Considerations for clients with musculoskeletal issues

Question 1

Phase 1: Inflammation

Answer 1

3-4 days after injury (depending on severity)
Redness, swelling, pain, localized increased temperature
Causes stiffness to stabilize the area to prevent further injury

Question 2

RICE

Answer 2

Restricted Activity
Ice
Compression
Elevate

Question 3

Phase 2: Repair

Answer 3

up to 6 weeks
Initial formation of scar
Pain-free non weight bearing movement

Question 4

Phase 3: Remodeling

Answer 4

4 weeks to 2 years
Increased strength of scar tissue
Progressive, pain free exercise

Question 5

Muscle Strains

Answer 5

Grade 1: mild, intense local soreness or cramping of muscle. Strength of muscle remains normal
Grade 2: moderate. More severe pain that will cause weakness and decreased range of motion
Grade 3: severe. Complete tear of the the muscle. “tear” or “pop” accompanied by immediate pain and loss of function.

Question 6

Mechanism of injury: Ligament sprain

Answer 6

External force applies sufficient pressure to stretch the ligament to the point of injury

Question 7

Non-contact injury

Answer 7

Ground reaction force when an individual has insufficient strength, coordination, or stability to maintain control

Question 8

Ligament Sprains, Grade 1

Answer 8

Grade I: Minimal tenderness, swelling. Minimal impairment. Microscopic tearing of collagen fibers

Question 9

Ligament Sprains, Grade 2

Answer 9

Grade II: Moderate tenderness, swelling, decreased ROM, possible instability. Moderate impairment. Complete tears of some but not all collagen fibers

Question 10

Ligament Sprains, Grade 3

Answer 10

Grade III: Significant Swelling, tenderness. Instability.
Severe impairment
Complete tear/rupture of ligament

Question 11

Concussion

Answer 11

Brain injury that causes change in mental status
Confusion and disorientation
Speech may be slow/slurred, person may be uncoordinated

Question 12

Stress Fracture

Answer 12

Imbalance in bone formation and bone resorption

Question 13

Preventing Musculoskeletal Injury

Answer 13

Flexibility and Elasticity
Warm-up
Recovery

Question 14

Pain Management During workout

Answer 14

Explain that the affected area may be challenged
Explain the perceived pain scale (1-10)
Explain that the exercise will discontinue if pain exceeds 3
Encourage client to communicate any amount of pain

Question 15

Lower Extremity Injury

Answer 15

Muscular Training: Seated or lying exercises, exercises as prescribed by physician, exercises that do not involve the affected limb
Cardio: Water exercise, upper body ergometer, recumbent or stationary bike
Avoid: Movements that cause pain, weight bearing exercise until cleared by physician

Question 16

Upper extremity injury

Answer 16

Muscular Training: Exercises as prescribed by physician, exercises that do not involve the affected limb
Cardio: Walking, recumbent or stationary bike, elliptical machine
Avoid: Movements that cause pain, running, exercise that requires both hands for stability

Question 17

Back/Spinal Injury

Answer 17

Muscular Training: Exercises and stretches as prescribed by physician, body weight exercises as tolerated
Cardio: Water exercise, Walking, recumbent or stationary bike
Avoid: Movements that cause pain, high rep sets, weighted spinal rotation

Question 18

Chronic Injuries and Conditions

Answer 18

History: How?, original treatment? Seeing medical professionals?
Pain: How often? How severe?
Activity and Treatment: ROM limited? Meds?

Question 19

Impingement Syndrome

Answer 19

Inflammation of the supraspinatus tendon and subacromial bursa

Question 20

Program design for shoulder

Answer 20

1. Address postural imbalances
2. Strengthen scapular stabilizing muscles
3. Improve strength of the anterior shoulder muscles and pecs through controlled pushing motion
4. Introduce overhead activities

Question 21

Program design for elbow, wrist, and hand

Answer 21

1. Limit overuse by introducing various grips, wearing gloves
2. Increase ROM through stretches
3. Improve strength of the wrist and hand through exercises
4. Remove grips or gloves

Question 22

Improving Neck function

Answer 22

1. Observe relationship of neck position to that of the thoracic spine and shoulder. Address spine and shoulder position first
2. Introduce gentle movement and stretching
3. Refer to physician if pain is severe or persistent

Question 23

Improving low back function

Answer 23

1. Address imbalance between left and right side
2. Address posterior/anterior postural imbalance
3. Increase functional rotation of the hip
4. Strengthen the posterior chain (hamstrings, glutes)

Question 24

Piriformis Syndrome

Answer 24

Piriformis muscle becomes tight, taut or inflamed, causing compression of the sciatic nerve that runs between it and the gemelli

Question 25

Program design for hip

Answer 25

1. Address any imbalance between left and right side
2. Improve ROM in hip rotation
3. Improve hip-hinge mobility and stability
4. Improve strength of muscles in posterior chain

Question 26

Iliotibial Band friction syndrome

Answer 26

Distal portion of the IT band rubs against the lateral femoral epicondyle causing pain at the lateral aspect of knee

Question 27

Patellofemoral pain syndrome

Answer 27

Overuse, altered biomechanics, muscle dysfunction

Question 28

Program Design for knee

Answer 28

1. Address any imbalance between left and right
2. Address tightness and instability in the hip, ankle, and foot
3. Improve hip-hinge mobility and stability
4. Improve strength of muscles in posterior chain
   Chair sit, Bodyweight squat, cable squat

Question 29

Program Design For foot, ankle, and lower leg

Answer 29

1. Address mobility and stability in lower ankle
2. Improve strength in the muscles that control movement in the sagittal plane
3. Improve strength in muscles that control movement in the transverse and frontal plane
4. Improve strength in muscles of posterior chain

Question 30

Role and purpose of pain

Answer 30

A quick clear signal indicating the need to stop whatever one is doing to determine the cause of pain. Pushing through pain can cause acute injury to become chronic.