LL Rehabilitation

Question 1

Mechanotherapy

Answer 1

Tissue adapting according to stress.
Compression, tension, bending, torsion, shearing.
Signal cells to produce new proteins -> matrix remodeling.
Promote healing of muscle, tendon, ligament, cartilage and bone.

Question 2

Exercise Induced Hypoalgesia

Answer 2

Elevates pain threshold and tolerance.
Release of endogenous opioids (endorphins) and non-opioids (serotonin, norepinephrine, endocannabinoids).
Isometrics: >50% MVC until failure (5x45sec at 70%MVC).
Aerobic same affect at 75%VO2max for 10 min.
Resistance training also has affect.

Question 3

Balance/proprioception/Neuromotor Exercises

Answer 3

Single leg stance
Toe the line/tandem walking
Walking on heels/toes, forward/backwards.
Star test
Single leg airplane/superman
Progression: add reactive components (catching a ball).
Balance for fall prevention: 2x week, 12 weeks.

Question 4

Structured Neuromuscular Program

Answer 4

Fifa 11+
2x week, 20 min total.
Effective in reducing injury ACL and hamstring tears.
Rapid change in direction sport/cutting.

Question 5

Neuromuscular/motor control Training

Answer 5

Prevents injury in female handball and football players.
3x week for 15min.
Should target specific deficits for each player.
Pain free, otherwise compensating.

Question 6

Hip Strengthening in Patellofemoral Pain Syndrome

Answer 6

Reduces pain faster than quad strengthening.
Hip abd (glut med) and ER (glut max) used to prevent knee from dropping in.
Glut med: side bridge to neutral, single leg squat, single leg deadlift.
Glut max: forward step up, single leg squat, single leg deadlift.

Question 7

Adductor Strengthening

Answer 7

Injury prevention and rehab.
Gliding (eccentric) (tears usually in eccentric)
Copenhagen adductor exercise (isom ULeg, con. ecc. Lleg).

Question 8

Hamstring Strengthening

Answer 8

Nordic curls for injury prevention! 2-3 weeks, 2-3 sets, 6-10 reps with 2 min rest.
L-protocol for rehabilitation (early stage, quicker rehab):
- Extender (tensile stretching of hams, quads working) 2x day, every day, 3 x 12 reps.
- Diver (eccentric lengthening): 1x every other day, 3 x 4 reps.
- Glider (eccentric lengthening): 1x every 3rd day, 3 x 4 reps.

Question 9

Tendinopathy Exercises

Answer 9

Achilles: Eccentric calf raises (heel drops) can go up on uninjured.
Patella: Reverse nordic curl, single leg stand to sit (eccentric quads).
Gluteal: Single leg focus (runners). Side bridge to neutral. Side lying abd (focusing on eccentric)

Question 10

Exercise prescription during injury - Phase 1

Answer 10

Acute. Approx. 5 days, longer if severe injury. Inflammatory phase.
POLICE. PEACE and LOVE.

Question 11

Exercise prescription during injury - Phase 2

Answer 11

Mechanotherapy (increase tissue load tolerance), address biomechanics, unload injured tissue, maintain general condition.

Question 12

Exercise prescription during injury - Phase 3

Answer 12

Replicate sport specific demands (controlled hopping, throwing)
-> return to sport.

Question 13

Exercise prescription during injury - Phase 4

Answer 13

Prevent Re-injury