Chapter 21: Clients with Orthopedic, Injury, and Rehabilitation Concerns Flashcards
refers to an injury with a sudden and obvious episode of tissue overload and subsequent damage
macrotrauma
the lack of overt trauma suggests that this reuslts from the accumulation of tissue damage across time
microtrauma
microscopic nerve damage in soft tissue
deafferentation
three phases of healing
inflammation
proliferation
remodeling
prepare for the new tissue formation that occurs during subsequent phases of tissue healing
inflammatory phase
this maximizes the natural physiological process of the inflammatory phase and supports appropriate tissue healing
rest
tissue repair begins this soon after injury
3-5 days
collagen fibers are strongest when they are arranged in this order
parallel and lie longitudinally to the primary line of stress
these types of exercises may be permitted during the repair phase
submaximal isometric exercises
this is the primary goal during the remodeling phase of healing
optimizing tissue function
with clients rehabilitating an orthopedic injury is is good practice to do this when progressing
increase only one exercise parameter at a time to make it easy to determine what may have triggered the negative response, should one occur
activity that will benefit the injured client
indication
activity that is inadvisable or prohibited because of a given injury
contraindication
and activity that may be performed under supervision of a qualified personal training and according to client limitations
precaution
people with low back pain, especially those with hypermobility or instability problems should have this type of work incorporated into their programs
balance
this is the most common type of disc herniation
posterolateral disc herniation
clients with herniated lumbar discs are generally encouraged to avoided these types of exercises
lumbar flexion
spondylolysis and spondylolisthesis commonly occur during the following types of exercises
lumbar extension
The trunk and legs provide this % of the total kinetic energy and total force for overhead activitres
51-55%
These types of exercises should be used to strengthen the Rotator cuff
endurance, low weight, closed chain
this is a pinching of the supraspinatus and the long head of the biceps tendon or subacromial bursa under the acromial arch
impingement syndrome
avoid these types of exercises for clients with impingement syndrome
overhead presses and upright row
The safe zone for impingement and shoulder instability
humerus below 90degrees elevation of the shoulder and arms anterior to the frontal plane of the body
this is the commonly torn muscle of the rotator cuff
supraspinatus
this is also known as runners knee
anterior knee pain
also known as the miserable alignment syndrome
anterior knee pain
anterior knee pain is due to the alteration of this be a variety of causes
tracking of the patella in the trochlear groove
in addition to quadraceps strengthening, exercises emphasizing unilateral balance tasks and targeting hip strength are recognized as an essential component of treating and preventing this condition
anterior knee pain
Movement contraindications(low back pain): Disc injury
lumbar flexion
lumbar rotation
Movement contraindications(low back pain): Muscle Strain
passive lumbar flexion during inflammatory phase
Movement contraindications(low back pain): spondylolysis and spondylolisthesis
Lumbar extension
Exercise contraindications(low back pain): disc injury
sit-up
knee-to-chest stretch
spinal twist
Exercise contraindications(low back pain): muscle strain
knee to chest strectch
Exercise contraindications(low back pain): spondylolysis
squat
shoulder press
push press
Exercise indications (low back pain): disc injury
passive lumbar extension stretches
isometric abdominal and extenssor strengthening, progressing to lumbar stabilization program
Exercise indications (low back pain): muscle strain
none during inflammatory phase
progressing to gentle flexion stretching followed by extension strengthening
Exercise indications (low back pain): spondylolysis
knee to chest stretch
abdominal crunch
pelvic neutral stabilization
Movement contraindications(shoulder): impingement syndrome
overhead with internally rotated shoulder or painful motions
Movement contraindications(shoulder): instability
anterior: combined external rotation with >90degree abduction
posterior: combined internal rotation, horizontal adduction and flexion
inferior: full elevation, dependent arm
Movement contraindications(shoulder): rotator cuff pathology
resisted overhead movements
Exercise indications (shoulder): impingement syndrome
shoulder press
lateral dumbbell raise with internally rotated shoulder
upright row above shoulder level
incline bench press
Exercise indications (shoulder): instability
bench press
pec deck
push up
behind the neck lat pull down and shoulder press
Exercise indications (shoulder): rotator cuff pathology
painful exercises and early quick eccentric actions
Exercise indications (shoulder): impingement
rotator cuff strengthening
pain-free exercises
Exercise indications (shoulder): instability
rotator cuff strengthing exercises
scapular strengthening
stabilization: static to dynamic
Exercise indications (shoulder): rotator cuff
rotator cuff strengthening beginning 4-6 weeks post-surgery
Movement contraindications (ankle): inversion sprain
inversion with weight bearing
exercise contraindications (ankle): inversion sprain
activites involing loaded or full weight bearing
exercise indications (ankle): inversion sprain
open chain ROM and strength until weight bearing is permitted
Movement contraindications (knee): anterior knee pain
closed chain knee movements with >90degrees flexion
open chain knee movements 0-30 degrees flexion
Movement contraindications (knee): ACL recon
open chain knee movements <45degree flexion
Movement contraindications (knee): total knee arthroplasty
closed chain knee movements >100degrees flexion
kneeling
Exercise contraindications (knee): anterior knee pain
full squat
full lunge
end of range leg extension
stair stepper with large steps
Exercise contraindications (knee): ACL recon
end of range leg extension
Exercise contraindications (knee): total knee arthroplastyt
full squat
full lunge
Exercise indications (knee): Anterior knee pain
1/4 to 1/2 squat and leg press
partial lunge/leg curl
stair stepper with short choppy steps
Exercise indications (knee): ACl recon
3/4 squat and leg press step-up leg curl stiff-leg deadlift elliptical trainer
Exercise indications (knee): total knee arthroplasty
1/4 to 1/2 squat and leg press partial lunge leg extension and leg curl stationary bike aquatics, swimming
movement contraindications (hip)
forceful hip flexion
hip abduction and rotation
exercise contraindications (hip)
ballistic or forced stretching
exercise indications (hip)
aquatic walking
movement contraindications: osteoarthritis
high impact activites
exercise contraindicaitons: osteoarthritis
running
snow skiing
jogging
exercise indications: osteoarthritis
bicycle
stair stepper
elliptical training
aquatics, swimming
movement contraindications: RA
high-impact cardiovascular exercise
neck flexibility or strengthening in clients with hisotry of neck instability
movements outside the safe zone
exercise contraindications: RA
running or jogging
upper trapezius stretch
manually resisted neck strengthening
behind the neck shoulder press
exercise indications: RA
moderate intensity aerobic endurance exercise (60-80%)
Range of motion and flexibility exercises
isometric exercise (for the unstable joint)
water aerobics
stationary bicycling
