Sports Level 3 course Flashcards
What percentage of patients with Achilles tendinopathy did not have pain on loading despite pain on palpation?
1 in 4 (25%) of patients with pain on palpation did not have pain on loading.
palpation is sensitivity, but no specific
This highlights the limitation of using palpation as a diagnostic tool.
What is the reliability of pain on loading compared to recalled pain in patients with Achilles tendinopathy?
Pain on loading is more clinically relevant than recalled pain
40% of patients had differences between recall pain and loading pain
40% of participants had discrepancies between recalled pain and pain on loading.
What should clinicians be cautious about when reviewing articles on tendinopathy?
Pain on palpation and imaging are not reliable inclusion criteria.
Also consider the patients who have been included - eg: is a mid-aged sedentary women likely to have PT
Pain in the Achilles region presents a heterogeneous group of clinical presentations.
What is the recommended rate of loading for different tissues?
- 50-120 bpm – bone/joint/muscle
- 120-150 bpm – fascial loading
- Above 150 bpm – tendon
This is important for prescribing metronome-based exercises.
How can a clinician isolate the soleus muscle during assessment?
Hang toes over the edge of a step
An eccentric component can also be added for better isolation.
What is a recommended exercise for foot intrinsics?
‘Wall Pilates’
DL and SL and “turned out” reps and pulses
make sure big toes aren’t in valgus and dont curl toes
Lean against the wall with big toe straight and perform specific reps and pulses.
What loading strategy is suggested for patellar femoral joint (PFJ) pain?
Use a pulsing leg press or single-leg squat (in a painfree ROM) at 60-70 bpm. aim for a load that induces fatigue after 50-60 reps (bone loading principles), could do this 2x a day
Aimed at bone/joint loading, aiming for fatigue at ~50-60 reps.
if a patient reports radiating pain into their shin with squats, what may it indicate?
Saphenous nerve involvement
Could differentiate with nerve trunk palpation, neural tension stretch, neural glides + myofascial releases along the nn trunk
Tenderness on palpation may also be present.
What exercise may be effective for for tibial tuberosity pain?
It responds to isometric tibialis anterior loading
This refers to dorsiflexion (DF) loading.
What are the characteristics of peritendon pain in Achilles tendinopathy?
- Diffuse pain along the tendon
- Aggravated by friction/shear loads
- Poor tolerance to heavy sustained isometrics
needs to be addressed before addressing any co-existing tendinopathy
Pain may be hard to localize and can be exacerbated by running.
Which tendon is stiffer than the Achilles tendon and can provoke pain?
Plantaris tendon 3-10x stiffer
It is 3-10 times stiffer than the Achilles tendon.
What footwear is recommended for patients with Hallux limitus/rigidus?
Hoka shoes
These shoes can help relieve symptoms.
What is a key risk factor for low back pain (LBP) in elite rowers?
- Previous history of LBP
- Rapid increases in training/competition load
- Increased years of exposure to sport
- Ergometer sessions lasting more than 30 minutes
Other factors include rapid increases in training load and ergometer sessions over 30 minutes.
How does rowing biomechanics affect the risk of low back pain?
- Increased spinal flexion over time (creep)
- Limitations in hip flexion can lead to increased lumbar flexion
Rowing requires a relatively vertical pelvic position.
What percentage of rowers experienced low back pain in a 12-month period according to the study?
61% in rowers, 51% in athletic population, 36% in general population
This is higher compared to other athletes and the general population.
What is the role of the abdominals during the rowing drive phase?
They work eccentrically as a braking force and initial the forward trunk movment
This is crucial for maintaining spinal stability.
Fill in the blank: The sutures from Achilles tendon surgery usually dissolve around ______ weeks.
4 weeks
This timing may influence loading protocols post-surgery.
