344 Practicum Log Book

Brianna Crighton
Placement: Velox U16

Table of Contents
1) Daily Log Practices
-page 3-30
2) Reflection of Training Experience
-page 31-32
3) Further Analysis of Injury
-page 33-36
4) Coaches Evaluation

Daily Log Practices

Hours to date: 52.5
Remaining in season: Approximately 15

Sept. 11, 2014 Orientation

6:00-8:30pm
The Velox head trainers demonstrated how to tape an ankle. We each did two practice
tapes on other junior trainers. We went through our orientation guide and all the medical
kit contents, where the stock is stored, and what we have to get ready for each game and
practice. This included prepping the medical kits, preparing the ambulance entrance, and
where to get ice and water bottles. We also went over injury assessment and how to
differentiate between contractile and inert tissue injuries.
Sept. 16, 2014 Orientation
6:30-8:30pm
We were shown how to do both a plantar fasciitis and a wrist tape by the head trainers.
We each did one practice tape of each on another junior trainer. We went through
concussion assessment, how to use a SCAT 3 form and when to send a player back to the
game. We then did two practice scenarios each. After orientation, the Valhalian rugby
team was finished practice and I did a 20-minute post practice massage.
S- Player said that his left shoulder and upper fibers of his trapezius muscles were tight
and sore. He also said that he regularly gets them massaged out post practice.
O- Asked player pre massage questions and applied atomic bomb.
A- Tight deltoid and upper trapezius muscles
P- 20-30 minute slow, deep massage that focuses on the deltoid and upper trapezius
muscles.
Note: The head trainer supervised this and gave me directions on proper massage
technique since it hadnt been covered in the course yet.
Sept 18, 2014 Orientation
5:30-8:30pm
The coach of the womens team went over the basic rules of rugby with us and we played
a short session with the head trainers. We were also shown how to tape a thumb and we
each practiced on one other trainer. We went over when/when not to use ice and heat on
injuries and the contraindications of use. Before we left we stocked our medical kits for
our first games that weekend.

Sept. 21, 2014 Game 1 at Windsor Park

10:00am-1:00pm
Prevention Techniques
-Initial field assessment for any debris or anything that could inflict injury on athlete. The
playing field was in good condition at our arrival.
-Noted the ambulance entrance and reviewed the EAP for this location
-Prepared ice and water for the players
Taping Experience and Assessments/Treatments
Player 13
S- Athlete said that he needed his right wrist taped prior to the game for a previous hyperextension injury. He said the pain was localized to his wrist when he forcefully extends it
and rated the pain a 3 out of 10.
O- AROM tests were done on both sides, starting with his uninjured wrist, pain in
extension. PROM tests were done on both sides, starting with uninjured wrist, pain in
flexion. The player did not have any weakness in flexion, extension, supination,
pronation, ulnar deviation or radial deviation when compared to his uninjured wrist. The
player still had full ROM in both active and passive movement.
A- Grade 1 muscle strain to the players wrist extensors, possibly extensor digitorum
muscle.
P- Taped wrist to limit extension for game. Will follow up with athlete at next practice.
Player 4
S- Athlete came off field during half time complaining that his shoulder was subluxing
when we tackles and catches the ball. He said he could hear popping and rated the pain a
5/10 during the pop and mildly sore afterward.
O- AROM testing revealed pain in flexion and abduction. PROM testing revealed pain in
flexion and abduction. All other movements pain free. Both tests were done to his
uninjured arm initially to allow for comparison. No pain observed in resistance tests for
all movements in neutral position. Full ROM and firm end feels observed that are the
same when compared to uninjured side. Pain only observed at end range. At this point I
referred to the senior trainer at the game about proper treatment for a shoulder injury.
A- Inert tissue grade 1 sprain, likely superior/middle glenohumeral ligaments. Pain could
also be capsular since there is pain experienced in a few directions.
P- We suggested the player sit out for the game and gave him ice, after educating him on
the risks and benefits. The ice was removed after 10 minutes. We also referred the athlete
to see a physiotherapist about the subluxing. I will follow up with player at next practice.

Castaways Player
S- Athlete came off field after his head was landed on in a tackle. He complained of a
headache and lots head pressure. He rated the headache pain a 6/10.
O- Josh and I performed a SCAT 3. Player did not display any memory loss or
disorientation but rated the head and neck pain high. We followed up on headache and
pressure every 5-10 minutes and these symptoms persisted. The athlete did not develop
further neurological symptoms at the game.
A- Grade 2 concussion, based on the high pain rating and persistent symptoms
P- Removed player from game and observed every 5-10 minutes for changes in
symptoms. Educated player on proper return to play protocol and also spoke to parents,
informing them on the proper protocol and how to watch for worsening symptoms.
Normally would follow up at next practice but this was a player from the opposing team.
Player 12
S- We were called on to field by the ref for the athletes bleeding left leg. Player was not
in pain or distraught.
O- It was a small 1 cm, superficial wound on his left calf. We rinsed with water and used
to gauze to clean excess blood.
A- Small scratch that immediately clotted.
P- We covered the cut to prevent it from re opening and the athlete returned to play.
Reflections
I really enjoyed being at the game; I liked it a lot more than I thought I was going to. The
practical experience was more relevant than just reading about these situations in
textbooks. Looking back on the injuries, I felt like I actually knew more than I thought I
did going into the game and I feel more confident in my abilities moving forward. It was
comforting to have Mark, the senior trainer, and Josh both there so I had someone to ask
questions to and didnt have to handle each injury alone.
I did well on the wrist tape job, even though I was nervous since it was my first taping of
an athlete. The tape prevented extension when I tested his motion after. Next time Ill
have the player sit down for the tape job because I found it difficult to tape a player taller
than me.
Sept. 25, 2014 Practice 1
4:30-7:00pm
Prevention Techniques
-Filled ice bags and water bottles
-Did perimeter assessment of field for any debris, noted that the Velox home field is quite
run down and very muddy

-Stocked our medical kit for the game this Sunday

Taping Experience and Assessments/Treatments
Junior Womens Player
S- Athlete approached trainers asking to have her right hamstring taped for a previous
strain.
O- Athlete had full ROM in both AROM and PROM tests when compared to uninjured
leg. She only felt pain in active hip extension and passive hip flexion. She also showed no
weakness when comparing resistance tests. Therefore, the player was safe to tape.
A- Grade 1 hamstring strain.
P- I watched Britney, a Camosun trainer, tape because I had never seen a hamstring tape
before.
Velox U18 Player
S- Athlete approached trainers before practice to have his left ankle taped for previous
inversion sprain.
O- We assessed his AROM, PROM and resistance, starting each test with his uninjured
ankle. He noted mild pain in both passive and active ROM but was still within full range
compared to his right. No weakness in his left ankle was present.
A- Grade 1 sprain to either his ATFL or lateral ankle ligaments.
P- Britney showed us a different method when she taped his ankle to prevent inversion.
Britney will follow up with him for the next game since she is the trainer assigned to the
U18 team.
Follow-ups
-Player 13 was not experiencing pain in his wrist today and did not want it taped. I will
check with him again at the Sunday game.
-Player 4 had gone to see a physiotherapist since the weekend game. He was given
exercises to strengthen his rotator cuff muscles and advised to take it easy until the pain
has gotten better. He chose to practice today but wont be playing in the game this
Sunday.
Reflections
Today I noticed that practices are going to be much more laid back than games. Most of
our role as a trainer is during the beginning preparation of the field and the players. I can
improve as a trainer by reviewing the taping methods weve gone over in class before
each game until Im confident I can perform them without hesitation.
I spoke to player 4s father and said that I would look into taping his sons shoulder for
future games to add extra stability and prevent future subluxations.

Sept. 28, 2014 Game 2 at Velox

11:30am-3:00pm
Prevention Techniques
-Initial field assessment and coned off ambulance entrance
-Prepared ice and water for the field
-Checked medical kit for supplies and set up station on field
Taping Experience and Assessments/Treatments
Player 12
S- Athlete said that his right quadriceps muscle was tight and sore pre game. He rated the
pain a 1 or 2 out of 10 but was uncomfortable. He asked for a pre game massage.
O- I asked the player if he had warmed up, which he had, and the pre massage questions.
Player still had full ROM, both active and passive, when compared to his left side. He
had no weakness when compared to his left side. His thigh showed no inflammation or
acute injury.
A- Tight quadriceps muscle from delayed onset muscle soreness
P- I performed a 5 minute pre game massage, starting with quick effleurage and moving
into squeezing and wringing petrissage. The massage was superficial and fast to increase
blood flow. Since this was the first massage I had given to a player on the U16 team I
kept methods conservative.
Note: Followed up with player after game and he said that it felt much better. He did not
want a post game massage.
Velox U14 Player
S- Parent approached me as the U14 game was ending, asking me to look at his childs
right knee that was injured in the game. The player said that it had taken a blow to the
medial side and he had heard a pop. He rated the pain an 8/10 and did not want me to
touch or move it. He was not confident that he could stand or put weight on it
O- I was unable to do PROM, AROM, or resistance testing due to the pain of the injury. I
did notice significant swelling on the medial side of the knee. The player was in pain and
upset but did not appear to be showing signs of shock. The patellar appeared to be in
correct orientation when compared to his left leg.
A- Possible stress fractures of the tibia or fibula, depending on angle of impact; It could
also be an inert tissue sprain to one of the medial collateral ligaments of the knee. Further
analysis was not possible without moving the limb.
P- I gave the player ice after educating on the risks and benefits. He kept the ice on for
about 10 minutes. I advised the player and his dad that he should go see a doctor for x-

rays. If I see the player at Velox again I will check up on him, unfortunately he is not on
the team I am working with.
Castaways Player
S- Castaways coach asked me to tape a few of his players pre game because their trainer
was unable to make it. The player said he needed his right ankle taped from a previous
inversion injury. He said he wasnt in any pain currently but wanted it taped for
preventative measures.
O- I performed AROM, PROM and resistance tests to his left ankle and then his right
ankle for flexion, extension, inversion and eversion. He didnt experience any pain or
weakness in his right ankle and had full range of motion.
A- Previous grade 1 sprain of ATFL or lateral collateral ankle ligaments
P- I taped his right ankle to prevent inversion.
U18 Velox Player
S- Athlete asked me to tape his left wrist before his game for a previous hyperextension
injury.
O- I performed AROM, PROM and resistance tests to his right wrist and then his left
wrist for flexion, extension, pronation, supination, ulnar deviation and radial deviation.
He only experienced mild pain in active extension and passive flexion pain. He
experienced mild weakness in wrist extension compared to his right side but still had full
range of motion.
A- A grade 2 strain of the wrist extensors, specifically the extensor digitorum muscle.
P- Taped to prevent extension.
Player 7
S- Athlete said landed on his right wrist fully flexed and that it is really painful to extend.
He described the pain as sharp and rated it a 7/10.
O- He agreed to do a functional assessment and pain was observed in all movements for
AROM testing. The ROM of his right wrist was significantly less when compared to his
left. PROM testing was done on his left wrist and only for flexion and extensions on his
right. Empty end feels were felt for both due to pain in moving through the motion.
Further PROM and resistance testing were not done since the player was in significant
pain.
A- Probable wrist fracture of either the radius or ulna.
P- I pulled the player from the game and gave him ice after educating on the risks and
benefits. He kept the ice on for about 10 minutes. After icing, since the pain had not

decreased I splinted his wrist and advised him to go to the hospital for x-rays. Will follow
up with him at next practice.
Player 14
S- Athlete was kicked in the left eye in a ruck and was lying on the ground when we
approached him. When we got to him he said that he could see fine out of him eye but
had a bit of a headache.
O- The athlete was not bleeding and I checked his vision in both eyes. There was no
evident physical damage compared to his right eye. We asked if he had any head/neck
pain or was dizzy at all which he didnt. He did not appear to be disorientated about
where he was or how he had gotten to the field today. When he sat up he said that he felt
much better and wanted to return to the game.
A- Grade 1 concussion
P-We advised him to let us do a full sideline concussion assessment but he refused and
the coach returned him to play. After the game we checked on him and he still didnt
mention any symptoms but did not want a full assessment. We advised he take it easy and
to get checked by a doctor if any symptoms begin or get worse. We educated him and his
parents about post concussion protocol. Will follow up with athlete at next practice.
Player 11
S- Player came off field at half time with a very swollen lateral left calf. He said that it is
the side he lands on when he tackles and that this has been happening for the past 3
weeks. He said that it usually takes 3-4 days for the swelling to go down and it was
almost back to normal before he tackled this game. He rated the pain a 3/10 that was
slightly higher when pressure was applied to the swelling.
O- Aside from significant swelling there were no abnormalities compared to his right leg.
The swelling did not limit his range of motion at either his knee or ankle but he did a
slight limp, favoring his left leg.
A- Muscle contusion, possibly his tibialis anterior or peroneus longus muscles. It is also
possible that it is a small stress fracture causing swelling with contact.
P- I gave the player ice after educating on the risks and benefits. He kept the ice on for
about 5 minutes. I recommended that he sit out for the rest of the game and to see a
doctor for further examination and x-rays if needed. The coach put the player back in the
game after about 15 minutes on the sidelines. I will follow up with at next practice.
Player 6
S- Athlete took a knee to his lower back, in the lumbar region and near his kidneys. He
did not initially get up so we went onto the field to see him. He was in a lot of pain but
was able to sit up and move to the sidelines with assistance. He said that the pain was
sharp, radiating from his lower back and rated it an 8/10.

O- The athlete was not confident moving and was experiencing a lot of pain. He was
struggling to sit upright on the sidelines so we laid him down. He was pale, sweaty and
had a lot of pain in his back. He was lucid and not disoriented about where he was. He
did not report any pain in the cervical region of his spine. No neurological symptoms
were present, just pain and the muscle spasm of his back. Observation of his back did not
reveal any signs of internal bleeding.
A- Large muscle strain of the lower back; possible injury to kidneys or other abdominal
organs as well as possible rib fracture.
P- We advised he be stabilized and have an ambulance called. His mother said not to and
she took him to the hospital. Before he went to the hospital we gave him ice. He kept the
ice on his lower back for about 10 minutes. He needed two people to assist him as he
walked. I will follow up with him at the next practice or by emailing the team manager.
Player 8
S- Athlete came to me after the game with shoulder pain. He said that it wasnt from a
specific injury during the game but that it was sore. He said the pain was a mild ache, and
he rated it a 4/10.
O- AROM testing revealed pain in flexion and abduction. PROM testing revealed pain in
flexion and abduction. All other movements pain free. Both tests were done to his
uninjured arm initially to allow for comparison. No pain observed in resistance tests and
full ROM and firm end feels observed that are the same when compared to uninjured
side.
A- Inert tissue injury, possibly capsular or grade 1 sprain to glenohumeral ligaments. The
pain could also be due to impingement of subacromial structures.
P- I gave the player ice after educating on the risks and benefits. He kept the ice on for
about 10 minutes. Advised that if his shoulder is still painful tomorrow that he should see
a doctor for further examination. I will follow-up with him at practice.
Reflections
This game was significantly more stressful. Part of that was because there wasnt a senior
trainer present, so only Josh and I were responsible for the players. I left the game today
feeling very overwhelmed. I felt that I hadnt been taught enough to provide the level of
care I was expected to. It was a very over whelming experience.
I had a couple situations with players, 11 and 14 specifically, where I received resistance
from the coach when trying to remove the athletes from play. This was a difficult
situation to deal with but I explained the risks to the players and coach. I think I need to
be more assertive as a trainer and build a relationship with the players and coach.
Hopefully this will come as the team gets to know me and becomes more comfortable
with me. It was also very stressful dealing with player 6s injury. Josh and I both wanted
to call an ambulance based on the amount of pain he was in but his mom didnt want us

to. Since he is a minor we have to respect her wishes. I left the game today feeling like I
wasnt as prepared as I should have been. I can improve by reviewing what happened
today and following up with the injuries.
Follow-ups
I contacted the team manager after the game for an update on some of the injured players.
-Player 7 went to the hospital and has a wrist fracture.
-Player 14 went to doctor for follow up on being kicked in the eye but it was
undetermined if he had a concussion from earlier. He was not showing symptoms at the
doctors appointment.
-Player 11 had X-rays done of his later calf and no fractures were present, just a deep
muscle contusion.
-Player 6 was taken to the emergency room and found to have a fractured left rib, grade 2
strain of the lower back muscles, specifically in the lower thoracic and lumbar region,
and a stress fracture to his left ankle, near the lateral malleolus on the fibula.
Oct. 2, 2014 Practice 2
4:30-7:30pm
Prevention Techniques
-Filled ice bags and water bottles
-Did perimeter assessment of field for any debris
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
Player 5
S- Athlete asked to have his right and left achilles taped for an injury that he had over a
year ago and resulted in achilles tendinitis. He is currently not playing and is seeing a
physiotherapist who recommended trying a practice with tape.
O- We did AROM and PROM tests on both his right and left ankles for plantar flexion,
dorsiflexion, inversion and eversion. He noted some discomfort during active
dorsiflexion in both ankles. All other movements were pain free. Weakness could not be
assessed since both ankles are affected.
A- Chronic achilles tendinitis
P- I watched Britney tape both his achilles because I had never seen one taped before. I
will follow up at the Sunday game, if he is there to play.
Follow-ups
Player 11- The swelling from the deep contusion on his left calf had gone down
completely and he said it wasnt painful anymore. There was a dark bruise present but no
other signs of injury. I told him as long as the swelling doesnt come back and he is pain
free he is okay to play Sunday.

Player 6- Athlete was at practice but not playing. He was on crutches with an air cast for
a stress fracture on his left ankle. He said he is feeling much better but is still pretty sore
from the spinal contusion and cracked rib. He is going to come to the game on Sunday
but wont be playing for at least a few weeks.
Player 4- Athlete said his shoulder was still sore but felt much better. He said that he still
hadnt seen a doctor or physiotherapist and I recommended that he should if the pain is
still bother in him. He continued to practice today.
Reflections
The practice this evening was a lot smoother than the game on Sunday. I was relieved to
find out that each of the injured players only had minor injuries and have been listening
to our recommendations to see a doctor when necessary. Today Im starting to notice how
eager these kids are to return to play and I will need to be thorough when making
decisions about when they are ready. I did well following up on the injured athletes.
Oct. 5, 2014 Game 3 in Vancouver
Covered by Josh because they can only afford to take one trainer per Vancouver game.
Follow-up:
-Player 10 had wrist hyperextension and 2nd digit injury on left hand
Oct. 9, 2014 Practice 3
4:30-7:00pm
Prevention Techniques
-Prepped ice and water bottles for players
-Walked field for perimeter assessment
-Stocked our medical kit for the game this coming Thursday
Taping Experience and Assessments/Treatments
Player 5
S- Athlete asked to have his right and left achilles taped again for his achilles tendinitis.
He said the taping from the last practice helped and his physiotherapist thinks he should
start practicing with the team again.
O- AROM, PROM and resistance tests were not done again since they were done for this
injury the last time he practiced.
A- Chronic Achilles tendinitis.
P- I taped both his right and left achilles tendons for support.

Junior Womens Player

S- Athlete asked to have her right hamstring taped again for a previous strain.
O- Athlete had full ROM in both AROM and PROM tests when compared to uninjured
leg. She only felt pain in active hip extension and passive hip flexion. Further testing was
not done because she has had this taped by us previously.
A- Grade 1 hamstring strain.
P- I taped her right hamstring muscle.
Velox U18 Player
S- Player arrived at practice asking about knee pain he was having on the left side in the
medial region. He said that he crashed his bike and landed with his medial knee
contacting the frame of the bike.
O- Initial observation observed minor swelling and slight bruising compared to the right
side. AROM and PROM tests were done and pain was experienced in flexion for both.
All other ranges were pain free. There was slight weakness when adducting during the
resistance test compared to the right side. He said the pain was localized to the medial
portion of his knee and rated it a 3/10.
A- Inert tissue injury of a medial collateral knee ligament, likely a grade 1 sprain.
P- We advised the player take it easy and avoid any direct force to his knee. He decided
that he wanted to play after the risks of further injury had been explained to him.
Follow-ups
Player 7- Athlete was at practice after hairline wrist fracture. He has been cleared by a
doctor to participate in practices only but absolutely no tackling. He will not be playing in
the game this weekend.
Player 6- Athlete was at practice again but not playing. Today he was off crutches but still
in an air cast for his left ankle. He said that he is feeling a lot better but still having some
back pain when sitting for long periods of time at school. He will not be playing at in the
game this weekend.
Player 4- Athlete said his shoulder was still sore but that he had been going to rehab for
it. He said that he had been cleared to start playing again this weekend but that he should
have it taped for additional support. I will look into how to tape a shoulder for the next
game.
Reflections
The players are starting to be more familiar with me and I feel like they are comfortable
coming to me with their injuries and questions. Im feeling more confident in my
knowledge and abilities, especially the few tape jobs Ive been doing regularly. I think
that the game this Thursday is going to go well.

Oct. 16, 2014- Game 4 at Claremont

4:00-7:00pm
Prevention Techniques
-Prepped ice and water bottles at Velox and brought to Claremont
-Checked that kit was properly stocked before the game
-Walked field for perimeter assessment; noted that the grass is very long so it was
difficult to determine if there was any debris
Taping Experience and Assessments/Treatments
Player 10
S- Athlete asked to have his left wrist taped for a hyper-extension injury that happened at
the last game. He also said that he had his 2th and 3th phalanges taped. He said that Josh
did an assessment and taped him at the Tuesday practice earlier this week.
O- I performed AROM, PROM and resistance tests to his right wrist and then his left
wrist for flexion, extension, pronation, supination, ulnar deviation and radial deviation.
He only experienced mild pain in active extension and passive flexion. He had no
weakness in wrist extension compared to his right side and had full range of motion.
A- Grade 1 strain of wrist extensors, likely the extensor digitorum muscle.
P- I taped both his left wrist to limit extension and his phalanges together. He said that the
tape felt great, secure but not too tight.
Player 4
S- Athlete asked to have his right shoulder taped for added stability. He has been in
physiotherapy to strengthen his shoulder and prevent future subluxation.
O- Athlete has been previously assessed and has full active and passive ROM. He does
not show any weakness in his right shoulder compared to his right.
A- Inert tissue grade 1 sprain, likely of the superior/middle glenohumeral ligaments and
weakness of the rotator cuff muscles.
P- I watched Stefan tape his right shoulder because I have never seen one taped before.
He used tensoplast and liteplast tape. The athlete said that his shoulder felt secure.
Player 2
S- Player arrived at the game saying that he wasnt going to play because he was
experiencing pain in his left knee and ankle. He said that he had just started playing
volleyball and that he thought it had to do with the explosive jumping he wasnt used to
doing.
O- No noticeable swelling and or bruising was evident when compared to the right side.
AROM and PROM tests were done for all movements at both joints and compared to the

uninjured side. Pain was experienced in active and passive flexion of the knee. Pain was
present in active and passive plantar flexion. All other ranges were pain free. There was
no observed weakness or pain during the resistance test when compared to the right side.
He said at rest the pain was a 6/10.
A- Overuse injury to the lateral collateral ligament of the knee and tibocalcaneal ligament
from playing on a new indoor environment, as well as exposing these joints to a different
type of force. These are both likely grade 1 sprains.
P- We advised the player take it easy and avoid any direct force to his knee and ankle. He
has been icing the injury and will continue to follow the icing guidelines we explained to
him. We recommended that he follow up with a doctor if it is still painful after a couple
days rest.
Player 8
S- Athlete came off the field during the game complaining of pain in his left palm. He
said he was pretty sure someone stomped on it during a ruck.
O-Pain was localized to the palmar surface, over the 1st metacarpal. Slight swelling when
compared to his right palm. Player still had full range of motion flexing and extending
fingers and wrist, only experiencing pain in active flexion of his first phalange. All other
active and passive movements were pain free. No pain in the wrist region or with any
active, passive or resistance tests. Pain was the most evident with pressure on the 1st
metacarpal but only on the palmar side. Pressure on the dorsal side was not painful. When
pressure applied to palm region he rated the pain a 6/10 but said there was minimal to no
pain when there was no pressure applied to his palm.
A- Contusion of the 1st Metacarpal on the palmar side.
P- I gave him ice after educating on the risks and benefits. He kept the ice on for about 10
minutes and then returned to play.
Scotland Team Player
S- I approached player when he came off field after he hit his head on the ground in a
tackle. He said that his head didnt hurt except a little bit near his eye.
O- He appeared dizzy and disoriented after hitting his head. He looked like he was having
a hard time focusing and kept holding his head up. When I approached him and asked
how he was feeling he said that he did not want to be assessed for a concussion. I did an
eye exam, comparing his sore right side to his left eye. There was no sign of bleeding or
any abnormalities. I checked his vision individually in both eyes, as well as his tracking
and peripheral vision. He was asymptomatic for all tests when compared to his left eye.
A- Grade 1 concussion

P- I recommended that he sit out for the remainder of the game and educated him on
proper concussion protocol. He wanted to return to play so I educated him on the risks of
further head injury and second impact syndrome. The coach returned him to the game. I
followed up with him after and he said that his head wasnt sore anymore but his eye
region was still tender. I recommended that he see a doctor for a further eye exam.
Unfortunately I cant follow up with him at the next practice.
Player 3
S- Athlete approached me after the game about hitting his head when he was tackled. He
said that he has had a concussion before and the head pain he had was similar to this. He
rated the pain a 3/10 and said that was mostly localized toward the back of his head
where he hit it on the ground.
O- I performed a SCAT 3 on him. His short-term memory and orientation appeared to be
a normal level of functioning. He did report moderate head pain and congestion. He also
struggled with the balancing tasks. He did not appear to have any other abnormalities.
A- Grade 2 concussion
P- Since he has had a concussion previously I reminded him of the post concussion
protocol. I spoke to him and his parents and recommended that they follow up with a
doctor if any of his symptoms worsen or dont improve in the next couple hours. I also
recommended that they check his mental status regularly until he is asymptomatic. I will
follow up with him at the next practice.
Follow-ups
Player 7- Athlete was at the game but not playing.
Player 6- Athlete was not at the game today.
Player 5- Athlete was at the game but still not playing. He will practice as usual this
week.
Reflections
This was the first game they have played in the later afternoon so it was getting dark by
the second half. This made it more difficult to watch for the mechanism of injuries. It also
increased the risk of injuries made by improper tackling.
This was also the first game that they played against a travelling team. I noticed that this
game had a much higher rate of penalties due to the aggressive nature of the visiting
team. The game moved a slower pace but it seemed like there was a larger focus on
injuring a player rather than carrying out a play. This was mostly from the visiting team
but the Velox boys were getting more aggressive toward the end. At one point a visiting
player was punching one of ours.
Im also realizing how difficult it is to not be able to treat someone if they refuse
treatment. It makes me very uncomfortable to watch these kids return to a game in a unsafe manner. I know that Im covering myself by informing them of the risks but Id like

to find a way to improve my educating so they dont want to return to the game with
these risks.
Oct. 22, 2014- In-class discussion of placement experiences
In class I talked with a group that included trainers from the Velox mens rugby teams and
trainers from the Rams high school football team.
We discussed differences between the youth and adult teams including:
-How parent involvement is both beneficial for organization and limiting because you can
only provide care to their discretion
-How the mens teams tend to underplay their injuries and the younger teams tend to over
report their pain
-How the men will tell you exactly how they want a tape job done and if you need to alter
it whereas most of the younger players will say it is good how it is
-We discussed how the youth teams, both rugby and football, dont tend to want pre or
post-game massages, where the adult team does regularly. This might be a comfort level
since the younger players have a larger age difference from the trainers.
-We compared the differences between rugby and football injuries and there are a lot of
similarities, especially with concussion rates
-I shared about my experience with player 6, who had the spinal contusion and how it
was a stressful experience in the first couple weeks but that I learned a lot about my
ability to handle these situations.
Oct.23, 2014 Practice 4
4:30-7:00pm
Prevention Techniques
-Prepped ice and water bottles for players
-Walked field for perimeter assessment; everything appeared to be safe
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
Player 4
S- Athlete asked to have his right knee taped for an injury earlier in the week. He said he
didnt really know what happened to it but he thinks he did it running. He rated the pain a
4 and said that it was mostly just annoying.
O- AROM, PROM and resistance tests were done comparing his right knee to his
uninjured left knee. He noted mild pain in active knee flexion and passive knee extension.
There was no weakness observed when compared to his left side. There were no signs of
inflammation or contusion with observation and the athlete had full range of motion. All
other movements were pain free.
A- Grade 1 knee flexor strain, possibly one or all of the quadriceps muscles.

P- I watched Stefan tape his knee to limit flexion because I had never seen a knee tape
before. He provided lateral and medial support and limited full flexion but allowed
movement to still be possible since this important for running. The athlete stood and
walked. He said he felt stable and still had enough range to play.
Note: He did not have his shoulder taped for the practice. He said that his physiotherapist
said that it was more important to have it taped when there was high frequency of direct
forceful contact.
Follow-ups
Player 7- Athlete received clearance from his doctor to start playing in games again this
coming weekend. I assessed his AROM, PROM and resistance again and he had full
range in all movements with no pain. He was able to functionally catch and throw with
aim and distance. He also participated in practice tackling scenarios and did not appear
apprehensive about tackling.
Player 3- Athlete went to the doctor a week ago, after the last game, for his concussion.
He has been resting and following return to play protocol for the week. I assessed him
with the SCAT 3 again and he appeared asymptomatic. He was cleared to practice today
and if he is still asymptomatic he will be clear to play at the game this Sunday.
Reflections
Today was a mellow practice, with only one athlete needing tape. I think Im doing well
at getting to know the players and the coach. I think they respect my training and what I
have to say. Ive been having better communication with the coach regarding injured
athletes and their current playing status.
Oct. 26, 2014 Game 5 in Vancouver
8:00am-5:30pm
Prevention Techniques
-Picked up and prepped ice and water bottles for players before leaving for Vancouver
-Walked field for perimeter assessment at field we were visiting. It appeared to be in
good condition with no red flags for injury
-Spoke the coach/trainer of the home team and went over their EAP, including where the
ambulance would arrive if needed.
Taping Experience and Assessments/Treatments
Player 5
S- Athlete asked to have his right and left achilles tendons taped again, this time so he
could try playing for part of the game this week. He said he had been cleared to do this by
his physiotherapist. He said he would only play until he was in pain.
O- AROM, PROM and resistance tests were not done again because he is regularly taped
for his chronic tendinitis. He did not have any acute injuries or inflammation to either
region and was not in pain when walking.

A- Chronic achilles tendinitis.

P- I taped both his right and left achilles tendons to limit dorsiflexion.
Player 4
S- Athlete asked to have his right shoulder taped again to provide extra stability. He did
not want his knee taped again. He said that it felt better this week and that he didnt have
any pain when moving.
O- Athlete has been previously assessed and has full active and passive ROM. He does
not show any weakness in his right shoulder compared to his right. He only mentions a
small amount of pain in flexion and abduction, both passive and active.
A- Inert tissue grade 1 sprain, likely of the superior/middle glenohumeral ligaments and
weakness of the rotator cuff muscles.
P- I taped his right shoulder the way Stefan taught me to at the last game. The athlete said
that his shoulder felt secure but not too tight. I checked with him during the game and he
said that it was holding up through the game.
Player 9
S- Athlete came off field during a play with a bloody nose. He said he has a history of
chronic nose bleeds and that it didnt start because of an injury in the game and that he
wasnt in any pain.
O- He was holding his head forward, pinching at the bridge of his nose. The bleeding had
slowed when he came off the field. There were no visible signs of contusion or
lacerations on his face. The blood was only coming from his nose.
A- Epistaxis
P- I gave him a half tampon to use as a plug and some gauze to clean off his nose. He
returned to the game after the bleeding had stopped.
Player 7
S- Athlete approached me near the end of the game and said that he had hit his head. He
said he had a bit of a headache but it felt mostly like a bump on his head. He rated the
pain a 1/10 and it was localized to the one point on the top left side of his head where he
hit it.
O- I performed a SCAT 3 on the sidelines. Aside from the mild headache he had no other
abnormal symptoms. He did not have any visible or tactile signs of a bump or
inflammation in the region that was sore.
A- Grade 1 concussion

P- I advised him to sit out for the rest of the game and monitored him for any worsening
of symptoms. His head pain was gone after about 5 minutes on the sidelines. I educated
him on proper concussion protocol and advised that he take it easy for the next week. I
also told him to be aware of the types of symptoms that could appear later and that if they
do he should see a doctor.
Player 1
S- After the game the athlete said that he had hit his head in the game and that he has had
head pain for the last half. He rated the pain a 3/10 but said that it hasnt gotten any
better. He also said that he didnt really remember exactly how he hit his head but it was
during a ruck. He didnt mention any other symptoms.
O- I performed a SCAT 3 with him. He noted also having head congestion and some mild
neck pain. He did not appear disoriented and his short term memory was functional but
his head pain was persistant.
A- Grade 2 concussion
P- I educated him and his parents on proper concussion protocol and advised that he take
it easy for the next week. I recommended that if his headache doesnt get better in the
next couple hours or if any symptoms appear or worsen that he should see a doctor. I will
follow up with him at the next practice and run through another SCAT 3.
Follow-ups
Player 3- Athlete was still asymptomatic post concussion a week and a half previous. He
played for the second half of the game and said that he felt fine after the game.
Player 6- Athlete was at the game but still not playing. He mentioned that he is going to
the doctors this week to see if he is cleared to start practicing again.
Player 7- Athlete played his first game back with no injury to his wrist. He appears to be
at a fully functional level. I spoke with him after the game and he said it wasnt sore and
that the game went well.
Player 5- When I followed up with him after the game he said that he had felt pretty good
playing today. He only played the first half because his tendinitis started to be a bit
uncomfortable.
Reflections
Today was my first solo game and I felt confidant in my abilities and the level of
responsibility I have for the team. I did well performing full SCATs on athletes with
minor head traumas. I now feel confident carrying out a SCAT but this method could be
improved if we had baseline scores for each athlete. Since this wasnt the case, I
monitored both athletes symptoms over time. Since this was an away game in
Vancouver, I spent a lot more time with the athletes and the coach. I feel like a part of the
team now, and Im going to miss them when this course is over.

Oct. 30, 2014 Practice 5

4:30-7:00pm
Prevention Techniques
-Brought ice and water bottles out for players
-Walked field for perimeter assessment; it was very muddy today because of the heavy
rain
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
No players needed to be taped for practice this week.
Follow-ups
Player 7- Athlete had followed post concussion protocol since the game on Sunday. He
was still asymptomatic and was cleared to practice the non-contact drills. If he is still
asymptomatic on Sunday he will be cleared to play in the game.
Player 1- Athlete went to the doctor after the last game when likely had a concussion. He
is not at practice this week and will not be playing in the game Sunday. He is following
the post concussion protocol but his symptoms are not dissipating as quickly as with
player 7.
Player 4- Athlete said that his knee was feeling much better this week and he did not need
it taped again.
Player 6- He said he has been cleared by a doctor to play. He is starting off easy at
practice. I assessed his AROM, PROM and resistance of his left ankle compared to his
uninjured right. He did not have any pain during assessment and had full range of motion.
He has normal gait walking and running without aids. I will observe him during practice
to determine how he handles the functional tasks.
Reflections
It is starting to get much colder and darker during practices now. Im finding that most of
our athletes dont require very much pre practice care. Some have general questions
about their health and exercising. Ive also noticed that the youth teams do not generally
want post game/practice massages or stretching from the trainers.
Nov. 2, 2014 Game 6 at Velox
11:30am-2:00pm
Prevention Techniques
-Prepared ice and water bottles for players and brought them onto sidelines
-Walked field for perimeter assessment, no debris present
-Coned off the ambulance entrance

Taping Experience and Assessments/Treatments

Player 6
S- Athlete asked to have his left ankle taped for support and protection of his previous
fracture. He said that his doctor cleared him to play.
O- AROM, PROM and resistance tests were done, comparing his left ankle to his
uninjured right ankle. He had full range of motion in flexion, extension, inversion and
eversion. He did not mention pain in active or passive ROM and there was no noticeable
weakness.
A- Preventative/Protective tape for post stress fracture of fibula
P- I taped his left ankle to limit his range of motion and decrease the likelihood of a
repeat fracture. I advised the athlete that he was returning to play pretty quickly since his
initial injuries. He said that he was still going to play. I recommended that if anything
starts to hurt, that he should come off the field.
S- I approached athlete at half time about rib pain during the game in the same area that
he cracked in game 2. He said the pain was low down and not affecting his breathing. He
said he was going to continue playing, against my advice to sit out. He came off the field
5 minutes later in pain.
O- Athlete was visibly in pain; he was holding and protecting his left side, in the ribs
region. His facial expressions were in pain but he looked like he was trying to walk it off.
A- Re injury to previously cracked rib. It is possible it was not fully healed and he had
returned to the game too early.
P- Athlete was pulled from game and given ice to apply to his ribs after being educated
on the risks and benefits. He had the ice on for 10 minutes and said that the pain was
reduced but still there. I advised that he see a doctor and have an X-ray done. I will
follow up with him at the next practice.
Player 4
S- Athlete asked to have his right shoulder taped again to provide extra stability.
O- Athlete has been previously assessed and has full active and passive ROM. He does
not show any weakness in his right shoulder compared to his right.
A- Inert tissue grade 1 sprain, likely of the superior/middle glenohumeral ligaments and
weakness of the rotator cuff muscles.
P- I taped his right shoulder. During the game he athlete said that the tape felt too tight
around his ribs and it was making it difficult for him to breath. I adjusted the anchors and
instructed him to take a deep breath and hold it while I locked down the tape around his
ribs. He said that it felt much better and that it was secure around his glenohumeral joint.

Player 5
Josh taped his left and right achilles tendons for chronic achilles tendinitis again.
Note: He used a new method that used tensoplast. The method was the same except that
the three fanning bands were split in half and an artificial tendon was created on either
side of the achilles rather than just one over top of it. The athlete said that he prefers this
method because it is stable but still allows for movement.
Player 18
S- Athlete came off the field during the game complaining of pain in his left hand. He
said that it was stepped on in a ruck. He said the pain was localized to the back of his
palm and he rated it a 3/10 when pressure is applied to that area.
O- The athlete was able to move all his fingers and thumb without pain, as well as make a
tight fist. When palpated, there was no tenderness or pain to the palmar surface of his
metacarpal region, only to his dorsal side. Each metacarpal was palpated and no extreme
pain was observed. Minor pain was noted when the dorsal side of the 2nd and 3rd
metacarpals were palpated. The skin was intact without any lacerations or inflammation
visible when compared to his uninjured hand. Some redness of the skin was evident in the
region.
A- Contusion to the dorsal side of the 2nd and 3rd metacarpal bones of the left hand.
P- I removed the player from the game and gave him ice after educating him on the risks
and benefits of use. He kept the ice on for 10 minutes and then I checked his hand. He
reported that the pain had decreased and he returned to play in the second half. I will
follow up with him at the next practice.
Player 7
S- Athlete went into the splits in a ruck and was helped up and off the field. He was
limping and in quite a bit of pain.
O- After sitting him down for a few minutes, we assessed his active range of motion. He
said there was only pain in flexion of his left hip. Comparing his PROM of his left side to
the right side, there was noticeable pain with extension of his left hip. There was no
noticeable weakness in any movement when comparing the left to the right.
A- Grade 1 strain of the hip flexors
P- We pulled him from the game and gave him ice after explaining the risks and benefits
of use. He kept the ice on for 10 minutes and we checked the skin for irritation. No
irritation was observed and the pain was getting better. He sat out for the remainder of the
game. I will follow up with him at the next practice.

Follow-ups
Player 1 was not at the game
Player 7 was walking without pain by the end of the game.
Reflections
It was very raining and we were playing an aggressive visiting team. Since it is getting
late in the season, the stakes are higher each game. This week, both teams were
undefeated. This was the first game that a fight broke out on the field and both players
were benched. I feel like Im doing well in my position because the coach listened to my
recommendations with player 6 and pulled him from the game. I need to practice taping
thumbs to improve. I havent done one all term.
Nov. 6, 2014 Practice 6
4:30-7:00pm
Prevention Techniques
-Brought ice and water bottles out for players
-Walked field for perimeter assessment
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
Player 2
S- Athlete asked us to assess his right ankle before the practice. He said that he has knee
instability that he thinks have caused a chain affect problem in his ankle. He noticed it at
the Tuesday practice this week when he was in stance with his right foot forward, bearing
most of the weight. He said that at one point he just felt it give way and he knew he
couldnt put any more weight on it.
O- I did a full ankle assessment, starting with AROM, which only resulted in pain during
inversion. PROM comparisons to his uninjured left side yielded no pain and his full range
of motion was still present. There was no noticeable weakness compared to his left side.
A- Grade 1 sprain to ATFL or lateral collateral ligament of the ankle
P- I taped his ankle to limit inversion.
Player 6
I spoke to the athlete at the beginning of practice and recommended that he sit out and
give himself more time to rest based on his rib pain at the game on Sunday. He said that
he had been cleared by a doctor to play and wanted to continue to practice as normal. I
explained the risks of returning to play without fully letting his injuries heal and he
decided to play against my recommendation.
S- Toward the end of practice, the athlete had to be assisted off the field by two other
players. He couldnt put any weight on his left ankle and was not confident in walking or
standing on his own. He rated the pain a 7/10, localized to his lateral malleolus in the

same area where he stress fractured it in September. He described the pain as a deep, ache
that hurt even more to touch.
O- There was visible swelling compared to his right ankle but he was in too much pain
for any range of motion assessment or resistance testing.
A- Probable re-fracture of the fibula in the lateral malleolus region.
P- We sat him down and iced the region after explaining the risks and benefits. He kept
the ice on for 10 minutes until the region felt numb. At the end of practice I spoke to him
and his mom, I advised that they go to the hospital that evening for new X-rays and
further evaluations. I explained that it was possible that there was a new fracture to the
previously injured region. I will follow up at the next practice; the athlete will not be
playing in the game this Sunday. I will make sure he has clearance from a doctor before
he plays or practices again.
Player 9
S- Athlete suffered a knee-to-knee blow with another player in a tackle, injuring his left
knee. We approached him on the field and he initially did not feel confident weight
bearing and rated the pain a 4/10, localized to his knee, specifically the patellar region.
He noted that the pain occurred initially when he was extending his leg from a flexed
position. After a few minutes he was able to stand and move to the sidelines.
O- The athlete still had full AROM and said there was a consistent ache that wasnt
aggravated by active or passive movement tests. He did not have any weakness compared
to his right knee and could bear weight again. Some inflammation was observed
compared to his right knee.
A- Contusion of the patellar region; possibly grade 1 sprain of patellar ligament.
P- I gave him ice after explaining the risks and benefits of use. He kept the ice on for 10
minutes and then I checked his knee again. No irritation was present. He felt better after
15 minutes and was walking around. I advised him to take it easy for the next couple days
and to follow up with a doctor if the pain gets worse. I will follow up with him before the
game on Sunday.
Player 4
I noticed that the athlete was limping while practicing, favoring his right leg. I asked him
and he said he was having knee pain but did not want an assessment. I recommended that
he sit out if he was in pain and that he would be at risk for further injury if he continued
to play. He returned to practice.
Follow-ups
Player 7- Athlete said that his hip flexors felt fine today. He said that he took it easy for a
couple days after the game Sunday and waited for the pain to ease. He had full range of
motion and no observable abnormalities.

Player 1- Athlete was back at practice after concussion. I assessed him and he was
asymptomatic. If symptoms do not return he will be cleared to play Sunday.
Player 18- Athlete reported no pain to his hand injured in the game on Sunday. He said
that it had felt much better after icing it and it hadnt bothered him since the day of.
Reflections
Tonight was very windy. We are having issues with players not listening to advice of
trainers and returning to play too early. Ive done well at giving recommendations to rest
and educating on the risks of premature return but there is a limit to what I can do at this
point. Bottom line is that they can return if they choose to and the coach allows it, which
is something I wish I could change. I spoke to the coach and manager about player 6 and
they both agreed that he should not have been playing already.
Nov. 9, 2014 Game 7 at Windsor Park
Stefan covered this game. He reported that there were no new injuries that will need
follow-ups.
Nov. 13, 2014 Practice 7
4:30-7:00pm
Prevention Techniques
-Brought ice and water bottles out for players
-Walked field for perimeter assessment
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
Player 9
S- Athlete was limping on the field. We approached him and he said that he rolled his
right ankle when he was running. He rated the pain a 5/10 and said that he had previously
had an inversion sprain and it felt the same as this pain.
O- I did a full ankle assessment including AROM, PROM and resistance testing for both
his left and right ankles. He noted pain in active and passive inversion and dorsiflexion.
All other movements did not aggravate the pain. He did not have any weakness compared
to the left ankle and still had full range of movement
A- Grade 1 sprain to ATFL or lateral collateral ligament of the ankle
P- I gave him ice after educating him on the risks and benefits of use. He iced his ankle
for 10 minutes. I checked for any irritations. I recommended that he use the brace he has
from his previous sprain and to rest it. If the pain is better I can tape his ankle for the
game Sunday as long as there isnt inflammation. I will follow up with him on Sunday.

Player 4
S- Athlete approached us during practice and said that his right leg was sore. He said that
it has been hurting for a while and that he thinks he injured it running. He was not sure
how long he was running for when it happened but he rated the pain a 4/10. It was
localized to the medial, posterior region of his thigh.
O- I assessed the active and passive ROM of his left and right hip for flexion, extension,
adduction, abduction and internal/external rotation. He reported pain only in active
adduction/flexion and passive abduction. He had no present weakness when his right hip
was compared to his left hip. He was limping slightly but not inflammation or signs of
contusion were visible.
A- Grade 1 strain of his hip adductors, possibly due compensation from a knee injury
earlier in the season.
P- Taught athlete some exercises to stretch his hip adductors and hamstrings. We will
wrap his groin for the Sunday game with a tensor bandage. I will follow up with him on
the weekend.
Follow-ups
Player 6- Athlete was not at practice.
Player 9- Athlete said his knee was better this week after the contact at last weeks
practice. He said there was some swelling and bruising for a couple days but it healed and
he wasnt in any pain.
Reflections
It is dark for the entire practice now and very cold. It is difficult to stand and watch the
practices sometimes because we are needed much less than at the games. Ive also gotten
to know a few of the parents to regularly attend the games and I have a lot of respect for
them. It would be a stressful sport to watch as a parent.
Nov. 16, 2014 Game 8
10:30am-1:30pm
Prevention Techniques
-Prepared ice and water bottles for players and brought them onto sidelines
-Walked field for perimeter assessment, no debris present
-Coned off the ambulance entrance
Taping Experience and Assessments/Treatments
Player 4
S- Athlete asked to have his right shoulder taped again to provide extra stability. He also
asked to have his right groin taped for his adductor strain last practice. He said the pain
had decreased but it was still bothering him a bit.

O- Athletes shoulder has been previously assessed and has full active and passive ROM.
He does not show any weakness in his right shoulder compared to his right. I assessed the
active and passive ROM of his left and right hip again. He reported pain only in active
adduction/flexion and passive abduction. He had no present weakness when his right hip
was compared to his left hip.
A- Inert tissue grade 1 sprain, likely of the superior/middle glenohumeral ligaments and
weakness of the rotator cuff muscles. As well as a grade 1 strain of his hip adductors.
P- I taped his right shoulder, checking to make sure that the tape around his chest was not
too tight. I also tensor wrapped his right groin to assist adduction.
Player 10
S- Athlete asked to have his left shoulder taped for a previous subluxation at a practice.
He said there wasnt any pain unless there was a forceful blow during a tackle. He saw a
doctor and has been cleared to play, but has not done any physiotherapy. He has only
subluxed his shoulder the one time.
O- AROM, PROM and resistance testing was done to both his uninjured right shoulder
and his left shoulder. The athlete did not report any pain or decreased range of motion for
any tests.
A- Weakness of the rotator cuff muscles; possible grade 1 sprain to superior/middle
glenohumeral ligaments.
P- I taped his left shoulder to provide stability. I advised him to see a physiotherapist for
further rehab if it is at all painful while playing or if it subluxes again. I will follow up
with him again at the next practice.
Player 5
S- Athlete asked to have his right and left achilles tendons taped again to play in the
game.
O- AROM, PROM and resistance tests were not done again because he is regularly taped
for his chronic tendinitis. He did not have any new symptoms or observed abnormalities.
A- Chronic achilles tendinitis.
P- I taped both his right and left achilles tendons to limit dorsiflexion.
Player 9
S- Athlete asked to have his right ankle taped for his re-inversion sprain last practice. He
said the pain was much better, but it was still a bit sore. He rated the pain a 2/10.
O- There was no present swelling and minimal bruising compared to the left ankle. I re
assessed his active and passive ROM, as well as resistance. He still only noted pain active

and passive inversion and dorsiflexion, but much less than on Thursday night. There was
no noticeable weakness in any movement when comparing the left to the right.
A- Grade 1 inversion sprain
P- I taped his right ankle to limit inversion. I will follow up with him throughout the
game to see how he is doing.
Player 3
S- Athlete asked to have his blister on the side of his left foot covered so it did not get
worse while playing.
O-The blister was near the base of metatarsal I and almost completely healed. There was
still a bit of inflammation and the new skin was still pink.
A- Blister
P- I covered it with a non-adherent pad, which I put a small amount of skin lube on to
reduce friction. I then held the pad down with tape.
Player 8
S-Athlete came off field with a bloody nose. He said he got hit in the nose with
someones shoulder during a ruck. He said it didnt hurt.
O- He was holding his head forward, pinching at the bridge of his nose. There were no
visible signs of contusion or lacerations on his face and his nose did not appear to be
fractured.
A- Epistaxis
P- Once the bleeding slowed after a minute I gave him a half tampon to use as a plug and
some gauze to clean off his nose. He returned to the game after the bleeding had stopped.
I then disposed of the gauze and gloves appropriately.
Follow-ups
Player 1 was still asymptomatic from previous concussion. He was cleared to play.
Player 6 was still not at the game.
Reflections
A lot more of our players need pre game taping compared to the first couple weeks. This
is a great opportunity for us to practice different tape jobs and various joint assessments.
Im improving a lot on my ankle tape because Im finally comfortable with the method of
heel locking. I still need to improve on the technique of my wrist tape though. I find it an
awkward angle to tape at.

Nov. 20, 2014 Practice 8

Prevention Techniques
-Brought ice and water bottles out for players
-Walked field for perimeter assessment
-Stocked our medical kit for the game this Sunday
Taping Experience and Assessments/Treatments
Player 9
S- Athlete asked to have his right ankle taped for his re-inversion sprain. He said the pain
was much better, but it was still a bit sore. He rated the pain a 2/10.
O- There was no present swelling and minimal bruising compared to the left ankle. I did
not re assess his range of motion because he is getting this ankle taped regularly.
A- Grade 1 inversion sprain
P- I taped his right ankle to limit inversion.
Follow-ups
Player 6- Athlete will not be playing for the remainder of the season as per doctor
recommendations.
Reflections
The ankle I taped tonight was the best tape job Ive done this semester. I felt confident
and knew how to do each step without hesitation. Ive come a long way in my taping
abilities from the beginning of the semester.

Personal Reflection
Things that went well:
During this practicum, I built a relationship with the players, the coaches and the team
manager. I became part of the team and they trusted me to provide care and information.
The players are comfortable coming to me for assessment and advice, and for the most
part they followed my recommendations.
Throughout this experience my confidence has grown, not only in my trainer abilities but
also toward pursuing a future career as a health care professional. This was a great
opportunity to apply not only what Ive been taught in EPHE 344 but other classes as
well in a real life situation that required me to make executive decisions that I could
support. My confidence in my taping and concussion assessment increased dramatically
in this placement, largely due to lots of hands on experience during games. This
experience taught me that Im very interested in continuing on in a sports therapy
position at some point in the future.
Im very happy that I had the opportunity to work with the Velox rugby club and senior
trainers there. They provided an extensive support network for us with orientation
sessions and being available to answer questions. Since there were a lot of students from
our class placed with Velox teams it also provided an opportunity to get to know a lot of
my peers. Working at Velox was also a unique opportunity to observe both a youth teams
and adult teams and how they interact together. Although I was positioned with the U16
team, I was able to watch the adult teams practice and compete.
Things I would change:
I loved working with Velox. Initially I was disappointed to be working with a youth team
rather than an adult team though. I thought there would be less practical experience but I
had a great team to work with and had tons of hands on training. The coaches were
supportive and the team manager was very organized. They both treated me like part of
the team and I very much enjoyed being there. I dont have anything I would change
about my overall placement but in the future it would be nice to experience working with
an adult team to compare the differences.
Looking back on my experience, I would definitely try harder to prevent a few players
from returning to play too early. This was a struggle that I imagine many trainers battle
with because at the end, the player can decide whether to play or not. I also felt that it
would have been beneficial to have the taping and injury assessment training done prior
to starting the practicum. The initial couple games were very over whelming and I did not
feel that I had had enough training to properly care for the injuries that occurred. Later on
in the term I realized that this structure had forced me to work in a situation that I had
been uncomfortable with and I think I grew from that. Im much more confident in what I
know and my ability to treat athletes. In a future placement I would like to do more pre
season assessments with my players, especially SCATs, to have some baseline values to
compare to during the season.
Initially the communication between the trainers and the team was difficult, especially
getting to know each player and getting them comfortable with us. This was a difficult

age to work with at times, since they are already awkward and uncomfortable with their
changing and growing bodies, but after the first couple practices they had familiarized
themselves with us and respected what we had to say. There were only a couple athletes
during the season that didnt fully listen to our recommendations. This mostly had to do
with seeing a doctor for a follow up or taking more time off to fully heal an injury.
Communication between the two trainers I worked with on this team specifically and
Mark, the head trainer was very effective as well. We never had a practice or game that
wasnt covered by at least one trainer, and usually two or three of us were there. Mark
was great about making sure someone was picking up the supplies and organizing who
went to which game. The team manager also played a role in how smoothly everything
went with our team. She sent us regular email updates weekly about changes to practices
and games. I also texted her regularly to follow up on player injuries, when I didnt have
a way to reach them.
What I learned:
In this practicum I learned that working as an athletic trainer is a position I really enjoy
being in and is something I hope I can continue with after the course is over. I learned a
lot about myself in a position of authority as well as working with a team. I now have a
lot more confidence in my skills as well as my ability to make executive decisions based
on what I have been taught and my previous experiences in the health care field. I did not
expect to take as much from this experience as I have and Ive learned a lot of practical
assessment and treatment techniques that I will be able to use in the future. I learned that
this position is also stressful at times, not just because of the responsibility to care for
players but also the competitive nature of sports and the drive to return to play. I
developed a relationship with my team and I care about all the players. Im really going
to miss them when their season wraps up in the next couple weeks. Mostly, I learned that
a practicum I thought was going to take up a bunch of time actually became a position I
looked forward to going to each week.

Further Analysis of Player 6s Injuries in Game 2

Events prior and during incident:
Athlete was on field during the first half of the game and he was not previously injured.
He did not have a history of ankle or rib fractures previously. During a ruck, he went
down and another player landed on top of him with his knee directly on his lower back.
The athlete remained on the ground and we went onto the field to assess him. We initially
assessed for neurological symptoms, which were not present. He was able to sit up with
assistance but was in a lot of sharp pain, located in his lower thoracic and lumbar region
of his back. The game was paused and with assistance he was moved to the sidelines for
further evaluation.
SOAP notes of initial injury:
S- Athlete took a knee to his lower back, in the lumbar region and near his kidneys. He
did not initially get up so we went onto the field to see him. He was in a lot of pain but
was able to sit up and move to the sidelines with assistance. He said that the pain was
sharp, radiating from his lower back and rated it an 8/10.
O- The athlete was not confident moving and was experiencing a lot of pain. He was
struggling to sit upright on the sidelines so we laid him down. He was pale, sweaty and
had a lot of pain in his back. He was lucid and not disoriented about where he was. He
did not report any pain in the cervical region of his spine. No neurological symptoms
were present, just pain and the muscle spasm of his back. Observation of his back did not
reveal any signs of internal bleeding.
A- Large muscle strain of the lower back; possible injury to kidneys or other abdominal
organs as well as possible rib fracture.
P- We advised he be stabilized and have an ambulance called. His mother said not to and
she took him to the hospital. Before he went to the hospital we gave him ice. He kept the
ice on his lower back for about 10 minutes. He needed two people to assist him as he
walked. I will follow up with him at the next practice or by emailing the team manager.
Analysis and description of injury:
After a follow up it was determined that he had a large sprain of his lower back muscles,
possibly the latissimus dorsi and/or erector spinae among others. Additionally he suffered
a stress fracture of his left ankle on the lateral malleolus of the fibula and a cracked left
rib 11. The muscle strain was due to over stretching and tearing that lead to damage of the
muscle fibers. This caused inflammation and was the major cause of the throbbing pain
the athlete experienced on field. His body produced muscle spasms as protective
mechanism to prevent further stretching of the already torn back muscles. This is why he
had difficulty sitting upright, because his back muscles would have been actively
extending his spine. Stress fractures, also known as hairline fractures are tiny cracks in
the bone. Often stress fractures are the result of overuse injuries. This may have been the
case with the athlete where the force of the injury finally resulted in a break. The stress
fracture of his left fibula and rib would need to be rested from activity for a minimum of

6-8 weeks, likely longer. This allows the tissue time to heal. Ribs usually heal within a
few weeks but a longer recovery is recommended for high contact sports, like rugby,
where the athlete will be a high risk of forceful impact to the region. Initially icing and
elevation can help reduce inflammation symptoms, promoting a faster recovery. After the
swelling decreases, the ankle can be splinted or casted. In the athletes case he was put in
an air cast to allow some mobility still. When returning to play it is recommended to be
gradually, rushing back in can lead to re injury. It is also important to note that if there are
any difficulties breathing, the athlete should seek medical attention.
Reflection of what I did right and what I would change:
With this athlete, I did well in the initial assessment and follow-up, especially considering
it was only the second game of the season. I followed proper protocol, ruling out spinal
injury before moving the athlete to the sidelines. I had never witnessed a muscle spasm
cause such extreme pain before and it was a stressful experience at that level of training.
The athlete was present at practices and games after the incident but did not play again
until practice on October. 30. At that time he had been cleared by a doctor to return to
play and I did a full assessment of his ankle. He did not report any rib pain at the time. He
did not have any indication of pain or loss of function/range of motion during the practice
and was confident in tackling drills. He was cleared by the coach to play at the game
Sunday and I assessed and taped his ankle again for the game (see SOAP notes below).
S- Athlete asked to have his left ankle taped for support and protection of his previous
fracture. He said that his doctor cleared him to play.
O- AROM, PROM and resistance tests were done, comparing his left ankle to his
uninjured right ankle. He had full range of motion in flexion, extension, inversion and
eversion. He did not mention pain in active or passive ROM and there was no noticeable
weakness.
A- Preventative/Protective tape for post stress fracture of fibula
P- I taped his left ankle to limit his range of motion and decrease the likelihood of a
repeat fracture. I advised the athlete that he was returning to play pretty quickly since his
initial injuries. He said that he was still going to play. I recommended that if anything
starts to hurt, that he should come off the field.
During the game on Sunday I noticed the athlete was holding his left rib cage and was
showing painful facial expressions. I approached him at half time and asked how he was
doing, if he was having any pain in his ribs. He said that they were sore but that he was
okay. I asked him to come off the field and informed him about the risk of re injury if he
continued to play. He decided against my recommendation. I spoke to the coach and let
him know that the athlete was having rib pain in the same region where he previously
cracked one and that he was at risk for re injury (see SOAP notes below).
S- I approached athlete at half time about rib pain during the game in the same area that
he cracked in game 2. He said the pain was low down and not affecting his breathing. He

said he was going to continue playing, against my advice to sit out. He came off the field
5 minutes later in pain.
O- Athlete was visibly in pain; he was holding and protecting his left side, in the ribs
region. His facial expressions were in pain but he looked like he was trying to walk it off.
A- Re injury to previously cracked rib. It is possible it was not fully healed and he had
returned to the game too early.
P- Athlete was pulled from game and given ice to apply to his ribs after being educated
on the risks and benefits. He had the ice on for 10 minutes and said that the pain was
reduced but still there. I advised that he see a doctor and have an X-ray done. I will
follow up with him at the next practice.
The athlete was back at practice on Thursday and said that he felt much better but had not
seen a doctor. I again recommended that he discontinue playing and allow his body more
time to heal. I advised that if his ribs were still sore, his ankle was likely not fully healed
as well. He said he had been cleared by a doctor and wanted to continue to practice. I
explained the risks of returning to play without fully letting his injuries heal and he
decided to play against my recommendation. Toward the end of practice he re injured his
previously fractured ankle (see SOAP notes below).
S- Toward the end of practice, the athlete had to be assisted off the field by two other
players. He couldnt put any weight on his left ankle and was not confident in walking or
standing on his own. He rated the pain a 7/10, localized to his lateral malleolus in the
same area where he stress fractured it in September. He described the pain as a deep, ache
that hurt even more to touch.
O- There was visible swelling compared to his right ankle but he was in too much pain
for any range of motion assessment or resistance testing.
A- Probable re-fracture of the fibula in the lateral malleolus region.
P- We sat him down and iced the region after explaining the risks and benefits. He kept
the ice on for 10 minutes until the region felt numb. At the end of practice I spoke to him
and his mom, I advised that they go to the hospital that evening for new X-rays and
further evaluations. I explained that it was possible that there was a new fracture to the
previously injured region. I will follow up at the next practice; the athlete will not be
playing in the game this Sunday.
Working with this athlete was a good opportunity to follow the process of healing
throughout a season and it provided me with the opportunity to really get to know the
athlete and follow up with his recovery regularly. Although his main priority was to
return to play regardless of his healing, he became quite comfortable coming to me with
his injuries and questions during the season. He is currently re-casted and not playing in
the final games of the season. Reflecting back on this experience I would make a larger

complaint to the coach about his early return. I did well informing both the player and the
coach of the risks but I think that I trusted the opinion of the coach too much and believed
the player when he said he had been cleared by a doctor for a second time after his rib
pain. With this experience to back up my previous judgment I will not be so lenient in the
future when it comes to athletes returning to play. I realize that there is a limitation to
what I can do to prevent their return, since it is their decision in the end, but that is
something I am going to work on in the future.

Coaches Evaluation
Was emailed to you by Mark McNeil.