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Brad 4th Ed Part 2 > Ch. 44 Sports Medicine > Flashcards

Ch. 44 Sports Medicine Flashcards

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1
Q

What is the potential biomechanical dx for lateral epicondylosis?

A

Posterior deltoid weakness

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2
Q

What is the potential biomechanical dx for hamstring strain?

A

Tight hamstring

Weak gluteal musculature

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3
Q

What is the potential biomechanical dx for metatarsal fx?

A

Supinated foot

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4
Q

What is the potential biomechanical dx for athletic pubalgia?

A

Weak core muscles

Tight hip girdle

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5
Q

What is the potential biomechanical dx for Shoulder impingement w/ rotator cuff strain?

A

Periscapular weakness or inhibition

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6
Q

What is the potential biomechanical dx for patellofemoral syndrome?

A

Quad & glut weakness/inhibition

Overpronation

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7
Q

What is the potential biomechanical dx for repetitive ankle sprains?

A

Weak peroneals

Proprioceptive dyfxn

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8
Q

What should all “pre-rehab” programs address?

A

Strength
Flexibility
Endurance

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9
Q

Describe the wind up phase of throwing

A

Start: pitcher initiates motion
Stop: max knee lift of the lead leg when ball removed from glove
Few injuries during this phase

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10
Q

Describe the early cocking/stride phase of throwing

A

Stride leg and hip/knee of pivot leg extend toward batter propelling body into stride
Throwing shoulder ABD/Ext/ER into “semicocked position”

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11
Q

Which shoulder muscles are used during the early cocking phase?

A

SA & trap protract & upwardly rotate scapula
Middle deltoid ABD
Supraspinatus positions humeral head

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12
Q

Describe the late cocking phase of throwing

A

Max shoulder ER

Amount of ER correlates with speed of ball

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13
Q

What are the dynamic stabilizers of the anterior shoulder?

A

Long head of the biceps
Subscapularis
Pec major

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14
Q

what are the static stabilizers of the shoulder?

A

Glenohumeral ligaments
Capsule
Labrum

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15
Q

What are common injuries during the late cocking phase of pitching?

A 
Anterior instability
Internal (posterior-superior) impingement
Type II SLAP lesion
Articular surface rotator cuff tears
Bicipital tendinopathy
Ulnar collateral ligament injury
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16
Q

Describe the acceleration phase of throwing

A

Shoulder moves from 175 deg ER to 90-100 deg IR at ball release
Shoulder ABD fixed at 90 deg

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17
Q

What determines arm position in vertical plane?

A

Trunk lateral flexion

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18
Q

What does hanging or dropping elbow result in?

A

Reduced pitch velocity

Risk of rotator cuff or UCL injury

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19
Q

Describe the deceleration phase of throwing

A

Eccentric muscle force of posterior shoulder girdle to decelerate rapid IR
Start: ball release
Stop: arm reaches 0 deg IR

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20
Q

Describe the final phase of throwing

A

Passive phase

Body catching up with throwing arm

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21
Q

What are common injuries from deceleration phase of pitching?

A

Posterior instability
Isolated rotator cuff tears
SLAP lesions

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22
Q

How does the gait cycle change with increase speed?

A

Stance phase decreases

Double limb support not present with running

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23
Q

How is foot strike with slower running and walking?

A

Heel to toe

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24
Q

What happens to foot strike with increase speed?

A

Forefoot strike with lowering heel to ground

Sprinting: forefoot

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25
What is the entry or catch phase of swimming?
hand entry into the water until beginning of backward movement
26
What is the pull phase of swimming?
hand in vertical plane of shoulder
27
What is the push phase of swimming?
Hand below shoulder & pushes through water until its exit at greater trochanter
28
What is the recovery phase of swimming?
Aerial return of hand
29
Which muscles contribute to propulsion phase of swimming?
ABD/ER move to ADD/IR Major: pec major & lat dorsi Minor: SA, subscap, teres major
30
What is a common injury with breaststroke?
Medial knee injury with inc valgus load MCL sprain Medial plica/synovitis
31
What should be the focus of swimming pre-rehab?
Scapular stabilization Endurance training og SA & lower trapezius Stretching IR, posterior capsule, cervical & thoracic mobilization
32
What should the goal of ACL injury prevention be?
Inc knee & hip flexion during landing | Balance quad to hamstring activation ratio
33
What is doping?
Any substance or method used to increase performance
34
How can Tylenol blunt the anabolic response of muscle to exercise?
Max dose can dec prostaglandins produced after eccentric exercise
35
What can NSAIDs inhibit?
Prostaglandin E2 which plays a role in bone healing
36
Which forms of steroids are prohibited by WADA?
Oral Rectal IV IM
37
Why are diuretics banned in some sports?
Theoretically increase urine ouput to mask use of other banned agents
38
Why are beta-blockers banned in some sports?
Anxiolytic effects
39
What is Erythropoietin (EPO)?
Glycoprotein hormone produced at kidney in response to tissue hypoxia to inc erythrocytes
40
What is Cr?
Compound made from amino acids glycine, arginine, and methionine
41
What is Cr phosphate supplementation proposed to do?
Benefits short duration, high-intensity, repetitive exercise by enhancing triphosphate regeneration
42
What are the goals of PPE?
ID life threatening conditions ID cond that limit competition ID factors that predispose injury Meet legal requirements of state & institution
43
What is benign exercised associated collapse?
Form of postural HOTN from blood pooling in legs when pt stops running and leg muscles no longer acting as a venous pump
44
Tx of exercise associated collpase
Oral rehydration | Lying athlete down with legs & pelvis above heart level
45
Tx if exercise associated collapse does not respond after 30 minutes of conservative tx
Orthostatics Electrolyte assessment IVF
46
DDx of exercise associated collapse
``` Benign exercise associated collapse Cardiac arrest Heat illness/stroke Hypoglycemia Hyponatremia Hypothermia Muscle cramps Neuro conditions ```
47
What are the sx of exercise associated hyponatremia?
``` Lightheadedness Nausea HA Vomiting Confusion Obtundation Seizures Death ```
48
What is the pathophysiology of exercise associated hyponatremia?
Fluids shifts from low osmotic pressure in blood causing cerebral edema and neurogenic pulmonary edema
49
What are RF for exercise associated hyponatremia?
Weight gain during race Marathon time >4 hrs BMI extremes
50
What are the fluid replacement guidelines in a marathon?
Drink when thirsty | 400-800 ml (14-27 oz)/hr racing
51
What is heat exhaustion?
Inability to continue to exercise in the heat but is NOT related to body temperature
52
What is heat stroke?
Multi-organ system failure secondary to hyperthermia
53
Which age group is not recommended to return to play after a concussion the same day?
<18 yo | Adult professionals may return
54
Who should get neuro imaging after concussion?
Suspected intracranial ABN Prolonged LOC Focal neuro deficits Progressive decline in neuro status
55
When can RTP be considered after concussion?
After patient is asx of concussion sx
56
What is the cause of a stinger/burner?
Tensile (stretch) or compressive injury to the cervical nerve root or brachial plexus
57
Who is more likely to get a tensile injury to the brachial plexus?
Young athletes with weaker neck and shoulder girdle strength leaving them at risk for lateral neck bending and ispilateral shoulder/arm depression
58
Who is more likely to get a compression injury to the cervical nerve root?
Older, stronger and experienced athlete from forceful cervical extension and rotation narrowing the neural foramen ex) professional defensive backs or offensive lineman
59
What is the clinical presentation of a stinger?
Sudden onset of burning pain in one upper limb in a single dermatome lasting seconds to minutes after a traumatic event
60
What are the MC dermatomes stingers happen in?
C5, C6 or C7
61
Which stingers should be evaluated for SCI?
Bilateral sx Motor impairment Multiple stingers
62
Which patients with stingers can RTP the same day?
Sx fully recover in <15 minutes
63
If a patient has multiple stingers when can they RTP?
Holder for number of weeks that correspond to stingers in a season or if >3 stingers end the season
64
Which athletes are MC to present with exericesed induced bronchospasm (EIB)?
Cross-country skiers Winter sports Runners
65
What is the proposed mechanism of EIB?
Water loss and cooling in the airway that occurs with hperventilation triggers bronchoconstriction
66
What are tx for EIB?
Warm up prior to sport Short, vigours bursts of exercise (15-20 minutes) prior to competition Short-acting beta-agonist 15 min prior to exercise Adding cromolyn if sx persist and then inhaled corticosteroids
67
What are common causes of anemia in athletes?
Iron def Physiologic or Pseudoanemia Foot-strike hemolysis
68
What will be shown on labs in iron def anemia?
Microcytic anemia Ferritin <30 ng/mL TIBC elevated
69
What is pseudoanemia?
Seen in endurance athletes | Lower Hgb due to plasma volume expansion causing dilution
70
What is foot-strike hemolysis?
RBC destruction in feet from running impact
71
Which athletes are at a higher risk for an eating disorder?
``` Femailes Gymnastics Figure skating Dancers Distance runners Divers Swimmers ```
72
What is anorexia?
Body wt 15% below expected Morbid fear of fatness Feeling thin when fat Amenorrhea
73
What is bulimia nervosa?
Binge eating 2/wk for at least 3 mo Loss of control over eating Purging behavior Overconcern with body shape
74
Describe L1 locomotor impairment the cycling athlete
Minor or no lower limb impairement
75
Describe L2 locomotor impairment the cycling athlete
Disability in one leg but able to pedal normally w/ or w/o prosthesis
76
Describe L3 locomotor impairment the cycling athlete
Lower extremity disability, pedal using one leg, w/ or w/o upper limb disability
77
Describe L4 locomotor impairment the cycling athlete
Severe disability affecting both lower limbs, w/ or w/o upper limb disability

Brad 4th Ed Part 2 (28 decks)

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