lec 5 - treatment, rehab, and RTS

Question 1

what are the 3 main elements of diagnosis

Answer 1

history
physical exam
imaging

Question 2

what are the three stages of rehab

Answer 2

acute stage (right after injury)
rehab stage (days to weeks)
training stage

Question 3

what is involved in the training stage

Answer 3

sport specific training
- gradual transiton from controlled rehab exercises to sport specific training
- functional and sport specific testing to determine whether an athlete can tolerate sport specific training loads

Question 4

what stage of strength should an athlete be at before being allowed to compete

Answer 4

at least 85-90% of original strength regained

Question 5

what is involved in the acute stage

Answer 5

PEACE, PRICE, POLICE in acute injury
partial unloading of the injured structure in repetitive injury
- early management and treatment

Question 6

what is involved in the rehab stage

Answer 6

• monitor pain and swelling
• ensure normal ROM, strength, NM function, and normal aerobic capacity
• alternative training
• specific training
• other therapies - manual treatment, taping/bracing, meds, diet, etc

Question 7

how can injury alter NM function

Answer 7

painful conditions may result in reflex inhibtions
= changes in mvmt patterns
= unfavourable loading pattern
= increased risk of re injury

Question 8

what are the three elements of the RTS continuum

Answer 8

• return to participate
• return to sport
• return to perform

Question 9

what plays an important role in RTS decision making

Answer 9

functional and sport specific conditioning tests
- open skills = dynamic skills in changing environment
- closed skills = fixed and predictable environment
psych readiness is important

Question 10

what is low back pain in athletes often called

Answer 10

posterior element overuse syndrome

Question 11

what is the continuum of PEOS

Answer 11

1. bone stress reaction
2. stress fracture - spondyloysis
3. slipping of vertebra (full break) - spondylolisthesis

Question 12

what are risk factors fro PEOS

Answer 12

excessive extension and rotation loads
improper technique
hyperlordosis

Question 13

what is the process to RTS after spondy surgery

Answer 13

week 1 = short walks and stretching
week 2-9 = static stabilisation exercises (core)
week 6-12 = dynamic strength exercises
week 9-12 = low impact aerobic training
RTS between 6 months and 1 year

Question 14

how to prevent LBP in youth athletes

Answer 14

recognition of risk factors
reduced training during rapid growth
proper techniques
core strength
hamstring and hip flexor flexibility

Question 15

what is the most common groin injury

Answer 15

adductor related groin pain

Question 16

what are the symptoms of adductor related groin pain

Answer 16

pain during sprinting, direction changes, and kicking
pain in the insertion of the adductor longus

Question 17

what is the grading system for groin pain (done through MRI)

Answer 17

grade 0 = no acute injury
grade 1 = edema only
grade 2 = structural disruption
grade 3 = complete tear

Question 18

what are the two exercise therapy programs for groin injury

Answer 18

holmich exercise program - for chronic pain
progressive groin exercise program - for acute injury

Question 19

what is involved in the holmich exercise program

Answer 19

2 weeks - isometric and dynamic exercises to reactivate the adductor muscles
6-10 weeks - heavier resistance training, balance, coordination
jogging after 6 weeks if asymptomatic
NO stretching of adductors through the whole program
sport specific training after the program

Question 20

what is involved in the progressive groin exercise program

Answer 20

9 groin exercises - alternate days, 3 days per week
NO pain allowed during the exercises

Question 21

what is the RTS progression during groin injury

Answer 21

1. clinically pain free
2. controlled sports training
3. full team training
4. RTS