Injury Management Rehabilitation & Return to Play

Question 1

What are the short term goals of injury rehab?

Answer 1

• control pain and minimize swelling
• maintain / improve flexibility
• enhance core stability
• restore / increase strength & endurance
• re-establish neuromuscular control / proprioception / balance
• maintain cardiorespiratory fitness
• functional progressions

Question 2

what is the long term goal of injury rehabilitation

Answer 2

return to practice / competition as quickly and safely as possible

Question 3

When should you begin rehabilitation?

a) 12 hours post injury to allow for swelling to decrease
b) 1 week post injury to allow for fibroblastic repair
c) 1 week post injury to allow for inflammation to subside
d) immediately
e) B & C

Answer 3

D - immediately

Question 4

What are some factors to consider when developing a return-to-play plan? (7 points)

Answer 4

• MOI
• age of individual
• major anatomical structures involved
• injury severity
• stages of tissue healing
• type of sport or activity
• chronicity of the injury

Question 5

Resting heart rate increases approximately ____ beat for each day of immobilization

Answer 5

1/2

Question 6

When should you start exercising in a pain-free ROM post injury?

Answer 6

by day 3 or 4

Question 7

When does post-surgical exercise phase begin?

a) immediately
b) 12 hours post surgery
c) 24 hours post surgery
d) 48 hours post surgery
e) none of the above

Answer 7

B - post-surgical exercise phase begins 24 hours post-surgery

Question 8

What does POLICE stand for?

Answer 8

Protect 
Optimal Loading 
Ice 
Compression 
Elevation

Question 9

define load

Answer 9

external force acting on the body causing internal reactions within the tissues

Question 10

define stiffness

Answer 10

• ability of a tissue to resist a load

- greater stiffness = greater magnitude load can resist

Question 11

define stress

Answer 11

internal resistance to a load

Question 12

strain

Answer 12

internal change in tissue (length) resulting in deformation

Question 13

draw out the stress-strain relationship

Question 14

force that results in tissue crush - two forces applied towards one another is called

Answer 14

compression

Question 15

force that pulls and stretches tissue

Answer 15

tension

Question 16

force that moves across the parallel organization of tissue

Answer 16

shear

Question 17

• two force pairs act at opposite ends of a structure
• 3 forces cause bending (3 points)
• already bowed structures encounter axial loading

Answer 17

bending

Question 18

• loads caused by twisting in opposite directions from opposite ends. Shear stress encountered will be perpendicular and parallel to the loads

Answer 18

torsion

Question 19

true or false; bone bending, but not breaking can still cause a pathological response

Answer 19

true

Question 20

healing time of muscle strains

Answer 20

6-8 weeks

Question 21

1st degree mm strain

Answer 21

some fibers stretched or torn, full ROM but painful

Question 22

2nd degree muscle strain

Answer 22

multiple fibers torn. Active contraction is painful. Divot palpable. Some swelling and discolouration. Decreased ROM

Question 23

3rd degree mm strain

Answer 23

complete rupture of mm, at the MT junction or off of the bone. Significant impairment. Great deal of pain initially but diminishes due to nerve damage

Question 24

true or false; extreme mm fatigue can lead to cramps

Answer 24

true

Question 25

true or false; muscle guarding and muscle spasms are synonymous

Answer 25

false;
mm guarding is splinting to minimize pain
mm spasm is increased tone d/t upper MN lesion in brain

Question 26

two types of mm spasms

Answer 26

1. ) clonic

2. ) tonic

Question 27

true or false; crepitus could be associated with tendinitis

Answer 27

true

Question 28

how would you treat tendinosis?

a) immediate rehab
b) it is chronic, so impossible to treat
c) stretching and strengthening
d) none of the above

Answer 28

stretching and strengthening

Question 29

what would you expect with acute and chronic tenosynovitis?

Answer 29

acute - rapid onset, crepitus, diffuse swelling

chronic - thickening of tendon with pain and crepitus

Question 30

true or false; contusions can lead to overproduction of calcium deposits and lead to myositis ossificans

Answer 30

true

Question 31

what are the components of a synovial joint?

Answer 31

• hyaline and/or articular cartilage
• fibrous connective tissue capsule
• ligaments
• capsule with synovial membrane
• joint cavity with synovial fluid
• blood and nerve supply
• muscles
• menisci (fibrocartilage)

Question 32

grade 1 ligamentous sprain

Answer 32

• minor fiber damage & minimal instability
• mild to moderate pain
• minimal loss of function and swelling

Question 33

grade 2 ligamentous sprain

Answer 33

• tearing of fibers with moderate joint instability
• moderate to severe pain
• swelling & moderate loss of function

Question 34

grade 3 ligamentous sprain

Answer 34

• complete tear and may sublux
• extreme pain initially
• inevitable loss of function
• severe instability and swelling

Question 35

define subluxation

Answer 35

• partial dislocation

- spontaneous joint relocation

Question 36

true or false; in the case of a dislocation, attempt to reduce

Answer 36

false; do not reduce

Question 37

define dislocation

Answer 37

• complete disarticulation of a joint

- stabilizing structures disrupted

Question 38

separation

Answer 38

separation of the fibrous joint d/t stretching/ tearing of the supporting tissues

Question 39

Wolff’s Law of bone

Answer 39

• every change in form and function or in its function alone is followed by changes in architectural design

Question 40

types of bone fractures

Answer 40

• greenstick
• comminuted
• linear
• transverse
• oblique
• spiral
• avulsion
• impacted
• depressed