mt2 Flashcards
what are the internal factors of injury prevention that can decrease injury risk
screening
fitness and conditioning
what are the external factors of injury prevention that can decrease injury risk
environmental protective equipment
which types of screening would a kinesiologist do
medical history, wellness screening
what are the components of fitness most relevant for injury prevention
flexibility
plyometric ability
what is the FIFA 11+ dynamic warmup
protocol designed to reduce non contact soccer knee injuries
40% decrease of injuries in adolescent soccer
what must be checked for helmets
correct model for athlete’s head shape
check key points for correct size and fit
what is the effect of ankle braces
little to no negative impact on performance
much more support for longer compared to tape
what are knee braces
reduces the chance of ligament injuries.
neoprene sleeves do not provide any structural support
what are the phases of tissue response to injury
inflammatory/ acute
fibroblastic repair
maturation- remodelling
what are the signs of inflammation
SHARP
swelling
heat
altered function
redness
pain
describe the stages and goals of the inflammatory response phase
goals
-protect
-isolate
-decrease injurious agents
-prepare for repair
stages
-vasoconstriction, coagulation
-vasodilation or selling
-clot formation
what is the POLICE acronym
protection
optimal loading
ice
compression
elevation
what is the best method of icing
frozen water with crushed ice.
20min on and 1 hr off.
what are the sensations of ice application
cold pain
burning
aching
numbness
what are some reasons why someone should not ice
Raynaud’s syndrome
diabetes
recent surgery
sensitive skin
altered sensation
at what humidity is evaporation not effective as a means of heat loss
effective up to 65
doesn’t work past 75
when does mild dehydration occur
2% of body weight lost in fluid
what systems does being dehydrated impair
cardiovascular and thermoregulatory
what is the definition of exertional heat exhaustion
inability to sustain adequate cardiac output
due to inadequate fluid replacement
what is the second phase of tissue repair
fibroblastic repair phase
how long does the fibroblastic repair phase last
weeks
describe the fibroblastic repair phase
when collagen formation builds around injury forming scar tissue. too much scar tissue can prevent injury recovery
describe the third phase of tissue repair
maturation and remodelling
it can take years
the collagen laid down in fibroblastic repair is broken down and realigned based on the applied tensile force.
what factors can impede ligament
healing
chronic inflammation
- acute inflammatory phase lasting too long
- returning to acute inflammatory phase after disruption in early fibroblastic phase
how does ligament repair typically happen
repair involves laying down random strands of collagen that then realign in reaction to stresses
why would intraarticular tears take longer than normal ligament tears to heal.
synovial fluid dilutes hematoma and prevents clotting
how does skeletal muscle healing differ from ligament healing?
myoblastic cells form to regenerate myofibrils
describe the sequence of tendon repair
stage 1: tendon will stick to surrounding tissues
stage2: tendon will gradually separate becoming more mobile
stage3: tensile strength gradually returns
what are the stages of bone acute fracture healing
- hematoma in the cavity and surrounding tissue forms in the first 2 days
-osteoblasts fill the calluses to immobilize site
-calluses formed from bone fragments between the gap
-osteoblasts make the callus hard to replace soft cartilage callus
-bone adapts to stresses by regulating osteoblast and osteoclast activity
what factors can impede the healing of bone
poor blood supply and poor immobilization
what is foot pronation
eversion, dorsiflexion, abduction
what is foot supination
inversion, plantar flexion, adduction
what are the two phases of normal gait
stance (foot is on ground)
swing (foot in the air)
describe the connection between gait and foot pronation and supination
when the foot first touches down it is in supination then transitions into pronation at the mid stance to unlock mid foot and shock absorb. transitions back to provide rigid lever to push against
what is pes planus. what causes it and what are the signs and symptoms
flat foot.
excessive pronation
weak supporting structure (FHL, FDL, TP)
high impact activity
pain and weakness in a flat medial longitudinal arch
bulging navicular
how to manage pes planus
orthotics
arch taping
strengthen strengthen muscles
what is pes cavus, symptoms
it is a high arch foot.
high medial longitudial arch
bad shock absorption
heavy calluses on ball and heel of foot. pain in lower leg
why is excessive foot supination a bad thing
too rigid of a foot prevents proper shock absorption, reduces calcaneaocuboid mobility and also limits tibia internal rotation. this can have consequences up the kinetic chain
how to manage pes cavus
orthotics
release achilles/gastroc and plantar facia
what is plantar fasciitis. what can it be caused by, symptoms
pain in transverse arch and heel.
high stresses on fascia
sudden reduction in arch support
excessive pronation
increased pain in the first steps and dorsiflexion, toe extension
how to manage plantar fasciitis
soft orthotic,
arch taping, night splint
achilles/gastroc stretching
what is the common causes and signs of metatarsal stress fractures
usually second meta tarsal
called march fracture
sudden increase or change in running pattern
localized pain at rest especially after training
what is turf toe, what are the symptoms, management
great toe hyperextension
pain and swelling which increases during push off
taping, rest, increase shoe forefoot rigidity
what is sever’s disease, signs
agpophysitis of calcaneus
pain in posterior heel below achilles attachment
similar symptoms to plantar fasciitis
what static stability supports the lateral aspect of ankle
PTF (posterior talofibular) , CF(calcaneofibular) , ATF (anterior talofibular)
what static stability supports the medial
aspect of the ankle
deltoid ligament
what is the most stable and unstable position of the ankle
stable in dorsiflexion and least stable in plantar flexion.
what degrees of dorsiflexion and plantar flexion are required for normal gait
10 dorsiflexion
20 plantar flexion
what type of hinge joint is the ankle
stable
in an inversion sprain which ligament is most commonly injured
ATF.
what avulsion fractures can happen during an inversion sprain
lateral malleolus, base 5th mt
what is the Ottawa ankle rule
a field assessment to see if Xray is required
inability to bear weight for 4 steps
tenderness in inferior or posterior malleoli or mid foot.
tenderness at base of 5th mt or navicular
what is the difference in damage between a grade 2 and grade 3 inversion ankle sprain
grade 3 involves all 3 ligaments and can result in talocrucal subluxation
what type of fractures can accompany an eversion ankle sprain
fibula shearing
tibia avulsion
what is a syndesmotic sprain, mechanism, symptoms
a high ankle injury
forced rotation of leg in dorsiflexion
pain with weight bearing and dorsiflexion
structural vs functional instability
structural = ligament
function = skeletal muscle
what is achilles tendinopathy. Symptoms
achilles tendon and sheath inflammation causing fibrosis and scarring.
This causes restrictions in movement that manifest as pain and stiffness. crepitus in plantar flexion and dorsiflexion
achilles tendinopathy management
NSAIDS
reduce stressors
strengthening using eccentrics and isometrics
what is the positive Thompson test
also known as squeeze test,
test for achilles tendon rupture by squeezing gastroc to look for foot movement
what is MTSS
medial tibial stress syndrome also known as shin splints
what are the 4 stages of symptoms of MTSS
pain after activity
pain before and after activity and not affecting performance
pain before during and after activity affecting performance (high risk of tibial stress fracture )
pain preventing performance
what is the function of the ACL
restricts anterior translation and internal rotation of the tibia
what is knee valgum and varum
valgum is knees closer together
varum is knees farther apart
what ligaments would an knee brace be used to protect
MCL
ACL following sprain or surgery
what are the signs and symptoms of a grade2 MCL sprain
complete tear of deep capsular ligament. partial tear of MCL
laxity at 30 degrees of flexion
slight swelling
what are the signs and symptoms of a grade3 MCL sprain
complete loss of MCL stability
moderate swelling
hamstring guarding
positive valgus stress test
what causes LCL sprains
varus force
what usually causes ACL sprains
sudden deceleration with knee in extension and or knee valgus
what are the symptoms of an ACL sprain
pop with severe pain and disability
positive anterior drawer and Lachman’s sign (testing if tibia can slide forward)
rapid swelling at joint line
how does a PCL sprain typically occur
fall on bent knee. car crash dashboard injury
how do meniscus injuries typically happen
axial force, rotation and valgus force
what are some symptoms of meniscus injury
joint line pain
joint locking
pain squatting bellow 90
why do meniscus lesions usually result in surgery
poor circulation
joint locking
what kinesiologist management can be done for meniscal lesions
limit loaded movements past 90
strengthen knee extensors and flexors using open kinetic chain exercises
educate on jumping and landing technique
what is osgood-schlatter disease
apophysitis at the tibial tubercle
how to manage osgood-schlatter
reduce stressors
improve quad flexibility
how do most forearm fractures occur
FOOSH and direct blow
what is a colle’s fracture
FOOSH forces distal end of radius or ulna into posterior displacement
what is a Smith fracture
FOOSH forces distal end of radius or ulna into anterior displacement
what are the symptoms of a Colle’s fracture
dinner fork deformity
can include median nerve damage
what are the signs and symptoms of a lunate dislocation or subluxation
pain, swelling and difficulty executing wrist flexion
hypermobile lunate and unstable scaphoid lunate complex
what are the symptoms of a scaphoid fracture
pain with radial flexion, pain in anatomical snuff box
what is the management of a scaphoid fracture
xray
immobilization for 6 weeks then protection against impact loading for 3 more months.
usually unstable fractures will need surgery
How can a TFCC injury be aggravated
twist of wrist while in ulnar deviation
what is deQuervains’s
tendinopathy in extensor pollicis braves and abductor pollicis longus
who is more likely to have deQuervains’s
training with barbell frequently
what is mallet finger. symptoms, management
an avulsion injury to the finger extensor tendon at insertion.
unable to extend distal end of finger completely
police, splinting
what is jersey finger, symptoms, management
rupture of flexor digitorum profundus tendon from insertion on distal phalanx
finger cannot be completely flexed.
surgical repair
what is gamekeeper’s thumb? management?
sprain of UCL of MCP joint of thumb
imaging, splint, tape
what are the two common mechanisms of injury of finger dislocation
hyperextension
twisting in semi flexed postion
