Exercise/ sports medicine

Question 1

What is the definition of physical activity?

Answer 1

•Any bodily movement produced by skeletal muscles that requires energy expenditure

Question 2

What is the definition of exercise?

Answer 2

Physical activity that is planned, structured, repetitive, and purposeful

Question 3

What are the types of physical fitness?

Answer 3

• Cardiorespiratory endurance
• Muscular strength
• Balance and coordination
• Flexibility

Question 4

What are the benefits of exercise in those with diabetes?

Answer 4

• Reduced risk of developing type 2
• Dose response reduction risk
• Modest improvement in glucose control
• Reduction in CVD risk
• 33% reduction in microvascular complications
• Acute exercise improves insulin sensitivity
• Reduction in cardiovascular complications

Question 5

What are the classification of injuries?

Answer 5

•Traumatic 
 - bone 
 - articular cartilage 
 - joint 
 - ligament 
 - muscle 
 - tendon  
•Overuse

Question 6

What are the traumatic sports injuries?

Answer 6

• Fractures and dislocations
• Major muscle - ligament - tendon injuries
• Head and spinal injuries
• chest and abdominal injuries

Question 7

What are the causes of bone injury?

Answer 7

• direct e.g. tackle

* Indirect (fall or twisting) trauma

Question 8

What are the classifications of bone fracture?

Answer 8

• Transverse
• Oblique
• Spiral
• Comminuted
• Avulsion (piece of bone attached to tendon or ligament is torn away)

Question 9

What are the clinical features of bone fracture?

Answer 9

• Pain
• Tenderness
• Localised bruising
• Swelling
• Deformity
• restriction of movement

Question 10

What is the management of bone fracture?

Answer 10

• Anatomical and functional realignment
• May need resection
• Plaster cast or surgical stabilisation

Question 11

What is the function of articular cartilage?

Answer 11

Absorbs shock and compressive forces and permits almost frictionless joint movement

Question 12

What is used for the imaging of articular cartilage?

Answer 12

MRI and arthroscopy

Question 13

Where are the common sites of injury to articular cartilage?

Answer 13

• Talus
• Femoral condyles
• Patella
• Humerus

Question 14

What are injuries to articular cartilage associated with?

Answer 14

Soft tissue injuries

Question 15

What may articular cartilage injury predispose to?

Answer 15

Premature osteoarthritis

Question 16

What are the treatment options for articular cartilage injury?

Answer 16

• Perforation
• Alteration of joint loading
• Cell transplantation

Question 17

What is dislocation

Answer 17

Trauma produces complete dislocation fo the articulating surface

Question 18

What is subluxation?

Answer 18

Some contact of the articulating surface remains

Question 19

What is damaged in dislocation?

Answer 19

Surrounding joint capsule and ligaments

Question 20

What are the complications of dislocation?

Answer 20

•Associated nerve or blood vessel damage

• axillary nerve in shoulder
• brachial artery at elbow

Question 21

What is the treatment of dislocation?

Answer 21

• Reduction
• Muscle relaxants
• Protect to allow soft tissue to heal
• Early protected mobilisation
• Rebuild muscle strength

Question 22

Explain muscle injury due to overuse

Answer 22

• Intrinsic and extrinsic factors, increased participation, increased intensity and duration lead to overload
• Overload leads to tissue injuries
• Tissue injury leads to inflammation which leads to pain
• If there is continued activity it can lead to tissue injury

Question 23

When does strain/tear of muscle occur?

Answer 23

• When demand exceeds muscles capacity
• Common if cross 2 joints
• Common during sudden acceleration or deceleration

Question 24

Which muscles are most commonly affected my strain/tear?

Answer 24

• Hamstring
• Quadriceps
• Gastrocnemius

Question 25

Describe grading of muscle strain/tear

Answer 25

Grade 1: few fibres, localised pain, no loss of strength

Grade 2: significant no. of fibres, swelling, pain on contraction, reduced strength and limitation of movement

Grade 3: Complete tear - most common at musculotendinous junctions

Question 26

What is the management of muscle strain/tear

Answer 26

• First aid to minimise bleeding, swelling and inflammation
• Electrotherapy
• Soft tissue therapy
• Stretching
• Strengthening

Question 27

What are the predisposing factors to muscle strain/tear

Answer 27

• Inadequate warm up
• Insufficient joint range of motion
• Excessive muscle tightness
• Fatigue/overuse/inadequate recovery
• Muscle imbalance
• Poor technique
• Previous injury
• Altered biomechanics

Question 28

What causes a quadriceps rupture

Answer 28

• Direct impact against contracted muscle

* Or sudden vigorous contraction due/ direct blow to muscle belly

Question 29

What is the cause of hamstring rupture?

Answer 29

Overload and forceful contraction

Question 30

What are the symptoms and signs of hamstring rupture?

Answer 30

• Sudden intense pain
• Muscle spasm
• Tenderness and swelling
• Potential palpable gap

Question 31

What is the treatment of hamstring rupture?

Answer 31

• NSAIDs
• Electrotherapy
• Strength and stretching exercises
• Surgery in sportsmen

Question 32

What makes up a tendon?

Answer 32

Normal tendons consist of tight parallel bundles of collagen fibres

Question 33

Where are injuries to tendons most likely to occur on the tendon?

Answer 33

At the point of least blood supply

Question 34

Which sites are the most common for tendon injury?

Answer 34

• Achilles

* Supraspinatus at shoulder

Question 35

Where does the achilles tendon run?

Answer 35

From gastrocnemius to insert into the posterior aspect of the heel

Question 36

What are the signs of achilles tendonopathy?

Answer 36

• Pain, especially going uphill as it is compressed
• Local swelling
• Local tenderness
• Crepitus on ankle movement

Question 37

What is the prevention of achilles tendonopathy?

Answer 37

• Active rest, alter the training schedule
• Heel wedge
• NSAID
• Immobilisation
• good shoes with no heel tabs
• DO NOT steroid inject