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KIN 375 > MIDTERM > Flashcards

MIDTERM Flashcards

1
Q

Why is injury a part of athletics?

A

The health and safety of athletes should always be a high priority

Possessing knowledge on preventing or minimizing the risk for injury is important

Providing treatment outside of your scope of practice could have legal implications!

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2
Q

What is Sport Medicine?

A

Broad field of medical practices related to physical activity and sport

A multidisciplinary approach to health management or achievement of full potential

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3
Q

Sport medicine is typically classified as relating to?

A

performance enhancement or injury care and management

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4
Q

Main focus of Fitness Professional Roles?

A

improving performance

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5
Q

A higher level of fitness = ?

A

higher athletic performance & decreased risk for injury

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6
Q

Injury prevention is concerned with?

A

Both the performance enhancement & injury management side of the umbrella

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7
Q

Roles & Responsibilities of a Sport First Aider?

A

Injury Prevention

Management of Acute injuries

Referral

Record

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8
Q

Components of injury prevention?

A

Pre-Participation Screening (i.e. A medical with a doctor to check for underlying conditions)

Conditioning

Risk Factors for sport

Taping/Bracing

Protective Equipment

Having a plan (EAP)

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9
Q

What is Pre-participation Examination?

A

Initial pre-participation exam prior to start of practice is critical

Purpose is to identify athletes that may be at risk

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10
Q

Injury prevention should include? (Before they can play)

A

Medical history, physical exam (with doctor), orthopedic screening, wellness screening (mental health), concussion testing

Establishes a baseline (knowing what their strength was before injury)

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11
Q

What is conditioning?

A

Warm up

Cool Down

Demands of sport (ex aerobic? Anerobic? Upper? Lower?)

Risk Factors

Intrinsic/Extrinsic

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12
Q

What intrinsic risk factors?

A

Age

Sex

Body Composition

Health (Previous injuries) - Physical Fitness -(Muscle strength, flexibility, aerobic)

Anatomy

Skill Level

Psychological Factors

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13
Q

What is Extrinsic Risk Factors?

A

Sports Factors

Protective Equipment

Sports Equipment

Environment (ex. rainy and make turf slippery)

PP 1 SLIDE 13

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14
Q

What is taping?

A

Injury Prevention method

Athlete must have full range of motion and strength for tape to be applied

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15
Q

Most common joints taped?

A

Ankles

Wrists

Thumbs/fingers

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16
Q

Explain why protective equipment is important?

A

Selection, fitting and maintenance of protective equipment are critical in injury prevention

If equipment results in injury due to defect or inadequacy for intended use manufacturer is liable

If equipment is modified, the modifier becomes liable

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17
Q

Explain how helmets are tested to be of use?

A

Must be CSA tested

Not a warranty

Indicates that helmet met requirements of performance tests when manufactured/re-conditioned

Helmets should undergo regular recertification and reconditioning

Will allow equipment to meet necessary standards for multiple seasons

Follow manufacturer’s directions

Must routinely check fit (ex. haircut, kids are growing, etc.)

Certification is of no avail if helmet is not fit and maintained

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18
Q

WARNING ABOUT HELMETS:

A

Do not strike an opponent with any part of this helmet or face mask. This is a violation of football rules and may cause you to suffer severe brain or neck injury, including paralysis or death. Severe brain or neck injury may also occur accidentally while playing football. NO HELMET CAN PREVENT ALL SUCH INJURIES. USE THIS HELMET AT YOUR OWN RISK

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19
Q

Other Protective Equipment include?

A

Face Protection

Throat Protection

Mouth Guards

Ear Guards

Eye Protection

Neck Protection

Shoulder Pads

Sports Bras

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20
Q

Types of braces?

A

Off the shelf

Customized

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21
Q

What are off the shelf braces?

A

Pre-made and packaged

Can be used immediately

May pose problem relative to sizing (not specific to person just S, M, L)

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22
Q

What are customized braces?

A

Constructed according to the individual

Specifically sized and designed for protective and supportive needs

Very expensive (ex. knee brace is at least $1000)

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23
Q

Management of Acute Injuries acronym?

A

POLICE

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24
Q

What does POLICE stand for?

A

Protection

Optimal Loading

Ice (15-20 min)

Compression – the more the better

Elevation (right above heart) – the more the better

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25
Q

What is the record acronym?

A

SOAP note format

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26
Q

What does SOAP stand for?

A

S: Subjective (history of injury/illness)

O: Objective (information gathered during evaluation)

A: Assessment (opinion of injury based on information gained during evaluation)

P: Plan (short and long term goals of rehab)

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27
Q

How to write SOAP notes?

A

Add Tx after O.
Tx means treatment

Ask them to follow up with you

When typing:
Can have spaces and gaps
S:…
O…
Tx…

Blue or black pen if writing.
Don’t leave any blanks to let people write other things in. If there is spaces and gaps draw a line through. Ex. S:… O:…
Tx…

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28
Q

Define trauma?

A

physical injury or wound that is produced by an external or internal force

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29
Q

Define load?

A

external force or forces acting on internal tissue

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30
Q

Define stiffness?

A

ability of a tissue to resist a load

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31
Q

Define stress?

A

internal resistance to an external load

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32
Q

Define strain?

A

extent of deformation of tissue under loading

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33
Q

Define deformation?

A

change in shape of a tissue

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34
Q

Define elasticity?

A

property that allows a tissue to return to normal following deformation

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35
Q

Define yield point?

A

elastic limit of tissue

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36
Q

Define plastic?

A

deformation of tissues that exists after the load is removed

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37
Q

Define creep?

A

deformation of tissues that occurs with application of a constant load over time

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38
Q

Define mechanical failure?

A

exceeding the ability to withstand stress and strain, causing tissue to break down (when injury occurs)

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39
Q

What is injury?

A

external forces directed on the body that result in internal alteration in anatomical structures that are of sufficient magnitude to cause damage or destruction to that tissue

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40
Q

What is the stress/strain curve?

A

How much force vs how much strain

The stiffer, the more deformation

We want athletes to be flexible

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41
Q

Components of tissue loading?

A 
Compression
Tension
Shearing
Bending
Torsion
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42
Q

What is compression?

A

External loads applied toward one another in opposite directions

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43
Q

What is tension?

A

A force that pulls or stretches tissue. Equal and opposite external loads that pull a structure apart

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44
Q

What is shearing?

A

Equal but not directly opposite loads are applied to opposing surfaces to move in parallel directions relative to one another

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45
Q

What is bending?

A

4 point: two force pairs act at opposite ends of a structure

3 point: three forces cause bending (2 forces on same side and one force on the other side of bone)

When an already bowed structure is axially loaded

Ex. deadlifting can cause a disk injury

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46
Q

What is torsion?

A

Twisting in opposite directions from the opposite ends of a structure

Think of wringing out a dish cloth.

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47
Q

Types of Injuries? (2)

A

1) Acute or Traumatic Injuries: something initiated the injury process
E.g.: direct blow

2) Chronic or Overuse Injuries: when it doesn’t heal properly (sometimes athletes do not notice right away)
E.g.: repetitive dynamic use over time

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48
Q

Types of Musculoskeletal Structures?

A

Skeletal Muscle

Synovial joints

Bone

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49
Q

Components of Skeletal Muscle?

A

Tendon

Fascia

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50
Q

Types of Synovial joints?

A

Ligament
Bursa
Meniscus
Labrum

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51
Q

What is/what does Skeletal Muscle do?

A

Composed of contractile cells, called fibers

Produce movement

Have connective tissue covering

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52
Q

What are tendons?

A

Band of dense connective tissue that attaches a skeletal muscle to a bone

Usually cord-like, but occasionally broad/flat (aponeurosis)

Sometimes covered by a tendon sheath whose layers slide along each other as the tendon moves to decrease friction (ex. in wrist)

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53
Q

What is fascia?

A

Dense sheet of connective tissue that lines the body wall

In the limbs, fascia separates each region into compartments whose muscles tend to have similar actions and innervation

Around some joints, there are thickened bands of fascia called retinacula that help keep tendons anchored down

Ex. meat video when he pulls the meat around.

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54
Q

Types of muscular injuries?

A 
Strains
Cramps
Guarding
Spasm
Soreness
Tendinitis/Tendinosis
Tenosynovitis
Contusion
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55
Q

What are cramps?

A

involuntary muscle contractions (dehydration)

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56
Q

What is guarding?

A

muscle contraction in response to pain

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57
Q

What is a spasm?

A

reflex reaction caused by trauma

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58
Q

What is soreness?

A

caused by overexertion in exercise (ex: DOMS)

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59
Q

What is Tenosynovitis?

A

inflammation of a tendon and its synovial sheath

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60
Q

What is a contusion?

A

blunt force to an area

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61
Q

What are muscle strains?

A

Stretch, tear or rip to muscle or adjacent tissue

May range from minute separation of connective tissue to complete tendinous avulsion or muscle rupture

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62
Q

How many grades of muscle strain are there?

A

3

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63
Q

What is a grade I muscle strain?

A

some fibers have been stretched resulting in tenderness and pain

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64
Q

What is a grade II muscle strain?

A

number of fibers have been torn, usually a depression or divot is palpable, some swelling and discoloration result (1%-99% torn)

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65
Q

What is a grade III muscle strain?

A

Complete rupture of muscle or musculotendinous junction, significant impairment, with initially a great deal of pain that diminishes due to nerve damage

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66
Q

What is tendinitis?

A

Gradual onset, with diffuse tenderness due to repeated microtrauma and degenerative changes

Inflammation of the tendon

Obvious signs of swelling and pain (heat and redness)

Crepitus

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67
Q

What is crepitus?

A

Sticking of tendon due to accumulation of inflammatory by-products on irritated tissue (creaking sounds that occurs between tendon and inflammation)

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68
Q

What is tendinosis?

A

Without proper healing tendinitis may begin to degenerate and result in tendinosis

Less inflammation, more visibly swollen with stiffness and restricted motion

Sometimes a tender lump will appear (the frays of torn tendon)

Tendinopathy

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69
Q

What is tendionpathy?

A

refers to either tendinitis or tendinosis (something is going on with the tendon)

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70
Q

What are contusions?

A

a.k.a. bruise

Result of sudden blow to body

Hematoma results from blood and lymph flow into surrounding tissue

Chronically inflamed and contused tissue may result in generation of calcium deposits (myositis ossificans)

Prevention through protection of contused area with padding

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71
Q

What are synovial joints?

A

Highly movable joints

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72
Q

What are ligaments?

A

Thick band of dense connective tissue that is especially resistant to forces acting in a particular direction

Present in most synovial joints

Can be extracapsular (outside the articular capsule) or intracapsular (inside the articular capsule

They are non-contractile tissue, if contracted they will not go back to normal shape.

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73
Q

What is meniscus?

A

Pad of fibrocartilage between the articular surfaces that absorbs shock & increases the stability of the joint

Present in select synovial joints (e.g., knee joint- medial and lateral meniscus)

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74
Q

What is labrum?

A

Ring of fibrocartilage surrounding the “socket” of ball-and-socket joints that increases the stability of the joint

Present in the hip joint and shoulder joint

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75
Q

What is bursa?

A

Fluid-filled sac-like structure located between tissues (e.g., bones/ligaments, bones/tendons) to reduce friction

Present throughout the body

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76
Q

What types of joint injuries can occur?

A

Ligament Sprains
Dislocation and Subluxations
Osteoarthritis: wearing down of hyaline cartilage
Bursitis

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77
Q

What types of ligament sprains can occur?

A

Stretch, tear, or rip of ligament

Occurs when stress is applied to a joint that forces motion outside its normal limits

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78
Q

How many grades are in ligament sprains?

A

3

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79
Q

What is grade I ligament sprain?

A

some stretching of ligament fibers. Some pain, minimal loss of function, no abnormal motion, and mild point tenderness

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80
Q

What is grade II ligament sprain?

A

some tearing of ligament fibers. Pain, moderate loss of function, swelling, and instability with tearing and separation of ligament fibers (1%-99% torn)

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81
Q

What is grade III ligament sprain?

A

total tearing of the ligament. Extremely painful, inevitable loss of function, severe instability and swelling, and may also represent subluxation

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82
Q

What are dislocations?

A

Separation of bony articular surfaces

bone is forced out of alignment and stays out until it is manually or surgically reduced

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83
Q

What are subluxations?

A

Separation of bony articular surfaces

bone is forced out of alignment but goes back into place- some people are just more prone to this because of their anatomy

Should get some type of rehab so that this does not keep occurring and can strengthen the surrounding muscle.

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84
Q

What is bursitis?

A

Inflammation of a bursa- caused by impingement in area such acromial area

Can be acute or chronic

Ex. hit to area or gradual.

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85
Q

What is bone?

A

Contains osteocytes (bone cells) fixed in intercellular matrix

Outer surface is compact tissue, inner aspect is cancellous bone

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86
Q

Types of fractures?

A

Open fracture

Closed fracture

Greenstick fracture

Spiral fracture

Avulsion fracture

Comminuted fracture

Stress fracture

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87
Q

What is a Open fracture?

A

displacement of the fracture causes bone to break through tissues (painful for even things like wind hitting it because nerves are exposed)

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88
Q

What is a Closed fracture?

A

little movement or displacement, does not penetrate superficial tissue (need ends to touch so might use like screws to make ends touch using surgery)

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89
Q

What is a Greenstick fracture?

A

incomplete break in bones that have not completely ossified (typically in younger children who have more cartilage in their bones)

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90
Q

What is a Spiral fracture?

A

S-shaped separation (happens when one part of bone is planted and then spiral/twisting motion breaks bone)

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91
Q

What is an Avulsion fracture?

A

separation of bone fragment from its cortex at an attachment of a ligament or tendon

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92
Q

What is a Comminuted fracture?

A

three or more fragments at the fracture site (ex. car accident)

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93
Q

What is a Stress fracture?

A

Result from overuse

Commonly occur in weight-bearing bones of leg or foot

Pain usually begins as a dull ache that becomes progressively worse over time

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94
Q

List the components of the anatomical position?

A

Standing erect

Head level and eyes facing forward

Upper limbs at the sides of the body with palms turned forward

Feet are flat on the floor and feet are facing forward

95
Q

The three phases of the healing process?

A

Inflammatory response

Fibroblastic repair

Maturation-Remodeling phase

96
Q

What is the Inflammatory Response Phase?

A

Acute

0-5 days

Inflammation present to protect, localize, and rid the body of damaged tissue to prepare the next phase of healing
Critical to the entire healing process

If it does not accomplish what it is supposed to or it does not subside, normal healing cannot take place

97
Q

What are the Cardinal Signs of Inflammation? (SHARP)

A 
Swelling 
Heat- compare joints and see if there’s extra heat on a joint
Altered function
Redness
Pain
98
Q

What is the Fibroblastic Repair Phase?

A

Subacute

3-21 days

Healing and restoration of damaged tissue

Regenerative activity leading to scar formation

99
Q

What is the Maturation-Remodeling Phase?

A

15+ days

Strength of scar tissue continues to increase

May take 1 or more years to be 100%

Continual remodeling of new tissue in response to movement and body’s demand

Thickening and increased strength of tissues

100
Q

Factors that Impede Healing?

A

Extent of injury

Edema- thickened swelling

Hemorrhage

Poor Vascular Supply

Separation of Tissue

Muscle Spasm

Atrophy

Corticosteroids

Keloids and Hypertrophic Scars

Infection

Humidity, Climate, Oxygen Tension

Health, Age, and Nutrition

101
Q

Common Healing Time Frames?

A

Cartilage: limited, up to 18 months

Ligament: remodeling stage, up to 12 month

Grade 1: 7-14 days

Grade 2: 6-8 weeks

Grade 3: may require surgery

Tendon: 4-5 weeks

Muscle: 6-8 weeks

Bone: 3-8 weeks

102
Q

4 stages of bone healing?

A

Hematoma formation- blood accumulates creating the hematoma

Soft Callus- new blood vessels form and create mesh work, rejoins fractured bones together

Hard Callus- when the soft callus becomes the bony callus

Remodeling- bony callus is remodeled to create strong bone

103
Q

When to Splint?

A

Mechanism of injury could indicate a fracture

Audible “crack”

Severe pain

Inability to move joint/limb

Deformity present

104
Q

Types of Splints?

A

Vacuum

Air

SAM (ie soft splint)

Rigid (ie quick splint)

Traction

105
Q

Rules to splint long bones?

A

Immobilize around suspected fracture

Immobilize joint above

Immobilize joint below

106
Q

Rules to splint joints?

A

Immobilize bone segment above the injury

Immobilize bone segment below the injury

107
Q

Rules for splinting in general?

A

Dress any wounds prior to applying splint

Splint in position found

Splint prior to moving the athlete

Splint should not allow any movement of injured body part to move

108
Q

8 steps of the application of a splint?

A

1) Stabilize segment in position found
2) Check pulse, motor, sensation distal to injury
3) Gather appropriate material

4) Apply splint
Utilize padding if necessary
Minimal movement should occur during application

5) Recheck pulse, motor, sensation
6) Reassure athlete throughout application
7) Transportation
8) Follow up instructions

109
Q

See lecture 3 slides 20/21

A

.

110
Q

What are Therapeutic Modalities?

A 
An intervention that helps healing.
Examples: 
Ice
Heat
Massage
Interferential Current (feeling sensations rather than the pain)
Ultrasound
Muscle Stim
TENS
111
Q

Using Therapeutic Modalities?

A

Therapeutic modalities can be an effective adjunct to various techniques of therapeutic exercise.

Knowledge of the healing process is critical.

A variety of modalities can be utilized by sport first aiders, including: cryotherapy, and massage

112
Q

Classification of Therapeutic Modalities?

A

Thermal conductive energy.

Electrical energy.

Electromagnetic energy.

Sound energy.

Mechanical energy.
Energy can be absorbed, refracted, reflected, or transmitted.
Energy must be absorbed to produce physiological response.

113
Q

What is Thermotherapy?

A

Physiological effects of heat depend on type of heat energy applied, intensity of energy, duration of exposure, and tissue response.

Heat must be absorbed to increase molecular activity.

114
Q

Desired Effects of thermotherapy?

A

Increased collagen extensibility; decreased joint stiffness; reduce pain; relief from muscle spasm; reduction of edema and swelling; increased blood flow.

115
Q

Physiological Effects of Heat?

A

Increases extensibility of collagen

Pain relief

Muscle spasm

Assists with healing process

116
Q

What is pain relief in terms of Physiological Effects of Heat? (Gate control mechanism)

A

Activates gate control mechanism

Gate Control Mechanism:
The nervous system telling you that you have pain
Rubbing it has sensory nerves that go to the pain and it focuses on the rubbing.
So the brain feels sensation over pain

117
Q

What is muscle spasm in terms of Physiological Effects of Heat?

A

Increased blood flow reduces ischemia

118
Q

What is Assists with healing process in terms of Physiological Effects of Heat?

A

Raises tissue temperature, increases metabolism resulting in reduction of oxygen tension, lowering pH, increasing capillary permeability and releasing bradykinins and histamine resulting in vasodilation

Parasympathetic impulses stimulated by heat are also believed to be a reason for vasodilation

119
Q

Transmission of Thermal Energy happens by?

A

Conduction

Convection

Radiation

120
Q

What is conduction?

A

Heat is transferred from a warmer object to a cooler one.

Dependent on temperature and exposure time.

Temperatures of 116.6°F(47 °C) will cause tissue damage, and temperatures of 113° F (45 °C) should not be in contact with the skin longer than 30 minutes.

Examples include moist hot packs, paraffin, ice packs, and cold packs.

121
Q

What is convection?

A

Transfer of heat through movement of fluids or gases.

Temperature, speed of movement, and conductivity of the part impact heating.

Example: whirlpools.

122
Q

What is radiation?

A

Heating is transferred from one object through space to another object.

Examples: shortwave diathermy, infrared heating, and ultraviolet therapy.

123
Q

Heat treatment indications?

A

Subacute or chronic inflammatory conditions

Reduction of subacute or chronic pain

Subacute or chronic muscle spasm

Decreased range of motion

Hematoma resolution

Reduction of joint contractures (decreased ROM)

124
Q

Heat treatment contradictions?

A

*do not apply this modality

Acute injuries

Impaired circulation

Poor thermal regulation

Anesthetic areas

Abdomen or low back during pregnancy

125
Q

Heat treatment precautions?

A

*just be careful when applying modality

Areas of decreased sensation

Around the eyes or testicles

126
Q

Equipment for Hydrocollator Packs?

A

Silicate gel pads submersed in 72-77oC (160-170o F) water

Maintains heat for 20-30 minutes; must use 6 layers of terry cloth to protect skin

127
Q

Indications for Hydrocollator Packs?

A

Used for general muscle relaxation and reduction of pain-spasm-ischemia-hypoxia-pain cycle

Limitation - unable to heat deeper tissues effectively

128
Q

Application for Hydrocollator Packs?

A

Pack removed from water; covered w/ 6 layers of toweling which are removed as cooling occurs; area treated for 15-20 minutes

Athlete must be comfortable and should not lay on pack

129
Q

Equipment for Whirlpool Bath?

A

Varying sizes used to treat a variety of body parts

Tank w/ turbine that regulates flow
Agitation (amount of movement) is controlled by air emitted from pump

130
Q

Indications for Whirlpool Bath?

A

Combination of massage and water immersion

Provides conduction and convection

Swelling, muscle spasm and pain

131
Q

Application for Whirlpool Bath?

A

Temperature is set according to treatment goals

Athlete should be set up to be reached by agitator (8-12” from agitator)
Do not place directly on injured site

132
Q

Special considerations for Whirlpool Bath?

A

Must be careful with full-body immersion

Proper maintenance is necessary to avoid infection

As volume of body part immersion increases, temperature should decrease.
Safety is a major concern
-Electrical outlets

Contraindicated for acute injuries due to gravity dependent position

133
Q

What is cryotherapy?

A

Used in first aid treatment of trauma to the musculoskeletal system

When applied intermittently w/ compression, rest and elevation it reduces many adverse conditions related to inflammation and the reactive phase of an acute injury

134
Q

Cryotherapy relies on? & why?

A

Conduction

Degree of cooling depends on the medium, length of exposure, and conductivity.

At a temperature of 38.3°F (3.5°C) muscle temperature can be reduced as deep as 4cm.

Tissues with a high water content are excellent conductors.

Most common means of cold therapy are ice packs and ice immersion.

Wet ice is a more effective coolant due to the energy required to melt ice.

  • Hunting response.
  • Measured temperature change.
  • Does not represent a change in circulation.
135
Q

Physiological Effects of Cold? (6)

A

Vasoconstriction

Blood viscosity

Decreases extent of hypoxic injury to cells

Decreases metabolic rate and vasoconstriction decreases swelling associated w/ inflammatory response

Decreases free nerve ending excitability and peripheral nerve.

Decreases muscle spasm.

136
Q

What is Vasoconstriction?

A

Reflex action of smooth muscle due to sympathetic nervous system and adrenal medulla

137
Q

What is Blood viscosity?

A

Increases with extended cooling

138
Q

What is Decreases extent of hypoxic injury to cells?

A

Decreases cell metabolic rate and the need for oxygen through circulation, resulting in less tissue damage

139
Q

What is Decreases free nerve ending excitability and peripheral nerve?

A

Analgesia caused by raising nerve threshold.

140
Q

What is Decreases muscle spasm?

A

Muscle becomes more amenable to stretch as a result of decreased GTO and muscle spindle activity

141
Q

Cold treatment indications?

A

Acute injury or inflammation

Acute, chronic, or postsurgical pain

Prevent edema formation

142
Q

Cold treatment Contraindications?

A

Circulatory insufficiency

Cold hypersensitivity/hives

Anesthetic skin

Open wounds

143
Q

Cold treatment precautions?

A

Over the carotid sinus

Over areas of infection

Near the eyes

Over superficial nerves

*Never want to put ice on both sides of neck because it can cause issues with brain function (carotid arteries)
Don’t want to freeze fluid in eye
Dont want to freeze nerves

144
Q

Expected Sensations of Cold Treatment?

A

Stage, Response, Estimated Time after Initiation:

Stage: 1
Cold Sensation
0-3 minutes

Stage: 2
Mild burning, aching
2-7 minutes

Stage: 3
Relative cutaneous numbness
5-12 minutes

145
Q

Equipment for Ice Massage?

A

Foam cup with frozen water - creating a cylinder of ice (towel will be required to absorb water)

146
Q

Indications for Ice Massage?

A

Used over small muscle areas (tendons, belly of muscle, bursa, trigger points)

147
Q

Application for Ice Massage?

A

Ice is rubbed over skin in overlapping circles (10-15 cm diameters) for 5-10 minutes

Patient should experience sensations of cold, burning, aching, & numbness: when analgesia is reached the treatment is finished

148
Q

Special considerations for Ice Massage?

A

Communication with patient is key!

149
Q

Equipment for Ice Water Immersion?

A

Variety of basins or containers can be used, small whirlpool

Temperature should be 10-16oC (50-60 o F)

150
Q

Indications for Ice Water Immersion?

A

Circumferential cooling of a body part

151
Q

Application for Ice Water Immersion?

A

Patient immerses body part in water and goes through three stages of cold response
Treatment may last 10-15 minutes

Once numb, body part is removed

152
Q

Special considerations for Ice Water Immersion?

A

Cold treatment makes collagen brittle – must be cautious with return to activity following icing

Be aware of allergic reactions and overcooling

153
Q

Equipment for Ice Packs?

A

Wet ice (flaked ice in wet towel)

Crushed or chipped ice in self sealing bag

Chemical Cold packs

Gel pack

Liquid pack

154
Q

Application for Ice Packs?

A

Ice is applied to body part, wrap with flexiwrap or tensor to hold in place and to add compression

Treatment may last 15-20 minutes

Once numb, ice bag is removed

155
Q

Special considerations for Ice Packs?

A

Avoid excessive cold exposure

With any indication of allergy or abnormal pain, treatment should be stopped

When using gel packs, a single layer of toweling should be used

Crushed or flaked ice can be directly applied to skin

156
Q

What is a massage?

A

Systematic manipulation of soft tissue.

157
Q

Therapeutic effects of a massage?

A

Mechanical responses

Occur as a direct result of pressures and movements.

Encourages venous flow and mild stretching of superficial tissue

158
Q

Physiological Responses of Massage?

A

Increases circulation

Reflex effect

159
Q

What is increase in circulation?

A

removal of metabolites, overcoming venostasis

Increased circulation through reflexive and mechanical stimuli

Capillary dilation, stimulation of cell metabolism, decreasing toxins, and increase lymphatic and venous circulation

160
Q

What is the reflex effect?

A

Relaxation can be induced by slow superficial stroking of skin

Stimulation achieved by quick brisk strokes, causing contraction of tissue

Primarily psychological impacts

161
Q

Massage treatment indications?

A

Improve circulation

Chronic conditions

Musculotendinous adhesions

Trigger points

Edema reduction

Post event recovery

162
Q

Massage treatment contradictions?

A

Acute injury or inflammation

Open wounds

Anesthetic skin

Skin conditions/infected areas

Varicose veins or hematoma

Allergies to massage cream

Prior to sporting event!!

163
Q

What is effleurage?

A

Stroking divided into light and deep.

Can be used as a sedative or to move fluids.

Multiple stroking variations exist.

Pressure variations.

164
Q

What is petrissage?

A

Kneading.

Involves picking up skin between thumb and forefinger and rolling and twisting in opposite directions.

Used for deep tissue work.

165
Q

What is friction?

A

Used around joints and in areas where tissue is thin.

Areas with underlying scarring, adhesions, spasms, and fascia.

Goal is to stretch underlying tissue, develop friction, and increase circulation.

Movement is across the grain of the affected tissue.

Avoid treatment with acute injuries.

166
Q

Components of tapotement?

A

Cupping

Hacking

Pinching

167
Q

What is cupping?

A

Produces invigorating and stimulating sensation.

Series of percussion movements rapidly duplicated at a constant tempo.

168
Q

What is hacking?

A

Used to treat heavy muscle areas; similar to cupping.

169
Q

What is pinching?

A

Lifting of small amounts of tissue between thumb and first finger in quick and gentle pinching movements.

170
Q

Components of sport massage?

A

Usually confined to a specific area

Massage lubricants

Positioning of athlete

Exhibit confidence

Develop confident, gentle approach to massage

Stroke towards heart to enhance lymphatic and venous drainage

Superficial->Deep->Superficial

Proximal ->Distal -> Proximal

171
Q

What is Sport Massage: Usually confined to a specific area?

A

Rarely given to full body: full-body massage is time consuming, generally not feasible.

Five-minute treatment can be effective.

172
Q

What is Sport Massage: Massage lubricants?

A

Enables hands to slide and move easily over body, reducing friction. Rubbing dry area can irritate skin.

Mediums include: powder, lotion, oil liniments.

173
Q

What is Sport Massage: Positioning of athlete?

A

Area must be easily accessible and must be relaxed. (ex. prop up on pillow)

174
Q

What is Sport Massage:

A

Good body positioning (clinician and athlete) and develop good technique

175
Q

How to Ensure Privacy and Integrity?

A

Due to direct physical contact, professionalism must be maintained at all times.

Critical when dealing with patient of opposite sex.

Be sure that area being treated is the only area exposed.

An additional athlete or colleague should also be present.

Record any therapeutic modalities administered in your SOAP notes.

176
Q

The Sequence of Prevention Model?

A
  1. What is the injury problem?
  2. What are the risk factors?
  3. Introduce preventative measure(s)
  4. Evaluate preventative measure(s)
177
Q

What is 1. What is the injury problem?

A

Understand the common injuries that occur in your sport, age, gender

About 60-70% of sport-related injuries are in the lower extremity

178
Q

What is 2. What are the risk factors?

A

Intrinsic

Extrinsic

Modifiable

Non-modifiable

179
Q

What is 3. Introduce Preventative Measures?

A

Sport Specific

Venue/Environment

Athlete Specific

Coaching Specific

Specific to Mechanism of Injury

180
Q

What is Neuromuscular Training?

A

Exercises that train the nervous and muscular systems to work together to produce optimal muscle activation patterns.

181
Q

Neuromuscular Training is needed to?

A

Support dynamic joint stability

Decrease joint forces

Improve motor programming

Improve movement patterns

182
Q

What is NMT (Neuromuscular Training) Exercises?

A

Bodyweight

Partner-resistance

Little to no equipment
Controlled

Focus on correct technique – Movement quality over quantity

Long-term outcome: Building joint resiliency over time if done consistently

183
Q

Components of NMT?

A

Aerobic

Balance

Strength

Agility

184
Q

What are Aerobic Exercises?

A

Jogging

Side shuffles

Kaeroke/Grapevine

High knees

Heel kicks

Skipping (forward, backward, sideways)

185
Q

What are balance exercises?

A

Single leg balance

Hard floor –> foam pad

Hands on hips –> ball tosses (or sport specific equipment)

Eyes open –> eyes closed

RDL’s/airplanes

Partner taps

186
Q

What are strength exercises?

A 
-Planks
Front
Side
Side with rotations
Plank taps
Leg lifts

-Lunges
Forward
Backward
Side lunges

-Nordic Hamstring Curls

187
Q

What are agility exercises?

A

Starts and Stops

Zig Zag Running

Change of direction

Jumping

Single leg hops

188
Q

What are the NMT Principles?

A

Monitor technique!!

Be sport specific

Perform regularly

Different anatomical planes

Use progressions and regressions

189
Q

What are 4. Evaluate Preventative Measures?

A

Injury tracking

Improved skill

Improved performance

190
Q

Functions of the foot?

A

Absorbs force

Acts as a stable base of support

191
Q

How many bones does the foot contain?

A

26

Seven tarsals
Five metatarsals
Fourteen phalangeal bones

192
Q

Bones of foot are held together by?

A

ligaments and fascia

193
Q

What is the Talus and Calcaneus?

A

Tarsal bones that form the ankle

Talocrural joint

194
Q

What forms the instep of the foot?

A

Navicular, cuboid, and three cuneiforms bones

195
Q

3 bones that make the talocrual joint?

A

Tibia (border, medial malleolus)

Fibula (head, lateral malleolus)

Talus (dome)

196
Q

What do arches in the foot do?

A

Assist the foot in supporting the bodyweight and absorb shock of weight bearing

197
Q

What is the Metatarsal arch?

A

Stretches from the first to the fifth metatarsal

198
Q

What is the Transverse arch?

A

Extends across the transverse tarsal bones

199
Q

What is the Medial longitudinal arch?

A

Originates along the medial border of the calcaneus

Extends forward to the distal head of the first metatarsal

Typically biggest arch

200
Q

What is the Lateral longitudinal arch?

A

Follows the same pattern as the medial longitudinal arch

201
Q

What is the Plantar fascia (plantar aponeurosis)?

A

Thick white band of fibrous tissue originating from the medial aspect of the calcaneus at the distal end of the metatarsals

202
Q

Ligaments in ankle?

A

Deltoid Ligament- medial ankle sprain

Anterior Inferior Tibiofibular Ligament (AITF)-high ankle sprain

Anterior Talofibular Ligament (ATF)

Calcaneofibular Ligament (CF)

Posterior Talofibular Ligament (PTF)

203
Q

Anterior Compartment (dorsiflexion)?

A

Tibalis Anterior

Extensor Hallucis Longus (EHL)

Extensor Digitorum Longus (EDL)

Peroneus Tertius

204
Q

Posterior Compartment (plantarflexion)?

A

Gastrocnemius

Soleus

Achilles Tendon

205
Q

Deep Posterior Compartment (inversion/little plantarfelxion)?

A

Tibialis Posterior

Flexor Digitorum Longus (FDL)

Flexor Hallucis Longus (FHL)

206
Q

Lateral Compartment (eversion)?

A

Peroneus Brevis

Peroneus Longus

207
Q

Specific foot & ankle questions? (History)

A

Were you wearing a brace or tape during time of injury?

Training surfaces or changes in footwear?

Changes in training, volume or type?

Does footwear increase discomfort?

208
Q

Specific foot & ankle questions? (Observations)

A

Thickening of Achilles

Watch gait, are they limping?

Is there pes planus (flat arch)/cavus (high arch)?- balance on one foot test

Are there structural deformities?

Look at shoe wear patterns on older shoe

209
Q

Ankle Palpation: Pulses?

A

Dorsalis Pedis Pulse: between extensor digitorum and hallucis longus tendons

Posterior Tibial Pulse: behind medial malleolus along Achilles tendon

210
Q

Range of Motion in ankle?

A

Plantarflexion
Occurs at the talocrural joint

Dorsiflexion
Occurs at the talocrural joint

Inversion
Occurs at the subtalar joint

Eversion
Occurs at the subtalar joint

Supination
Combination of Inversion of heel, adduction or forefoot, and plantarflexion

Pronation
Combination of eversion of the heel, abduction of the forefoot, dorsiflexion

211
Q

Common Injuries in the ankle?

A

Ankle Sprains

  • Inversion
  • Eversion

Syndesmotic (high ankle)

Muscle Strains

Fractures

Achilles Tendon Rupture

Medial Tibial Stress Syndrome (Shin Splints)

Achilles Tendinitis

Plantar Fasciitis

212
Q

Knee is known as?

A

Commonly considered a hinge joint because it’s principle movements are flexion and extension

Not a true hinge joint because of the rotation that occurs at the tibia

213
Q

Stability in knee depends on?

A

ligaments, joint capsule, and muscles surrounding the joint

214
Q

Knee Provides stability in?

A

weight bearing and mobility in locomotion

215
Q

Knee Consists of four bones?

A

Femur: lateral and medial femoral condyles
Tibia: plateau, tuberosity, shaft/crest
Patella: superior, medial & lateral borders
Fibula: fibular head/neck, shaft

216
Q

What types bursae are there?

A 
Prepatellar
Suprapatellar
Intrapatellar
-Deep
-Superficial
217
Q

Specific knee questions? (History)

A

Did your knee collapse?

Did you knee lock up?

Did swelling occur?

Does your knee give way?

218
Q

Specific knee questions? (Observations)

A

Watch gait, are they limping?

Genu valgum and genu varum

Hyperextension and hyperflexion

Patella alta and baja

Do the knees look symmetrical? Is there obvious swelling? Atrophy?

219
Q

Range of Motion in the knee?

A

Flexion

Extension

Internal Rotation

External Rotation

220
Q

Common injuries in the knee?

A

Ligament Sprains

  • MCL
  • LCL
  • ACL
  • PCL

Muscle Strains

Meniscus Tear

Bursitis

Patella Dislocation/Subluxations

Patellar Tendinitis

221
Q

Anterior portion of hip?

A

Iliopsoas

Rectus femoris

Sartorius

222
Q

Posterior portion of hip?

A

Gluteus (maximus, medius, minimus)

Hamstrings (Biceps femoris, Semitendinosus, Semimembranosus)

223
Q

Medial portion of hip?

A

Adductors (brevis, longus, magnus)

Pectineus

Gracilis

224
Q

Lateral portion of hip?

A

Tensor fascia latae

Iliotibial band

225
Q

Deep portion of hip?

A

Piriformis

Quadratus Femoris

Obturator Internus

Obturator Externus

Gemellus Superior

Gemellus Inferior

226
Q

Specific hip & pelvis questions? (History)

A

Snapping/Popping?

Clicking?

227
Q

Specific hip & pelvis questions? (Observations)

A

Pelvis anterior or posterior tilted?

PSIS, ASIS, iliac crest levels

Standing on 1 leg

Internal or External rotation

228
Q

Range of Motion in hip?

A

Flexion

Extension

Abduction

Adduction

Internal Rotation

External Rotation

229
Q

Common injuries in hip?

A

Groin Strain (adductor or hip flexor)

Dislocated Hip

Hip Labral tear

Sciatica/Piriformis Syndrome

Hip Pointer (contusion)

230
Q

Joints in the shoulder?

A

Sternoclavicular joint (SC)

Acromioclavicular joint (AC)

Coracoclavicular joint (CC ligaments – trapezoid and conoid, coracoacromial)

Glenohumeral joint (GH)

231
Q

Specific shoulder questions? (History)

A

Crepitus, numbness, distortion in temperature?

Clicking or grinding?

What provides relief?

232
Q

Specific shoulder questions? (Observations)

A

Rounded shoulders

Kyphotic T-Spine

Acromion Processes

Clavicles

Scapulae (elevated, rotated, winged)

Scapulohumeral rhythm

233
Q

Range of Motion in shoulder?

A

Flexion

Extension

Abduction

Adduction

Horizontal Adduction

Horizontal Abduction

Internal Rotation

  • 0 degrees
  • 90 degrees

External Rotation

  • 0 degrees
  • 90 degrees
234
Q

Common injuries in shoulder?

A

Fractures

  • Clavicle
  • Scapula
  • Humerus

AC joint Sprain

Shoulder subluxation or dislocation

Labral tear

Impingement

Bursitis

Bicep Tendinitis

KIN 375 (1 decks)

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