Bosh Flashcards
Arm injury, trunk injury, lower extremetieis and footstike
What percentage of arm injuries occur at the wrist?
25%
What are the two types of shoulder injuries?
Acute - single, traumatic
Chronic - multiple, recurrent
Name some shoulder injury predisposing factors
- Muscle weakness
- previous injury
- explosive sports (discus/javelin)
- ligament laxity
- Age
In what sports are shoulder dislocations most common?
Anterior dislocation are frequent in football, rugby, canoeing, judo, wrestling.
Posterior dislocations are frequent when falls occur.
Wheres does shoulder bursitis/ tendonitis occur and what are the symptoms?
Occurs 2-4 inches from the top of the shoulder In the rotor cuff.
Abduction can cause inflammation and soreness.
Explain impingement syndrome and causes
Impingement syndrome occurs when the arm swings in a arc and the rotator cuff impinges under the corachoacromion arch.
What are the causes and predisposing factors for impingement syndrome
Caused by poor technique and overuse.
laxity in the IGHL causes instability in the joint increasing injury risk.
What is the treatment for impingement syndrome?
- Reduce swelling
- Immobilisation
- Physiotherapy exercises
Name traumatic elbow injuries
- Explosive ligament tears
- Fractures
- Dislocations
what’s the most common site of elbow nerve injury
near surface
What is tennis elbow?
Pain at lateral epicondyle to forearm muscle.
What causes tennis elbow?
Overuse of extensor and supinator muscles
What are treatments for tennis elbow?
- Rest
- Physio
- Immobilise
- can operate to lengthen the extensor carpi radials brevis
What is golfers elbow?
pain as extended wrist in full supination at flexor tendon origin
What are possible treatments for golfers elbow?
- Change in technique
- eccentric training to strengthen tendon
- Cortisone may work in fluid of tendon - but weakens.
What is Carpel tunnel syndrome?
Median nerve located in the centre of the wrist that are protected by flexor muscles on the inside of the wrist, becomes damaged from overuse in extension positions such as cycling or rowing. This causes compression on the median nerve.
name Symptoms of Carpel Tunnel syndrome?
- numbness
- Paraesethesis
- Weakness of finger flexion
- Loss of sensation in radial 3.5 fingers
Name some treatments for carpel tunnel syndrome
- Rest
- Wrist splint a 30 degrees flexion
- Anti-inflammatory medication
How does a wrist sprain occur?
A direct blow or twist to wrist with flexion or extension
How is a wrist sprain treated?
- Check for no bone damage X-ray
- Non-steroid anti-inflam (NSAID)
- RICE
- Taping/brace
- Gradual retraining
- Resume within 1-2 weeks
What is boxers knuckles and how is it caused?
bursitis (metacarpel head),
intermetacarpel ligament instability because strapping not appropriate
What percentage of injuries reported are neck and trunk? (1989 postal survey: Sheffield)
7.3%
how are fractures normally caused?
traumatic blows
What are palpitations?
Extra heart beats (electrical) not pulse waves produced.
athletes may demonstrate low heart rate
How to identify Angina?
A vice like pain in chest
how to treat exercise induced asthma
relieved by inhaler (blue - Ventolin)
check they have this before exercise.
respiratory trouble may also be caused by allergies.
where are abdomen injuries most common?
spleen and liver
what are the signed of an abdominal injury ?
- Rigidity
- shock
- rapid pulse
- sweating
what are the signed of a kidney injury?
Kidney – bruising, bleeding in urine
what are the signs of an intestinal injury?
usually duodenal as close to
surface.
Rigidity.
Usually a blow.
what are the signs of a bladder injury?
Traumatic blow – blood in urine
- Blood in urine may also be underproduction of urine (not drinking + heavy exercise)
what are the signs of a urethra injury?
Traumatic blow, bleeding
what are dermatomes ?
segmental distribution of spinal nerve
pain, lack of sensation in an area of dermatomemay indicate injury site
what does the transverses muscle do?
Transversus acts at initiation of movement to stabilise trunk in overhead and lower limb action
when are the internal obliques and transverses activated?
in hollowing actions.
What muscles are prime movers of trunk flexion?
Rectus abdominis and lateral fibres of external obliques
what is valgus of the foot ?
A position of Everton (foot outwards towards the lateral
What is Varus of the foot?
A position of inversion (foot inwards towards medial)
what is subtler neutral position of the foot?
Neither pronated nor supinated - dead of talus not protruding from behind navicular on either medial or lateral side.
Define pronation
A single motion whose component consists of adbuction, eversion and dorsiflexion of one segment or joint in relation to another (ie outwards & upwards)
Define Supination
A single motion. opposite to pronation (ie. inwards and downwards)
what is normal function of the foot?
Posteriolateral contact (5-7°)→pronation to neutral with internal tibial rot →femoral rotation (to absorb shock). Now mid-stance.
List and describe typical foot problems?
Excessive pronation - pain medial side of leg associated with high impacts as pronate for foot strike - excessive motion at subtalar joint.
* Failure to re-supinate
* Late pronation
Related: tibial stress syndrome
What is cavus foot and its symptoms?
Rigid foot - cannot absorb as much impact
Symptoms: Pain usually lateral aspect of lower leg (lateral impact)
Related: Trochanteric bursitis, peroneal tendonitis
What is femoral torsion?
twist in femur shaft (in/out) during gait.
Describe Genu varum (bow legs)
Often have rigid, high arched feet – leads to supinated feet.
Often increased range of pronation
Describe Genu Valgum (knock knees)
With femoral anteversion
internal rotation
* Large Q angle
* Weakness of hip rotators
* Tightness of adductors
* Wide pelvis
* Tight hamstrings and calves
* Knock-on from excessive pronation
Describe Genu Recuvatum (hyperextended knees)
Ligament laxity
* Increased stress on knees, muscular imbalance and increased pronation
What is a common orthoses ?
Common insert in midsole up to (10 deg
varus/valgus) to adjust pronation and knee pain
What percentage of people were rear foot striker in Ket et al. (1983)?
81% Rear foot strike
(19% midfoot, 0% fore foot)
Which footstrike is the most efficient?
Heel
In which foot strike is the impact peak delayed
Fore foot strike
Which foot strike causes increased forces through the achilles? What problem does this cause?
Fore foot strike. Achilles tendonopathy
Where do fractures of the shoulder occur and why?
Clavicle, this is the weakest structure in the shoulder
Who are acromioclavicular joint injuries most common in?
Young athletes, as part of a fall
What does IGHL stand for?
Inferior glenohumeroal ligament
What is the function of the rotator cuff?
Centres the humeral head in the glenoid and gives the other muscles power
What is the discrepancy of the shoulder joint?
4mm
What is the effect of translation and compression of the humeral head?
Entrapment of labarum between the humeral head and glenoid rim, this causes a labral tear
What does fatigue in pronator muscles cause?
Tensile strength of UCL increased and therefore there is more stress of UCL (ulnar collateral ligament)
Whats the function of the labarum?
Outside part of the cartilage allows for smooth moving of the humeral head
What are the training protocols for rotator cuff injuries?
Therabands, weigthed cables, pulling (external rotators), pushing (internal rotators), should be on both sides equally to strengthen
What is the effect of cortisone injections on tendons?
Weakens if over a longer period of time, can cause the tendons to harden
When is the chance of sciatica increased?
When the nerve runs through the middle of the hamstring group and underneath the periformis
What happens if the subtalar joint is not level?
The axis of movement is not directionally horizontal, its at an angle, increasing joint movement (eversion and inversion)
What effect does muscular imbalance have on loading?
Changes the loading between medial and lateral
What is the role of shoes?
Shock absorption, stabilization, flexibility, lightweight and support
Which footstrike is most economical?
Midfoot, faster with 7% more energy used
What footstrike is the fastest?
Forefoot
What factors determine footstrike patterns?
Speed of the action or the task
What is the effect of footstrike on oxygen uptake?
No difference, increase in carbohydrate oxidation
What could be the effect if an individual suddenly changes striking pattern?
Slow down or cause injury to the runner by putting unnecessary stress through the foot
Why is the impact peak invisible in force graphs of forefoot runner?
As they start in plantar flexion, initial force is expected to occur at the same time as the drive force
What is the relationship between ground reaction force and injury?
Greater ground reaction force and greater impact peak was found to have a lower injury rate
What is the injury risk of forefoot strikes?
Not metabolically efficient, no reduction in impact forces and no reduction in running related injuries
What is the difference in loading between FF and HS
FF - increase in calf and knee
HS - increase in hip and knee
What injuries come from footstrike?
Achillies tendionopathy, plantar facitis and patellofemoral pain
