Midterm Flashcards
athletic therapy vs. physiotherapy
athletic therapists:
- specialize in MSK disorder, orthopaedic injuries, and on field emergency care
- usually for athletes and sports injuries
physios:
- learn MSK disorders but also study other areas
what are athletic therapists responsible for?
- injury prevention
- clinical evalutation
- rehab
- emergency care
- conditioning
- applying protective equipment
unexposed injuries
any condition that does not break the skin
compression injuries
can include:
- contusion
- strains
- sprains
- bursitis
- tendinopathy
- dislocations
contusion
direct blow that causes damage to tissues
myositis ossificans
pieces of calcium that form in the muscle if there are repeated blows to the same area
strains
can be from micro or macrotrauma
sprains
a twist or excessive stress that results in stretching or tearing of stabilizing connective tissues
bursitis
inflammation of the fluid filled sacs at the sites of bony prominences between muscle and tendon
tendinopathy
overuse of tendon (tendinitis or tendinosis)
tendinitis
inflammation of a tendon caused by overuse or repetitive motions
tendinosis
degradation of the tendon without inflammation
tenosynovitis
inflammation of tendon and its synovial sheath
dislocation
from forces causing the joint to go beyond its normal limit
exposed injury
any condition that goes outside the skin and exposes underlying tissues
- abrasions
- lacerations
- punctures
fractures
interruptions of bone continuity
- simple
- compound
- green stick
- stress
- comminuted
simple fracture
no or little displacement of bones
compound fracture
enough displacement that bone breaks through skin
green stick fracture
incomplete break in bone that is not ossified (children)
stress fracture
added stress out on the bone before it can adequately respond (too much training)
comminuted fracture
3 or more fragments
when to tape
- injury prevention
- acute injury management
- return to activity
ankle injuries account for ___% of all emergency room load
12%
ankle sprains comprise ~ ___% of all sports injuries
14%
___% of ankle sprains are of the lateral ligaments. why?
95%
- lateral malleolus extends further down than medial
- stronger medial ligaments
- talus is narrow posteriorly
degrees of ankle sprains
grade 1:
- ligaments stretch
grade 2:
- ligamanets tear slightly
grade 3:
ligaments completely tear
ankle treatment
- P.I.E.R
- R. I. C. E
- ankle rehab
- x-ray
when to x-ray an ankle injury?
inability to weight bare and walk for 4 steps
ankle injury prevention
- proper footwear
- taping
- surface conditions
- strengthening and flexibility
dorsiflexion sprain
high ankle sprain
eversion
tenderness between tibia and fibula
dorsiflexion sprain treatment
- taping to prevent dorsiflexion
- heel lift
- casting or surgery
ankle rehabilitation stages
stage 1:
- PIER or RICE
- control swelling and pain
stage 2:
- PIER or RICE
- moist heat
- restore ROM
stage 3:
- tape
- functional exercise
- continue first 2 stages
achilles injuries
- achilles tendinitis
- achilles tendinosis
- achilles tenosynovitis
achilles tendinosis vs. tendinitis vs. tenosynovitis
tendinitis:
- inflammation where the achilles tendon becomes filled with inflamed cells
tendinosis:
- no evidence of inflammation. degeneration
tenosynovitis:
- occurs in achilles tendon sheath
achilles tendonitis eccentric loading routine
- warmup tendon
- achilles stretching
- drop and stop exercises
- repeat stretches
- ice to cool down
achilles rupture
thompson test:
- used to determine if achilles is ruptured
- squeezing calf muscle to see if heel moves
exercise-induced leg pain
- medial tibial stress syndrome
- stress fractures
- compartment syndrome
medial tibial stress syndrome
irritation of the tibia at points where the soles and tibialis posterior attach to it
caused by overuse in runners and those who run on heard surfaces
stress fractures
- excessive pronation
- poor running shoes
compartment syndrome
- increased pressure in muscle
- can cause necrosis if not treated promptly
- need fasciotomy
factors in injury prevention
- reduction in force
- strength of body parts
- screening of participants
reduction of force
- good equipment
- taping
- good technique
- rules to prevent force
- safe facilities
- balanced opponents
strengthening body parts
- minimizes injuries
- ensure no muscle imbalance
screening of participants
- physical exam
- medical history
- lifestyle
controversy on icing
- can decrease the activity of fibroblasts which are cells that help build and repair tissues
- reduction in activity in these cells may inhibit the body’s ability to properly heal
effects of acute icing
- decrease pain
- decrease muscle spasm
- decrease metabolism
- decrease circulation
pain control with ice
- 10 mins of cold application can decrease the excitability of the free nerve ending and peripheral nerve
- must use caution due to loss of pain sensitivity
cold and metabolism
- cold slows metabolism in areas and decreases waste products that accumulate
- leads to less cellular damage due to secondary tissue hypoxia
secondary tissue hypoxia
-reflex vascular spasm due to trauma can result in decreased O2 to cells in injured area
- cells then die
- cold decreases metabolic rate and aerobic needs and reduces cell death
cold and circulation
- in first 10 mins, cold causes vasoconstriction and then a cyclic pattern of vasodilation and vasoconstriction (hunting repsonse)
- decreased bleeding into injured tissues and decreased inflammation
cold plunge claims
- reduced inflammation
- boost immunity
- alleviate depression and anxiety
- changes in hormones lasting hours
concussion definition
sport-related concussion is a traumatic brain injury caused by direct blow to the head, neck, or body resulting in an impulsive force being transmitted to the brain
concussion mechanisms
1) direct
- blow causing direct trauma to the brain
2) indirect
- trauma of the head/neck causes the brain to move and hit the walls of the skull (i.e. whiplash)
concussion return to play protocol
- symptom limited activity
- light aerobic activity to increase heart rate 35%
- sport specific activity with no impact
- no contact training
- full contact after medical clearance
- game play
concussion risks
- intracranial bleed
- subdural hematoma (slow)
- epidural hematoma (fast)
- life threatening
- secondary impact syndrome
- fatal brain swelling following minor head contact
- occurs in those who had symptoms of previous concussion
- chronic traumatic encephalopathy
- progressive degenerative disease of brain in those with repeated head trauam
- memory loss, confusion, impaired judgement, aggression, etc.
medial meniscus is affect in ___% of meniscus injuries. why?
medial
medial is not as mobile as the lateral and medial attaches to the MCL
function of meniscus
- mechanical spacers that contribute to joint stability
- increase surface area contact on knee by 1/3
- shock absorption
- assist nutrition in the joint
- help locking mechanism
cause of meniscus tears
- twisting
- direct hit to knee
osteochondritis dissecans
when you get a joint mouse (piece of cartilage or bone torn off from the main body which floats around)
ACL Sprain/Tear
ACL keeps knee stable by preventing the tibia from sliding forward
caused by:
- direct blow posteriorly to femur
- plant and twist
- over flexion
PCL sprain/tear
PCL connects the anterior part of femur to the posterior part of tibia
ACL/PCL tear tests
Lachmen and drawer test
unhappy triad
tear of the:
- medial collateral ligament
- medial meniscus
- ACL
Medial collateral ligament injury
- direct blow to lateral part of knee
- or twist of knee
Lateral collateral ligament injury
- direct blow to medial part of knee
- or twist
MCL/LCL test
Valgus test
patella dislocation
apprehension test
patellofemoral pain
- caused by degenerative arthritis or patella femoral stress syndrome
- abnormal patella tracking in femoral groove
- Q angle > 20 degrees
- patellar compression test
normal Q angle
males = 10
females = 15
anatomical and hormonal factors on knee injuries
- intercondylar notch size
- pelvis size
- ligament laxity
- reflex time
- quads/hams strength ratio
- hormones
