Chapter 22: Rehabilitation and Reconditioning Flashcards
provides medical care to an organization, school, or team
team physician
makes the final determination of an athlete’s readiness for return to competition
team physician
prescribes medication as needed
team physician
typically responsible for the day-to-day physical health of the athlete
athletic trainer
responsibilities include management and rehabilitation of injuries resulting from physical activity and prevention of injuries through the prescription of sport-specific exercise and the application of prophylactic equipment
athletic trainer
can play a valuable role in reducing pain and restoring function to an injured athlete, typically outpatient
physical therapist
typically focuses on strength, power and performance enhancement
strength and conditioning professional
member of the sports medicine team which assist with the post acute rehabilitation and reconditioning of injured athletes, has a formal background in exercise science
exercise physiologist
this person has a background in sport nutrition and may provide guidelines regarding proper food choices to optimize tissue recovery
nutritionist or registered dietician
this professional helps the injured athlete better cope with mental stress accompanying an injury
counselor, psychologist, or psychiatrist
a form of treatment required by the rehapilitating athlete
indication
an activity or practice that is inadvisable or prohibited due to the given injury
contraindication
specific, sudden episode of overload injury to a given tissued, resulting in disrupted tissue integrity
macrotrauma
complete displacement of the joint serfaces
dislocation
partial displacement of the joint surfaces
subluxation
these two conditions may result in joint laxity or instability
dislocation
subluxation
ligamentous trauma
sprain
partial tear of the ligament without increased joint instability
first degree sprain
partial tear with minor joint instability
seconds degree sprain
complete tear with full joint instability
third degree sprain
musculotendinous trauma is classified as either of these two things
contusion
strain
direct musculotendinous trama
contusion
indirect musculotendinous trauma
strain
an area of excess accumulation of blood and fluid in the tissues surrounding the injured muscle
muscle contusion
tears in muscle fibers and are further assigned grades
strains
partial tear of individual muscle fibers and is characterized by strong but painful muscle activitgy
first degree strain
partial tear of muscle with weak, painful muscle activity
second degree strain
complete tear of muscle fibers and is manifested by very weak, painless muscle activity
third degree strain
strains are most likely to occur at these two locations
musculotendinous junction
tendon attachment to bone
overuse injury, results from repeated abnormal stress applied to a tissue by continuous training or training with little recovery time
microtrauma
most common overuse injury to bone
stress fracture
type of microtrauma that is the inflammation of a tendon
tendinitis
degenerative condition characterized by minimal inflammation and neovascularizaiation
tendinopathy
three stages of tissue healing
inflammatory response phase
fibroblastic repair phase
maturation-remodeling phase
initial reaction to injury and is necessary in order for normal tissue healing to occur
inflammation
both of these types of inflammation occur during the inflammatory response phase
local and systemic
inhibits contractile tissue and can significantly limit function
edema
the escape of fluid into the surrounding tissue
edema
the inflammatory phase typically lasts this long, but may be longer
2-3 days (typically less than a week)
healing phase which is characterized by catabolism and replacement of tissued that are no longer viable following injury
fibroblastic repair phase
begins as early as two days after injury and may last up to two months
fibroblastic repair phase
the weakened tissued produced during the repair phase is strengthed during this phase of healing
maturation-remodeling phase
fibers transition from type III to stronger type I collagen allowing the newly formed tissued the opportunity to improve its structure, strength, and function (tissues begin to align along lines of stress
maturation-remodeling phase
this can last months to years after injury
remodeling
age, lifestyle, degree of injury, and the structure that has been injured can affect this
healing time
the athlete must meet these to progress from one phase of healing to the next
specific objectives
primary goal of treatment during the inflammatory response phase
prevent distruption to new tissue
exercise directly involving or stressing the injured area is not recommended during this phase
inflammatory response phase
the treatment goal of this phase is to prevent excessive muscle atrophy and joint deterioration of the injured area
fibroblastic repair phase
to protect new, and relatively weak collagen fibers the athlete should avoid this involving the damaged tissue during the fibroblastic repair phase
active resistive exercise
these are permissablie during the fibroblastic repair phase but their goal is to promote collagen synthesis and manage pain
therapeutic modalities
these types of exercises can be done during the repair phase provided that it is pain free and otherwise indicated by the physician or athletic trainer
isometric
exercises which include concentric and eccentric muscle action
isotonic
ability of muscle to respond to afferent sensory information to maintain joint stability
neuromuscular control
afferent sensory information that occurs in response to stimulation of sensory receptors in skin, muscles, tendons, ligaments, and joint capsule
proprioception
this contributes to the conscious and unconscious efferent control of posture, balance, stability, and sense of position
proprioception
outcome of this phase is the replacement of damaged tissues with collagen fibers
maturation-remodeling phase
primary goal of this phase is optimizing tissue function while transitioning to return to play or activity
maturation-remodeling phase
athletes improve function by continuing and progressing the exercises performed during the repair phase and by adding more advance, sport specific exercsies that allow progresssives stresses to be applied to the injured tissue
maturation-remodeling phase
this is the collective effort or involvement of two or more sequential joints to create movement
kinetic chain
exercise in which the terminal joint meets with considerable resistance that prohibits or retrains its free motion
closed kinetic chain
exercise in which the terminal joint is free to move
open kinetic chain
these types of exercises are possible during the fibroblastic repair phase
submaximal isometric, isokinetic, and isotonic
balance and proprioceptive training
these (4) types of exercise are possible options during the maturation-remodeling phase
joint angle specific strengthening
velocity-specific muscle activity
close/open kinetic chain
proprioceptive training
T/F: the same principles used to design resistance and aerobic training programs for uninjured athletes should not be applied during rehab and reconditioning
False
DAPRE
daily adjustable progressive resistive exercise
how many sets for DAPRE
4
DAPRE protocol
first set 10 rep 50% estimated 1RM
2nd set 6 rep 75% estimated 1RM
3rd set max reps at 100% estimated 1RM
4th set adjusted to reps completed during 3rd
De Lorme protocol
1st set 10 reps 50% 10rm
2nd set 10 reps 75% 10RM
3rd set 10 reps 100%10RM
Oxford system protocol
1st set 10 reps 100%10RM
2nd set 10 reps 75% 10RM
3rd set 10 reps 50% 10RM
sport specific training may require this from the rehabilitation programming
change in programming to reflect the specific demands of the sport (endurance, hypertrophy, strength)
less than this percent in side-to-side differences in strength and functional performance is considered acceptable
10%
