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KNSS 220 Athletic Therapy > Intro, AT, Emergency, Injury, and Rehab > Flashcards

Intro, AT, Emergency, Injury, and Rehab Flashcards

1
Q

What are 3 stages of healing?

A
  • inflammatory response phase
  • fibrotic repair or proliferation phase
  • remodelling or maturation phase
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2
Q

How long does the inflammatory response phase last?

A

~ 7 days

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3
Q

What does the injury look like in the inflammatory response phase?

A
  • red
  • big
  • tender to touch
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4
Q

What causes pain in the inflammatory response phase?

A

pressure​ ​of​ ​all​ ​the​ ​chemicals​ ​pushing​ ​on​ ​the​ ​skin​ ​and​ ​tissues

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5
Q

Why is swelling necessary for the body to heal?

A
  • body​ ​sending​ ​chemical​ ​mediators​ ​to​ ​injury​ ​area​ ​to​ ​help​ ​clean​ ​everything​ ​up​ ​(damage, debris​ ​tissue)
  • goal​ ​is​ ​to​ ​get​ ​rid​ ​of​ ​all​ ​damaged​ ​tissue​ ​from​ ​area​ ​and​ ​bring​ ​all​ ​chemicals​ ​towards​ ​area that​ ​help​ ​with​ ​healing
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6
Q

Why is lack of swelling bad?

A

you​ ​are​ ​not​ ​getting​ ​all​ ​the​ ​chemicals​ ​needed

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7
Q

What is chronic inflammation?

A
  • inflammation goes on for too long
  • can​ ​be​ ​because​ ​you​ ​are​ ​continuing​ ​to re-aggravate​ ​the​ ​injury​ ​(more​ ​swelling)
  • can​ ​be​ ​because​ ​you​ ​are​ ​not​ ​taking​ ​care​ ​of​ ​it (RICE)
  • allows​ ​body​ ​to​ ​re-aggravate​ ​the​ ​swelling
  • eventually becomes weaker joint
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8
Q

What is the fibrotic repair or proliferation phase also called?

A

fibroblastic repair

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9
Q

What is the timeframe of the proliferation phase?

A

weeks 2-3 (depends on injury)

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10
Q

Describe what happens in the proliferation phase.

A
  • subacute phase
  • regain ROM, try to get strength back
  • adding exercises
  • important that we don’t cause more damage (safe exercises)
  • people start feeling better, need to keep them from doing too much
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11
Q

What is the goal of the proliferation phase?

A
  • ​help​ ​repair​ ​the​ ​tissue​ ​that​ ​has​ ​been​ ​damaged,
  • ​repair​ ​circulation
  • get​ ​all debris​ ​tissues​ ​out​ ​of​ ​the​ ​way​ ​and​ ​bring​ ​in​ ​brand​ ​new​ ​tissue
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12
Q

What is the timeframe of the remodelling or maturation phase?

A
  • longest phase

- anything past 4 weeks, up to 18 months

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13
Q

Describe what happens in the remodelling or maturation phase.

A
  • chronic phase
  • sports specific drills
  • return to play/lifestyle
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14
Q

What is the goal of the remodelling or maturation phase?

A
  • strengthening the tissue

- needs to be as strong as possible

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15
Q

How does chronic inflammation affect the remodelling or maturation phase?

A
  • never​ ​get​ ​to​ ​this​ ​stage
  • always​ ​going​ ​from​ ​stage​ ​1​ ​to​ ​stage​ ​2​ ​and back
  • will​ ​always​ ​be​ ​weak​ ​unless​ ​they​ ​can​ ​go​ ​through​ ​all​ ​the​ ​phases​ ​properly
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16
Q

What is Wolffs Law?

A
  • Need​ ​to​ ​have​ ​stress​ ​on​ ​an​ ​injured​ ​tissue​ ​to​ ​force​ ​it​ ​to​ ​get​ ​better​ ​(regardless​ ​of​ ​what​ ​the
    tissue​ ​is)
  • Need​ ​to​ ​be​ ​safe​ ​stress
  • Without​ ​this​ ​you​ ​get​ ​chronic​ ​injury
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17
Q

What is an application of Wolffs Law?

A
  • walking casts/boots

- less casting

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18
Q

Name 6 factors that impede healing.

A
  • Continued​ ​re-aggravation
  • Infection
  • Not​ ​eating​ ​well
  • Not​ ​enough​ ​rest
  • Smoking
  • Too​ ​much​ ​stress
  • Same​ ​as​ ​when​ ​you’re​ ​sick
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19
Q

Describe the timeframe for healing for cartilage injuries.

A
  • In​ ​discs​ ​in​ ​back,​ ​meniscus​ ​in​ ​knee​ ​etc.
  • No​ ​good​ ​blood​ ​flow
  • 8-10​ ​weeks
  • Some​ ​may​ ​never​ ​heal​ ​(no​ ​good​ ​blood​ ​flow,​ ​continued​ ​re-aggravation)
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20
Q

Describe the timeframe for healing for ligament injuries.

A
  • 6​ ​weeks​ ​for​ ​second​ ​degree​ ​or​ ​2​ ​ligaments

- 4​ ​weeks​ ​for​ ​first​ ​degree​ ​or​ ​1​ ​ligament

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21
Q

Describe the timeframe for healing for muscle and tendon injuries.

A
  • 6-8​ ​weeks
  • Longer​ ​due​ ​to​ ​elasticity
  • need​ ​to​ ​build​ ​up​ ​strength​ ​so​ ​that​ ​it​ ​can​ ​withhold​ ​the​ ​forces applied​ ​to​ ​it
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22
Q

Describe the timeframe for healing for nerve injuries.

A
  • Very​ ​slow​ ​(mm/year)
  • Never​ ​fully​ ​regenerate/heal
  • 2-3​ ​year,​ ​likely​ ​permanent
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23
Q

Describe the timeframe for healing for bone injuries.

A
  • Soft​ ​callus​ ​(physically​ ​attached)​ ​at​ ​2​ ​weeks
  • Can​ ​start​ ​doing​ ​some​ ​exercise​ ​at​ ​2​ ​weeks
  • Fully​ ​healed​ ​at​ ​6-8​ ​weeks
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24
Q

What will affect timeframe for healing, regardless of the injury?

A

surgical repair

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25
Q

What are the 3 phases of rehab?

A
  • acute phase
  • subacute phase
  • chronic/restructuring/remodelling phase
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26
Q

How long does the acute phase last?

A

from​ ​point​ ​of​ ​injury​ ​to​ ​3​ ​days​ ​(72​ ​hours)​ ​post-injury

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27
Q

What occurs in the acute phase?

A
  • need​ ​to​ ​baby the​ ​injury
  • RICE,​ ​take​ ​it​ ​easy
  • sets​ ​up​ ​inflammatory​ ​response
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28
Q

How long does the subacute phase last?

A

3​ ​days​ ​post-injury​ ​for​ ​3-4​ ​weeks

29
Q

How long does the chronic/restructuring/remodelling phase last?

A
  • from​ ​3-4​ ​weeks​ ​through​ ​18-24​ ​months
  • If​ ​the​ ​injury​ ​site​ ​was​ ​immobilized​ ​for​ ​some​ ​time,​ ​this​ ​process​ ​would​ ​be​ ​longer
  • If​ ​you​ ​had​ ​surgery,​ ​you​ ​have​ ​to​ ​restart​ ​the​ ​process
30
Q

Describe pain, and how it affects rehab.

A
  • Perception​ ​of​ ​pain​ ​can​ ​be​ ​controlling​ ​factor​ ​injury​ ​healing​ ​with​ ​an​ ​athlete
  • Not​ ​the​ ​factor​ ​the​ ​starts​ ​or​ ​stops​ ​rehab
  • Happens​ ​when​ ​specific​ ​nerve​ ​fibres​ ​in​ ​our​ ​body​ ​get​ ​torn/damaged/impacted;​ ​Nociceptors
    are​ ​free​ ​nerve​ ​endings​ ​=​ ​what​ ​causes​ ​you​ ​pain
31
Q

What can you get pain from?

A
  • pressure​ ​(swelling)
  • burning​ ​(thermo-type​ ​receptor)
  • cooling
32
Q

What are the 4 categories of pain?

A
  • cutaneous pain
  • pain from muscles/ligaments/tendons
  • bone pain
  • internal organ pain
33
Q

Describe cutaneous pain.

A

​- at​ ​surface​ ​of​ ​skin

  • usually​ ​sharp​ ​or​ ​burning​ ​sensation
  • very​ ​localized, easy​ ​to​ ​point​ ​out
34
Q

Describe pain from muscles/ligaments/tendons.

A

​- deeper,​ ​aching​ ​feel

  • ​bleeding​ ​=​ ​throbbing
  • ​vague location
35
Q

Describe bone pain.

A
  • ​deep,​ ​“deep​ ​aching​ ​toothache”
  • generally​ ​creates​ ​nausea
  • ​more​ ​intense​ ​pain
36
Q

Describe internal organ pain.

A
  • generally​ ​referred​ ​pain​ ​(ex.​ ​Heart​ ​attack:​ ​shoulder/arm​ ​hurts)
  • either really​ ​dispersed​ ​area,​ ​or​ ​area​ ​far​ ​away
  • Pain​ ​=​ ​lack​ ​of​ ​oxygen
37
Q

What is acute pain?

A
  • ​lasts​ ​less​ ​than​ ​6​ ​months​ ​(into​ ​the​ ​first​ ​part​ ​of​ ​maturation​ ​phase)
  • Normal​ ​to have​ ​pain​ ​and​ ​discomfort​ ​with​ ​some​ ​activity
38
Q

What is chronic pain?

A
  • past​ ​6​ ​months

- generally​ ​have​ ​other​ ​issues​ ​going​ ​on​ ​beyond​ ​physical injury

39
Q

How can we control pain?

A
  • Manual​ ​therapy
  • ultrasound/razor
  • Currents​ ​(used​ ​mainly​ ​for​ ​pain​ ​and​ ​swelling,​ ​gate​ ​control​ ​theory)
40
Q

What is gate control theory?

A
  • Body​ ​can​ ​only​ ​feel​ ​one​ ​sensation​ ​from​ ​one​ ​area​ ​at​ ​a​ ​time
  • Touch​ ​over​ ​top​ ​of​ ​pain​ ​spot​ ​will​ ​force​ ​the​ ​brain​ ​to​ ​feel​ ​the​ ​touch​ ​instead​ ​of
    the​ ​pain,​ ​because​ ​touch​ ​changes
41
Q

What is referred pain?

A
  • Cross​ ​over​ ​of​ ​nerves,​ ​pain​ ​travels​ ​farther​ ​away
  • The​ ​farther​ ​the​ ​pain,​ ​the​ ​worse​ ​the​ ​condition
  • Pain​ ​from​ ​farther​ ​away​ ​can​ ​eventually​ ​become​ ​a​ ​second​ ​injury;​ ​Pain​ ​= body​ ​treats​ ​it​ ​like​ ​something​ ​is​ ​wrong,​ ​muscles​ ​spasm
  • Pain​ ​from​ ​far​ ​away​ ​can​ ​distract​ ​from​ ​real​ ​injury
42
Q

Name 6 things that make you more susceptible to injury.

A
  • Tired
  • Smoking
  • Improper​ ​form
  • Improper​ ​posture
  • Improper​ ​warm​ ​up/cool​ ​down
  • Genetic​ ​factors​ ​(conditions,​ ​weaker​ ​ligaments,​ ​tall/short,​ ​muscle​ ​fibre​ ​types,​ ​lifestyle)
43
Q

How can we speed up healing?

A
  • Medications​ ​(decrease​ ​pain,​ ​decrease​ ​swelling,​ ​decrease​ ​spasm)
  • Modalities
  • Exercise
44
Q

Name 6 modalities.

A
  • cryotherapy
  • thermotherapy
  • contrast bath
  • ultrasound
  • laser
  • electric current
45
Q

What is the general rule for heat and cold?

A
  • pain = ice
  • stiff = heat
  • if you can’t tell, go with ice. It won’t make anything worse
46
Q

Describe cryotherapy.

A
  • cold​ ​(ice​ ​pack,​ ​ice​ ​bath,​ ​ice​ ​massage)
  • Reduce​ ​swelling​ ​(vasoconstriction:​ ​constricting​ ​blood​ ​vessels​ ​so​ ​that​ ​you can’t​ ​get​ ​circulation​ ​to​ ​the​ ​area)
  • 4​ ​sensations:​ ​cold​ ​(skin),​ ​burn​ ​(nerves),​ ​ache​ ​(deeper​ ​tissues),​ ​numb (nothing)​ ​(typically​ ​takes​ ​7​ ​minutes​ ​to​ ​get​ ​through​ ​all​ ​4,​ ​all​ ​structures)
47
Q

What is the general prescription (time) for cryotherapy?

A
  • General​ ​rule:​ ​20​ ​minutes​ ​on,​ ​1​ ​hour​ ​off

- 1​ ​hour​ ​off​ ​=​ ​everything​ ​comes​ ​back​ ​to​ ​feeling​ ​before​ ​doing​ ​it​ ​again​ ​to avoid​ ​frostbite

48
Q

Describe thermotherapy.

A
  • Heat​ ​(hot​ ​pack,​ ​hot​ ​bath,​ ​infrared​ ​lights)
  • Vasodilation:​ ​bring​ ​blood​ ​to​ ​area
  • Muscle​ ​spasm,​ ​try​ ​to​ ​flush​ ​out​ ​what​ ​is​ ​causing​ ​the​ ​spasm
49
Q

What is the general prescription (time) for thermotherapy?

A

no time limit for heat

50
Q

Describe contrast bath.

A
  • combination of hot and cold, back and forth
  • back and forth between constricting and dilating
  • creates muscle pump = tight, relaxing
  • For​ ​too​ ​much​ ​swelling​ ​or​ ​swelling​ ​has​ ​been​ ​there​ ​for​ ​too​ ​long
51
Q

When do we use contrast bath?

A
  • Commonly​ ​after​ ​days​ ​3-5​ ​when​ ​there​ ​is​ ​still​ ​too​ ​much​ ​swelling
  • Will​ ​not​ ​use​ ​a​ ​contrast​ ​bath​ ​before​ ​day​ ​3​ ​(we​ ​want​ ​inflammation​ ​up​ ​to​ ​that point)
52
Q

What is the general prescription (time) for contrast bath?

A
  • generally​ ​1​ ​min.​ ​and​ ​hot,​ ​1​ ​min.​ ​in​ ​cold,​ ​and​ ​back​ ​and​ ​forth​ ​for​ ​15 minutes
  • need​ ​to​ ​put​ ​area​ ​up​ ​after​ ​15​ ​minutes​ ​to​ ​drain
53
Q

Describe ultrasound.

A
  • Sound​ ​wave​ ​that​ ​goes​ ​into​ ​tissue
  • creates​ ​heat​ ​from​ ​the​ ​inside​ ​out
  • vibrates​ ​cells​ ​(helps​ ​break​ ​down​ ​scar​ ​tissue)
  • Tends​ ​to​ ​be​ ​subacute​ ​modality
  • Should​ ​never​ ​feel​ ​anything
54
Q

When shouldn’t we use ultrasound?

A
  • head​ ​injuries​ ​or​ ​bone​ ​injuries​ ​(fractures,​ ​breaks)
  • in​ ​acute​ ​phase​ ​of​ ​injury​ ​because​ ​we​ ​do​ ​not​ ​need​ ​any​ ​more heat
55
Q

Describe laser.

A
  • Gives​ ​energy​ ​to​ ​the​ ​cell​ ​that​ ​are​ ​damaged
  • Turns​ ​all​ ​the​ ​cells​ ​that​ ​aren’t​ ​working​ ​back​ ​on
  • Helps​ ​speed​ ​healing
  • Should​ ​never​ ​hurt,​ ​may​ ​feel​ ​warm
56
Q

When shouldn’t we use laser?

A
  • ​in​ ​eyes
  • in​ ​cancerous​ ​tumor​ ​to​ ​avoid​ ​giving​ ​it​ ​more​ ​energy​ ​than
    they​ ​already​ ​have
57
Q

Describe electrical current.

A
  • TENS:​ ​buzzing​ ​sensation

- Muscle​ ​stimulation:​ ​creates​ ​contraction​ ​in​ ​muscle,​ ​used​ ​post​ ​surgery​ ​or spinal​ ​cord​ ​injury

58
Q

What is interferential current?

A
  • 4​ ​pads​ ​on​ ​at​ ​1​ ​time
  • Decreases​ ​pain​ ​(gate​ ​control theory)
  • Can​ ​be​ ​turned​ ​up​ ​high​ ​enough​ ​to​ ​create​ ​muscle​ ​contraction (decrease​ ​spasm,​ ​make​ ​a​ ​muscle​ ​fire,​ ​fatigue​ ​a​ ​muscle)
  • Has​ ​effect​ ​on swelling,​ ​can​ ​make​ ​it​ ​move.
59
Q

Name the order of rehab exercises.

A
  1. ROM
  2. isometrics
  3. isotonics
  4. isokinetics
  5. functional patterns
  6. cardio
  7. flexibility
  8. proprioception
60
Q

Describe ROM for rehab exercises.

A

getting full motion at the joint

61
Q

Describe isometrics for rehab exercises.

A
  • strengthening
  • no​ ​movement​ ​of​ ​the​ ​joint​ ​(decreased​ ​risk​ ​of​ ​re-injury)
  • pushing against​ ​something​ ​in​ ​a​ ​stationary​ ​way
62
Q

Describe isotonics for rehab exercises.

A
  • ​strengthening
  • like every​ ​exercise​ ​at​ ​the​ ​gym​ ​(ex.​ ​Bicep​ ​curls)
  • closer​ ​to​ ​full​ ​ROM
63
Q

Describe isokinetics for rehab exercises.

A
  • strengthening
  • same​ ​speed
  • need​ ​particular​ ​machines​ ​(same​ ​tension,​ ​same movement​ ​throughout​ ​exercise)
64
Q

Describe functional patterns for rehab exercises.

A
  • add​ ​back​ ​exercises​ ​that​ ​look​ ​closer​ ​to​ ​sport​ ​specific
  • need​ ​to​ ​have enough​ ​movement​ ​and​ ​strength​ ​for​ ​safety
65
Q

Describe cardio for rehab exercises.

A
  • many ​different​ ​ways
  • cardio​ ​is​ ​needed​ ​to​ ​keep​ ​them​ ​at​ ​a​ ​level​ ​they​ ​need​ ​to​ ​participate without​ ​causing​ ​further​ ​damage
66
Q

Describe flexibility for rehab exercises.

A

need​ ​to​ ​be​ ​able​ ​to​ ​stretch​ ​the​ ​muscles​ ​around​ ​the​ ​damaged​ ​area

67
Q

Describe proprioception for rehab exercises.

A
  • balance
  • both​ ​legs​ ​and​ ​arms
  • lose​ ​this​ ​immediately​ ​after​ ​injury,​ ​needs​ ​to be​ ​retrained
68
Q

What is return to play/activity?

A

involves​ ​gradual​ ​progression​ ​of​ ​functional​ ​activities,​ ​increasing​ ​stress​ ​on​ ​injured structure

69
Q

What are the 5 pieces of return to play?

A
  1. Full,​ ​pain​ ​free​ ​ROM
  2. At​ ​least​ ​90%​ ​strength​ ​of​ ​the​ ​injured​ ​area
  3. Need​ ​to​ ​be​ ​able​ ​to​ ​safely​ ​do​ ​the​ ​functional​ ​pieces​ ​of​ ​your​ ​sport
  4. Need​ ​to​ ​be​ ​psychologically​ ​ready​ ​to​ ​rejoin​ ​sport​ ​(feel​ ​ready​ ​to​ ​rejoin)
  5. Re​ ​train​ ​to​ ​do​ ​the​ ​activity​ ​that​ ​got​ ​you​ ​injured​ ​(body​ ​remembers​ ​how​ ​you​ ​were​ ​injured)

KNSS 220 Athletic Therapy (14 decks)

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