Lecture 5 Treatment and rehabilitation Flashcards
1
Q
Ice
A
- Overlapping phases of healing:
- Hemostasis (0–several hours after injury),
- Inflammation (1–3 days),
- Proliferation (4–21 days) and,
- Re-modelling (21 days–2 years)
- It has been suggested that ice could disrupt the inflammation as well as the proliferation phases.
- Therefore, potentially, impairing tissue repair.
- BUT ice can effectively relieve pain.
2
Q
Wound healing
A
- Tissue never achieve the same level of tissue strength then before injury!
- It can reach up to 80% of it’s original strength.
- Form and function of the scar tissue depend on loading the
tissue during this stage – injured area needs proper loading! - Don’t confuse the tissue strength of the injured area and function!, load the tissue in order to restore function
3
Q
Re-injury
A
- Re-injury most often in the same location (Wangensteen et al, 2016)
- If the injury has gained enough strength, then the biomechanical
weak-point becomes the interface between the scar tissue, and
regenerating skeletal muscle fibre (Pieters et al, 2021)
4
Q
Elements of diagnosis- History
A
- age; sex
- details of injury
- training program and training history: spikes in load, were they prepared for the task ahead of them
- diet
- history of previous injury
- general health
- work/ and leisure activities
- other predisposing factors
5
Q
Elements of diagnosis- physical examination
A
- Inspection
- palpation
- ROM testing: active means athlete does it, passive means clinician does it
- strength testing
- ligament testing
- neural testing
- spinal examination
- bio-mechanical examination: balance and stability exercises
6
Q
Elements of diagnosis- imaging
A
- X-ray (radiography)
- CT (computed tomography)
- US (ultrasound)
- MRI ( magnetic resonance imaging)
7
Q
Stages of rehabilitation
A
- acute stage
- rehabilitation stage
- training stage
- often don’t know if they’ve moved from one stage to another
8
Q
Acute stage
A
Acute injury: PEACE/PRICE/POLICE
Repetitive injury: partial unloading of the injured structure, the loading pattern must be altered
9
Q
Rehabilitation stage
A
Monitor pain and swelling-> ensure normal ROM-> ensure strength-> ensure normal neuromuscular function-> ensure normal aerobic capacity
- restore their functions
10
Q
Rehabilitation stage: monitor pain and swelling
A
- It is necessary to tolerate some pain
- gradually increasing pain and/or swelling need to be reduced
11
Q
rehabilitation stage: re-establish ROM
A
- Normal ROM is a prerequisite for returning the athlete to normal technique
- reduced ROM limits ability to do strength and other training
12
Q
Ensure normal strength
A
- Often Manual Muscle Test – The Oxford Scale
(0-5) (Navi, 2019) - Consider, what is normal?
- Sport, Limb Dominance etc. (Kalata et al, 2020)
- Strength v Endurance
- Equipment v No Equipment
- 10-15% often used as marker, of symmetry, left vs right, for RTS
13
Q
Rehabilitation stage: neuromuscular training to regain normal neuromuscular function is vital
A
- Painful conditions may result in reflex inhibitions → changes in movement
patterns → unfavourable loading pattern → INCREASED RISK OF RE- INJURY - Acute ligament injuries may also result in reduced joint position sense and
coordination → INCREASED RISK OF RE-INJURY - Proprioceptive training
- Progressive strength training (injured structures)
14
Q
Normal aerobic capacity
A
- sport specific aerobic fitness
- modifiable intrinsic risk factor for injury
15
Q
Rehabilitation stage: alternative training
A
- training the other muscles and not on the injured areas
- maintaining general strength and endurance
- well performed alternative training will allow the athlete to return to sport sooner
