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Ortho II > Ortho II: Knee (Tendinopathy, ITB syndrome, Overuse) > Flashcards

Ortho II: Knee (Tendinopathy, ITB syndrome, Overuse) Flashcards

1
Q

What sports is patellar tendinopathy most common in?
-4 things

A

Basketball
Volleyball
Long jump
High jump

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2
Q

How long are athletes with patellar tendinopathy often unable to play?

A

> 3 months

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3
Q

What factors are associated with increased risk of patellar tendinopathy?
-4 things

A

Decreased eccentric quad strength
Decreased quad and hamstring flexibility
Increased foot pronation velocity
Excessive training volume

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4
Q

How does Leadbetters principle of transition relate to patellar tendinopathy?

A

Doing too much too quick without gradual progression leads to increased risk of patellar tendinopathy

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5
Q

What is used as a questionnaire to assess for overuse?

A

VISA score

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6
Q

What should be assessed during observation if patellar tendinopathy is suspected?
-4 things

A

Foot type
Muscle symmetry
Tendon thickness
Movement patters

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7
Q

What should be palpated if patellar tendinopathy is suspected?

A

Inferior patellar pole

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8
Q

What is an excellent functional movement test to assess for patellar tendinopathy?

A

Decline squat test

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9
Q

What is the decline squat test?

A

Single leg quat with foot on decine
Positive test if tendon pain

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10
Q

What did Curwin and Stannish find in 1984 as effective treatment for patellar tendinopathy?

A

Drop squats

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11
Q

What is the Alfredson Protocol used for?

A

Patellar tendinopathy

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12
Q

What are the guidelines of the Alfredson Protocol?

A

Eccentric training at 4/10 pain
3x15 reps
2x/day
7 days/week
12 weeks

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13
Q

What are the most common factors of successful patellar tendinopathy rehab?
-3 things

A

Decline squats
Eccentric training
Time away from sport

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14
Q

Why are eccentric exercises effective at treating patellar tendinopathy?
-3 things

A

Increased type 1 collagen content
Increased tendon stiffness
Decreased neovascualrity

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15
Q

Why are decline squats effective at treating patellar tendinopathy?
-3 things

A

Increase in patellar tendon force
Increase in patellar tendon strain
Increase in quad recruitment

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16
Q

What type of mobility exercises are effective for treating patellar tendinopathy?

A

Stretching of hamstrings and quads

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17
Q

What is the general guidelines for Phase 1 of Patellar Tendinopathy rehab?

A

Isometrics to reduce pain

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18
Q

How should isometric exercises be implement in Phase 1 of patellar tendinopathy rehab?
-2 things

A

Build up to 45 second reps for 5 reps
Do it 4-5 times per day

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19
Q

What is the general guidelines for Phase 2 of Patellar tendinopathy rehab?

A

Slow heavy load, ease into compression zone

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20
Q

When should Phase 2 of patellar tendinopathy rehab begin?
-2 things

A

Pain is stable on morning test
Pain is settled from peak

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21
Q

How should exercises be implemented in Phase 2 of patellar tendinopathy rehab?
-4 things

A

4 x 6-8 reps
Slow
Heavy
Single leg eccentric, Double leg concentric

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22
Q

What are some consideration for Phase 2 of patellar tendinopathy rehab?
-3 things

A

Avoid compressive loads
Avoid speed
Encourage evening to avoid leg fatigue during day

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23
Q

What is the general guideline for Phase 3 of patellar tendinopathy rehab?

A

Power

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24
Q

When should Phase 3 of patellar tendinopathy rehab begin?

A

Pain is stable on morning test
Symmetry in muscle bulk
Good strength

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25
What are some measures that would indicate good strength to begin Phase 3 of patellar tendinopathy rehab? -3 things
25 single leg raises 1.5 x BW on leg press Addressed deficits
26
How should exercises be implemented for Phase 3 of patellar tendinopathy rehab? -3 things
Every 2-3 days Assess response Consider neural reprogramming
27
What is an important consideration when beginning Phase 3 of patellar tendinopathy rehab?
Only add/change one thing at a time
28
What is the general guideline for Phase 4 of patellar tendinopathy rehab?
Sport specific and elastic function
29
When should Phase 4 of patellar tendinopathy rehab begin? -4 things
Pain is stable on morning test Symmetry in muscle bulk Good strength Addressed deficits dealing with power
30
How should exercises be implemented for Phase 4 of patellar tendinopathy rehab? -3 things
Every 2-3 days Assess response Must keep strength going
31
What needs to be considered during Phase 4 of patellar tendinopathy rehab? -4 things
Only add/change one thing at a time Don't add load and speed together May mix phase 3 and 4 exercises together Consider tendon capacity
32
What is the guide to tendon load and overload on a day to day basis?
24 hour behavior How it feels today reflects response to load yesterday
33
How should pain respond as load is increased in a patellar tendinopathy program?
Pain should decrease as load increases
34
How does evidence support bracing for patellar tendinopathy?
No direct evidence to support or refute
35
What demographic is IT Band syndrome common in?
Runners and cyclists
36
Why is IT Band syndrome a problem of compression rather than A-P friction?
Because the IT Band in TFL thickening and not a distinct tendon
37
What is the typical history associated with IT Band Syndrome? -3 things
Gradual onset Lateral knee pain with activity Snapping sensation over lateral knee
38
What may be found during muscle length tests in the presence of IT Band Syndrome?
Shortness of lateral thigh muscles and glutes
39
What muscles are often weak in IT Band Syndrome?
Gluteus Medius Hip External Rotators
40
What are some biomechanical factors associated with IT Band Syndrome? -4 things
Leg length difference Supinatory foot type Increased hip adduction and knee internal rotation Narrow step width
41
What pain provocation test is used for IT Band Syndrome?
Noble compression test
42
What should be palpated if IT Band Syndrome is suspected?
Lateral femoral epicondyle
43
What are the recommended interventions for IT Band Syndrome?
Relative rest Pain modalities Mobility exercises Strengthening Address biomechanical issues
44
What are the common sites of bursitis in the knee? -3 things
Prepatellar: "Housemaids knee" Pes anserine
45
What is the mechanism of injury for knee bursitis? -3 things
Overuse/Repeated kneeling Traumatic blow to anterior knee Infection such as staph aureus
46
What are the symptoms of bursitis? -2 things
Pain Swelling
47
What may be found during examination that is indicative of bursitis?
Palpable extraarticular fluid
48
What interventions are used to treat bursitis? -4 things
Pain modalities Iontophoresis Address cause Padding to relieve pressure
49
What is Sinding-Larsen-Johansson's?
Distal patellar pole apophysitis
50
What is Osgood Schlatter's?
Tibial tubercle apophysitis
51
What causes apophysitis/Sinding Larsen Johansson's/Osgood Schlatters?
Rapid growth at growth plate and repeated tensile stress
52
What symptoms are often seen in apophysitis/Sinding Larsen Johansson's/Osgood Schlatters? -2 things
Pain Bony Hypertrophy
53
Where is pain located in Osgood Schlatter's?
Tibial tubercle
54
Where is pain located in Sinding Larsen Johansson's?
Inferior Patellar Pole
55
What can be found during examination that is indicative of apophysitis/Sinding Larsen Johansson's/Osgood Schlatters? -2 things
Pain with palpation Quad length impairment
56
What should be used as interventions to treat apophysitis/Sinding Larsen Johansson's/Osgood Schlatters? -2 things
Patient education on icing and protection LE Stretching
57
What are some potential complications related to knee fractures? -3 things
Nerve damage Fat embolism Acute compartment syndrome
58
What should be done if a fat embolism is suspected post fracture?
Medical emergency
59
What are the symptoms of a fat embolism? -4 things
SOB Tachypnea Tachycardia Chest pain
60
What nerves are often trapped near the knee? -2 things
Saphenous nerve Fibular nerve
61
Where is the saphenous nerve being pinched in peripheral nerve entrapment?
Adductor canal
62
Where would someone feel pain related to peripheral nerve entrapment of the saphenous nerve?
Medial knee and calf
63
What does the fibular nerve get pinched in peripheral nerve entrapment?
At fibular head
64
Where would someone feel pain related to peripheral nerve entrapment of the fibular nerve?
Lateral calf

Ortho II (7 decks)

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