Injury and Rehab plan, why do we feel pain Flashcards
Why is an accurate diagnosis important in injury recovery?
A. To determine the phase of rehabilitation.
B. To reduce the need for medication.
C. To ensure the most effective recovery plan.
D. To eliminate the possibility of further injuries.
C. To ensure the most effective recovery plan.
Correct: Accurate diagnosis allows for targeted treatments and appropriate rehab plans.
A. Partially correct but not comprehensive; diagnosis is needed before determining rehab phases.
B. Incorrect; medication needs depend on the injury and patient context, not solely on diagnosis.
D. Incorrect; while reducing the risk of further injury is important, it’s not the primary reason for diagnosis.
Which of the following should be included in managing goals and expectations for injury recovery?
A. Identifying patient resources.
B. Listing medications used.
C. Establishing timelines for recovery.
D. Including only short-term goals.
Answer:
C. Establishing timelines for recovery.
Correct: Timelines help patients understand the expected duration and progression of recovery.
A. Important but part of history taking, not goal management.
B. Incorrect; medication history aids diagnosis but isn’t part of goal-setting.
D. Incorrect; goals should include both short-term and long-term objectives.
During the acute phase of rehabilitation, which of the following is the primary goal?
A. Increase joint stability.
B. Improve active and passive range of motion (AROM, PROM).
C. Enhance muscle hypertrophy.
D. Focus on sport-specific movements.
Answer:
B. Improve active and passive range of motion (AROM, PROM).
Correct: AROM and PROM restoration are critical during the acute phase to regain mobility.
A. Incorrect; joint stability is a focus in later phases.
C. Incorrect; hypertrophy is emphasized in phase 2 or 3.
D. Incorrect; sport-specific movements occur in phase 4.
What is the primary focus of phase 2 (Restore ADLs) in rehabilitation?
A. Improve power and endurance.
B. Regain voluntary muscle activation.
C. Increase joint stability and resistance to movement (RROM).
D. Focus on agility training.
Answer:
C. Increase joint stability and resistance to movement (RROM).
Correct: Phase 2 focuses on improving stability and muscle strength to restore daily function.
A. Incorrect; power and endurance are emphasized in phase 4.
B. Incorrect; voluntary activation is part of phase 1.
D. Incorrect; agility training is introduced in phase 3.
Which exercise type is emphasized in the prevention phase of rehabilitation?
A. Controlled exercises to restore range of motion.
B. Complex movements for speed and agility.
C. Sport-specific exercises to maintain functional abilities.
D. Extrinsic stimuli to improve joint stability.
C. Sport-specific exercises to maintain functional abilities.
Correct: The prevention phase aims to maintain gains and enhance performance in a sport-specific manner.
A. Incorrect; this is part of the acute phase.
B. Incorrect; complex movements are emphasized in the return-to-sport phase.
D. Incorrect; extrinsic stimuli are part of phase 2.
Which of the following should be considered when prescribing rehabilitation exercises?
A. Frequency, Intensity, Time, and Type (FITT).
B. Goals and timelines of the patient.
C. The patient’s ability to perform the exercise.
D. All of the above.
D. All of the above.
Correct: Effective exercise prescription requires considering FITT, patient goals, and their current ability.
A. Partially correct; FITT is crucial but not the sole factor.
B. Partially correct; goals guide progress but are incomplete without other considerations.
C. Partially correct; ability is vital but doesn’t cover all aspects of prescription.
What is the main goal of the return-to-sport phase?
A. Restore RROM and joint stability.
B. Develop speed, agility, and strength.
C. Improve voluntary muscle activation.
D. Enhance power and movement patterning.
B. Develop speed, agility, and strength.
Correct: The return-to-sport phase focuses on functional movements that simulate athletic demands.
A. Incorrect; this is a focus of earlier phases.
C. Incorrect; voluntary activation is part of the acute phase.
D. Incorrect; power and patterning are more relevant in phase 4.
What is optimal loading mean, I am thinking as in it doesn’t cause pain or doesn’t cause too much pain
Optimal loading refers to the practice of applying the appropriate amount of mechanical stress or activity to an injured tissue to stimulate healing without causing additional harm. The goal is to strike a balance between rest and movement, avoiding complete immobilization while also preventing excessive strain.
Key Points About Optimal Loading:
Doesn’t Cause Damage:
Loading should not exacerbate the injury or create additional tissue damage.
Mild or Tolerable Pain is Acceptable:
Some discomfort during rehabilitation or movement is normal and expected, as long as it is mild and does not worsen the condition. Pain that subsides after stopping the activity is usually acceptable.
Promotes Healing:
Gentle stress on the tissue stimulates blood flow, promotes the deposition of collagen, and prevents deconditioning, stiffness, or atrophy.
Progressive:
Loading progresses as healing advances. Initially, it might involve passive movements or very light activity, gradually increasing to active movements, resistance exercises, and finally sport-specific activities.
Individualized:
The “optimal” load varies based on the type and severity of the injury, the phase of healing, and the patient’s specific needs.
What Optimal Loading Is Not:
Rest-only approach: Prolonged rest can lead to stiffness, muscle atrophy, and delayed recovery.
Excessive loading: Too much stress too soon can reinjure the tissue or delay healing.
In summary, optimal loading means finding the right intensity and type of movement to support recovery, ensuring it’s enough to promote adaptation but not so much that it hinders healing. Let me know if you’d like examples of how optimal loading might be applied in specific injuries!
What is the mose efficicent principal for recovery in up to date science as of 2025
A) POLICE
B) PRICE
C)RICE
A. POLICE Is the Most Efficient:
Protect:
Prevent further injury by minimizing stress on the affected area initially.
This step is particularly important during the first 24-72 hours after an injury.
Optimal Loading:
Encourages appropriate mechanical stress to the injured tissue, which helps maintain range of motion (ROM), strength, and blood flow.
Promotes tissue healing by stimulating collagen deposition and remodeling.
Reduces the risks of muscle atrophy, joint stiffness, and chronic dysfunction caused by prolonged immobilization.
Ice:
Reduces pain and swelling in the acute phase.
Evidence for ice’s effectiveness is mainly anecdotal for swelling but strong for pain relief.
Compression:
Helps control swelling and provides support to the injured area.
Elevation:
Reduces swelling by encouraging fluid drainage away from the injured site.
Why PRICE and RICE Are Less Optimal:
PRICE:
The “Rest” component often led to excessive immobilization, which can delay healing.
RICE:
It completely omits the idea of “Optimal Loading,” which is now understood to be critical in recovery.
The Evidence Behind POLICE:
Research shows that early, gentle movement under controlled conditions promotes better long-term outcomes compared to complete rest. Immobilization can lead to stiffness, delayed tissue repair, and weaker tendons or ligaments. POLICE provides a balanced framework to protect the injury while gradually reintroducing function.
Conclusion:
POLICE is considered the most efficient method for recovery according to current science, as it combines the benefits of protection and rest with the advancements in understanding the importance of controlled loading. This approach fosters faster and more complete recovery compared to PRICE or RICE.
Which of the following factors is NOT part of evaluating tissue health for return to play?
a. Demographics
b. Symptoms
c. Functional tests
d. Medical history
c. Functional tests
Correct: Functional tests are part of evaluating tissue stresses, not tissue health.
a. Demographics: This is part of tissue health, as age, sex, and other demographic factors can influence recovery.
b. Symptoms: Symptoms are crucial for understanding tissue health and the current state of healing.
d. Medical history: A comprehensive medical history is essential for assessing the tissue’s condition and prior injuries.
Tissue Health
a. Demographics:
More information
Importance: Age, sex, and other demographic factors significantly affect recovery because they influence tissue properties and healing rates. For example:
Younger individuals generally heal faster due to better cell turnover and collagen synthesis.
Women may experience different injury patterns or recovery times due to hormonal differences affecting ligaments and tendons.
Relevance: Tailoring rehabilitation plans to demographic factors ensures realistic timelines and appropriate intensity levels.
b. Symptoms:
Importance: Symptoms like pain, swelling, or stiffness provide direct insight into the injury’s current state and whether healing is progressing as expected.
Relevance: Monitoring symptoms helps adjust rehabilitation intensity and avoid setbacks.
d. Medical History:
Importance: A detailed history reveals previous injuries, surgeries, or chronic conditions that could affect recovery. For instance, prior ACL tears may increase the risk of re-injury.
Relevance: Medical history aids in identifying patterns, predisposing factors, and potential complications.
Which factor is NOT typically considered when assessing tissue stresses in return-to-play decisions?
a. Type of sport
b. Limb dominance
c. Legal implications
d. Psychological factors
c. Legal implications
Correct: Legal implications fall under risk tolerance, not tissue stresses.
a. Type of sport: The type of sport determines the physical demands and stresses placed on the tissue.
b. Limb dominance: This can affect the injury’s functional recovery and performance demands.
d. Psychological factors: Mental readiness and stress tolerance are part of tissue stress evaluation.
More information
Tissue Stresses
a. Type of Sport:
Importance: Different sports place varying demands on tissues. Contact sports like rugby stress joints differently than non-contact sports like swimming.
Relevance: Understanding sport-specific stress helps design targeted rehabilitation and functional tests.
b. Limb Dominance:
Importance: Dominant limbs often experience greater workloads, making them more prone to stress injuries but potentially faster to recover due to habitual use.
Relevance: Accounting for limb dominance ensures balanced rehabilitation and avoids overcompensation injuries.
d. Psychological Factors:
Importance: Mental readiness and stress tolerance impact recovery and performance. Fear of re-injury or lack of confidence can hinder an athlete’s return to peak performance.
Relevance: Psychological assessment identifies potential barriers and allows for interventions like counseling or gradual exposure to gameplay.
Which of the following would be the best example of a risk tolerance factor in a return-to-play decision?
a. Desire to compete
b. Functional tests
c. Protection ability
d. Symptoms
a. Desire to compete
Correct: Desire to compete is a risk tolerance factor, as it reflects the athlete’s willingness to play despite potential risks.
b. Functional tests: These assess tissue stress and are not related to risk tolerance.
c. Protection ability: This evaluates tissue stress during gameplay, not risk tolerance.
d. Symptoms: Symptoms help determine tissue health, not risk tolerance.
more information
Risk Tolerance
Definition: Risk tolerance refers to the athlete’s and stakeholders’ willingness to accept potential risks, including re-injury or performance deficits, in the context of returning to play.
c. Legal Implications:
Importance: Legal and ethical issues arise if an athlete returns prematurely or if there are conflicts of interest, such as pressure from sponsors or teams. Decisions must consider liability and fairness.
Relevance: Clear documentation and informed consent protect all parties and ensure ethical decision-making.
a. Timing in the Season:
Importance: Athletes may feel more pressure to return during critical points in the season (e.g., playoffs).
Relevance: Timing influences the acceptable level of risk based on competitive priorities.
c. External Pressure (Skewing Risk Tolerance):
Importance: Pressure from coaches, teammates, or sponsors can lead athletes to downplay symptoms or overestimate their readiness.
Relevance: Decision-makers must remain objective and prioritize health over external expectations.
b. Conflicts of Interest:
Importance: Team doctors or coaches may prioritize team success over the athlete’s health, creating ethical dilemmas.
Relevance: Independent medical opinions and transparency reduce biases and protect athletes’ welfare.
Why might “pressure from others” influence the return-to-play decision?
a. It increases tissue stress.
b. It is a psychological factor.
c. It can skew the athlete’s risk tolerance.
d. It has no significant effect.
Answer:
c. It can skew the athlete’s risk tolerance.
Correct: External pressure can make athletes accept higher risks than they would otherwise tolerate.
a. It increases tissue stress: Pressure from others doesn’t directly affect physical stress on tissues.
b. It is a psychological factor: While it has psychological elements, this is not the best explanation.
d. It has no significant effect: External pressure can significantly impact decision-making in return-to-play scenarios.
Which of the following is a legal implication to consider in return-to-play decisions?
a. Timing in the season
b. Conflicts of interest
c. Limb dominance
d. Competitive level
b. Conflicts of interest
Correct: Conflicts of interest, such as pressure from sponsors or teams, can have legal and ethical implications in decision-making.
a. Timing in the season: This is a risk tolerance factor, not a legal implication.
c. Limb dominance: This is related to tissue stresses.
d. Competitive level: This falls under tissue stress evaluation.
Which of the following best describes a myofascial trigger point (MTrP)?
A. An area of reduced blood flow in bone tissue
B. A tender spot within a shortened band of muscle
C. A localized area of nerve inflammation near a joint
D. A generalized area of muscle swelling
a) A tender spot within a shortened band of muscle
Correct: This is the accepted definition of a trigger point, characterized by a localized, hyperirritable spot within a taut band of skeletal muscle.
b) A tender point unrelated to muscle fibers
Incorrect: Tender points (like those in fibromyalgia) are unrelated to taut muscle bands and lack the characteristic taut band or referred pain of MTrPs.
c) A nerve-related condition causing referred pain
Incorrect: While trigger points can produce referred pain, their cause is not directly nerve-related but rather related to dysfunction in muscle and fascia.
d) A tear in the muscle fibers
Incorrect: A trigger point involves muscle tightness and irritation, not a physical tear in the muscle fibers.
Which of the following best describes the mechanism of pain relief via dry needling?
A. Decreasing blood flow to the muscle
B. Inducing micro-stretches in shortened muscle fibers
C. Blocking the release of acetylcholine
D. Stimulating peripheral nerve endings
b) Inducing micro-stretches in shortened muscle fibers (Correct: This is a key mechanism of dry needling pain relief.)
a) Decreasing blood flow to the muscle (Incorrect: Dry needling aims to improve blood flow and relieve ischemia.)
c) Blocking the release of acetylcholine (Incorrect: Acetylcholine release increases at motor end plates, contributing to MTrPs.)
d) Stimulating peripheral nerve endings (Incorrect: The twitch response is localized to the muscle, not nerves.)
What evidence supports acupuncture for MTrPs?
a) Acupuncture shows strong evidence of long term benefits for chronic pain
b) Studies confirm wet needling is always superior to dry needling
c) Dry needling reduces pain and improves quality of life compared to sham or no treatmetn
d) All studies agree on its effectiveness
c) Dry needling reduces pain and improves quality of life compared to sham or no treatment (Correct: Studies indicate that dry needling is effective for reducing pain and improving quality of life.)
a) Acupuncture shows strong evidence of long-term benefits for chronic neck pain (Incorrect: Most studies show acupuncture provides short-term, immediate benefits, not long-term improvements.)
b) Studies confirm wet needling is always superior to dry needling (Incorrect: Research shows no consistent difference between wet and dry needling for MTrPs.)
d) All studies agree on its effectiveness (Incorrect: Evidence for acupuncture is mixed, with some studies showing no significant improvement.)
What is the purpose of palpating trigger points?
A. To identify inflammation in nearby ligaments
B. To locate the taut band and tender nodule that elicits pain
C. To determine joint range of motion
D. To measure muscle hypertrophy
Which palpation technique involves rolling over the taut band in the muscle, similar to plucking a guitar string?
A. Flat palpation
B. Pincer palpation
C. Snapping palpation
D. Linear palpation
What is the primary difference between active and latent trigger points?
A. Active trigger points are only painful during movement, while latent trigger points are painful at rest.
B. Active trigger points cause spontaneous pain, while latent trigger points do not.
C. Latent trigger points cause swelling, while active trigger points do not.
D. Latent trigger points are more common in tendons than muscles.
- What are common pathogenesis factors for MTrPs?
a) Prolonged poor posture
b) Surgical scars
c) Repetitive microtrauma
d) All of the above
**d) All of the above
a) Prolonged poor posture (Correct: Poor posture contributes to chronic muscle strain and MTrPs.)
b) Surgical scars (Correct: Scars can alter biomechanics and lead to trigger point formation.)
c) Repetitive microtrauma (Correct: Repeated muscle stress and overuse are major causes of MTrPs.)
What is the mechanism of pain relief in acupuncture and dry needling for trigger points?
A. Blocking nerve conduction near the trigger point
B. Evoking muscle twitches that stretch shortened muscle fibers
C. Reducing synovial fluid production in nearby joints
D. Increasing lactic acid buildup
B. Evoking muscle twitches that stretch shortened muscle fibers
Correct: Dry needling and acupuncture can cause a local twitch response, which helps release taut bands of muscle fibers, improve blood flow, and reduce pain through mechanical and neurological effects.
A. Blocking nerve conduction near the trigger point
Incorrect: Neither acupuncture nor dry needling primarily works by blocking nerve conduction. Instead, they focus on muscle tissue and trigger points.
C. Reducing synovial fluid production in nearby joints
Incorrect: Trigger points and dry needling target muscle tissue, not synovial fluid or joint structures.
D. Increasing lactic acid buildup
Incorrect: Trigger points already have poor circulation and waste product accumulation. Pain relief from needling is achieved by improving circulation, not by increasing lactic acid buildup.
Do you still get benefits even if the muscle doesn’t twitch:
Here’s why benefits occur even without a twitch:
Mechanical Disruption of Trigger Points:
The insertion of a needle into the muscle can mechanically disrupt the taut bands and improve the mobility of muscle fibers, even without a visible twitch.
Improved Blood Flow:
The act of needling promotes localized microtrauma, which enhances circulation in the area, reduces ischemia, and improves oxygen delivery to the muscle tissue.
Neurological Effects:
Needling can stimulate sensory nerve fibers and lead to the release of pain-modulating chemicals like endorphins, which can help reduce overall pain.
Central Desensitization:
The needling process can also reduce central sensitization by modulating the nervous system’s pain processing pathways, contributing to overall relief.
Reduction of Muscle Tone:
Even without a twitch, the needling process can reduce hyperactivity in motor endplates and decrease excessive acetylcholine release, which helps relax the muscle.
Clinical Takeaway:
The local twitch response is helpful but not mandatory for dry needling or acupuncture to be effective. The combination of physiological and neurological responses elicited by the needle can still provide therapeutic benefits, particularly in terms of pain reduction and improved function.
What outcome measures are commonly used to assess the effectiveness of trigger point treatments?
A. Muscle strength and BMI
B. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), and Quality of Life (QOL)
C. Electrolyte balance and resting heart rate
D. ROM only
Answer: B. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), and Quality of Life (QOL)
Which of the following has been demonstrated as the most effective in managing myofascial trigger points based on studies?
A. Dry needling only
B. Heat therapy alone
C. Lidocaine injection and botox injection
D. Sham acupuncture
Answer: C. Lidocaine injection and botox injection
