Assessment of sport injuries 2 exam Flashcards
Pathology
Tissue healing
Tissue changes
Affected Structures
Aetiology
Mechanism
Cause of injury
Contributing factors
Clinical signs and symptoms
Presentation of injury
Epidemiology
What population group is the injury common to?
What are potential referral pathways for injury
Refer to their GP
Refer to A and E
OR refer to a consultant
Observation
What are you looking for with your injury
Touch
What are you feeling for and why would it feel like that>
AROM
Active range of motion
PROM
Passive range of motion
Laxity
Looseness of a bone or joint
Shoulder injuries
- Long head of biceps tendinopathy
- AC Joint sprain
- SLAP tear
- Frozen shoulder/Adhesive capsulitis
- Supraspinatus tear
Elbow, Wrist & Hand injuries
- Lateral epicondylitis
- Colles’ fracture
- Carpal tunnel syndrome
- Scaphoid fracture
- Mallet finger
Hip injuries
- Iliopsoas related groin pain
- Insertional hamstring tendinopathy
- Rectus femoris strain
- Labral tear
- Femoral stress fracture
Knee injuries
- ACL rupture
- Biceps femoris sprain
- Meniscus tear
- Medial tibial stress syndrome
- Patellofemoral Pain Syndrome
Ankle injuries
- ATFL sprain
- Achilles tendinopathy
- Plantar fasciitis
- Navicular stress fracture
- 1st MTP joint OA
Biceps Tendinopathy
Aetiology - Overuse from throwing activities. Previous trauma
Pathology - Acute inflammation of Biceps tendon longhead can lead to chronic degeneration and then structural weakness graded 1-4
symptoms - anterior shoulder pain,
Clicking or audible popping noises,
Tenderness on palpation
Clinical tests - Empty can test, speeds test
Epidemiology - typically observed in young adult athletes doing overhead throw sports, swimming, baseball and tennis
AC Joint sprain
Aetiology - A hard, direct hit to the shoulder
Falling and landing onto shoulder or repetitive overhead movements
Pathology - Involves AC and Coracoclavicular ligaments. Injury triggers inflammation and maybe deformity
symptoms - shoulder pain and swelling, deformity, tenderness
Clinical signs - Scarf test
Epidemiology - Occur in contact sports at 20-40 year age group mostly in males
SLAP tear (superior labral anterior posterior)
Aetiology - Falls onto outstretched arm or overhead throwing
Pathology - superior labrum provides shoulder stability
Damage can compromise shoulder mechanics, leading to instability, reduced strength, and pain.
symptoms - Catching or popping, locking in shoulder movement or pain
Clinical signs - Crank test, speeds test
Epidemiology - Slightly more males 20-50 who play overhead sports eg baseball, or can be caused by degeneration for older ppl
Frozen shoulder/Adhesive capsulitis
Aetiology - Can happen post surgery or post stroke or another traumatic condition can cause this injury
Pathology - has three stages Freezing. frozen and thrawing stages where it gets better
symptoms - Shoulder pain at night and at rest and stiffness.
Restricted external rotation, flexion and abduction
Clinical tests - Painful arc test, resisted PROM of flexion
Epidemiology - In women, as approximately 70% of individuals who present with a frozen shoulder, are females. As well as older people 40 - 60
Supraspinatus tear
Aetiology - Fall on an outstretched arm
Degenerative: Wear and tear of the tendon slowly over time
Pathology - One of 4 rotator cuff muscles.
Assists in shoulder abduction and stabilizes the shoulder joint.
Can be graded 1-3
symptoms - Decreased ROM
Pain at rest and at night,
Stiffness or burning
Clinical tests - Empty/full can test or supraspinatus muscle test
Epidemiology - It mostly affects the dominant arm with people above 40 more so males
Lateral Epicondylitis (tennis elbow)
Aetiology - Overuse of muscles of forearm and elbow. Repetitive wrist extension and forearm supination/pronation
pathology - Involves degeneration and specifically affects common extensor tendon and Lateral epicondyle of the humerus
symptoms - Pain, Stiffness.
Clinical signs - mills test
epidemiology - Effects 35- 50 year olds common in tennis players and grip sports
Colles’ fracture
Aetiology - from simply falling on an outstretched wrist in extension
pathology - Distal radius fracture. Involves deformity and can lead to arthritis or osteoporosis
clinical signs & symptoms - Severe wrist pain, Swelling, Deformity, Numbness or tingling
epidemiology - More common in women over 50 mostly postmenopausal
Carpal tunnel syndrome
Aetiology - results from increased pressure in the carpal tunnel and compression of the median nerve
pathology - Involves compression of median nerve, which can lead to damage
symptoms - tingling or numbness
Clinical tests- Tinels/ phalens test
epidemiology - usually occurs between ages 36 and 60 and is more common in women who are pregnant. Or manual labourers
Scaphoid fracture
Aetiology - following a fall onto an outstretched hand or
Traumatic injury through contact sports and road traffic accidents
pathology - Most common carpal bone fracture can have healing complications due to tenuous blood supply. Can be TYPE ABCD
symptoms - Deep, dull ache in wrist and also swelling
Aggravated pain by pinching and gripping.
Clinical tests - Scaphoid palpation
epidemiology - predominantly affect young adults, with a mean age of 29 years.
Higher incidence in males in high impact sports, rugby, football
Mallet finger
Aetiology - Sudden forced flexion or extension from hitting a ball
pathology - Disruption of extensor mechanism at distal interphalangeal joint
clinical signs & symptoms - Swollen and pain in the finger
epidemiology - More common in ball sports and men 20-50 years old basketballers or baseball or cricket.
Iliopsoas related groin pain
Aetiology - Acute trauma or overuse of the iliopsoas
pathology - Consists of psoas major psoas minor and iliacus muscles. Provides stability and has 3 grades with grade 3 most painful.
symptoms - Groin aches and pain when using iliopsoas
Clinical tests - Faddir or thomas test
epidemiology - Young adults and soccer player. Slightly more prevalent in females
Insertional hamstring tendinopathy
Aetiology - Overstretching, overuse or too high training intensity Or inflammation
pathology - characterized by degeneration, inflammation, or injury to the tendons of the hamstring muscles at their attachment site on the pelvis
symptoms - Pain in the glutes and thigh
Clinical tests - Painful palpations
epidemiology - long distance runners and athletes taking part in sprints or football and hockey more common in females
Rectus femoris strain
Aetiology - . Sudden deceleration of the leg via kicking
or violent contraction of the quadriceps via sprinting. Or overuse
pathology - Grade 1 - tightness
Grade 2 - Sharp pain when running
Grade 3 - Severe pain in thigh
Grade 4 - complete tear
symptoms - Bruising, swelling and pain or tightness
Clinical tests - straight leg raise
epidemiology - Common in basketball, rugby or footballers, more so males
Labral tear
Aetiology - Direct trauma - e.g. motor accidents, falling with or without a hip dislocation, slipping
Sporting activities that requiring twisting and turning, eg - ballet
pathology - Involves acetabulum, labrum and tranverse ligaments. Helps with joint stability and proprioceptive feedback
symptoms - A constant dull pain with periods of sharp pain. Night pains, clicking
Clinical tests - FABER, FADDIR, straight leg raise
epidemiology - More common in female dancers or gymnasts or older people from degeneration
Femoral stress fracture
Aetiology - Repetitive load on the bone maybe after recovering from another injury. Trauma or overuse.
pathology - 3 grades to describe progression of fracture. Progresses through stress reaction then microfracture development then finally complete fracture.
clinical signs & symptoms -
Point tenderness on palpation
Local swelling
Pain with activity
epidemiology - Occurs more commonly in women and distance runners
ACL rupture
Aetiology - Pivot or cutting movements. Landing from a jump with knee extended
pathology - Leads to altered joint biomechanics. Can trigger inflammation or initiate degenerative changes. Grade 1-4 depending on how much laxity
symptoms - Audible crack or pop, extreme pain and swelling
Clinical tests - Lachmanns, Anterior drawer test
epidemiology - female athletes associated with pivoting, decelerating and jumping.
Biceps femoris sprain
Aetiology - Usually happen in the 2nd phase of a swinging phase so when kicking
pathology - 3 grades of injury with 1 being mildly severe and 3 being extremely severe
symptoms - Pain, Tenderness, Loss of ROM
Clinical tests - straight leg raise
epidemiology - Very common in football and running and slightly more in males
Meniscus tear
Aetiology - Often happens from traumatic sporting injuries to knee or when turning.
pathology - Disruption of meniscal tissue can lead to cartilage damage has 3 grades. Can cause Osteoarthritis
symptoms - Pain, popping sounds, joint line tenderness
Clinical tests- Thessalys, Mcmurrays test
epidemiology - more common in males, because they are more involved in aggressive sporting
Medial tibial stress syndrome (Shin splints)
Aetiology - Large increase in load, volume and high impact exercise can put at risk
pathology - Involves tibialis posterior, soleus and FDL leads to inflamation and stress fracture if untreated
clinical signs & symptoms - Pain during exercise.
Pain persists all day
Tightness
epidemiology - More common in female athlete runners 15-50
Patellofemoral Pain Syndrome (runners knee)
Aetiology - overuse and overload of the patellofemoral joint or a fall or trauma
pathology - Muscular imbalances like weak quadriceps can lead to inflammation and degeneration. Involves patella tendon, femur and quads
clinical signs & symptoms - Anterior knee pain or tenderness around patella
epidemiology - Young adults, slightly more in female runners or cyclists
ATFL sprain
Aetiology - Sudden inversion of the ankle likely to happen when foot is in plantarflexion
pathology -3 grades of injury with grade 3 complete tear. Involves anterior talofibular ligament
symptoms - Pain, tenderness and swelling, bruising
Clinical tests - Anterior drawer test, Talar tilt test,
epidemiology - Common in basketball players and indoor sports and younger adults 15-35
Achilles tendinopathy
Aetiology - Repetitive overload of Achilles tendon or degeneration.
pathology - Can be midportion Achilles (most common) or insertional Achilles at the calcaneal insertion
symptoms - Morning pain, Achilles becoming thicker, Stiffness
Clinical tests - Calf raise, Achilles palpation
epidemiology - more common in males 30-50 years, running and jumping sports
Plantar fasciitis
Aetiology - overuse injury, primarily due to repetitive strain but can occur as a result of trauma. Inflammation of plantar fascia.
pathology - Plantar fascia is thick band of connective tissue supporting arch of foot to absorb shock when running,. Graded 1-4
symptoms - Tenderness and sharp pain
Clinical tests - Windlass test
epidemiology - 40-60 year olds slightly more common in females and runners
Navicular stress fracture
Aetiology - The cause is a repetitive chronic load to the midfoot or overuse
pathology - A crack or break in the navicular bone and occurs due to poor blood supply so makes it harder for the bone to recover and repair.
clinical signs & symptoms - chronic mid-foot ache and a limp, tenderness
epidemiology - Young male athletes 15-30 High impact sports, football, gymnasts, dancers
1st MTP joint OA (Hallux Rigidus)
Aetiology - A degenerative condition of first MTP joint cartilage. Or trauma or repetitive load.
pathology - Osteophytes can form on dorsal part of joint. Inflammation can happen Grade 1-4
clinical signs & symptoms - Pain, swelling, redness, stiffness, loss of motion
epidemiology - More common in 30-60 females post menopausal. Or people with deformities in foot
Red flags
Cauda equina
Cancer
Night pain
Unexplained weight loss
Infection
Avascular necrosis
Yellow flags
Past depression
High stress levels
Social withdrawals
Inappropriate expectations
What do active movements assess
- To Assess Function and Strength
- Helps identify the range of motion
- Assesses muscle strength, coordination, and pain during self-initiated movement.
What do passive movements assess
- To Assess Joint Mobility
- Identify Joint Stiffness or Pain
- Useful for patients unable to move actively
- Useful for us to evaluate the joints end feel
What do resisted movements assess
- Helps Determine Strength Levels
- Helps identify weaknesses
Shoulder Function tests
- Press up
- Overhead lifting
- Throwing
Knee Function tests
- Squat
- Step up
- Lunge
- Jump
- Kick
Ankle Function tests
- Heel raise
- Jump
- Hop
- Skip
Elbow wrist and hand function tests
- Wall press up
- Press up
- Under arm throwing
- Overhead throwing
Hip function tests
- Walk
- Run
- Squat
- Lunge
- Jump
Shoulder Observations
- Hip levels
- Spine Curvature
- Foot positioning
- Shoulder levels
Shoulder touch
- Hot/cold
- Dry/ Scaly or shiny
Elbow/ wrist hand Observations
- Hand position compared to other side
- Scars
- dropped wrist
- Clawed fingers
Elbow/ wrist hand touch
- Dry / sweaty skin
Hip observations
- How their gait is (walk)
- Hip shouldnt be coming out loads trendelburg.
Observation of Knee
- Q angle
Observation of Ankle
- Bruising or swelling when standing
