Lower Leg Contusion/Hematoma CIP #2

1. Lower Leg Contusion/HematomaCIP #2 Kierston Cooper

2. Condition • An athlete sustained a contusion in the lower leg/shin area. Pain, discoloration, and swelling increased upon any contact or trauma following the initial injury. In order to minimize the risk of further injury to the site, I decided to apply a preventative device.

3. Materials Used • To fashion this preventative device, I used blue memory foam, Cramer Ortho Gel, Stein’s White Adhesive Latex Foam, a pair of scissors, pre-wrap, elastic tape, and 1 ½ inch Zonas tape.

4. Materials

5. Procedure • I started by cutting out a hole from the middle of an appropriately-sized piece of blue memory foam to mimic the function of a donut pad, which provides a “buffer zone” for the injury and decreases the likelihood of further trauma. I applied it to the injury site, along with a circle of Cramer® Ortho Gel™inside the hole in the memory foam to attempt to provide extra comfort for the lower leg, which is comparable to 2nd skin® for blisters. Afterwards, I applied another layer of foam over the site, a layer of Stein’s White Adhesive Latex Foam.

8. Procedure cont. • I covered the device with pre-wrap and elastic tape to hold the mechanism in place. I anchored that to the skin with 1 ½ inch Zonas tape to provide stability and try to ensure that the tape work would not be removed during play.

10. Precaution To Take • You must be aware of the compression that you are putting on the spot. Because it was a contusion, the device must be applied fairly loosely. If it goes on too tight, the contusion symptoms can return and blood can pool in the area, negating any progress and making the injury worse.

11. Progression • As the athlete’s contusion became smaller and less painful, I began to take away components of the tape work. I also let the athlete and their comfort level during play dictate how quickly I progressed in terms of getting them out of the preventative device.

12. Progression cont. • I started the progression by beginning to do the tape job without the gel pad in the middle of the memory foam. As the athlete’s comfort level continued to increase, I began to remove the layer of white adhesive latex foam from the tape job as well, leaving us with the memory foam donut pad. Once the athlete felt that the memory foam was no longer necessary, I discontinued use of the tape job.

14. Device Monitoring • I had the supplies for the device prepared in case the device became weak and started to come off, or in case the contusion flared again. I did not use tape alone over the contusion because, again, the added compression of tape to the skin would only cause more blood to pool in the injury site and make the contusion symptoms worse. At this point, the injury was basically closed out.