Lecture 2

Question 1

Strain

Answer 1

muscle and tendon

Question 2

Sprain

Answer 2

ligament

Question 3

Dislocation

Answer 3

complete loss of connection between 2 bones

Question 4

Subluxation

Answer 4

partial dislocation. some continuity/connection

Question 5

Tendinopathy

Answer 5

all problems related to tendons

Question 6

Synovitis

Answer 6

inflammation of synovial fluid

Question 7

Hemarthrosis

Answer 7

bleeding into tissues or joints

Question 8

Bursitis

Answer 8

inflammation to bursa

Question 9

Contusion

Answer 9

bruise/impact injury

Question 10

Overuse syndrome

Answer 10

more than 1 event leading to injury

Question 11

Grade 1

Answer 11

mild, no significant loss of continuity or stability

Question 12

Grade 2

Answer 12

moderate pain, unable to continue activity, pain w/palpation & stress to tissue. significant number of fibers are torn.

ligament = increased joint mobility

Question 13

Grade 3

Answer 13

severe pain, near complete or complete tear of tissue, stress to tissue is usually painless, may palpate defect

ligament = unstable

Question 14

Stages of inflammation and repair

Answer 14

acute stage = inflammatory
subacute = repair/healing
chronic = maturation/remodeling

continued if not healed –> chronic inflammation & pain

Question 15

Phase 1 Interventions

Answer 15

avoid excessive stretching
single-limb balance
grapevine
plank, 5x10s
side plank, 5x10s
bent knee bridge, 10x5s
low speed jogging

Question 16

Phase 1 Hamstring lengthening

Answer 16

the diver, 3x6 reps every other day
the extender, 3x12, 2xday

Question 17

Phase 2 Interventions

Answer 17

lateral shuffle
grapevine jog
rotating body bridge 5s on each side, 2x10 reps

supine bent knee bridge w/walk outs, 3x10

bridge on bench, single leg. 2x10

single limb balance windmills 4x8 reps

Question 18

Phase 2 lengthening

Answer 18

the glider, 3 sets, 4 reps, 3x week

progression is increased by increasing distance

Question 19

Phase 3 Interventions

Answer 19

skipping
rotating body bridge
sport-specific drills
forward-backward accelerations

Question 20

Tissue Response Stage

Answer 20

Inflammation
Most apparent in 1st 48 hours
Lasting 4 to 6 days on average

cellular, vascular, chemical

Question 21

Patient Response Acute Stage

Answer 21

Palpable pain/tenderness, swelling, heat, redness, pain at rest, loss of function
limitations in joint or muscle ROM = guarding
pain is before end range or even before actual movement
nerve endings are irritated due to altered chemical states

Question 22

Goal of acute stage

Answer 22

protection

Question 23

Goal of subacute stage

Answer 23

controlled motion

Question 24

Goal of chronic stage

Answer 24

return to function

Question 25

Acute stage plan of care

Answer 25

patient education
protection of the injured tissue
prevention of adverse effects due to immobility
decrease pain

Question 26

Acute stage interventions

Answer 26

PROM (to remote muscles)
grade 1 joint mob
muscle setting
massage for edema

Question 27

Precautions for Acute

Answer 27

signs of increasing inflammation after activity or intervention

Question 28

Contraindications for Acute

Answer 28

stretching and resistance exercises should not be performed at the site of the inflamed or swollen tissue

Question 29

Subacute stage, physiological response

Answer 29

14 to 21 days after onset of injury, can last 6-8 weeks
creation of new collagen, very easy to break

new capillary beds
pain = tissue resistance

Question 30

Plan of care for sub acute

Answer 30

muscle relaxation
joint mob
stretching
using new range
sub max isometric
active range
endurance

Question 31

Signs of excessive stress

Answer 31

soreness that doesn’t decrase after 4 hours, isn’t resolved in 24
pain that comes on earlier/increased
decreased ROM
swelling/red/warmth
weakness
decreased use

Question 32

Chronic stage Tissue reponse

Answer 32

maturation and remodeling
21-60 days fibroblasts being remodeled
reduction of wound size
quality of collagen increases
remodeling of tissue

Question 33

Plan of care chronic stage

Answer 33

education, stop hands on
progression
return to high demand

Question 34

Non-modifiable risks of hamstrings

Answer 34

prior history
greater than 23
ACL, calf strains, other knee/ankle injuries

Question 35

Modifiable risks for hamstrings injuries

Answer 35

hamstrings weakness
fatigue
strength and coordination deficits

Question 36

What contributes to high rate of reinjury?

Answer 36

persistent weakness in injured muscle
reduced extensibility of musculotendon
adaptive changes in biomechanics or motor patterns
strength/control of lumbopelvic muscles

Question 37

Nordic hamstrings

Answer 37

help to prevent hamstring tears. does not reduce the severity of the injury

1x per week, 2 sets 6 reps

Question 38

Planes of movement

Answer 38

Early active mobilization in the frontal and transverse planes
progress to movements in sagittal plane