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Intro to sports injury management > Semester 1 year 1 > Flashcards

Semester 1 year 1 Flashcards

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1
Q

4 characteristics of muscles.

EEIC

A

Extensibility.
Elasticity.
Irritability.
Contractility.

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2
Q

What are tendons?

A

Tissue which connects muscles to bones.

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3
Q

What are ligaments?

A

Tissue which spans between articulating bones.

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4
Q

Whats does mechanism of injury mean?

A

How we describe an injury as having occured.

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5
Q

What are the 2 main categories of injury?

A

Acute and overuse.

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6
Q

What is an acute injury?

A

An injury which occurs at a single identifiable traumatic event. Forces apllied is greater than it can withstand.

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7
Q

What are the two forces that can cause acute and overuse injuries?

A

Extrinsic and Intrinsic forces.

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8
Q

What are extrinsic forces? What is an example of a extrinsic force?

A

Forces which are applied from outside of the body.

E.G. an opponent or object.

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9
Q

What are intrinsic forces? What is an example of a intrinsic force?

A

Forces from inside the body.

E.G. contraction of a muscle or joint movements.

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10
Q

What is an overuse injury?

A

Excessive tissue stress and injury caused by factors taking their toll over time.

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11
Q

What are the extrinsic factors that may cause an overuse injury?

A 
Training load.
Footwear.
Environment conditions.
Equipment set up.
Ground surface.
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12
Q

What are the intrinsic factors that may cause an overuse injury?

A 
Age.
Gender.
Muscular Inbalance.
Malalignment.
Lack of mobility.
Body composition.
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13
Q

Common Injury Types

A

How muscle, tendon and ligament injuries are classified.

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14
Q

What is a muscle strain/tear? How is it caused?

A

Excessibe forces cause muscle fibres to fail.
Over use (microtears) worsen overtime.
Overstretching
Overexertion

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15
Q

What does EAMC mean?

A

Exercise Associated Muscle Cramps

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16
Q

What is a cramp?

A

A sudden, painful and involuntary contraction. Often temporary likely tobe cause by fatigue.

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17
Q

What is a contusion?

A

Direct compressive force to the muscle.

This causes damage to blood vessels and bruising. (Not always visible.)

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18
Q

What is contusion known/described as?

A

Dead leg.

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19
Q

What muscles are at greater risk of a strain/tear?

A

Muscles crossing two joints.

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20
Q

What are the classifications of muscle strains?

Order least sever to most.

A

Grade I, Grade II and Grade III.

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21
Q

What is a grade I strain?

A 
Mild.
Small number of fibres torn.
Minimal loss of function.
Fascia intact.
Pain/tightness.
Minimal bleeding in tissue.
Spasm localised.
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22
Q

What is a grade II strain?

A 
Moderate-Severe
Large number of fibres torn.
Moderate-severe loss of function.
Fascia intact.
Pain and weakness.
Spasm in surrounding muscle.
Bleeding apparent.
Painful palpable mass.
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23
Q

What is a grade III strain?

A 
Severe strain/rupture.
Definite gap between muscle.
Muscle seperates from bone.
Sig. loss of strength and function.
Fascia partially/fully torn.
Pain
Spasm throughout surrounding muscle
Bleeding visible distally through tissue.
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24
Q

Tendinopathy

A

Clinical syndrome of pain and dysfunction in a tendon.

Often chronic.

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25
Q

How is tendinopathy presented as?

A

Localised pain.
Tenderness to palpation.
Impaired Function.

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26
Q

What is localised pain?

A

Athlete able to pinpoint exactly where the pain is.

Pain often reproduced when loading the tendon.

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27
Q

What is tenderness to palpation?

A

A focused area of tenderness when palpating the tendon.

Possibly at bony insertion or mid portion.

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28
Q

What is impaired function?

A

Athlete is not able to perform tasks aswell as they used to. E.G. less strength, speed or jump height.

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29
Q

Tendon Strain and Rupture

A

Occur often at the musculotendious junction (MJT).

Ruptures likely to be due from degeneration overtime.

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30
Q

Common mechanism of injury for ligament sprains

A

Landing and changing direction.

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31
Q

What are the grades of ligament sprains?

A

Grade I, II and III.

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32
Q

What is a grade I ligament sprain?

A 
Some collagen disrupted.
Localised tenderness of palpation.
Minimal swelling.
Normal ROM.
Little functional deficit.
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33
Q

What is a grade II ligament sprain?

A 
Most fibres disrupted.
Significant tenderness to palpation.
Considerable swelling.
Increased joint play- endpoint present.
Moderate functional deficit.
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34
Q

What is a grade III ligament sprain?

A 
Complete disruption of collagen fibres.
Audible pop and immediate pain.
Rapid swelling.
Significant joint play- No end point.
Significant functional deficit.
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35
Q

What is force?

A

Push or pull acting on a tissue.

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36
Q

What is torque?

A

force acting around an axis to produce rotation of tissue.

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37
Q

What are the 5 forces and torque acting on a tissue?

A 
Tension
Compression
Bending
Torsion
Shear
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38
Q

Deformation

A

Not all forces will cause injury however may cause deformation.

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39
Q

What does the stress-strain curve show?

A

All tissues can tolerate a certain level of deformation before they fail.

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40
Q

Stress

A

Force applied to deform a structure.

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41
Q

Strain

A

Resulting deformation of the structure.

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42
Q

Toe Region

A

Tissue starts to take up the slack.
Fibres begin to straighten.
Crimped state.

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43
Q

Elastic Region

A

Tissue deforms.

Return to normal force if removed.

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44
Q

Yield Point

A

Tissue deformed in plastic= no elasticity

Permanent deformation occurs (injury).

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45
Q

Plastic Region

A

Strains and Sprains occur.

Severity=amount of force and tissue deformation.

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46
Q

Failure Point

A

Complete tissue failure
Grade III
Tissue unresponsive to load=loss of function.

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47
Q

What is the soft tissue repair process?

A

The bodys replacement of destroyed tisssue by living tissue.

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48
Q

What are the 4 stages of the soft tissue repair process?

A

Bleeding.
Inflammation.
Proliferation.
Remodelling.

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49
Q

What occurs in the bleeding stage?

A

Damage to blood vessels.
Muscle>tendon and ligament.
Typically lasts 4-6 hours.

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50
Q

What occurs in the inflammation stage?

A

Essential for repair.
Peaks at 1-3 hours post injury.
Diminishes over 3-14 days.

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51
Q

What occurs in the proliferation stage?

A

Production and laying of scar tissue.
Begins 24-48hours.
Peaks 14-21 days.
Diminishes over 4-6months.

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52
Q

What occurs in the remodelling stage?

A

Organisation of scar tissue.
Scar behaves similarly to injured tissue.
Begins 3-7days.
Diminishes 6-24months.

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53
Q

What is scar tissue?

A

Natural product of the tissue repair process.
Structurally weak.
Restriction in movement.

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54
Q

What is the biggest risk factor for injury?

A

Previous injury.

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55
Q

Swelling

A

Accumulation of fluid in a joint or around tissues.
A common sign of injury.
Caused by tissue irritation/significant vascular trauma.

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56
Q

Oedma

A

Swelling between tissues.

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57
Q

What is tissue irritation (insidejoint/oedma) swelling?

A

1) Inflammation caused by soft tissue damage causes capillary walls to become more permeable.
2) Plasma and proteins leak out of capillariesthrough walls into surrounding tissue.
3) Proteins attract water- increasing swelling.

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58
Q

Effusion

A

Swelling within joints.

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59
Q

What is effusion?

tissue irritation inside a joint

A

1) synovial membrane irritated meniscus damaged.

2) Plasma and proteins leak out of capillaries through synovial membrane into joint space.

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60
Q

Significant Vascular Damage

A

1) e.g. ACL ruptured
2) Blood leaks out of ruptured ACL filling up joint space. (haemarthrosis)
3) plasma and proteins leak out of capillaries through synovial membrane into joint space.

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61
Q

What is pain?

A

A result of sensory and emotional experiences.

Warning sign to prevent further injury.

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62
Q

What are the 3 types of pain?

A

Nociceptive pain
Neuropathic pain
Central pain

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63
Q

Nociceptive pain

A

Normal response to damaging or potentially damaging stimuli.

E.G. injury of tissues such as skin and muscles.

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64
Q

Neuropathic pain

A

Pain initiated or caused by damaged disease in the sensory nervous system.
E.G. compressed nerves and nerve lesions.

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65
Q

Central pain

A

Damage/dysfunction to the CNS
Heightened sensitivity of pain.
E.G. result of significant disease or trauma.

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66
Q

Pain cells

A

Nociceptors

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67
Q

Where are nociceptors found?

A

Skin, muscles, joints and bones.

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68
Q

What do nociceptors do?

A

Carry pain from uninjured area to the brain via teh spinal cord.

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69
Q

How to decrease pain

A

1) Decrease sensitivity of nociceptors of injured site.
2) Decrease ability of spinal cord to carry signals to brain.
Achieved by introducing stimulus.

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70
Q

Gate control theory

A

Non-painful input closes “gates” to painful input.
Prevents pain travelling to the CNS.
Non-painful input suppresses pain.

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71
Q

What is cryotherapy?

A

Cold therapy

72
Q

How does cryotherapy reduce pain?

A

Slows speed of sensory nerve signals.
Activates non-painful nerve cells which interrupt pain signals.
Lessen effects of chemical stimuli that are detected by nociceptors.

73
Q

How does ultrasound reduce pain?

A

UT energy absorbed may lessen the sensitivity of nociceptors.

74
Q

How does electrotherapy reduce pain?

A

Electrical stimulation activates non-painful nerve cells which interrupt pain signals.

75
Q

What is ultrasound therapy?

A

Application of sound energy to soft tissues.
Sound waves travel through skin via gel.
Effect cells involved with pain and tissue repair.

76
Q

Effects of UST on thermal

A

Promote soft tissue healing process.
Increase extensibility.
Reduce muscle spasm.
Reduce pain.

77
Q

Effects of UST on inflammation and repair

A

Reduce healing time.
Stimulate production of collagen.
Increase extensibility of scar tissue.
Decrease inflammation.

78
Q

Contraindications to UST

A

Cancer
Pacemakers
Haemmorrhage
Ischaemic tissue
Venous thrombosis
Dont use on the eye, growth plates or genitals
Application on trunk or pelivis during pregnancy.

79
Q

Sensation Issues- UST

A

UST produces heat.
Patient must be able to tell the difference between hot and cold.
If machine is dysfunctional patient must be able to tell.

80
Q

Depth of the lesion to be treated.

A

Superficial (<2cm)=3MHz

Deep (2-5 or 6cm)=1MHz

81
Q

Pulse Ratio

A 
Acute= Pulse 1:4/3 (20%-25%)
Subacute= Pulse 1:3/21 (25%-33%-50%)
Chronic= Pulse 1 2/1/continous (33%, 50%, 100%)
82
Q

Intensity required at the lesion

A 
Acute= 0.1-0.3 w/cm^2
Subacute= 0.2-0.5 w/cm^2
Chronic= 0.3-0.8 w/cm^2
83
Q

Area to be treated in relation to the treatment head size.

A

E.G 1x 2x 3x etx.

84
Q

What is electrotherapy?

A

Application of electricity to the body for a therapeutic effect.
Stimulation of tissues.
Applied to the body via electrodes.

85
Q

Why use electrotherapy?

A

Decrease pain via:
gate control theory
Modulation of pain via brain.
(endorphins and enkephalins)

86
Q

Contraindications of electrotherapy

A 
Pacemaker
Trunk or pelvis during pregnancy
eyes, anterior neck
Skin conditon- easily damaged skin
Risk of haemorrhage
Poor blood flow
Venous thrombosis
Active epiphyseal regions in children.
87
Q

Sensation issues -Electrotherapy

A

Skin irritation- pain and/or electrlytic burns.

Assess patients ability to distinguish between sharp and blunt.

88
Q

Application of interferential therapy.l

A

Begin with short treatments to gauge the patients response to treatment.
Acute= 5-10mins
Other= 20-30mins

89
Q

AMF

A

Frequency of electrical current application.

90
Q

Pattern

A

Rate of change in frequency.

91
Q

Vector

A

Local or diffuse treatment.

92
Q

Time

A

How long you want the treatment to last.

93
Q

Carrier frequency

A

4KHz most common.

94
Q

When is cryotherapy used?

A

Commonly with acute injuries to decrease pain.

95
Q

Why is cryotherapy used?

A

Gate control theory.
Slows nerve conduction velocity.
May decrease swelling accumulation.

96
Q

Examples of cryotherapy

A 
Freeze gel/spray
Bagged Ice
Game ready
Frozen peas
Ice massage
Ice pack
97
Q

Application of cryotherapy

A

Constant 10-15 minutes of crushed ice.
Every 2-4hours
Damp towel between skin and ice.
Apply for initial 48-72hours.

98
Q

Negative side effects of cryotherapy

A

Burns, hypothermia, nerve injury and frost bite.

99
Q

5 benefits of applying ice to an acute injury.

A 
Lowers sensation
Reduces swelling and heat
Soft tissue healing process
Vasoconstriction
Decrease pain
100
Q

PRICE

A 
Protection
Rest
Ice
Compression
Elevation
101
Q

POLICE

A 
Protection
Optimal
Loading
Ice
Compression
Elevation
102
Q

Why POLICE?

A

Too much rest affects tissue mechanics and structure during repair.

103
Q

What should rest be replaced with?

A

Progressive rehab.

104
Q

Early activity=

A

Early recovery

105
Q

What does progressive load do?

A

Restore strength and structure to repairing tissue.

106
Q

Research on POLICE for acute injuries

A 
P=
Definetly protect injury
O+L=
Definetly encouraged
I=
Definetly applied
C=
Probably apply compression
E=
Probably elevate
107
Q

Contraindication to cryotherapy

A 
Cold urticaria (allergic reaction to cold)
Raynauds phenomenon
Poor circulation
sensory impairment
Advanced diabetes
Hypertension
108
Q

Thermotherapy

A

Application of heat to decrease pain and muscle spasm.- Gate controltheory
Not used on acute injuries= incerase inflammation and swelling.

109
Q

Application of thermotherapy

A

7-9mins to have therapeutic effects on superficial tissue.
15-30mins for deeper tissue.
Most pplications dont warm deeeper tissue.
CW ultrasound best for deeeper tissue.

110
Q

Examples of thermotherapy

A 
Jacuzzi
Ultrasound Therapy
Heat rub/spray
Sauna/Steam room
Hot water bottle
Warm bath
Infrared heat lamp
111
Q

Contraindications of thermotherapy

A 
Acute injury/inflammation
Poor circulation
OverAdvanced arthritus
Areas of poor sensation
Thrombophlebitis (inflamed veins)
112
Q

Purpose of athletic taping

A

Support ligamnets/capsule of injured joints
Support muscle/tendon
Enhance proprioceptive feedback from limb or joint.
Secure padding for compression or protection.

113
Q

Benefits of taping

A

Give athlete confidence
Increase stability
Incerase joint awareness
Decrease load through muscles and tendons.

114
Q

When is athletic taping applied

A

Before sport and removed after.

115
Q

What should you do before and after applying tape?

A

Prepare skin e.g. hair, sweat and clothing.

Check capillary refill distally.

116
Q

Which tape?

A muscle injury with swelling.

A

EAB

117
Q

Which tape?

A muscle injury with no swelling.

A

Zinc Oxide

118
Q

Which tape?

Ligament injury with acute swelling.

A

EAB

119
Q

Which tape?

Ligament injury with chronic swelling.

A

Zinc Oxide

120
Q

Which tape?

Ligament injury with no swelling.

A

Zinc Oxide

121
Q

Research into taping.

A

Tape loses 20-40% of effectiveness after 20mins.
Better tape=more longevity
Restricting movement may affect postural control.

122
Q

Tape and accessories

A

Zinc Oxide
Cohesive Bandage
Elasticated Adhesive Bandage (EAB)

123
Q

Steps of a lateral ankle sprain taping.

A

1) Proximal (5cm Zinc) and distal (5cm Zin) anchors.
2) Apply 5cm zinc stirrups x3 medial to lateral.
3) Apply 5cm zinc hprseshoes x3 medial to lateral.
4) Close up with 5cm Zinc.
5) Heel locks if required.

124
Q

Steps of glenohumeral instability taping.

A

1) Fix 5cm EAB anchor around arm and hyperfix from chest to scapula.
2) Apply 3.8cm rigid zinc tape from arm anterior to posterior over anterior capsule x3.
3) Repeat anterior to posterior over posterior capsule x3.
4) Reinforce tape with 7.5cm EAB lock.

125
Q

Clinical assessment.

A

Plan management of a patient.

Involve subjective and objective components.

126
Q

Subjective assessment.

A

I.E patient or subjective History (SHx)
Information collected from patient via questioning.
Questions focused on background and injury.

127
Q

Objective assessment.

A

Physical examination.
Visual observation.
Analyse response and reactions to movement and touch.
Confirm thoughts from SHx.

128
Q

Key components of Objective assesssment.

A 
Observation and Inspection
Active movements
Passive movements
Resisted movements
Palpation
129
Q

SALTAPS

A 
See
Ask
Look
Touch
Active movements
Passive movements
Strength testing
130
Q

When is SALTAPS used?

A

Pitchside- a progressive approach

Not appropiate for head or spinal injuries

131
Q

See

A

In a good positon to view athletes when competing.

132
Q

Ask

A

Player responsive?
e.g. what happened?
Where is the pain?

133
Q

Look

A

Expose injured area and inspect.
Signs of injury e.g bleeding, swelling and deformity.
Comparisons between limbs.
Facial expressions indicates severity.

134
Q

Touch

A

Carefully palpate exposed area.
Feel for deformity, temperature and swelling.
Lost sensation.
Tenderness and pain.

135
Q

Active movements

A

Voluntary movements.
Indicates bone, muscle, tendon, ligament integrity.
Assess all available joint movments.
Quality, Pain, ROM and willingness.

136
Q

Passive movements

A

Only is full active movement is available.
Therapist moves joints through full ROM.
Quality, Pain, ROM and willingness.

137
Q

Strength

A

Performed if no movemenet limitations.
Therapist applies forceful isometric resistance to joint movements.
Further examination of concentric resistance may follow.

138
Q

Hip Joint

A

Anatomical rehion comprising of the pelvis and femur.
Synovial ball and socket.
Strong and robust.
Reinforced by strong ligaments.

139
Q

Hip movements

A 
Abduction
Adduction
Flexion
Extension
Circumduction
Rotational
140
Q

Groin Injuries

A

Hernia
Pubic Bone Stress Injury
Hip Flexor Strain
Adductor Strain

141
Q

Hip Joint Pain

A

Labrum tear
Impingement
Osteoarthritis

142
Q

Objective Hip and Groin Assessment

A 
Observation and Inspection
Active range of Movement
Passive range of Movement
Resisted range of Movement
Palpation
143
Q

What to look for during Observation and Inspection?

A 
Expose skin and socks off:
Swelling
Bruising
Scarring
Deformity
Abnormalities
Skin conditons/damage
Facial expressions
Postural abnormalities
144
Q

How to perform AROM

A 
Instruct patients to move joint.
Demonstrate movement
2-3 reps
QPRW
Compare left and right
Overpressure- Endfeel
Goniometry
145
Q

Normal Joint End Feels

A 
Hard= Bone on Bone
Soft= Soft tissue approximation
Elastic= Capsule/ligament/muscle stretch
146
Q

Palpation

A 
Systematic and logical
Tenderness
Swelling
Deformity/abnormalities
Quality of palpation
147
Q

Key landmarks of anterior hip

A

Axis
Pubic tubercle
Greater trochanter

148
Q

Key landmarks of posterior hip

A

Iliac crest

Ischial tuberosity

149
Q

Key muscles of hip region

A

Gluteus maximus and medius
Iliopsoas
Rectus Femoris
Adductor Longus

150
Q

The knee joint

A

Femur, tibia, fibula and patella.
Synovial hinge joint.
Meniscus increase stability.

151
Q

Thigh region

A

Quadriceps and hamstrings.
Adductors.
Poduce movement and dynamically stabilise the knee.

152
Q

Knee movements

A

Flexion and Extension

Lateral Rotation and Medial Rotation

153
Q

Knee Injuries

A

Meniscus tear
MCL sprain/rupture
ACL partisl tear/rupture
Patella tendinopathy

154
Q

Assessing knee and thigh region

A 
Observation and Inspection
Active range of Movement
Passive range of Movement
Resisted range of Movement
Palpation
155
Q

QPRW

A

Quality
Pain
Range
Willingness

156
Q

Before palpation

A

Uniform neat
Short nails
Hygiene- washed hands
Consent to palpate

157
Q

Anterior Key Landmarks of knee and thigh region

A 
Patella
Patella tendon
Tibial tuberosity
MCL
Meniscus
LCL
158
Q

Key muscles of knee and thigh region

A 
Vastus Lateralis
Rectus Femoris
Vastus Medialis
Semitendinosus
Semimembranosus
Biceps Femoris
159
Q

What is the benefit of optimal loading over prolonged periods of rest?

A

Earlier mobility= earlier recovery-Quicker tissue healing

MECHANOTHERAPY

160
Q

How long would you advise the athlete to wait before loading the injured tissue and why?

A

2-3 days dependant on severity because swelling and inflammation should have reduced.

161
Q

Torque

A

Force acts around an axis to produce rotation of tissue.

162
Q

Tension

A

Pushing away muscle.

163
Q

Compression

A

Pushing together

164
Q

Bending

A

Move 2 ends together.

165
Q

Torsion

A

rotate around a bone e.g. change direction

166
Q

Shear force

A

2 bones rub together. E.g. vertebrae

167
Q

Why do muscles have more bleeding?

A

They are more vascular.

168
Q

Haemostasis

A

Bleeding phase.

169
Q

Signs of inflammation

A 
Swelling
Tenderness
Bruising
Heat
Redness
170
Q

Fibroplasia

A

Fibre build up. Fibres that have been damaged start to be built up.

171
Q

Angiogenesis

A

Vessel birth. Vessel build up. Capalliries, arteries and veins.

172
Q

Underwrap

A

Protect hair before taping.

173
Q

Foam

A

Protection on bony area or around.

174
Q

Heel and lace pads.

A

Irritable areas and to protect superior structures.

175
Q

Pre-tape

A

Adhesive

176
Q

Remover

A

Tape that you cant cut.

Spray destroys tape structure.

Intro to sports injury management (1 decks)

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