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

Question 1

Macrotrauma

Answer 1

An injury with a sudden and obvious episode of tissue overload and subsequent damage. (NSCA CPT, pg. 554)

Question 2

Microtrauma

Answer 2

The general term given to small injuries to the body. Microtrauma can include the microtearing of muscle fibres, the sheath around the muscle and the connective tissue. It can also include stress to the tendons, and to the bones. (NSCA CPT, pg. 554)

Question 3

Sprain

Answer 3

A wrench or twist the ligaments of (an ankle, wrist, or other joint) violently so as to cause pain and swelling but not dislocation. (NSCA CPT, pg. 554)

Question 4

Strain

Answer 4

An acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. (NSCA CPT, pg. 554)

Question 5

Fracture

Answer 5

A break, usually in a bone. (NSCA CPT, pg. 554)

Question 6

Deafferentation

Answer 6

Microscopic nerve damage in soft tissue. (NSCA CPT, pg. 554)

Question 7

Muscle Contusion

Answer 7

Commonly referred to as a bruise and occurs from a sudden and forceful blow to the body. The result is formation of a hematoma (blood tumor) in tissues surrounding the injured muscle. Speed of healing depends on extent of damage and internal bleeding. Contusions may severely limit movement of the injured muscle. (NSCA CPT, pg. 555)

Question 8

Muscle Strain

Answer 8

Often the result of an abnormal muscle action leading to a stretching or tearing of the muscle fibers. Strains are assigned grades or degrees (first, second, third) to indicate severity of injury. A first- or second-degree strain is a partial tear, whereas third degree reflects a complete tear- ing of the muscle tissue. Pain, strength limitations, and motion restrictions increase with an increase in the grade. (NSCA CPT, pg. 555)

Question 9

Tendinopathy

Answer 9

A more recently accepted term to describe the collective effects of tendinitis and tendinosis. (NSCA CPT, pg. 555)

Question 10

Tendinitis

Answer 10

Inflammation of a tendon. This microtrauma injury is frequently associated with obvious swelling and pain around the injured tendon. If left uncorrected or if the tissue is not allowed to
fully heal, may lead to tendinosis. (NSCA CPT, pg. 555)

Question 11

Ligament Sprain

Answer 11

Trauma to the tissues that connect bones and contribute to joint stability. Ligament sprains
occur when an excessive force (i.e., due to a change in movement direction) results in the joint moving beyond its anatomical limits and stretching the ligament. Ligament sprains are assigned grades (1, 2, 3) to indicate severity of injury. An increase in the grade is associated with greater pain and tenderness, swelling, joint instability, and loss of function. (NSCA CPT, pg. 555)

Question 12

Joint Dislocation

Answer 12

A joint dislocation occurs when a synovial joint moves beyond its normal anatomical limits. Dis- locations are divided into two categories: subluxation and luxation. A subluxation is a partial displacement or separation between two articulating bony surfaces. A luxation is a complete displacement resulting in a total disunion between two articulating bony surfaces. (NSCA CPT, pg. 555)

Question 13

Osteochondrosis

Answer 13

Osteochondrosis refers to degenerative changes in the epiphyses of bones, particularly during periods of significant growth in children. The exact cause(s) of osteochondrosis is not fully understood. Terms commonly used to describe variations of osteochondrosis are osteochondritis dissecans and apophysitis. (NSCA CPT, pg. 555)

Question 14

Osteoarthritis

Answer 14

Degeneration of the articular or hyaline cartilage in a joint. Can occur in any joint but is most common in weight-bearing joints such as the hip, knee, and ankle. (NSCA CPT, pg. 555)

Question 15

Bursitis

Answer 15

Bursae are small fluid-filled synovial membrane sacs designed to reduce friction between tissues such as tendon and bone. When irritated, the bursa becomes inflamed, resulting in bur- sitis. Bursitis commonly occurs in the hip, knee, elbow, and shoulder and is usually accompanied by swelling, pain, and partial loss of function. (NSCA CPT, pg. 555)

Question 16

Bone Fracture

Answer 16

A partial or complete disruption of a bone due to a direct blow. (NSCA CPT, pg. 555)

Question 17

Bone Stress Fracture

Answer 17

A microtraumatic injury that may result from an abnormal muscle action, fatigue-related failure in the stress distribution across the bone, dramatic change in exercise or training ground surface (e.g., wood to grass), excessive training volume, or both. Recent literature has also suggested that nutrition may play a significant role in stress fractures. (NSCA CPT, pg. 555)

Question 18

Inflammation Phase

Answer 18

The body’s initial reaction to injury and is necessary in order for normal healing to occur. (NSCA CPT, pg. 556)

Question 19

Repair Phase

Answer 19

The repair phase of healing allows for the replacement of tissues that are not viable following injury or surgery. (NSCA CPT, pg. 556)

Question 20

Remodeling Phase

Answer 20

Optimizing tissue function is the primary goal during this final phase of healing. (NSCA CPT, pg. 557)

Question 21

Indication

Answer 21

An activity that will benefit the injured client. (NSCA CPT, pg. 558)

Question 22

Contraindication

Answer 22

An activity or practice that is inadvisable or prohibited because of the given injury. (NSCA CPT, pg. 558)

Question 23

Precaution

Answer 23

An activity that may be performed under supervision of a qualified personal trainer and according to client limitations and symptom reproduction. (NSCA CPT, pg. 558)

Question 24

Spondyloysis

Answer 24

A defect, or fracture, of the pars interarticularis region of a lumbar vertebra. (NSCA CPT, pg. 561)

Question 25

Spondylolisthesis

Answer 25

The possible progression of spondylolysis, a forward slippage of one vertebral body on another. (NSCA CPT, pg. 561)

Question 26

Kyphotic Posture

Answer 26

Rounded shoulders. (NSCA CPT, pg. 562)

Question 27

Impingement Syndrome

Answer 27

A “pinching” of the supra- spinatus, the long head of the biceps tendon, or subacromial bursa under the acromial arch. (NSCA CPT, pg. 562)

Question 28

Anterior Instability

Answer 28

The head of the humerus moves too far forward, resulting in possible injury or dislocation. (NSCA CPT, pg. 565)

Question 29

Subluxation

Answer 29

A partial displacement or separation between two articulating bony surfaces.(NSCA CPT, pg. 568)

Question 30

Exercise Modification: Shoulder Press

Answer 30

When lowering the barbell, allow the bar to pass in front of the client’s head in order to minimize anterior shoulder stress. (NSCA CPT, pg. 568)

Question 31

Exercise Modification: Bench Press

Answer 31

When lowering the bar, clients with shoulder dysfunction should not allow the bar to touch the chest at its lowest point in order to minimize anterior shoulder stress. Keep the upper arms near the body to limit horizontal abduction and decrease shoulder stress. (NSCA CPT, pg. 568)

Question 32

Exercise Modification: Pec Deck

Answer 32

During the eccentric phase, clients with shoulder dysfunction should not allow the pads to pass behind the body at their most posterior position in order to minimize anterior shoulder stress. (NSCA CPT, pg. 568)

Question 33

Exercise Modification: Lat Pulldown

Answer 33

When pulling down the bar, allow the bar to pass in front of the client’s head in order to mini- mize anterior shoulder stress.
Use a reverse (supinated) grip to reduce shoulder joint stress. (NSCA CPT, pg. 568)

Question 34

Ankle Sprain

Answer 34

One of the most common sport-related injuries, accounting for 10% to 28% of all athletic injuries. (NSCA CPT, pg. 568)

Question 35

Open Kinetic Chain

Answer 35

Exercises that have the distal aspect of the extremity terminating free in space. (NSCA CPT, pg. 572)

Question 36

Closed Kinetic Chain

Answer 36

Those that occur with the distal part of the extremity fixed to an object that is either stationary or moving. (NSCA CPT, pg. 572)

Question 37

Arthritis

Answer 37

A general term encompassing several different diseases. The two primary arthritis classifications are osteoarthritis and rheumatoid arthritis. (NSCA CPT, pg. 576)

Question 38

Degenerative Joit Disease

Answer 38

The progressive destruction of a joint’s articular cartilage—the cartilage covering the surface of the given joint. (NSCA CPT, pg. 576)

Question 39

Rheumatoid Arthritis

Answer 39

A systemic inflammatory disease affecting not only the joint surface, but also connective tissue. (NSCA CPT, pg. 577)

Question 40

Tendinosis

Answer 40

Represents a histological definition of tendinitis and involves further breakdown and structural
degeneration of the injured tendon. (NSCA CPT, pg. 555)