TABLE A.

Hypothetical Injury Scenarios in Order of Presentation in the Online Survey Instrument^a

Scenario 1 (Scenario 6): A baseball pitcher has been having elbow pain for over 1 month. He has been icing his elbow, but has declined injury assessment by the certified athletic trainer, He is unable to complete practice one day late in the season due to pain. He reports that he was mid-pitch when the pain became”too much.’On assessment, he has significant medial elbow tenderness, mild swelling, and a positiveTinel’s test for the ulnar nerve.

Scenario 2 (Scenario E): A swimmer presents to the athletic training room with low back pain after a session in the weight room.The athlete reports that he was doing plyometrlc trunk rotation by catching and throwing a 10 pound weighted medicine ball when he started to feel pain in his right lower back, He has been swimming two sessions a day and has been lifting 5 days a weekfor the past 9 months with occasional complaints of non-specific soreness after a hard practice. Upon evaluation, there is significant muscle spasm in the right lumbar paraspinals and radicular pain along the anterior right thigh consistent with the L3 dermatome.There is no evidence of rig ht q uadriceps weakness.The quadrant test, which axially loads the right lumbar facets by overpressure through the shoulders when the athlete is seated and the lumbar spine hyperextended with right rotation and side bend, amplifies the symptoms, indicating possible nerve root irritation.

Scenario 3 (Scenario F): A soccer goalkeeper has been complaining of dominant leg quadriceps pain and tightness for several weeks. His initial visit to the athletic training room was without an assessment and he has been receiving treatment of moist heat and stretching prior to practice and games and ice after practice and games since then, After 3 weeks of daily heat, stretch, and ice treatments, the athlete collapses after punting the ball in the second half of a game. He complains of significant dominant left quadriceps pain, and there is a visible and palpable defect in the muscle.This game was played outside, and it had been snowing for a short time. The ball was in play in the opposing team’s half of the field for the majority of the game.

Scenario 4 (Scenario G): A female gymnast has been working on a new skill on the balance beam that includes a back handspring. As a habit, she has always taped her wrists and ankles before and iced her wrists and ankles after each practice. After 3 weeks of practicing this skill, she presents to the athletic training room with complaints of right wrist pain, and an inability to complete practice. She presents with significant redness and swelling over the right anterior wrist. She has pain and crepitus with active wrist flexion and passive wrist extension.

Scenario 5 (Scenario D): A freshma n fema le with no history of participation in crew has just wa Iked-on to the team. She has participated in all trai ning, practices, and weig ht lifting activities. She presented to the athletic tra ining room with com plaints of low back pain, where she was assessed with a diagnosis of muscle strain. No diagnostic tests (x-rays or MRIs) were performed. She has been heating before practice and icing after practice, as well as performing basic low back exercises as part of a rehabilitation program. She presents to the athletic training room during one practice with reports of a significant increase in her back pain. She reports that she was lifting a boat with a teammate when the teammate lost her grip and the boat shifted significantly.They did not drop the boat, but worked quickly and in an awkward position to lower It to the ground. On evaluation she has significant paraspinal spasm, left more than right, and a left trunk shift, Diagnostic tests have not yet been performed.

Scenario 6a (Scenario A): A junior female softball player with a history of right biceps tendonitis her freshman year presents in midseason with complaints of right anterior shoulder pain. She pitches with her right arm, Evaluation demonstrates rotator cuff weakness, biceps weakness, a positive Speed’s test, and positive impingement test, resulting in an assessment of biceps tendonitis.The athlete receives treatment and is placed on a rehabilitation program.

Scenario 6b (Scenario C): This same softball player was compliant with her rehabilitation program, performed exercises, and received treatment daily for 2 weeks. She then returned to fu II participation. One week after this retu rn to full pa rtlcipation the athlete fel I on an outstretched right arm during softball practice. Physical assessment at the second visit, confirmed byMRI presents a diagnosis of right full thickness labral tear and biceps tear.

MRI = magnetic resonance imaging

^aFor organization and presentation in the article, the order of scenarios was revised for clarity. The numbers and order are as presented in the original survey instrument. The letters correspond to scenario presentation in the article.