Chpt. 9- Orthopedics: Sports Injuries Flashcards
Two main reasons for injury in sports?
- Repetition
2. Trauma
What are 5 Repetition injuries?
- Throwing injuries - rotator cuff tendinitis, tear and labral injury
- IT Band Pain
- Shin Splints
- Patellar Tendinitis
- Muscle pulls/tears (groin, hamstring, quad, hip flexor)
What are 3 Traumatic injuries?
- Ankle: lateral ligament sprain
- Shoulder separation – AC injuries
- Knee soft tissue trauma (ACL, MCL and med meniscus)
*What is a Repetitive injury?
- a muscle that becomes fatigued and can no longer generate sufficient force to maintain correct biomechanics.
- The fatigued muscle then tears slightly (either in the muscle, tendon or bone).
_____ (most common), ____, and ___ are 3 muscles being torn during rotator cuff injurys
- Supraspinatous
- infraspinatous
- teres minor
What can many of the cuff tears be repaired with?
The arthroscope (invades into joint= for ex. knee)
How long does it take for rehab of rotator cuff injuries?
3-6 months
What does SLAP stand for?
Superior Labrum-Anterior and Posterior (to the biceps tendon)
@ glenoidhumeral joint
Do SLAP tears heal by themselves?
no, Arthroscopes can be used
What does patient have to wear after a SLAP tear ?
arm in sling after surgery to protect the sutures while the labrum heals
What do you work on as PT for a SLAP tear?
When do you usually begin?
- Rotator cuff strengthening
- throwing mechanism of patient
- flexibility
-» within the first week after surgery
For a SLAP tear reaching overhead is allowed approximately __ ___ after the surgery, and
return to throwing approximately __ ____after the surgery.
- 6 weeks
- 3 months
For a SLAP tear return to competition for throwers is usually between ___ to ____ after surgery.
For how long is supervised physical therapy for SLAP tears?
- 4 to 6 months
- 2 to 3 months at least
*What is a Bankart Tear ?
A Bankart lesion is when the labrum becomes detached from the front of the glenoid socket.
An active male who has had a dislocation of his dominant shoulder will have an approximately of how much percentage of having a repeat episode if he does not have surgical treatment and continues his usual activities.
80-90% chance
What is the most common reason of the IT band pain (repet. injury) ?
Running
- What are 2 signs of IT band syndrome (pain)?
- How do you test tenderness?
- reveal tenderness on ITB at lateral aspect of knee
- Gluteus medius is weak
-» Palpation
**What are 3 causes of IT band injury?
- Weak abductors
- Core muscles (effects knee, hips etc. putting lots of stress on IT band)
- Stress on knee (Genu Valgum)
What is Genu Varum?
“Bow legs”
-they cause tightening of the soft tissues on the outer aspect of the leg and knee, forcing the I.T.B. to rub with greater force against the edge of the femur. This will eventually produce inflammation and pain
What are some treatments for ITB?
- Strengthen hip abductors
- Strengthen core muscles
- **We are stretching Fascia not muscle, so LONG stretch important!!!
What is the ITB and where is the pain felt?
- pain felt outside or lateral side of knee
- ITB is not a muscle, it’s a thick band of tissue called fascia that starts on the outside hip, passes down the outside of the thigh and inserts into the side of the patella
What are 3 potential diagnoses for Shin Splints?
- Anterior or Posterior tibialis muscle tendinitis (front or back inflammation)
- Stress fractures of tibia
- Compartment syndrome
*What are two most common types of Shin splints?
- Anterior Shin Splints: A new-runner” : slapping of feet TIBIALIS ANTERIOR becomes inflamed
- Posterior Shin Splints: SOLEUS and the TIBIALIS POSTERIOR muscles affected
What is also a common cause for both Anterior Shin Splints & Posterior Shin Splints?
-over pronation
- *What is the treatment for Shin Splints?
(5) FOR INTERMEDIATE
-Acute: RICE
- Intermediate:
1. tibialis posterior exercises
2. Soleus exercises (Theraband)
3. Cycling and short distance (pain-free) running.
4. Examine for correct footwear!!
5. Also work on ABDUCTOR strength!
Late: return to RUNNING and continue STRENGTH and STRETCH
**What 4 areas of muscle that have to be strengthened to prevent lower extremity injuries?
Which other abductor muscle needs to be strengthened?
- core
- knee,
- shin
- ankle
VASTUS MEDIALIS for abductor strength
*What is Patellar Tendinitis?
“jumpers knee” Pain around the insertion of the ligamentum patellae.
How is Patellar Tendinitis aggravated?
-running or jumping (basketball/volleyball)
**What is the treatment for Patellar Tendinitis?
How long is the recovery time?
- Isotonic exercises for Quads and Abductors
- Check for Over pronation (footwear)
** 3-6 weeks
What are 5 common muscles pulled/torn?
(Grade 1-3)
What doe these muscles have in common?
- adductors (groin)
- Hamstrings
- Quads
- Hip flexors
- Gastrocnemius
-» 2 joint muscles!!
What is the treatment (intermediate) for a Muscle pull?
- light ISOTONICS on affected muscle
- STRETCH the affected muscle
- examine BIOMECHANICS
How could you progress in exercise/treatment in a muscle pull ?
- Leg extension:
ex. jumping, jumping over boxes with weights on shoulders
What are 3 most common Traumatic Sport Injuries?
- Lateral ligament sprain of the ankle (most common 85%) !!
- Shoulder separation – AC injuries
- Knee soft tissue trauma (ACL, MCL and medial meniscus)
What are the 3 common sprained ligaments in a Lateral ligament ankle sprains?
- ATL (Anterior Taloofibular Ligament)
- PTL (Posterior Talofibular Ligament)
- CFL (Calcaneofibular Ligament)
What are some Late treatments for a Sprained ankle?
-return to sport
- plyometrics (rapid repeated stretching and contracting of muscle)
- high level BALANCE exercises
?- Taping?
?-Bracing?
*What is the most common MOI for Lateral ligament ankle sprains?
-inversion sprain
What is the MOI of a Shoulder Seperations (AC ligament)?
Fall or trauma to lateral shoulder
What will grade 3 in a Shoulder Seperation look like?
What will it affect?
- Obvious bump on shoulder
- strength may be affected
What is a treatment for a Shoulder Seperation?
Acute: Brace, Isometrics, R.O.M
Intermediate: ISOTONIC RC ?ex’s and SCAPULAR STABILIZATION ex’s
Late: Return to sport, dynamic strengthening exercises.
What is the main function of the ACL?
prevent internal rotation of the femur on a fixed tibia
Frequently when the ACL is torn, the ___ is also torn
MCL
What is the “terrible triad”?
When the ACL, MCL, and medial meniscus is torn
*What are 2 ways in which the PT can examine for Anterior Translation (trauma to knee)?
- Lachman test (30 degrees)
2. Anterior Drawer Test (90 degrees)
***What is a post surgery method of treatment after a ACL injury ?
Why?
CLOSED chain!
-> Open-chain, resisted quad exercise are NEVER done for post-surg or Grade 2 sprains because of too much STRAIN on ACL
What is the Acute treatment for an ACL injury?
Acute(1-2 weeks) : PRICE, ROM muscle setting, isometrics, Bike (used for ROM)
What is the Intermediate treatment for an ACL injury?
Intermediate (2-8 weeks): work on regaining full ROM. Reduce flexion deformity (see right), isotonic, CKC (CLOSED KINEMATIC EXERCISES) ex’s
What is the late treatment for an ACL injury?
Late (8 weeks +): gradual return to sport, functional training, balance exercises, plyometrics.
What is often required if athlete is to return to contact sport after ACL injury?
Bracing
