Locomotor: Sports Injuries Flashcards

1
Q

Describe the main features of a walking gait

Think in terms of phases, support and significant moments

A
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2
Q

Main differences between a running gait and a walking gait?

A
  • There is no duel support, instead this is replased by a float phase
  • Greater upper body movement
  • Faster velocity, shorter cycle time, greater stride
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3
Q

In children if they have been injured during activity and there was a popping sound what could this imply?

A

Apophyseal avulsion

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4
Q

What is apophyseal avulsion?

A

This is where a tendon of a child is overstrained. However usually the tendon is stronger than the apophysis hence it pulls of the boney structure (e.g. tuberosity) breaking the apophysis.

Usually occures acutely and accompanied by a “pop”

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5
Q

Treatment of apophyseal avulsion

A

Conservative:

Rest, protective weight bearing and stretching

Surgery rarely needed unless the displacement is extreme

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6
Q

What is apophysitis and what is the treatment?

A

A chronic injury injury of the apophysis due to overuse and stress

Treatment is conservative with activity modification, NSAIDs, rest and stretches

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7
Q

Three types of shoulder dislocation and the reasons they might occur

A
  1. Anterior to glenoid fossa, most common and occurs from sporting injuries
  2. Posterior is more uncommon and occurs from extreme muscle contraction during seizure or electrocution
  3. Inferior occurs from hyperabduction and only from high energy trauma making it extremely rare
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8
Q

Anterior shoulder dislocation presentation

A

Squared off shoulder and upper limb held in adduction and internal rotation

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9
Q

What is harder to spot in a radiograph:

Anterior or posterior dislocation

A

Posterior is harder to spot, it is often missed and a second view can be helpful

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10
Q

3 Injuries that can occur in an anterior shoulder dislocation?

A
  • Hills-Sachs lesion
  • Bankart lesion
  • Surrounding soft tissue injury

Hills Sachs - ping pong ball injury - golf ball - played on hills found in sachs

Bankart lesion - break of plate - break the bank steal the art

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11
Q

What is a Hills-Sachs lesion?

A

This is where the posterior humeral head gets a compression fracture form the glenoid rim

Think a ping pong ball being pushed. Remeber by ping pong ball = golf ball = played on hill and carried in sacks

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12
Q

What is a Bankart lesion?

A

This compliments the Hills-Sachs and is where the anterior rim of the glenoid fossa is ripped by the humeral head

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13
Q

Treatment of an accute shoulder injury?

A

The 3 Rs

  • Reduce
  • Restrict
  • Rehabilitate
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14
Q
  • Where is the meniscus
  • What is it made of
  • What does it look like
  • What are it’s functions?
A
  • They sit above the condyles of the tibia
  • Consists of tough fibrocartilage
  • Looks like two Cs facing eachother - Coco Chenel Logo
  • Functions are force transmissiona nd stability. Medial attaches to the MCL
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15
Q

What history and physical indications might suggest a meniscal tear?

A
  • Twisting injury
  • Slow onset of swelling (Immediate may indicate ACL/PCL)
  • Locking (if the knee can’t fully extend this could indicate a displaced meniscal tear preventing the joint from extending)
  • Clicking
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16
Q

Examination for a meniscal tear?

A
  • Localised joint line tenderness
  • Can try to pick up joint effusion (build up of fluid in the joint) with a sweep test (this is some physio thing where you stroke the knee or some shit)
  • MRI is the gold standard
17
Q

Meniscal tears management?

A

Conservative

  • Physio
  • NSAIDs

Surgical

  • Repair first (aim to put it back in it’s anatomical position and let it heal)
  • Consider partial removal if repair fails
  • Full removal is bad and results in 100% cahnce of arthritis after 20years. If full removal is nessecary can consider a transplant
18
Q
  • What does the LCL stand for?
  • Where is the LCL?
  • What are it’s functions?
A
  • Lateral Collateral ligament
  • Extra-capsular
  • Attaches at the lateral epicondyle of the femur and travel inferiorly to the lateral fibular
  • Resists varus forces to the knee
19
Q
  • What does the MCL stand for?
  • Where is the MCL?
  • What are it’s functions?
A
  • Medial Collateral ligament
  • Extra-capsular
  • Attaches a the medial epicondyle of the femur and travel inferiorly to the medial tibia
  • Resists valgus forces to the knee
20
Q
  • What does the PCL stand for?
  • Where is the PCL?
  • What are it’s functions?
A
  • Posterior cruciate ligament
  • Attaches from the medial condyle of the femur and travel posteriorly to the posterior of the tibia
  • Prevents posterior translation of the fibia against the femur e.g. sliding. Also prevents hyper extension of the knee
21
Q
  • What does the ACL stand for?
  • Where is the ACL?
  • What are it’s functions?
A
  • Anterior cruciate ligament
  • Intra-capsular
  • Attaches from the posterior of the lateral condyle of the femur and travel anteriorly to the anterior tibial plateau
  • Prevents anterior translation of the fibia against the femur e.g. slidng
22
Q

What are the cruciate ligaments?

A

The are ligamnets supporting the knee

23
Q

What is this abnormal movement of the knee joint?

A

Varus

24
Q

What is this abnormal movement of the knee joint?

A

Valgus

25
Q

What history and physcal presentations may indicate an ACL tear?

A
  • Common injury from non-contact twisting e.g. wearing studded boots
  • Acompanied by a pop
  • Very quick swelling as the crcuiate ligamnets have their own blood supply resulting in a haemarthrosis
  • Often occurs with a menical tear
26
Q

ACL tear test?

A

Lachman’s test

27
Q

What history and physcal presentations may indicate an PCL tear?

A
  • Less common than ACL
  • Direct blow to knee in flexion or forceful hyperflexion
  • Pop and swelling
28
Q

PCL tear tests?

A
  • Can look for tibial sag (tibia miving back into place could be mistaken for an ACL injury)
  • Can perform a quadracepts active test
29
Q

MCL tear history and physical presentations?

A
  • Valgus stress injury from contact/direct blow
  • Swelling less imediate that cruciate tears as it has no direct blood supply
  • Medial knee pain
30
Q

LCL tear history and physical presentations?

A
  • Varus stress injury from contact/direct blow
  • Swelling less imediate that cruciate tears as it has no direct blood supply
  • Lateral knee pain
  • Often accompanies PCL tear
31
Q

Furhter investigations of ligamnet tears?

A
  • Radiograph primarily - can identify associated fractures
  • Lead to MRI for further detail
32
Q

What is a shin splint?

A

Is a colloqual term used to refer to three different pathologies:

  1. Tibial stress syndrome
  2. Tibial stree fracture
  3. Exertional compartment syndrome
33
Q

What is tibial stress syndrome?

A

It is a traction periosteitis occuring at the point of muscle attachment on the tibia

Periosteitis is an inflamation of the periosteum

Reported as pain over the tibia worst following exercis

Common in runners and could lead to a stress fracture

34
Q

What is exertional compartment syndrome?

A

It is a reversable compartment syndrome of the muscle compartments lower leg

It is reported as a burning pain/ itching in the lower leg compartment

Common in runners/ soldiers

Treated with activity modification but can also perform a faciotomy