C7 – Posterior forearm, middle finger
- C8 – Medial forearm, ring and little fingers
- T1 – Medial arm
Circulatory Evaluation
· Done previously by taking pulse
· Skin color/temperature
Immediate First Aid
· Ice
· Support
· Rest
· Referral
Functional Tests/Return to Play Considerations
· Normal/pain-free ROM
· Normal strength
· Normal neurological function (sensory/motor)
· Functional testing - movements specific to
sport/position
· Movements are fluid without an appearance of
hesitation
· Complete resolution of all symptoms of head
injury
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
15
CLINICAL PROFICIENCIES
KIN 197B:
KIN 191A and KIN 193
16
KIN 197B: Practicum in Athletic Training II
Competency Evaluation Sheet
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Separate sheets are provided for evaluation skills in the following areas. Each evaluation should
be completed for practice, competence, and field/scenario. You must have a rating of 4 or above
on the competence and field/scenario elements to pass.
 History
 Hip
 Knee
 Ankle
 Foot
 Spine and Sacroiliac Joint
Competency
PROTECTIVE EQUIPMENT
 Football helmet fitting
- Types of helmets
- Wet hair
- Ear holes
- Cheek pads
- Forehead/eyebrow
- Occiput
- Bladder/padding conforming
- Chinstrap
- Facemask
 Shoulder pads
- Normal vs. cantilever style
- Covers sternum
- Covers acromion process/tip of
shoulder
- Covers scapula
- Anchors (straps/laces)
 Rib brace/guard
 Mouthpieces
- OTC vs. custom
 Shoes
- Describe parts of shoe/how they
work
- Fit (shoe types vs. foot types)
 Orthotics
- Types/Construction
TAPING and WRAPPING
 Patellar tracking (McConnell taping)
 Patellar support (patellar tendonitis)
Practice
REQUIRED
Competence
Field/Scenario
17
REQUIRED
ADMINISTRATION
 Record Keeping - Knowledge of and
demonstrated ability to complete the
following with confidentiality
- Injury reports (SOAP)
- Daily record keeping/treatment log
- Coaches reports
- Progress notes
- Rehabilitation charts
- Emergency records
- Insurance records
- Physical examination records
- Written/hard copies vs. electronic
- Filing system/security
 Insurance
- Personal (professional liability)
- University (primary vs. secondary
coverage)
- Athlete (HMO/PPO/Direct)
- Procurement, claim processing
 Appropriately stock an athletic trainer’s kit
NR
18
REQUIRED
PHARMACEUTICAL
 Federal and State regulations
- Over the counter medications
- Prescription medications
 Proper storage and disposal
 Proper record keeping and inventory
 Analgesics use
 Anti-inflammatory use
 Anti-histamine use
 Antacid use
 Antiseptic and disinfectant use
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
19
KIN 197B - Practicum in Athletic Training II
HISTORY OF INJURY
All skills must be viewed, dated and initialed. Peers can evaluate Practice, while a Preceptor must
evaluate Competence and Field/Scenario elements.
Competency
Chief complaint
Tell me about your problem
History of the present problem
When did you first notice the symptoms?
Any prior history of this problem?
Any family history of similar symptoms?
Any recent change in your activity?
Aware of any specific mechanism of injury?
Any unusual sounds/sensations with injury?
Time sequence
Sudden or gradual onset of symptoms?
How long do the symptoms last?
Constant or intermittent symptoms?
When do the symptoms typically occur?
Location of symptoms
Point with one finger to area of most pain
Any other areas of pain/discomfort?
Characteristics of the pain
Characterize the pain (dull, sharp, etc.)
Does the pain radiate?
What relieves the pain?
What increases the pain?
Do the symptoms affect your activity level?
Participation in sport/activity
Sport/activity?
Position/event?
Frequency and duration of practices?
Could equipment be related to the injury?
What is the playing environment?
What type of warm-up pattern?
Personal management
Have you attempted any treatment?
Have you taken any medication?
Have you seen anyone else for the problem?
REQUIRED
Practice
Competence
NR
Field/Scenario
20
Do you have any opinion as to your problem?
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
21
KIN 197B - Practicum in Athletic Training II
HIP AND THIGH EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Observe in shorts (Use discretion)
· Deformity
- Genu recurvatum
- Genu valgum/varum
- Anteversion/Retroversion
· Discoloration
· Scars
· Bleeding
· Swelling
· Observe gait or ability to walk
· Compare bilaterally
Palpation
· Illiac Crests
· Pubic symphysis
· Ischial tuberosities
· Greater trochanter/Trochanteric bursa
· PSIS
· ASIS
· Sacroilliac joint
· Femoral triangle (contents/borders)
· Sartorius
· Adductor longus
· Gluteus medius
· Gluteus maximus
· Hamstrings
- Semimembranosis
- Semitendinosis
- Biceps femoris
· Rectus femoris
· Vastus lateralis/medialis/intermedius
REQUIRED
Practice
Competence
NR
Field/Scenario
22
REQUIRED
Range of Motion – Active, Passive and Resistive
· Hip internal
· Hip external rotation
· Hip flexion
· Hip extension
· Hip adduction
· Hip abduction
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Trendelenburg test
· Ober test
· Leg length (true vs. apparent)
· Thomas test
· Straight leg raise test
· Compare bilaterally
Neurological
· Peripheral nerves (sensory/motor function)
- Obturator
- Femoral
- Tibial
- Superior gluteal
- Inferior gluteal
· Nerve root levels
- L1-S2 dermatomes
- L1-S2 myotomes
Circulation
· Skin temperature/color
· Capillary refill
· Popliteal pulse
· Posterior tibial pulse
· Femoral pulse
Immediate First Aid
· Ice
· Elevation
· Compression
· Rest (crutches)
· Referral
NR
23
REQUIRED
Functional Tests/Return to Play Considerations
· Weight Bearing
· Gait
· Heel strike
· Toe-off
· Walk on toes
· Walk on heels
· Hop on both feet
· Hop on injured foot
· Straight line jog ½ speed
· Straight line jog ¾ speed
· Straight line jog full speed
· Full speed and come to stop over a 2-3
yard distance
· Full speed to a dead stop
· Large figure eight and make progressively
smaller and faster
· Carioca to left/right
· Full sprint and cut 90 degrees to left/right
· Movements specific to sport
· All movements must be pain free/no limp
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
24
KIN 197B - Practicum in Athletic Training II
KNEE EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Observe in shorts (use discretion)
· Deformity
- Genu recurvatum (hyperextension)
- Genu varum/valgum
· Discoloration
· Swelling
· Bleeding
· Scars
· Observe gait/ability to walk
· Compare bilaterally
Palpation
· Patella
- Superior pole
- Inferior pole
- Medial/lateral undersurface/borders
- Alignment considerations (medial,
lateral, baja, alta, tilt, rotation)
· Fibular head
· Tibial tuberosity
· Medial femoral condyle
· Medial tibial plateau
· Lateral femoral condyle
· Lateral tibial plateau
· Medial collateral ligament
· Lateral collateral ligament
· Joint line (menisci)
· Anterior superior tibiofibular ligament
· Quadriceps (rectus f., vastus l/m/i)
· Patellar tendon (infra. vs.supra patellar)
· Infrapatellar fat pad
· Gastrocnemius (medial/lateral head)
· Hamstrings (biceps femoris,
- Biceps femoris tendon
- Semimembranosis
- Semitendinosis
· Iliotibial band/insertion (Gerdy’s tubercle)
· Pes anserine muscles/insertion
· Popliteal fossa (borders, contents)
REQUIRED
Practice
Competence
NR
Field/Scenario
25
REQUIRED
Range of Motion – Active, Passive and Resistive
· Knee flexion
· Knee extension
· Ankle plantar flexion
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Tinel sign (behind fibular head)
· Menisci
- Check ROM full flexion/extension
- Apley’s compression/distraction
- Deep squat/duck walk
- McMurray’s test - thumb/index finger on
joint line, internal/external rotation with
varus/valgus force application
· Joint effusion
- Ballotable patella
- Suprapatellar pouch
- Differentiate from prepatellar bursitis
· Ligaments
- Varus at 0 degrees and 15-30 degrees
- Valgus at 0 degrees and 15-30 degrees
- Anterior drawer
- Posterior drawer
- Lachman/Modified Lachman
- Posterior sag sign (Godfrey’s sign)
· Compare bilaterally
Neurological
· Peripheral nerves (sensory/motor function)
- Obturator
- Femoral
- Tibial
- Superior gluteal
- Inferior gluteal
· Nerve root levels
- L1-S2 dermatomes
- L1-S2 myotomes
NR
26
REQUIRED
Circulation
· Skin temperature/color
· Capillary refill
· Popliteal pulse
· Posterior tibial pulse
· Dorsal pedal pulse
Immediate First Aid
· Ice
· Elevation
· Compression
· Rest (crutches)
· Referral
Functional Tests
· Weight Bearing
· Foot gait cycle
· Heel strike
· Toe-off
· Walk on toes
· Walk on heels
· Hop on both feet
· Hop on injured foot
· Straight line jog ½ speed
· Straight line jog ¾ speed
· Straight line jog full speed
· Full speed and come to stop over a 2-3
yard distance
· Full speed to a dead stop
· Large figure eight and make
progressively smaller and faster
· Carioca to left/right
· Full sprint and cut 90 degrees to
left/right
· Movements specific to sport
· All movements must be pain free/no
limp
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
27
KIN 197B - Practicum in Athletic Training II
ANKLE EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Remove shoes/socks bilaterally
· Deformity
· Bleeding
· Swelling
· Discoloration
· Scars
· Observe gait/ability to walk
· Compare bilaterally
Palpation
· Shaft of tibia
· Fibula
· Medial malleolus
· Dome of talus
· Lateral Malleolus
· Calcaneus
· Sustentaculum tali
· Deltoid ligament
· Anterior talofibular ligament
· Calcaneofibular ligament
· Posterior talofibular ligament
· Anterior inferior tibiofibular ligament
· Posterior inferior tibiofibular ligament
· Tibialis posterior tendon
· Flexor digitorum longus tendon
· Flexor hallicus longus tendon
· Tibialis Anterior
· Extensor hallicus longus tendon
· Extensor digitorum longus tendon
· Peroneus longus/brevis tendons
· Achilles tendon
· Extensor digitorum brevis
· Sinus tarsi
· Calcaneal and retrocalcaneal bursa
REQUIRED
Practice
Competence
NR
Field/Scenario
28
REQUIRED
Range of Motion – Active, Passive and Resistive
· Ankle dorsiflexion
· Ankle plantarflexion
· Ankle inversion
· Ankle eversion
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Anterior drawer
· Posterior drawer
· Eversion
· Inversion
- Foot in neutral position
- Foot in plantar flexed position
· Kleiger’s test (dorsiflexion/external
rotation)
· Thompson test
· Percussion test
· Squeeze (Compression) test
Neurological
· Peripheral nerves (sensory/motor function)
- Deep peroneal
- Superficial peroneal
- Tibial
·
Nerve root levels
- L4-S2 dermatomes
- L4-S2 myotomes
NR
29
REQUIRED
Circulation
· Skin temperature/color
· Capillary refill
· Dorsal pedal pulse
· Posterior tibial pulse
Immediate First Aid
· Ice
· Elevation
· Compression
· Rest (crutches)
· Referral
Functional Tests
· Weight Bearing
· Foot gait cycle
· Heel strike
· Toe-off
· Walk on toes
· Walk on heels
· Hop on both feet
· Hop on injured foot
· Straight line jog ½ speed
· Straight line jog ¾ speed
· Straight line jog full speed
· Full speed and come to stop over a 2-3
yard distance
· Full speed to a dead stop
· Large figure eight and make
progressively smaller and faster
· Carioca to left/right
· Full sprint and cut 90 degrees to
left/right
· Movements specific to sport
· All movements must be pain free/no
limp
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
30
KIN 197B - Practicum in Athletic Training II
FOOT EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Remove shoes/socks bilaterally
· Deformity
· Pes planus (flat feet)
· Pes Cavus (high arch)
· Forefoot varus/valgus
· Rearfoot varus/valgus
· Hallux valgus (bunion)
· Swelling
· Discoloration
· Bleeding
· Callous pattern
· Observe gait/ability to walk
· Observe wear on shoes
· Compare bilaterally
Palpation
· Medial malleolus
· Lateral malleolus
· Talar head
· Neck/dome of talus
· Sinus tarsi
· Calcaneus
· Sustenaculum tali
· Peroneal tubercle
· Navicular (tubercle)
· Cunieforms (1st, 2nd, 3rd)
· Cuboid
· Intertarsal joints
· Tarsometatarsal joints
· Metatarsal heads/shafts/bases
· Styloid process of 5th metatarsal
· Phalanges (proximal/middle/distal)
· Metatarsophalangeal joints
· Proximal/distal interphalangeal joints
· Sesamoid bones
REQUIRED
Practice
Competence
NR
Field/Scenario
31
REQUIRED
·
·
·
·
·
·
·
·
·
·
·
Longitudinal arches (medial/lateral)
Transverse metatarsal arch
Plantar fascia
Achillles tendon
Peroneus longus/brevis
Tibialis posterior
Flexor digitorum longus/brevis
Flexor hallicus longus
Tibialis anterior
Extensor digitorum longus/brevis
Extensor hallicus longus
· Calcaneal bursa
· Calcaneal fat pad
Range of Motion – Active, Passive and Resistive
· Toe/great toe flexion
· Toe/great toe extension
· Ankle dorsiflexion
· Ankle plantarflexion
· Ankle inversion
· Ankle eversion
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Toe tap test for fracture
· Compression of metatarsal heads
· Stress interosseous membrane between
metatarsals
· Varus/valgus stress at MP/PIP/DIP joints
· Toe hyperextension (stress plantar fascia)
Neurological
· Peripheral nerves
- Deep peroneal
- Superficial peroneal
- Tibial
· Nerve root levels
- L4-S2 dermatomes
- L4-S2 myotomes
NR
32
REQUIRED
Circulation
· Skin temperature/color
· Capillary refill
· Dorsal pedal pulse
· Posterior tibial pulse
Immediate First Aid
· Ice
· Elevation
· Compression
· Rest (crutches)
· Referral
Functional Tests
· Weight Bearing
· Foot gait cycle
· Heel strike
· Toe-off
· Walk on toes
· Walk on heels
· Hop on both feet
· Hop on injured foot
· Straight line jog ½ speed
· Straight line jog ¾ speed
· Straight line jog full speed
· Full speed and come to stop over a 2-3
yard distance
· Full speed to a dead stop
· Large figure eight and make
progressively smaller and faster
· Carioca to left/right
· Full sprint and cut 90 degrees to
left/right
· Movements specific to sport
· All movements must be pain free/no
limp
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
33
KIN 197B - Practicum in Athletic Training II
SPINE AND SACROILIAC JOINT EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Observe in shorts/underwear (use discretion)
· Observe fluidity of movement (example: onto
table or into room)
· Abdominal muscles/tone
· Posture
- Lordosis
- Scoliosis
- Kyphosis
· Scars
· Discoloration
· Bleeding
· Swelling
· Atrophy
· Posture (cervical, thoracic, lumbar curves)
· Leg length (true vs. apparent)
· Observe gait
· Hips, knees, feet (varus, valgus, recurvatum
Patella (malalignment)
· Compare bilaterally
REQUIRED
Practice
Competence
NR
Field/Scenario
34
REQUIRED
Palpation
· Tops of iliac crests - between L4/L5 spinous
processes
· PSIS – level of S2 spinous process
· Lumbar/sacral spinous processes
· Visible/palpable presence of any sacral or
lumbar spinous process “step off”
· SI joint (static and dynamic motion)
· PSIS
· ASIS
· Pubic symphysis
· Greater trochanter
· Ischial tuberosities
· Sacral triangle
· Paraspinal/erector spinae muscles
· Gluteal maximus/medius
· Quadratus lumborum
· Abdominal muscles
Ranges of Motion - Active, Passive and Resistive
· Trunk flexion
· Trunk extension
· Trunk rotation
· Trunk lateral bending
· Proper stabilization of movements
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Spring test for ligamentous mobility
· Valsalva maneuver
· Milgram test
· Kernig test
· Slump test
· Straight leg raise/Well straight leg raise
· SI compression/distraction
· Gaenslen’s test
· Patrick’s/FABER test
· Long sit test
NR
35
REQUIRED
NR
REQUIRED
NR
Neurological
· Peripheral nerves (sensory/motor function)
- Femoral
- Obturator
- Tibial
- Common peroneal
- Superior gluteal
- Inferior gluteal
· Nerve root levels
- L1-S2 dermatomes
- L1-S2 myotomes
· Reflexes
- Patellar tendon (L4-L5)
- Achilles tendon (S1-S2)
Specific Muscular Testing
· Erector Spinae (spinalis, longissimus,
iliocostalis evaluated as a group)
· Quadratus Lumborum
· Psoas and illiacus
Circulation
· Skin temperature/color
· Capillary refill
· Femoral pulse
Functional Tests
· Weight Bearing
· Foot gait cycle
· Heel strike
· Toe-off
· Walk on toes
· Walk on heels
· Hop on both feet
· Hop on injured foot
· Straight line jog ½ speed
· Straight line jog ¾ speed
· Straight line jog full speed
· Full speed and come to stop over a 2-3 yard
distance
· Full speed to a dead stop
· Large figure eight and make progressively
smaller and faster
· Carioca to left/right
· Full sprint and cut 90 degrees to left/right
· Movements specific to sport
· All movements must be pain free/no limp
36
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
37
CLINICAL PROFICIENCIES
KIN 197C:
KIN 191B and KIN 195
38
KIN 197C: Parcticum in Athletic Training III
Competency Evaluation Sheet
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
GENERAL MEDICINE
 Otoscope - Demonstrate appropriate use
 Chemstrips - Measure urine values
 Skin diseases - recognize signs and
symptoms associated with
- Poison ivy/sumac/oak
- Ringworm
- Warts
- Impetigo
- Herpes
 Disordered eating - recognize signs and
symptoms associated with
- Anorexia
- Bulimia
- Obesity
 Ears, Eyes, Nose, Throat - recognize signs
and symptoms associated with
- Common cold/rhinovirus
- Conjunctivitis
- Laryngitis
- Pharyngitis
- Rhinitis
- Sinusitis
- Tetanus
- Tonsillitis
REQUIRED
Practice
Competence
NR
Field/Scenario
39
REQUIRED
GENERAL MEDICINE
 Recognize signs/symptoms of the
following conditions
- Hypertension
- Hypertrophic cardiomyopathy
- Hypotension
- Migraine headache
- Syncope
 Recognize signs/symptoms of the
following viral diseases
- Infectious mononucleosis
- Measles (rubeola)
- German measles (rubella)
- Mumps (parotitis)
- Chicken pox (varicella)
 Recognize signs/symptoms of the
following systemic diseases
- Iron-deficiency anemia
- Sickle cell anemia
- Lyme disease
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
40
KIN 197C – Practicum in Athletic Training III
ABDOMEN AND THORAX EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Expose area (use discretion)
· Scars
· Atrophy/hypertrophy
· Discoloration
· Abdominal rigidity
· Bleeding
· Deformity
· Signs and symptoms of shock
· Difficulty breathing
· Cyanosis
· Ability to move/sit/stand
· Compare bilaterally
Palpation
· Start in quadrant furthest from pain
· Quadrants/contents
- Upper right
- Upper left
- Lower right
- Lower left
· Ribs (true/false/floating)
· Sternum/manubrium/xiphoid process
· Intercostal muscles/space
· Costochondral joints
· Chondrosternal joints
· Crepitus
· Rebound pain
· Rigidity
REQUIRED
Practice
Competence
NR
Field/Scenario
41
REQUIRED
Range of Motion – Active, Passive and Resistive
· Trunk flexion
· Trunk extension
· Trunk rotation
· Trunk lateral bending
· End feels for passive ranges
· Strength grades for resistive ranges
· Pelvic tilt
Stress Tests
· Rib cage squeeze
· Tap test
Neurological
· Referred pain sites/associated organs/structures
Circulation
· Skin temperature/color
· Capillary refill
· Radial pulse
· Brachial pulse
Immediate First Aid
· Ice
· Referral
Bladder Injury
Mechanism
· Severe blow to lower pelvic region
Signs and symptoms
· Pain and discomfort in lower abdomen
· Signs of Shock
· Hematuria
· Abdominal rigidity
· Desire but inability to urinate
· Nausea
· Uses stethoscope to determine bowel sounds
Management
· Physician referral
NR
42
REQUIRED
Splenic Injury
Mechanism
· Severe blow to upper left quadrant
Signs and symptoms
· Abdominal pain
· Signs of Shock
· Vomiting
· Abdominal rigidity
· Kerr’s sign
· Nausea
Management
· Physician referral
Kidney Injury
Mechanism
· Severe blow mid-back area/flank
Signs and symptoms
· Rigidity of back muscles
· Signs of Shock
· Vomiting
· Hematuria
· Nausea
· Referred pain in mid-thoracic region
posteriorly, radiating forward around trunk into
lower abdominal region
Management
·Physician referral
Blow to Solar Plexus:
Mechanism
· Severe blow to substernal area
Signs and symptoms
· Respirations stop due to temporary diaphragm
paralysis
Management
· Help athlete overcome apprehension
· Loosen belt and clothing around abdomen
· Encourage relaxation with inhalation through
nose exhalation through the mouth
NR
43
REQUIRED
Liver Injury
Mechanism
· Severe blow to upper right quadrant
Signs and symptoms
· Rigidity of abdominal muscles
· Signs of Shock
· Vomiting
· Nausea
· Pain and discomfort in area of blow
· Referred pain below right scapula and chest
Management
· Physician referral
Contusion/Strain of Rectus Abdominis
Mechanism
· Severe blow or exertion of abdominal muscles
Signs and symptoms
· Rigidity
· Pain/tightness in abdominal area
· Pain with trunk flexion or extension
Management
· Ice
· Compression
Pneumothorax: (traumatic vs. spontaneous)
Defined
· Pleural cavity filled with air
Mechanism
· Blunt force trauma
· Penetration of rib fracture or other implement
· Idiopathic (unknown) origin - spontaneous
Signs and symptoms
· Pain
· Difficulty breathing
· Signs of Shock
· Anoxia (loss of oxygen)
· Uses stethoscope to determine chest sounds
(auscultation)
Management
· Immediate physician referral
NR
44
REQUIRED
Hemothorax
Defined
· Blood in pleural cavity
Mechanism
· Blunt force trauma
· Penetration of rib fracture or other implement
Signs and symptoms
· Pain
· Difficulty breathing
· Signs of Shock
· Cyanosis
· Uses stethoscope to determine chest sounds
(auscultation)
Management
· Immediate physician referral
Lung Hemorrhage
Mechanism
· Violent blow or compression of chest
with/without
accompanying rib fracture
Signs and symptoms
· Pain with breathing
· Dyspnea (painful, labored breathing)
· Signs of Shock
· Coughing of frothy blood
· Uses stethoscope to determine chest sounds
Management
· Physician referral
Rib Fracture
Mechanism
· Kick or direct blow to rib cage
· General compression of rib cage (indirect)
Signs and symptoms
· Pain on inspiration
· Point tenderness
· Swelling
· Crepitus
· Paradoxical motion/flail chest
Special tests
· Compression of rib cage
· tap test
Management
· Physician referral
· Rib support (belt)
NR
45
REQUIRED
Sternal Fracture
Mechanism
· Direct blow to sternum
· Violent compressive posterior force
· Hyperflexion of trunk
Signs and symptoms
· Sharp chest pain localized over sternum
with inhalation
· Position of head and shoulders dropped forward
· Swelling
· Displaced fragments possible (significant if
posterior)
Management
· Physician referral
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
46
KIN 197C - Practicum in Athletic Training III
FACE EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Deformity
- Bite
- Ability to move eyes
- Squinting
· Swelling
· Atrophy
· Hyphema
· Conjunctivitis
· Pupil reaction to light/size
· Observe motions (smile, frown, etc..)
· Signs of head injury
· Panda bear eyes
· Depressed cheekbone
· Battles sign
· Scars
· Discoloration
· Bleeding
· Compare bilaterally
Palpation
· Maxilla
· Mandible
· frontal bone
· temporal bone
· Zygomatic arch
· Orbit
· Nasal bone/septum
· TMJ
REQUIRED
Practice
Competence
NR
Field/Scenario
47
REQUIRED
Cranial Nerves
1. Olfactory - identify scent from each
nostril
2. Optic - visual acuity
3. Occulomotor - constriction of pupil,
opening eyelid, eye
adduction/downward roll
4. Trochlear – upward roll of eyes
5. Trigmenial - clench teeth, palpate
masseters, facial sensation sharp vs. dull
6. Abducens – lateral ocular movement
7. Facial - raise eyebrows, close eyes
tightly, show teeth, frown, smiled, puff
out cheeks
8. Acoustic/Vestibulocochlear - test
unilateral hearing and balance
9. Glossopharangeal - say “ah”, swallow
and watch for coordinated “curtain
movement” of pharynx
10. Vagus - “gag” reflex
11. Spinal accessory - upper
trapezius/resisted
shoulder shrug, sternomastoid/turn head
against resistance
12. Hypoglossal - stick out tongue, look for
asymmetry, deviation or atrophy
Muscle Testing
· Jaw (open/close)
· Facial expressions
· Tongue movement
· Eye movements
· Compare bilaterally
Circulation
· Skin temperature/color
Immediate First Aid
· Ice
· Rest
· Referral
NR
48
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
49
KIN 197C - Practiccum in Athletic Training III
SHOULDER EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Observe without shirt or in tank top
· Differentiate between scoliosis and habitual
overhead motion
· Deformity
Arm position
Depressed/dropped shoulder
Scoliosis
Protracted shoulder due to tight pectoralis
major muscles
- Winged scapula
- Step-off of acromioclavicular joint
· Muscle atrophy
· Scars
· Discoloration
· Bleeding
· Observe posture
- Anterior view
- Posterior view
- Lateral view
· Scapular rhythm – 2:1 ratio
· Compare Bilaterally
REQUIRED
Practice
Competence
NR
Field/Scenario
50
REQUIRED
Palpation
· Scapula
- Spine of scapula – level of T3 spinous
process
- Acromion process
- Coracoid process
- Inferior angle
- Superior angle
- Medial/vertebral border
- Lateral/axillary border
· Clavicle
- Sternal/medial/proximal end
- Middle 1/3 – “s-curve”
- Acromial/lateral/distal end
· Humerus
- Humeral head
- Bicipital/intertubercular groove
- Greater tuberosity
- Lesser tuberosity
- Deltoid tuberosity
· Sternoclavicular joint/ligaments
· Coracoclavicular ligaments
· Acromioclavicular joint/ligaments
· Muscles
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
- Teres major
- Latissimus dorsi
- Trapezius (upper/middle/lower fibers)
- Deltoid (anterior/middle/posterior
fibers)
- Pectoralis major (sternal/clavicular
heads)
- Biceps brachii (long/short heads)
- Triceps brachii (long/medial/lateral
heads)
- Serratus anterior
· Axilla – lymph nodes
· Compare bilaterally
NR
51
REQUIRED
NR
REQUIRED
NR
Range of Motion - Active, Passive and Resistive
· GH extension
· GH flexion
· GH horizontal abduction
· GH horizontal adduction
· GH internal rotation
· GH external rotation
· GH abduction
· GH adduction
· Scapular depression
· Scapular elevation
· Scapular protraction
· Scapular retraction
· Cervical flexion
· Cervical extension
· Cervical lateral flexion (side bending)
· Cervical rotation
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Special Tests
· Piano Key (AC sprain)
· Biceps tests
- Speed’s test
- Yergason’s test
- Lundington’s test
· Impingement/rotator cuff tests
- Hawkins-Kennedy test
- Neer test
- Empty can test
- Drop arm test
- Painful arc
· Thoracic outlet syndrome tests
- Adson’s test
- Allen’s test
· GH instability tests
- Apprehension test
- Posterior apprehension test
- Relocation test
- Anterior/posterior translation/glide tests
- Sulcus sign
· Labrum tests
- Labral grind test
- Clunk test
· Compare Bilateral
52
Neurological
· Peripheral nerves (sensory/motor function)
- Axillary
- Musculocutaneous
- Median
- Ulnar
- Radial
· Nerve root levels
- C5-T1 dermatomes
- C5-T1 myotomes
· Reflexes
- Triceps (C7-C8)
- Biceps (C5-C6)
- Brachioradialis (C5-C6)
Circulation
· Skin temperature/color
· Radial Pulse
· Brachial pulse
· Capillary refill
Immediate First Aid
· Ice
· Rest (sling and swath)
· Compression
· Referral
· Elevation
Functional Tests/Return to Play Considerations
· Normal, pain-free ranges of motion
· Normal strength, neuromuscular control
· Movements specific to sport/position
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
53
KIN 197C - Practicum in Athletic Training III
ELBOW/ARM EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Deformity
- Carrying angle (cubitus valgus)
- Gunstock deformity (cubitus varus)
· Swelling
· Atrophy
· Isosceles triangle
· Observe motion
· Compare bilaterally
· Scars
· Discoloration
· Bleeding
· Olecranon bursitis
Palpation
· Olecranon process
· Lateral epicondyle
· Medial epicondyle
· Radial head
· Annular ligament
· Ulna
· Medial/ulnar collateral ligament
· Lateral/radial collateral ligament
· Cubital tunnel
· Wrist flexors (palm on medial elbow reference)
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
- Flexor digitorum superficialis
· Biceps brachii tendon
· Triceps brachii
· Wrist extensors
- Extensor digitorum
- Extensor pollicis longus
- Brachioradialis
- Supinator
· Antecubital space (borders and contents)
REQUIRED
Practice
Competence
NR
Field/Scenario
54
REQUIRED
Range of Motion – Active, Passive and Resistive
- Elbow flexion
- Elbow extension
- Forearm supination
- Forearm pronation
- End feels for passive ranges
- Strength grades for resistive ranges
- Compare bilaterally
Stress Tests
· Valgus with slight flexion
· Varus with slight flexion
· Tinel sign (cubital tunnel)
· Tennis elbow (elbow extended vs. flexed)
· Tap test
· Compare bilaterally
Neurological
· Peripheral nerves (sensory/motor function)
- Axillary
- Musculoceutaneous
- Median
- Ulnar
- Radial
· Nerve root levels
- C5-T1 dermatomes
- C5-T1 myotomes
- C4 dermatome/myotome
Circulation
· Skin temperature/color
· Radial pulse
· Brachial pulse
· Capillary refill
Immediate First Aid
·Ice
·Elevation
·Compression
·Rest (sling/swath)
·Referral
Functional Tests/Return to Play Considerations
· Normal, pain-free ranges of motion
· Normal strength, neuromuscular control
· Movements specific to sport/position
NR
55
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
56
KIN 197C - Practicum in Athletic Training III
HAND/THUMB EVALUATION
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
History - Refer to history page
Observation/Inspection
· Deformity
- Fist/metacarpal heads (Boxer’s fx)
- MP flexion (all fingers point to lunate)
- Dislocation (DIP/PIP/MP)
· Swelling
· Scars
· Discoloration
· Bleeding
· Atrophy (thenar/hypothenar eminence)
· Observe position and function
· Compare bilaterally
Palpation
· Radial styloid process
· Ulnar styloid process
· Anatomic snuff box
· Thenar eminence
· Hypothenar eminence
· Carpal bones (proximal and distal rows)
· Metacarpals (heads/shaft/bases)
· Phalanges (proximal/middle/distal)
· MP joints
· PIP joints
· DIP joints
· Extensor pollicis longus
· Abductor pollicis longus
· Extensor pollicis brevis
· 1st dorsal interossei
· Palmaris longus
· Flexor digitorum superficialis
· Flexor digitorum profundus
· Extensor digitorum
REQUIRED
Practice
Competence
NR
Field/Scenario
57
REQUIRED
Range of Motion – Active, Passive and Resistive
· Finger abduction
· Finger adduction
· MP joint flexion
· MP joint extension
· PIP joint flexion
· PIP joint extension
· DIP joint flexion
· DIP joint extension
· Thumb flexion
· Thumb extension
· Thumb abduction
· Thumb adduction
· Thumb opposition
· End feels for passive ranges
· Strength grades for resistive ranges
· Compare bilaterally
Stress Tests
· Tap test
· Phalens
· Tinel sign
· Valgus/varus test for MP/PIP/DIP
· Stress the metacarpals/phalanges longitudinally
(false joints)
· Finkelstein test
· Compare bilaterally
Neurological
· Peripheral nerves (sensory/motor function)
- Median
- Ulnar
- Radial
· Nerve root levels
- C5-T1 dermatomes
- C5-T1 myotomes
Circulatory
· Skin temperature/color
· Capillary refill
· Radial pulse
NR
58
REQUIRED
Immediate First Aid
· Ice
· Elevation
· Compression
· Rest (splint)
· Referral
Functional Tests/Return to Play Considerations
· Normal, pain-free ranges of motion
· Normal strength, neuromuscular control
· Movements specific to sport/position
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
NR
59
KIN 197C: Practicum in Athletic Training III
ICE BAGS
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Place patient in a comfortable position
2. Fill plastic bag with enough ice to last the
duration of the treatment
3. Use enough bags to cover the area being
treated
4. Remove excess air from bags
5. Apply one layer of a wet elastic wrap or
towel around the area to be treated (optional)
6. Place ice bag on area being treated
7. Secure ice bag in place with toweling or an
elastic bandage/plastic wrap
8. Check for frostbite during treatment
9. Watch for neuropathy over large superficial
nerves
10. Treatment time is 20 minutes
Indications
1. Acute injury or inflammation
2. Acute or chronic pain
3. Postsurgical pain and edema
Contraindications
1. Some cardiac/respiratory conditions
2. Uncovered open wounds
3. Circulatory insufficiency
4. Cold allergy and/or hypersensitivity
5. Neurological sensory deficit
Practice
REQUIRED
Competence
Field/Scenario
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
60
KIN 197C: Practicum in Athletic Training III
Cryostretch – Vapocoolant Spray
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Place patient in a comfortable position so that
the muscle group may be easily stretched
2. If spraying near the face, cover the patient’s
eyes, nose and mouth
3. Hold container upside down 12-18 inches
from the skin
4. Hold the bottle at a 30-45 degree angle from
the skin
5. Spray (sweep) the entire length of the muscle
in one direction only from distal to proximal
6. Do not frost the skin
7. Begin passive stretching as you start spraying
the area
8. Allow tissue to re-warm between sweeps
9. Repeat 2-3 times or until desired stretch
occurs
10. Monitor for frostbite
Indications
1. Trigger points
2. Muscle spasm
3. Decreased range of motion
Contraindications
1. Allergy to spray
2. Uncovered open wounds
3. Acute and/or post-surgical injury
4. Contraindications relating to cold application
5. Contraindications relating to passive
stretching
6. Use around eyes/nose/mouth (protect from
spray)
Practice
REQUIRED
Competence
Field/Scenario
61
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
62
KIN 197C: Practicum in Athletic Training III
Controlled Cold Therapy Units (Cryocuff)
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Fill cooling unit with ice as indicated
2. Add cold water to “fill” mark
3. Allow water to chill for 5-10 minutes
4. Select appropriate appliance for body part
5. Fasten distal strap snugly (Do not restrict
blood flow)
6. Fasten proximal strap loosely
7. Connect appliance to cooler using hose
provided
8. Open air vent to allow water to flow into the
appliance
9. Elevate cooler above body part
10. Remove air-bleed cap to force trapped air out
of appliance
11. Disconnect hose
12. Check for frostbite during treatment
13. Check for neuropathy over large superficial
nerves
14. Treatment time is up to 72 hours
continuously
Indications
1. Acute injury or inflammation
2. Acute or chronic pain
3. Post-surgical pain and edema
Contraindications
1. Some cardiac/respiratory conditions
2. Uncovered open wounds
3. Circulatory insufficiency
4. Cold allergy and/or hypersensitivity
5. Neurological sensory deficit
Practice
REQUIRED
Competence
Field/Scenario
63
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
64
KIN 197C: Practicum in Athletic Training III
Ice Immersion/Cold Whirlpool
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. If using whirlpool, verify GFCI operation
2. Prepare bucket/whirlpool with cold water
and ice (50-60º F)
3. Place neoprene caps on patient if necessary
to insulate fingers/toes
4. Immerse body part in bucket/whirlpool
5. If desired, turn on whirlpool, adjust amount
and direction of turbulence
6. Instruct patient not to turn whirlpool on or
off or touch any electrical connections while
in the whirlpool or while body is wet
7. Check patient regularly for nerve palsy
8. Watch patient’s level of consciousness
during treatment
9. Do not allow patient to continually withdraw
body part from water
10. Treatment time is 10-20 minutes
11. Wrap and elevate body part after treatment
Indications
1. Acute injury or inflammation
2. Acute or chronic pain
3. Post-surgical pain and edema
Contraindications
1. Some cardiac/respiratory conditions
2. Open wounds – must be dedicated treatment
3. Circulator insufficiency
4. Cold allergy and/or hypersensitivity
5. Neurological sensory deficit
6. Absolute inability to tolerate the cold
temperature
Practice
REQUIRED
Competence
Field/Scenario
65
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
66
KIN 197C: Practicum in Athletic Training III
Warm Whirlpool
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Verify GFCI operation
2. Fill whirlpool with hot water (100-110º F)
3. Add disinfectant (optional)
4. Place patient in a comfortable position using
a high chair or bench
5. Immerse body part in water
6. Turn turbine on and adjust amount and
direction of turbulence
7. Instruct patient not to turn whirlpool on or
off or touch any electrical connections while
in the whirlpool or while body is wet
8. Treatment time is 15-20 minutes
Indications
1. Subacute or chronic inflammation
2. Peripheral vascular disease
3. Decreased range of motion
4. Neurological sensory deficit
Contraindications
1. Acute conditions in which water turbulence
would further irritate injured areas or in
which the limb is placed in a gravity
dependent position
2. Patient’s requiring postural support during
treatment
3. Skin conditions/infections unless dedicated
whirlpool
4. Fever
Practice
REQUIRED
Competence
Field/Scenario
67
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
68
KIN 197C: Practicum in Athletic Training III
Paraffin Bath
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up/Application - Immersion Method
1. Thoroughly clean body part to be treated
with soap and water. After drying, use
alcohol to remove soap residue.
2. Have patient dip the body part into the
paraffin and remove.
3. Allow wax to dry (it will turn a dull shade of
white).
4. Repeat dipping in was 6-12 more times while
allowing drying in between each dip.
5. Place body part back in wax for duration of
treatment.
6. Have patient avoid touching the sides or
bottom of the unit because burns may result.
7. Do not allow patient to move joints, this may
crack dried wax and allow fresh paraffin to
touch the skin, increasing risk of burns.
8. Monitor for comfort and mottling of skin.
9. Treatment time is 15-20 minutes.
10. After treatment have patient scrape off
paraffin back into heating unit
Set-up/Application – Pack/Glove Method
1. Thoroughly clean body part to be treated
with soap and water. After drying, use
alcohol to remove soap residue.
2. Have patient dip the body part into the
paraffin and remove.
3. Allow wax to dry (it will turn a dull shade of
white).
4. Repeat dipping in wax 6-12 more times.
5. Place body part in plastic bag, aluminum foil
or wax paper.
6. Wrap and secure a terry cloth towel or
glove/oven mitt around body part.
7. Elevate body part if indicated.
8. Monitor for comfort and mottling of skin.
Practice
REQUIRED
Competence
Field/Scenario
69
Practice
REQUIRED
Competence
Field/Scenario
9. Treatment time is 15-20 minutes.
10. After treatment have patient scrape off
paraffin back into heating unit.
Indications
1. Subacute or chronic inflammation
2. Limitation of motion after immobilization
Contraindications
1. Open wounds
2. Skin infections
3. Neurological sensory deficit
4. Peripheral vascular disease
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
70
KIN 197C: Practicum in Athletic Training III
Moist Heat Packs
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Remove pack carefully from hydrocollator
using tongs.
2. Cover pack with a commercial terry cloth
covering or wrap pack with layers of
toweling.
3. Place patient in a comfortable position.
4. Place the pack on the patient. Do not let the
patient lie on the pack. Do not allow the
pack to come into direct contact with the
skin.
5. Completely cover any infected area of skin
with sterile gauze.
6. Check patient after first five minutes for
comfort and mottling and recheck patient
regularly.
7. Treatment time is 15-20 minutes.
8. Return pack to hydrocollator and allow 3045 minutes for it to reheat before reusing it.
9. Remove contaminated gauze if used and
wash toweling or commercial cover.
Indications
1. Subacute or chronic inflammation
2. Reduction of subacute or chronic pain
3. Subacute or chronic muscle spasm
4. Decreased range of motion
5. Hematoma resolution
6. Reduction of joint contractures
Contraindications
1. Acute injuries
2. Peripheral vascular disease
3. Impaired circulation
4. Poor thermoregulatory system
5. Neurological sensory deficit
Practice
REQUIRED
Competence
Field/Scenario
71
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
72
KIN 197C: Practicum in Athletic Training III
Cervical Traction
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
Competency
Set-up and Application
1. Establish that no contraindications are
present by questioning the patient.
2. Determine the patient’s weight.
3. The cervical musculature may be pretreated
with moist heat to decrease muscle spasm.
4. Instruct the patient to remove any earrings,
glasses, or other clothing that may interfere
with the placement of the halter.
5. Lay the patient on the treatment table in the
supine position.
6. Place a pillow or two under the patient’s
knees.
7. Position the unit so that the line of pull is
aligned with the midline of the body (i.e., so
that the head is not laterally flexed).
8. Secure the halter to the cervical region
according to the manufacturer’s instructions.
Normally the pressure points are the
occipital processes and, to a lesser degree,
the chin.
9. Connect the halter to the spreader bar.
10. Align the unit so that the angle of pull places
the cervical spine in approximately 25
degrees of flexion.
11. Remove any slack in the pulley cable.
12. Reset all controls to zero and turn unit on.
13. Adjust the RATIO to the appropriate on-off
sequence, normally a 3:1 or 4:1 ratio.
14. Adjust the TENSION to approximately 10
percent of the person’s body weight. If this
is the patient’s first exposure to intermittent
cervical traction, or if the person is
displaying apprehension about the treatment,
the TENSION can be initiated at its lowest
value.
Practice
REQUIRED
Competence
Field/Scenario
73
Practice
15. Instruct the patient as to what to expect
during the treatment and to inform you if any
discomfort is experienced. Explain that the
force of the pull is felt at the occiput and not
at the chin.
16. Set the appropriate treatment DURATION,
and initiate the treatment.
17. Allow the unit to cycle through its first
tension cycle. The TENSION maybe
gradually increased during subsequent
cycles. If pain is experienced at any time
during the treatment, decrease the amount of
force or discontinue the treatment.
18. Instruct the patient to remain relaxed during
both the on and off cycles.
19. If the pressure placed on the mandible causes
discomfort in the teeth or TMJ joint, gauze
or a mouthpiece may be placed between the
teeth to dissipate the force.
20. The treatment should last 10-20 minutes for
most injuries, 5-10 minutes for a herniated
disk.
21. If the traction unit does not automatically
shut off, gradually reduce the TENSION
over a period of three or four cycles.
22. Gain some slack in the cable and turn unit off
23. Remove the SPREADER BAR and
HALTER.
24. Question the patient regarding any perceived
benefit or complications derived from the
treatment.
25. Have the patient remain sitting or lying
supine for 5 minutes after the conclusion of
the treatment.
26. Record the pertinent information (tension,
duration, duty cycle) in the patient’s medical
file.
REQUIRED
Competence
Field/Scenario
74
Competency
Practice
REQUIRED
Competence
Field/Scenario
Indications
1. Cervical or lumbar muscle spasm
2. Certain degenerative disk diseases
3. Herniated or protruding intervertebral disc
4. Nerve root compression
5. Osteoarthritis
6. Capsulitis of the vertebral joints
7. Pathology of the anterior or posterior
longitudinal ligaments
Contraindications
1. Unstable spine
2. Diseases affecting the vertebra or spinal
cord, including cancer and meningitis
3. Vertebral fractures
4. Extruded disk fragmentation
5. Spinal cord compression
6. Conditions in which vertebral flexion and/or
extension is contraindicated
7. Conditions that worsen after traction
treatments
8. Osteoporosis
9. Conditions that have not been evaluated by a
physician
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
75
KIN 197C: Practicum in Athletic Training III
Ultrasound
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competency and Field/Scenario elements.
Competency
Set-up/Application - Water Immersion
1. Establish that no contraindications are
present by questioning the patient.
2. Place the patient in a comfortable position.
3. Inspect body part to be treated (check for
rashes, infections, open wounds)
4. Fill plastic, ceramic or rubber tub with water
5. Clean area to be treated to remove any body
oils, dirt, etc.
6. Immerse body part in water.
7. Select appropriate sound head size.
8. Determine and set frequency (1MHz3MHz).
9. Set duty cycle (20% – 100%).
10. Set treatment duration according to
determined frequency and duty cycle.
11. Place sound head in the water facing the
body part to be treated and begin slowly
moving the sound head approximately one
inch from the area being treated. Move the
sound head parallel to the body part.
12. Press start.
13. Adjust intensity to appropriate level while
keeping the sound head moving. (Intensity
may need to be set prior to pressing start on
some machines.)
14. Move sound head continuously at a moderate
speed (4cm/sec.)
15. If bubbles accumulate on the sound head
during treatment, quickly wipe them away
with your finger.
16. At the end of the treatment, turn all dials to
zero and remove sound head from water.
17. Dry body part.
18. Record treatment parameters.
Practice
REQUIRED
Competence
Field/Scenario
76
Practice
Indications
1. Joint contractures
2. Muscle spasm
3. Neuroma
4. Scar tissue
5. Trigger areas
6. Postacute reduction of myositis ossificans
7. Acute inflammatory conditions (pulsed
output)
8. Chronic inflammatory conditions (pulsed or
continuous output)
9. Body part to be treated is smaller than the
diameter of the sound head or has irregular
surfaces
Contraindications
1. Acute conditions
2. Ischemic areas
3. Tendency to hemorrhage
4. Areas around the eyes, heart, skull, or
genitals
5. Pregnancy when used over the pelvic or
lumbar areas
6. Over cancerous tumors (therapeutic doses
applied over tumors have been shown to
increase mass and weight of the tumor.)
7. Over the spinal cord or large nerve plexus in
high doses
8. Neurological sensory deficit
9. Over a fracture site before healing complete
10. Stress fracture sites
11. Over sites of active infection
12. Over the pelvic or lumbar area in
menstruating female patients
13. Areas of impaired circulation
REQUIRED
Competence
Field/Scenario
77
Practice
Set-up/Application – Bladder Method
1. Establish that no contraindications are
present by questioning the patient.
2. Place the patient in a comfortable position.
3. Inspect body part to be treated (check for
rashes, infections, open wounds)
4. Fill bladder (balloon or plastic bag) with
water. Can also use a bladder filled with gel
or silicone.
5. Make sure that all air pockets are removed
from bladder before sealing.
6. Apply coupling medium to body part being
treated.
7. Coat both sides of bladder with coupling
medium.
8. Place bladder on body part being treated.
9. Select appropriate sound head size.
10. Determine and set frequency (1MHz3 MHz).
11. Set duty cycle (20% – 100%).
12. Set treatment duration according to
determined frequency and duty cycle.
13. Place sound head on bladder and begin
slowly moving the sound head over the
bladder.
14. Press start.
15. Adjust intensity to appropriate level while
keeping the sound head moving. (Intensity
may need to be set prior to pressing start on
some machines.)
16. Move sound head continuously at a moderate
speed (4cm/sec.)
17. At the end of the treatment, turn all dials to
zero and remove sound head from bladder.
18. Remove gel from patient’s skin.
19. Dispose of used bladder.
20. Record treatment parameters.
REQUIRED
Competence
Field/Scenario
78
Practice
Indications – Bladder Method
1. Joint contractures
2. Muscle spasm
3. Neuroma
4. Scar tissue
5. Trigger areas
6. Postacute reduction of myositis ossificans
7. Acute inflammatory conditions (pulsed
output)
8. Chronic inflammatory conditions (pulsed or
continuous output)
9. Irregular surfaces or surfaces that can not be
immersed in water
Set-up/Application – Direct Method
1. Establish that no contraindications are
present by questioning the patient.
2. Place the patient in a comfortable position.
3. Inspect body part to be treated (check for
rashes, infections, open wounds)
4. Place toweling around area to be treated.
5. Clean area to be treated to remove any body
oils, dirt, etc.
6. Apply coupling medium to area.
7. Select appropriate sound head size.
8. Determine and set frequency (1MHz-3MHz).
9. Set duty cycle (20% – 100%).
10. Set treatment duration according to
determined frequency and duty cycle.
11. Begin slowly moving the sound head over
the medium, maintaining contact at all times.
12. Press start.
13. Adjust intensity to appropriate level while
keeping the sound head moving. (Intensity
may need to be set prior to pressing start on
some machines.)
14. Move sound head continuously at a moderate
speed (4cm/sec.) using overlapping strokes
or circles with firm pressure.
15. At the end of the treatment, turn all dials to
zero. Remove sound head from treated area.
16. Remove gel from patient’s skin.
17. Record treatment parameters.
REQUIRED
Competence
Field/Scenario
79
Practice
Contraindications – Direct Method
1. Acute conditions
2. Ischemic areas
3. Tendency to hemorrhage
4. Areas around the eyes, heart, skull, or
genitals
5. Pregnancy when used over the pelvic or
lumbar areas
6. Over cancerous tumors (Therapeutic doses
applied over tumors have been shown to
increase mass and weight of the tumor.)
7. Over the spinal cord or large nerve plexus in
high doses
8. Neurological sensory deficit
9. Over a fracture site before healing is
complete
10. Stress fracture sites
11. Over sites of active infection
12. Over the pelvic or lumbar area in
menstruating female patients
13. Areas of impaired circulation
Indications – Direct Method
1. Joint contractures
2. Muscle spasm
3. Neuroma
4. Scar tissue
5. Trigger areas
6. Postacute reduction of myositis ossificans
7. Acute inflammatory conditions (pulsed
output)
8. Chronic inflammatory conditions (pulsed or
continuous output)
REQUIRED
Competence
Field/Scenario
80
Practice
Contraindications – Direct Method
1. Acute conditions
2. Ischemic areas
3. Tendency to hemorrhage
4. Areas around the eyes, heart, skull, or
genitals
5. Pregnancy when used over the pelvic or
lumbar areas
6. Over cancerous tumors (Therapeutic doses
applied over tumors have been shown to
increase mass and weight of the tumor.)
7. Over the spinal cord or large nerve plexus in
high doses
8. Neurological sensory deficit
9. Over a fracture site before healing is
complete
10. Stress fracture sites
11. Over sites of active infection
12. Over the pelvic or lumbar area in
menstruating female patients
13. Areas of impaired circulation
REQUIRED
Competence
Field/Scenario
81
Practice
Set-up/Application - Phonophoresis
1. Establish that no contraindications are
present by questioning the patient.
2. Place the patient in a comfortable position
encouraging circulation to the area.
3. Inspect body part to be treated (check for
rashes, infections, open wounds)
4. Place toweling around area to be treated.
5. Clean area to be treated to remove any body
oils, dirt, etc.
6. Make sure skin is well moistened and
relatively hairless.
7. Apply medication to skin and rub in, then
apply coupling medium to area, or, apply
medicated ultrasound transmission media.
8. Select appropriate sound head size.
9. Determine and set frequency (1MHz 3MHz).
10. Set duty cycle (20% – 100%).
11. Set treatment duration according to
determined frequency and duty cycle.
12. Slowly move the sound head over the
medium, maintaining contact at all times.
13. Press start.
14. Adjust intensity to appropriate level while
keeping the sound head moving. (Intensity
may need to be set prior to pressing start on
some machines.)
15. Move sound head continuously at a moderate
speed (4cm/sec.) using overlapping stokes or
circles with firm pressure.
16. At the end of the treatment, turn all dials to
zero and remove sound head from the area
being treated.
17. Cover remaining medication with an
occlusive dressing.
18. Record treatment parameters.
REQUIRED
Competence
Field/Scenario
82
Practice
REQUIRED
Competence
Field/Scenario
Indications - Phonophoresis
1. Joint contractures
2. Muscle spasm
3. Neuroma
4. Scar tissue
5. Trigger areas
6. Postacute reduction of myositis ossificans
7. Acute inflammatory conditions (pulsed
output)
8. Chronic inflammatory conditions (pulsed or
continuous output)
Contraindications - Phonophoresis
1. Acute conditions
2. Ischemic areas
3. Tendency to hemorrhage
4. Areas around the eyes, heart, skull, or
genitals
5. Pregnancy when used over the pelvic or
lumbar areas
6. Over cancerous tumors (Therapeutic doses
applied over tumors have been shown to
increase mass and weight of the tumor.)
7. Over the spinal cord or large nerve plexus in
high doses
8. Neurological sensory deficit
9. Over a fracture site before healing is
complete
10. Stress fracture sites
11. Over sites of active infection
12. Over the pelvic or lumbar area in
menstruating female patients
13. Areas of impaired circulation
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
83
KIN 197C: Practicum in Athletic Training III
Electrical Stimulation
All skills must be viewed, dated and initialed. Peers can “check off” Practice, a Preceptor must
check off Competency and Field/Scenario.
Competency
HVPS, IFC, TENS, MENS
Set-up/Application - Principles
1. Establish that no contraindications are
present by questioning the patient.
2. Place the patient in a comfortable position.
3. Inspect body part to be treated (check for
rashes, infections, open wounds)
4. Clean the electrodes to remove any residual
gels or skin oils or use new electrodes
5. Clean the point to be stimulated with alcohol
to remove any body oils, lotions, dirt, etc.
6. Connect the leads to the unit and to the
electrodes.
7. If using carbon-impregnated rubber
electrodes, wet the sponge or apply gel to
electrodes. If using self-adhesive electrodes,
apply to patient
8. Determine the electrode placement technique
to be used.
9. If a monopolar technique is being used,
attach the dispersive electrode to a large
body mass (Do NOT cross the spinal cord,
or place over the abdomen or torso).
10. Secure electrodes in place if not selfadhesive.
11. Explain the sensations to be expected from
the treatment, and advise against any
unnecessary movement during the treatment.
12. Turn the unit on - Activate the POWER
switch.
13. Reset out put parameters - Fully reduce the
INTENSITY control and depress the RESET
button.
Practice
REQUIRED
Competence
Field/Scenario
84
Practice
14. Select output parameters
A. Select mode
B. Set the Pulse or phase duration (width)
C. Adjust the pulse (or beat) frequency (rate)
D. Select polarity (HVPS)
E. Select sweep frequency (IFC)
F. Select phase interval
H. Vector depth (according to the depth of
the tissue)
I. Vector Speed
15. Set treatment duration.
16. Begin treatment by pressing the start button
17. Slowly increase the intensity control until the
appropriate current level is obtained.
18. If necessary or applicable, adjust the balance
control to maximize comfort
19. If the unit does not shut off automatically,
gradually decrease the intensity and/or
depress the STOP button.
20. Remove the electrodes from the body, and
wipe away any residual gel.
21. Check the treatment area for burns, skin
irritation, or discoloration.
22. Conduct an interview with the patient
immediately following the treatment to
ascertain the effectiveness of the parameters
used.
23. Record treatment parameters and patient’s
comments.
Indications - (HVPS)
1. Reeducation of peripheral nerves
2. Delay of denervation and disuse atrophy by
stimulating muscle contractions
3. Reduction of post-traumatic edema
4. Maintenance of range of motion
5. Reduction of muscle spasm
6. Reeducation of partially denervated muscle
7. Facilitation of voluntary motor function
8. Increase in local blood circulation
REQUIRED
Competence
Field/Scenario
85
Practice
Contraindications - HVPS
1. Cardiac disability
2. Demand-type pacemakers
3. Pregnancy – over pelvic area
4. Menstruation – over pelvic area
5. Cancerous lesions
6. Sites of infections
7. Exposed metal implants
8. Over the carotid sinus, esophagus, larynx,
pharynx, on or around the eyes, the upper
thorax, the temporal region
9. Severe obesity
10. Areas of the skin irritated by the use of gel,
adhesive, or current flow
Indications - (TENS)
1. Control of chronic pain
2. Management of post-surgical pain
3. Reduction of post-traumatic acute pain
Contraindications - (TENS)
All of the above listed for HVPS and:
1. Pain of central origin
2. Pain of unknown origin
Indications – Interferential/IFC
1. Acute pain
2. Chronic pain
3. Muscle spasm
Contraindications – Interferential/IFC
All of the above listed for HVPS and TENS
REQUIRED
Competence
Field/Scenario
86
Practice
REQUIRED
Competence
Field/Scenario
Indications - MENS
1. Acute and chronic pain
2. Acute and chronic inflammation
3. Reduction of edema
4. Sprains
5. Strains
6. Contusions
7. Temporomandibular joint dysfunction
8. Carpal tunnel syndrome
9. Superficial wound healing
10. Scar tissue
11 Neuropathies
Contraindications - MENS
All of the above listed for HVPS and:
1. Pain or other symptoms of unknown origin
2. Osteomyelitis
General Principles – Electrical Stimulation
Student demonstrates the ability to select the
appropriate parameters for:
- Pain relief – gate control theory
- Pain relief – endogenous opiate theory
- Muscle re-education
- Electrode placement technique
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario
87
CLINICAL PROFICIENCIES
KIN 197D:
KIN 194
88
KIN 197D: Practicum in Athletic Training IV
Competency Evaluation Sheet
All skills must be viewed, dated and initialed. Peers can evaluate Practice elements, while a
Preceptor must evaluate Competence and Field/Scenario elements.
REQUIRED
Ranges of Motion - Demonstrate instruction of
the following
 Passive ROM exercises
- Lower extremity
- Upper extremity
- Trunk
- Cervical spine
 Active ROM exercises
- Lower extremity
- Upper extremity
- Trunk
- Cervical spine
 Active-assisted ROM exercises
- Lower extremity
- Upper extremity
- Trunk
- Cervical spine
Exercise to Improve Speed - Demonstrate
ability to instruct and knowledge of concepts
- Upper extremity
- Lower extremity
- Sprint work
- Fartlek training
Exercise to Improve Agility - demonstrate
ability to instruct and knowledge of concepts
- Carioca
- Cross-over
- Figure-eight
- Zig-zag
- Cutting maneuvers
- V-cuts
NR
89
Exercise to Improve Strength/Endurance demonstrate ability to instruct and knowledge of
concepts
- Cardiovascular
- Aquatic
- UBE
- Stationary bike
- Physioballs (upper and lower body)
- Stairmaster
- Treadmill
- Elliptical trainer
- Muscular
- Free weight
- Cuff weights
- Machine weights
Exercise to Improve Power - demonstrate
ability to instruct and knowledge of concepts
- Plyometric training
- Olympic lifts
- Stretch-shortening cycle
- Amoritization period
REQUIRED
Exercise to Improve Neuromuscular Control demonstrate ability to instruct and perform
- PNF patterns
- Upper Extremity D1
- Upper Extremity D2
- Lower Extremity D1
- Lower Extremity D2
- PNF techniques
- Contract/relax
- Hold/relax
- Quick reversal
- Slow reversal
- Rhythmic stabilization
- Propcioception/kinesthetic awareness
- Wobble board or balance
apparatus/BAPS
- Incline board
- Single-leg balancing (stable vs.
unstable surface)
- Weighted-ball rebounding
- Plyoballs
- Trampoline
NR
90
Sport-Specific Skill Instruction and
Improvement
- Running
- Throwing
- Catching
- Striking
- Biking
- Other specific skills
Core Stabilization Activities
- Stabilization
- Postural control
- Functional spine position
- “Dead bug” activities
- “Cat/camel” activities
- Physioballs
- Other activities
Joint Mobilization
- Upper extremity distraction
- Upper extremity glides
- Lower extremity distraction
- Lower extremity glides
- Explain the convex/concave rules
91
Comprehensive Oral Practical - You will pick two items at random from all the Oral Practical
evaluations you have done to this point. You will then perform the oral practical evaluation.
The 1st oral practical chosen was:
The 2nd oral practical chosen was:
You must have a rating of 4 or above on the competence and field/scenario elements to pass.
Please mark below with the following rating system:
5 = Superior - distinctly more than expected of an athletic training student
4 = Good – above average – better than expected
3 = Average – expected performance
2 = Fair – satisfactory performance
1 = Poor – unacceptable performance
Competence
Rating
Date and Initial
Rating
Date and Initial
Field/Scenario