Healthy Active Living & Sports Medicine Flashcards
List the structural differences in the pediatric spine that make it predisposed to back injuries
growth cartilage and secondary ossification centres which are susceptible to compression, distraction and torsion injury
List the clinical features of a child with spondylolysis
- hyperlordosis
- paraspinal muscle spasm
- hamstring tightness
What is the management of spondylolysis
- avoidance of painful activities (extension)
- abdominal strengthening
- hip flexor and hamstring stretches
- antilordotic exercises
- physiotherapy
- bracing for 4-8 weeks until pain-free, then activity is gradually increased with brace on, then wean brace over next few months
What are the characteristics of cerebral body apophyseal avulsion fracture
- from repetitive spinal flexion and extension
- sports like volleyball, gymnastics, weightlifting
- CT to diagnose
- Rest, heat, NSAIDs
- Rest for 3-6 months
List the features of disc herniation
- acute onset of flexion-related pain
- associated with back muscle spasm
- hamstring tightness
- buttock pain
- radicular symptoms (muscle weakness, paresthesias) are uncommon
- MRI can demonstrate
- MGMT: conservative, NSAIDs, physical therapy for 3-6 months. Surgery if caudal equine syndrome
What are red flag symptoms for back pain
- fever
- night sweats
- night pain
- neurological abnormalities
- weight loss
- malaise
What are the Ottawa ankle rules
Ankle Xray is only necessary if there is pain in malleolar zone AND one of:
- bone tenderness at posterior edge or tip of lateral malleolus
- bone tenderness at posterior edge or tip of medial malleolus
- inability to weight bear both immediately and in ED
Foot Xray is only necessary if there is pain in the mid foot zone and any of the following:
- bone tenderness at base of fifth metatarsal
- bone tenderness at navicular bone
- inability to weight bear both immediately and in ED
List management steps for ankle injuries
Protection: brace for 3-6 months while ligaments heal
Rest: avoid immobilization, early mobilization with bracing
Ice: 15min ice daily to TID for first 36 hours after
Compression: bracing as mentionned
Elevation: recommended
What are the essential elements of an ankle rehabilitation program
- returning to a normal range of motion
- strengthening the perineal musculotendinous unit
- optimizing flexibility of calf muscles and Achilles tendon
- proprioceptive rehabilitation
- bracing to provide extra support
How does febrile illness impact athletic performance?
- decreased muscle strength
- decreased endurance
- reduced exercise tolerance
- increased fatigue
When is it appropriate to exercise with an illness?
- If symptoms confined above the neck (congestion, sore throat), may continue to participate as able
- If systemic symptoms (fever, myalgias, diarrhea, elevated resting HR) refrain until symptoms have resolved for a period of 7-14 days = risk of prolonged illness, dehydration, more serious complications
How long should a patient with infectious mononucleosis be excluded from sport participation
- minimum 3 weeks from onset of symptoms
- After 3 weeks, may resume low-impact, non-contact training at 50% pre illness as long as:
a) resolution of symptoms
b) normalization of lab markers
c) normalization of splenomegaly (on U/S)
d) resolution of any and all complications
List ways to prevent infection in athletes
- well-balanced diet
- adequate sleep
- avoid overtraining and fatigue
- allow adequate recovery time following intense exercise
- avoid contact with sick people
- wash hands frequently
- don’t share water bottles or towels
- reduce life stressors
- get appropriate immunizations
List the management of concussion
- cognitive rest (no reading, texting, TV, screens and schools)
- physical rest (no exercise, phased, recreational activity)
List the return to learn steps
- cognitive rest
- increased cognitive tasks (15-20 min) at home
- resume modified school attendance (start with half days)
- increase school attendance
- return to play protocol
* **Don’t need to be symptom free to return to school
