Chapter 21: Clients with Orthopedic, Injury, and Rehabilitation Concerns

Question 1

refers to an injury with a sudden and obvious episode of tissue overload and subsequent damage

Answer 1

macrotrauma

Question 2

the lack of overt trauma suggests that this reuslts from the accumulation of tissue damage across time

Answer 2

microtrauma

Question 3

microscopic nerve damage in soft tissue

Answer 3

deafferentation

Question 4

three phases of healing

Answer 4

inflammation
proliferation
remodeling

Question 5

prepare for the new tissue formation that occurs during subsequent phases of tissue healing

Answer 5

inflammatory phase

Question 6

this maximizes the natural physiological process of the inflammatory phase and supports appropriate tissue healing

Answer 6

rest

Question 7

tissue repair begins this soon after injury

Answer 7

3-5 days

Question 8

collagen fibers are strongest when they are arranged in this order

Answer 8

parallel and lie longitudinally to the primary line of stress

Question 9

these types of exercises may be permitted during the repair phase

Answer 9

submaximal isometric exercises

Question 10

this is the primary goal during the remodeling phase of healing

Answer 10

optimizing tissue function

Question 11

with clients rehabilitating an orthopedic injury is is good practice to do this when progressing

Answer 11

increase only one exercise parameter at a time to make it easy to determine what may have triggered the negative response, should one occur

Question 12

activity that will benefit the injured client

Answer 12

indication

Question 13

activity that is inadvisable or prohibited because of a given injury

Answer 13

contraindication

Question 14

and activity that may be performed under supervision of a qualified personal training and according to client limitations

Answer 14

precaution

Question 15

people with low back pain, especially those with hypermobility or instability problems should have this type of work incorporated into their programs

Answer 15

balance

Question 16

this is the most common type of disc herniation

Answer 16

posterolateral disc herniation

Question 17

clients with herniated lumbar discs are generally encouraged to avoided these types of exercises

Answer 17

lumbar flexion

Question 18

spondylolysis and spondylolisthesis commonly occur during the following types of exercises

Answer 18

lumbar extension

Question 19

The trunk and legs provide this % of the total kinetic energy and total force for overhead activitres

Answer 19

51-55%

Question 20

These types of exercises should be used to strengthen the Rotator cuff

Answer 20

endurance, low weight, closed chain

Question 21

this is a pinching of the supraspinatus and the long head of the biceps tendon or subacromial bursa under the acromial arch

Answer 21

impingement syndrome

Question 22

avoid these types of exercises for clients with impingement syndrome

Answer 22

overhead presses and upright row

Question 23

The safe zone for impingement and shoulder instability

Answer 23

humerus below 90degrees elevation of the shoulder and arms anterior to the frontal plane of the body

Question 24

this is the commonly torn muscle of the rotator cuff

Answer 24

supraspinatus

Question 25

this is also known as runners knee

Answer 25

anterior knee pain

Question 26

also known as the miserable alignment syndrome

Answer 26

anterior knee pain

Question 27

anterior knee pain is due to the alteration of this be a variety of causes

Answer 27

tracking of the patella in the trochlear groove

Question 28

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

Answer 28

anterior knee pain

Question 29

Movement contraindications(low back pain): Disc injury

Answer 29

lumbar flexion | lumbar rotation

Question 30

Movement contraindications(low back pain): Muscle Strain

Answer 30

passive lumbar flexion during inflammatory phase

Question 31

Movement contraindications(low back pain): spondylolysis and spondylolisthesis

Answer 31

Lumbar extension

Question 32

Exercise contraindications(low back pain): disc injury

Answer 32

sit-up knee-to-chest stretch spinal twist

Question 33

Exercise contraindications(low back pain): muscle strain

Answer 33

knee to chest strectch

Question 34

Exercise contraindications(low back pain): spondylolysis

Answer 34

squat shoulder press push press

Question 35

Exercise indications (low back pain): disc injury

Answer 35

passive lumbar extension stretches | isometric abdominal and extenssor strengthening, progressing to lumbar stabilization program

Question 36

Exercise indications (low back pain): muscle strain

Answer 36

none during inflammatory phase | progressing to gentle flexion stretching followed by extension strengthening

Question 37

Exercise indications (low back pain): spondylolysis

Answer 37

knee to chest stretch abdominal crunch pelvic neutral stabilization

Question 38

Movement contraindications(shoulder): impingement syndrome

Answer 38

overhead with internally rotated shoulder or painful motions

Question 39

Movement contraindications(shoulder): instability

Answer 39

anterior: combined external rotation with >90degree abduction posterior: combined internal rotation, horizontal adduction and flexion inferior: full elevation, dependent arm

Question 40

Movement contraindications(shoulder): rotator cuff pathology

Answer 40

resisted overhead movements

Question 41

Exercise indications (shoulder): impingement syndrome

Answer 41

shoulder press lateral dumbbell raise with internally rotated shoulder upright row above shoulder level incline bench press

Question 42

Exercise indications (shoulder): instability

Answer 42

bench press pec deck push up behind the neck lat pull down and shoulder press

Question 43

Exercise indications (shoulder): rotator cuff pathology

Answer 43

painful exercises and early quick eccentric actions

Question 44

Exercise indications (shoulder): impingement

Answer 44

rotator cuff strengthening | pain-free exercises

Question 45

Exercise indications (shoulder): instability

Answer 45

rotator cuff strengthing exercises scapular strengthening stabilization: static to dynamic

Question 46

Exercise indications (shoulder): rotator cuff

Answer 46

rotator cuff strengthening beginning 4-6 weeks post-surgery

Question 47

Movement contraindications (ankle): inversion sprain

Answer 47

inversion with weight bearing

Question 48

exercise contraindications (ankle): inversion sprain

Answer 48

activites involing loaded or full weight bearing

Question 49

exercise indications (ankle): inversion sprain

Answer 49

open chain ROM and strength until weight bearing is permitted

Question 50

Movement contraindications (knee): anterior knee pain

Answer 50

closed chain knee movements with >90degrees flexion | open chain knee movements 0-30 degrees flexion

Question 51

Movement contraindications (knee): ACL recon

Answer 51

open chain knee movements <45degree flexion

Question 52

Movement contraindications (knee): total knee arthroplasty

Answer 52

closed chain knee movements >100degrees flexion | kneeling

Question 53

Exercise contraindications (knee): anterior knee pain

Answer 53

full squat full lunge end of range leg extension stair stepper with large steps

Question 54

Exercise contraindications (knee): ACL recon

Answer 54

end of range leg extension

Question 55

Exercise contraindications (knee): total knee arthroplastyt

Answer 55

full squat | full lunge

Question 56

Exercise indications (knee): Anterior knee pain

Answer 56

1/4 to 1/2 squat and leg press partial lunge/leg curl stair stepper with short choppy steps

Question 57

Exercise indications (knee): ACl recon

Answer 57

``` 3/4 squat and leg press step-up leg curl stiff-leg deadlift elliptical trainer ```

Question 58

Exercise indications (knee): total knee arthroplasty

Answer 58

``` 1/4 to 1/2 squat and leg press partial lunge leg extension and leg curl stationary bike aquatics, swimming ```

Question 59

movement contraindications (hip)

Answer 59

forceful hip flexion | hip abduction and rotation

Question 60

exercise contraindications (hip)

Answer 60

ballistic or forced stretching

Question 61

exercise indications (hip)

Answer 61

aquatic walking

Question 62

movement contraindications: osteoarthritis

Answer 62

high impact activites

Question 63

exercise contraindicaitons: osteoarthritis

Answer 63

running snow skiing jogging

Question 64

exercise indications: osteoarthritis

Answer 64

bicycle stair stepper elliptical training aquatics, swimming

Question 65

movement contraindications: RA

Answer 65

high-impact cardiovascular exercise neck flexibility or strengthening in clients with hisotry of neck instability movements outside the safe zone

Question 66

exercise contraindications: RA

Answer 66

running or jogging upper trapezius stretch manually resisted neck strengthening behind the neck shoulder press

Question 67

exercise indications: RA

Answer 67

moderate intensity aerobic endurance exercise (60-80%) Range of motion and flexibility exercises isometric exercise (for the unstable joint) water aerobics stationary bicycling