Sprains and Strains

Question 1

Acute vs. overuse

Answer 1

Acute- sudden trauma

Overuse - with repetiive activity

Question 2

Sprains…what is it, where does it occur, sx

Answer 2

Sretch and or terar of a ligament (stabilizes joints)

Most commonly in the ankle

AFL most, CFL, PTFL

Sx - pain, edema, ecchymosis, pop

Question 3

Strain

Answer 3

Stretch and or tear of muslce or tendon

Most in hamstrings/low back

Pain, muscle spasm, muscle weakness, edema, ecchymosis

Question 4

Mild
Mod
Severe

Answer 4

1 - stretching and soem damage to fibers

mod - partial tearing of the ligamen…abnormal laxity in certain ways

Severe - complete tear of the ligament or tendon…sig instability and jint nonfunction

Question 5

Non pharm Tx

Answer 5

RICE

Rest - take a break from activity that cuase…relative rest - need to strengthen to improve

Ice - 15 mnutes at a time

Compression - to reduce swelling

Elevation - above heart to reduce swelling

Question 6

Pharm tx

Answer 6

NSAIDs…Inhibit COX 1 and 2 so decreased prostaglandin formaiton

Take consistently…meloxicam or diclofenac are most common

Question 7

Hx of ankle sprain

Answer 7

Most common is ankle inversion

MOA needs to be in pt’s own words…demonstrate on uninjured side

Question 8

Ottawa ankle rules

Answer 8

Need Ankle X ray if pain in malleolar zone AND
Bone tenderness at posterior edge or tip of lat or medial malleolus

OR inability to bear weigth

Foot X ray if pain in midfoot and beone tenderness at vnavicular or base of 5th metatarsal…OR inability ot bear weight

Question 9

Ankle sprain PE

Answer 9

Edema and eccchyymosis…no erythema or warmth

Tenderness over ATFL and CFL

No tenderness over medial or lateral malleolus

Question 10

Ankle sprain mild and severe tx

Answer 10

RICE
Strenghtening
1-2 weeks

Severe - immobilize (don’t want to use crutches), elevate, ice…4 weeks to recover…PT

Both of these include proprioception

Question 11

MCL or LCL vs. ACL/PCL

Answer 11

WIth MCL or LCL, there will be no swelling inside the knee joint

Question 12

ACL and PCL function

Answer 12

ACL - prevent forward movement of the tibia…needed for pivots…think layup

PCL - prevents femur from sliding forward off the tibial plateua…think knee vs. dashboard***

Question 13

Medial and lateral menisci function

Answer 13

Protect articular surface from damage

Question 14

MCL and LCL function

Answer 14

MCL - prevents valgus opening of tibiofemoral joint

LCL - prevents varus

Question 15

Lachman test

Answer 15

Tests ACL

Stabilie fumer with outside hand

Move tibia anteriorly

Question 16

Posterior drawer

Answer 16

Knee at 90 felxion..apply posteriorly directed force to proximal tibia

for PCL

Question 17

Valgus stress

Answer 17

MCL

At 0 and 30 degrees of knee flexion

Same for varus test

Question 18

McMurray

Answer 18

Flex knee and place fingers on joint line

Ext rotate the leg and bring knee into extension

Plapbale pop or click

Question 19

Causes of effusions

Answer 19

THink about things INSIDE the joint

Question 20

What to do if suspicion for ACL tear

Answer 20

Brace and MRI…tylenol and ibubrofen for pain

Crutches

Ortho for surgery

ICE the knee

Question 21

ACL surgery

Answer 21

Bone patellar tendon autograft is preferred

6-9 months to return to sport

Need pre-hab

Question 22

MCL mech of injury

Answer 22

Valgus stress on a partially flexed knee

If severe laxity, then associated ACL tear

Question 23

LCL injury

Answer 23

Usually with PCL and always need surgery

Question 24

PCL MOI and tx

Answer 24

Direct blow with knee in flexed positon OR hyperexntension injury

Knee brace, rehab for 4 weeks (quad and hip)

Question 25

Hamstring strain typical

Answer 25

Sprinting and felt a pull then a pop in pro posteriro leg

Edema, ecchynosis, tenderness mid-belly of medial hamstring

Question 26

Hamstring strain MOI and tx

Answer 26

Forcefulll contraction as a result of hip flexion and knee extension

Ice, compresion, stretching, rehab

Semimembranosus, tendinosis, biceps femoris

Question 27

AC sprain

Answer 27

Separated shoulder

Probably landed directly on

Tenderness over AC joint with “step-off” contour

Question 28

AC sprain MOI and tx

Answer 28

Driect blow to lateral

ICe, sling, rest, 4-6 weeks full motion

Question 29

Wrist sprain and most common ligament

Answer 29

FOOSH

Mild edema of dorsal aspect

Pain with extension and flexion of wrist

Scapholunate ligament