L33: Upper limb exercise Flashcards
1
Q
What are 6 key steps in developing rehabilitation program?
A
- Obtain a thorough history: Current injury, previous injury, available resources
- Set long term goals
- Aim for an accurate diagnosis (may be provisional and subject to supplementary investigations)
- Identify key impairments in BF&S
- Identify potential physiological, psychological and logistic barriers
- Draft a realistic progress plan, including functional and measurable short -term goals
2
Q
What are the 4 phases of rehabilitation?
A
3
Q
What is Phase 1: Acute Management?
A
4
Q
What are the FITT for strength, endurance, power for Phase 2: Restore ADL?
A
- Strength: 3-5 sets, 3-6 reps, 90-120 sec rest, 90-100%RM, controlled
- Endurance: 1-2 sets, 15-30 reps, 45-60 sec rest, 50-70%RM, sport-specific
- Power: 3-4 sets, 8-12 reps, 45-60 sec rest, 40-60%RM, explosive
5
Q
What are the features (FITT) for strength, power for Phase 3: Replicate Sport- Specific Demands?
A
- Strengthening: Complex positions and movements
- Power: 3-4 sets, 8-12 reps, 45-60 sec rest, 40-60% RM, explosive
- Incorporate the whole kinetic chain (e.g. trunk rotation)
- Gradual return to sports/activity. Can start when minimal pain, full ROM, adequate strength.
6
Q
What are the features (FITT) for strength, power for Phase 4: Prevent Re- Injury?
A
- Continue to build power & endurance
- Repetition of new motor patterns (e.g. throwing mechanics)
7
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 3 goals of rehabilitation?
A
- Restore function and performance level (ideally above pre-injury level) - ○ Make representative team again this year
- US college scholarship
- Return to baseball in a safe and timely manner
- Rep team selections in 4 months
- Minimise the risk of re-injury
- Strengthen shoulder & elbow
- Improve throwing mechanics
8
Q
Mitch the pitcher
17 year old baseball player & year 12 student
Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
Right-handed thrower/ pitcher
You diagnose him with a grade 2 MCL sprain
What are 3 educations?
A
- Mitch +/- his coach or family may have unrealistic expectations of a rapid return to baseball
- Give Mitch an early outline of expected progress, with specific short-term goals, and specific tasks to achieve these goals
- Build confidence in the rehabilitation process
- Communicate the expected progress plan to Mitch’s coaches and family
- Fosters a collaborative environment
9
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 6 features of Phase 1?
A
- Rest from throwing for 2-3 months - depends on individual healing
- Anti-inflammatories may impede healing
- Ice 10 mins, 4x a day
- Splint to limit ROM especially at night
- ROM exercises: Wrist flexion & pronation (promote realignment of
- collagen fibres)
- Need full pain-free AROM before phase 2
10
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 4 features of Phase 2?
A
- Strengthen wrist flexors & pronators (improve medial elbow stability)
- Hypertrophy: 2-3 sets, 8-12 reps, 60-75 sec rest, 70-90% RM, slow on eccentric
- Can progress load, reps, isometric > concentric > eccentric
- Progressive strengthening of shoulder & elbow muscles
- General strength > functional strength > eccentric control
- Single plane movements > multi-plane/functional movements
- If period of immobilisation/inactivity, or if injured due to scapula, then must consider scapula
11
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 10 Thrower’s exercises of Phase 2?
A
12
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 4 features for Phase 3?
A
- Strength training: Complex positions and movements
- Power: 3-4 sets, 8-12 reps, 45-60 sec rest, 40-60% RM, explosive
- Incorporate the whole kinetic chain (e.g. trunk rotation)
- Gradual return to throwing ~3 months. Can start when minimal pain, full ROM, adequate strength.
13
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 4 features of interval sport program for Phase 3?
A
- 4-6 weeks
- Start with short distance throwing + long rest + low reps
- Go back a step if pain occurs
- Progress to throwing off the mound (step 15) when pain-free
14
Q
Mitch the pitcher
- 17 year old baseball player & year 12 student
- Presents with acute onset pain in medial right elbow, which occurred during early pre-season training
- Right-handed thrower/ pitcher
- You diagnose him with a grade 2 MCL sprain
What are 2 features of interval sport program for Phase 4?
A
- Continue to build power and endurance
- Repetition of new throwing mechanics
