Sports Medicine

Question 1

what part of the MSK system serves to protect, store fat cells, blood cell production, and store minerals and ions?

Answer 1

bone

Question 2

which part of the MSK system is responsible for movement

Answer 2

muscle

Question 3

which part of the MSK system connects muscle to bone and transfers force from muscle to bone

Answer 3

tendon

Question 4

which part of the MSK system connects bone to bone, acts as a static stabilizer of joint, and has neurosensory components?

Answer 4

Question 5

which part of the MSK is wide-spread connective tissue, and envelops muscles, blood vessels, nerves and organs?

Answer 5

fascia

Question 6

which part of the MSK acts as a synovial-lining od sacs

Answer 6

bursa

Question 7

function of deepfascai

Answer 7

separates muscle groups

Question 8

internal, external and inciting risk factors of an MSK injury

Answer 8

Question 9

risk factors for ACL tear

Answer 9

young age, poor quads, strength, and proprioception, lack of rest.

Question 10

what is the current program to prevent ACL injury

Answer 10

FIFA 11+. ACL neuromuscular training program is the number 1 way of preventing ACL tears. FIFA 11+ has 15 exercises that involve strengthening, plyometrics and agility, balance activity.

15 exercises: running,
core and leg strength, balance, plyometrics and agility

performed at least 2x/weel

Question 12

describe how Different types of tissue have different
abilities to heal often based on their
vascularization:

Answer 12

poor: knee minisci and tendon
good: muscle and skin

Question 13

healing occurs in four broad phases

Answer 13

1. bleeding
2. inflammatory phase
3. proliferation phase
4. remodeling phase.

Question 14

pathophysiology of a stress injury

Answer 14

accumulation of microtrauma from repetitive bone loading. Imbalance of bone remodeling and break-down

Chronic/overuse injury. Imbalance of bone build up vs bone breakdown. The lower extremity bones ar most at risk. Seen in sports with lots of weight bearing like track and field.

Typically present with gradual onset of pain— ont acute pain, but the pain goes from annoying to bad. Might get night pain. US may be painful because it vibrates the bone.

Diagnosed via Tripple phase bone scan. X Ray not usually helpful.

Question 15

which bone is most affected stress fracture

Answer 15

kiwer extremities most common (tibia and metatarsals)

 Any location of the tibia, but most
common at the medial distal 2/3 border  Most commonly seen in track and field,
running, dancing and jumping sports

Question 16

syymptoms of a stress fracture

Answer 16

Question 17

T/F XRays are helpful to diagnose a stress fracture.

Answer 17

false. usually not helpful– only positive in 10-25% of cases of bone scan positive stress fractures. bone scans are better to do

Question 18

management of stress fracturs

Answer 18

leg bracing may help and low intensity pulsed US. both aren’t really evidenced based.

overall you can just rest it and gradually go back to exercise.

Gradually increase the load on the bone by running longer distances (of that was their activity. Make sure they’re running with proper footwear. If there is chronic stress fractures, especially in women, think about REDs/malnutrition.

Question 19

a women with recurrent stress fractures should be screened for:

Answer 19

REDS and malnutrition

Question 21

What is the “dreaded black line”

Answer 21

an anterior tibia stress fracture. they have a higher rate of delayed union or non-union with 25-60% treatment failure.

Question 22

what is periostitis. what is it aka?

Answer 22

chronic inflammation of periosteum and adjacent fascia –> periosteal thickening.

aka Medial Tibial Stress Syndrome

Question 23

symptoms of periostitis;

1. usually related to increases in training volume
2. less severe with warm-up or if run on softer running surface
3. relieved with rest.
4. generalized tenderness along length of posterior medial border of the tibia
5. palpable focal swelling
6. pain with hopping.

It’s pretty hard to differentiate between periostitis and stress fractures. How can you tell the difference?

Answer 23

XR will be normal but triple phase bone scan will show difference.

Question 24

which one is periostitis? which one is a stress fracture?

Answer 24

periostitis is inflammation of the periosteum surrounding the bone, therefore it isn’t localized to one spot– it’s the entire bone that the affected periosteum is at. therefore, the right one is a periostitis.

Question 25

management of periostitis

Answer 25

basically it’s just symptomatic management. becomes more about addressing the pain rather than addressing the actual periosteum.

symptomatic management with activitiy modification, rest, ice, taping, NSAID change in footwear, stretching, orthotics.

if persistent or recurrent consider SURGERICAL PERIOSTEAL STRIPPING BUT THIS IS PAINFUL (usually good outcome once healed thoguh)