Sports Flashcards
Tasks and responsibilities of SEM
TIIMME PEN
* Injury and illness prevention
* Injury diagnosis, treatment and rehabilitation
* Management of medical problems
* Medical care of sporting teams and events
* Medical care in situations of altered physiology,
* Exercise prescription in health and in chronic disease states
* Exercise prescription in special subpopulations
such as at altitude, environmental extremes, or at
depth
* Performance enhancement through training
* Dealing with ethical issues, such as the problem of drug abuse in sport
* Nutrition and psychology
The scope that focuses on sports physiotherapist’s role:
MAPI
- Manager of the patient:
o Injury prevention (must be routine)
o Acute intervention
o Rehab
o Performance enhancement - Adviser:
o Promotion of a safe and active lifestyle
o Promotion of fair play and anti-doping practices (know which drugs are acceptable) - Professional leader
o Life-long learning
o Professionalism and management - Innovator
o Research Involvement
o Dissemination of best practice
o Extending practice through innovation
o Think outside the box
challenges to EBP
LILL (lil)
* Lack of access to evidence
* Inadequate skills to appraise and interpret published research
* Limited patient understanding of clinical health literacy
* Lack of time to address the above
Implementing EBP:
ARRIP
- Accessing research
- Retrieving articles
- Risk of bias
- Published appraisals
- Interpreting research about treatment
Immediate assessment on field
DR ABC
- D – danger
- R – respond
- A – airways
- B – breathing
- C - circulation
Further Assessment on field
SALTAPS or TOTAPS
- S–stop
- A–ask
- L–look
- T – touch
- A – active movements
- P – passive movements
- S–standup
- T–talk
- O – observe
- T – touch
- A – active movement
- P – passive movement
- S – skills tests
Purpose for periodic health evaluation
screening for unidentified injuries/risk of injury
POOF FICE
- Prevent injury through a prescribed corrective programme.
- Optimize athletes’ performance.
- To provide opportunities for counselling.
- Identify factors predisposing to injury.
- To fulfill legal & insurance requirements.
- To identify impediments.
- To classify according to individual qualification.
- To evaluate the stage of maturation.
Immediate treatment of soft tissues
acute
RICERS with no HARM
* R–rest
* I–ice
* C – compression
* E – elevation
* R – referral
* S – stretch
* NO
* H–heat
* A – alcohol
* R – running
* M - massage
treatment of soft tissues - subacute & chronic
PEACE & LOVE
P = Protect
Unload or restrict movement for 1 - 3 days
This reduces bleeding
Prevents distension of injured fibers
Reduces risk of aggravating injury
Minimise rest
Prolonged rest compromises tissue strength and quality
Let pain guide removal of protection and gradual reloading
E = Elevate
Elevate the injured limb higher than the heart
This promotes interstitial fluid flow out of the injured tissue
Although poor evidence for it - it still is recommended as there is a low risk-benefit ratio
A = Avoid anti-inflammatory modalities
Anti-inflammatory medications may negatively affect long-term tissue healing
Optimal soft tissue regeneration is supported by the various phases of the inflammatory process
Making use of medications to inhibit the inflammatory process could impair the healing process
Avoid ice
Use of ice is mostly analgesic
Although it is widely accepted as an intervention there is very little high quality evidence that supports the use of ice in the treatment of soft tissue injuries
Ice may potentially disrupt inflammation, angiogenesis and revascularisation
Ice may potentially delay neutrophil and macrophage infiltration
Ice may potentially increase immature myofibers
This can result in impaired tissue regeneration and redundant collagen synthesis
C = Compress
Intra-articular edema and tissue hemorrhage may be limited by external mechanical compression such as taping or bandages, but should still allow full range of movement at the joint.[5]
E = Educate
It is our responsibility as physiotherapists to educate our patients on the many benefits of an active approach to recovery instead of a passive approach
Early passive therapy approaches such as electrotherapy, manual therapy or acupuncture after an injury has a minimal effect on pain and function when compared to an active approach
If physiotherapists nurture a patient’s “need to be fixed” it may create dependence to the physio and actually contribute to persistent symptoms
Patients need to be better education on their condition
Load management will avoid over-treatment of an injury
Over-treatment may increase the likelihood of injections or surgery and higher costs
It is critical for physiotherapists to educate their patients and set realistic expectations about recovery times
Love
“After the first days have passed, soft tissues need LOVE”
L = Load
Patients with musculoskeletal disorders benefit from an active approach with movement and exercises
Normal activities should continue as soon as symptoms allow for it
Early mechanical stress is indicated
Optimal loading without increasing pain
Promotes repair and remodeling
Builds tissue tolerance and capacity of tendons, muscles and ligaments via mechanotransduction
O = Optimism
The brain plays a significant part in rehabilitation interventions
Barriers of recovery include psychological factors such as:
Catastrophisation
Depression
Fear
Research shows that these factors may more explain the variation in symptoms and limitations after an ankle sprain than the degree of pathophysiology
Pessimistic patient expectations influence outcomes and prognosis of an injury
Stay realistic, but encourage optimism to improve the chances of an optimal recovery
V = Vascularisation
Musculoskeletal injury management needs to include cardiovascular physical activity
More research is needed on specific dosage, but pain free cardiovascular activity is a motivation booster and it increases blood flow to injured structures
Benefits of early mobilisation and aerobic exercise in people with musculoskeletal disorders include:
Improvement in function
Improvement in work status
Reduces the need for pain medication
E = Exercise
Evidence supports the use of exercise therapy in the treatment of ankle sprains and it reduces the risk of a recurring injury
Benefits of exercise:
Restores mobility
Restores strength
Restores proprioception, early after an injury
Avoid pain to promote optimal repair in the subacute phase
Use pain as a guide to progress exercises gradually to increased levels of difficulty
functional recovery model
Functional recovery model (return to sport and performance).
The transition from
the rehabilitation phases of functional recovery (rehabilitation) to the actual performance is
highlighted.
Four stages are indicated, starting from on-field rehabilitation (OFR),
to return to training (RTT),
then return to competitions (RTC) and finally return to performance (RTP).
The model is applicable to any type of sport and the transition from one item to the next is based on
criteria rather than on time. Above the figures indicate the person/teamwho are essentially in
charge of the case at that period of functional recovery, involving a close working relationship
between medical and performance teams during the OFR to RTC stages.
Functional field testing
Only commenced once full ROM and strength achieved and once all signs of pathology have settled
with ADL’s
- Test functional ability- ATtACk A
o Acceleration/deceleration
o Time to maximum speed
o Ability to change direction
o Ideally- these tasks should match or surpass the physical requirements of the sport
o Look at core and functional training
o Agility and trunk stabilisation improves re- injury risk
Factors to be addressed before return to sport:
SaFFRR -safer
- Safety - is pt safe to return
- Risk of safety to others - incorrect biomechanics
- Functional capacity - do they have full capacity to return
- Functional requirements - Skill set for specific sport
- Regulations - regulations club or institution ito of drugs
stages of rehabilitation
Stage Functional level Sport Mx
FRISS - SINA - SPF
Initial - Poor - Nil,Substitute (swimming, cycling)
RICE - Stretch/ROM exercises Isometric exercises Stability program/fitness maintenance
Intermediate/ pre- participation - Good - add Isolated skills - Strength Neuromuscular exercises
Agility exercises
Advanced - Good - Commence sport specific agility work
-add power Functional activity
Return to sport (Can be broken down into OFR-RTT-RTC-RTP) - Good - Full
- Continue strength/power work, flexibility
Components of exercise program for rehab
- Muscle conditioning
o Muscle activation and motor control o Muscle strength
o Muscle power
o Muscle endurance - Cardiovascular fitness
- Flexibility
- Functional exercises
- Sports skills
- Hydrotherapy
- Correction of biomechanical abnormalities
Negative effects of poor prognosis (expected recovery):
Neg - n - alphabet
LMN R
LLMMN R
- Litigations
- Loss of trust
- Medical complications
- Miscommunication
- Reduced sport participation rates
indications rigid tape
acute injury care- compression, immobilisation (limit stretch of lig & muscle), pain relief
injury prevention- restriction of range, enhance proprioception, provide support for eccentric loading
benefits of kinesiology taping
o Effect on vascular and lymphatic drainage
o Pain reduction
o Improved proprioception feedback
Provides stability and supporting while allowing movement into ROM
Can be used for stimulation of muscles/ soft tissue with patients with neurological fall out
Can be used as a pain reliever as per the pain gait theory due tactile/compression stimuli that override the pain stimuli
*Can be used in replacement for EOB or rigid tape in athletes with psychological dependence on external support and stabilisation
increased lymphatic drainage and blood supply, reduced swelling
MECHANISM OF ACTION FOR PAIN RELIEF ACTION OF KINESIOTAPE
- kinesiotape acts through fast-conducting fibers (Aβ), creating synapses with inhibitory interneurons
when reaching posterior horn of the spinal cord, causing the closure of the gate and therefore
reducing the efferent sensory stimulus (C and Aδ fibers). - The tape decreases the load on a muscle or tendon by altering the point of the lever and decreasing the load at the affected area and therefore decreases the pain.
ESSENTIALS FOR GOOD TAPING
LUCky CAR MouNT
Before you start taping there are a few essentials that have to be remembered:
* Comparable sign
* Anatomy
* Mechanism of injury (allow yourself to be guided by this)
* Restrictions of movement
* Normal Biomechanics and Postural alignment
* Taping Principles
* Comfort and Compliance
* Understanding of the Sporting code
* Listen to the patient/client
