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Rehab Principles > Sprains, Healing Phases, Rehab Components > Flashcards

Sprains, Healing Phases, Rehab Components Flashcards

1
Q

What is rehabilitation?

A

Restoring something to it’s original state

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2
Q

What is a Grade I sprain?

A

Stretching and small tears - less than 50% of tissue fibers

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3
Q

What is a Grade II sprain?

A

More than 50% of fibers torn, but less than a complete tear

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4
Q

What is a Grade III sprain?

A

Complete tear of the tissue in question

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5
Q

What is a Grade IV sprain?

A

Complete tear of the tissue with the separation occurring at the bony attachment point

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6
Q

What is an evulsion fracture?

A

When a bony attachment point breaks off its bone and tears away with the muscle or ligament. Always requires surgical intervention

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7
Q

In evaluation, what does a Grade I sprain feel like?

A

Milk laxity with stable end point

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8
Q

In evaluation, what does a Grade II sprain feel like?

A

Moderate laxity, with a soft end point

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9
Q

In evaluation, what does a Grade III sprain feel like?

A

Significant laxity without end point. Joint is likely floppy, may bend the wrong way, etc.

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10
Q

What are the patient complaints of a Grade I sprain?

A
  • minimal pain and swelling
  • minimal loss of function
  • bruising unlikely
  • no difficulty bearing weight
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11
Q

What are the patient complaints of a Grade II sprain?

A
  • moderate pain and swelling
  • some loss of function
  • bruising likely
  • difficulty weight bearing
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12
Q

What are the patient complaints of a Grade III sprain?

A
  • severe pain and swelling
  • significant loss of function
  • bruising
  • difficulty weight bearing
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13
Q

What is the return to activity time for a Grade I sprain?

A

2 - 4 weeks

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14
Q

What is the return to activity time for a Grade II sprain?

A

6 - 8 weeks

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15
Q

What is the return to activity time for a Grade III sprain?

A

12 weeks - 6 months

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16
Q

What are the 3 phases of healing?

A
  • Inflammatory (Acute)
  • Repair (Subacute)
  • Remodeling (Chronic)
17
Q

What is the key to controlling Phase I of healing?

A

Controlling inflammation - not necessarily stopping it

18
Q

What are the symptoms of acute inflammation?

A

SHARP

  • swelling
  • heat
  • a loss of function
  • redness
  • pain
19
Q

What is are the therapy goals in the inflammation phase?

A
  • reducing pain and swelling

- movement in non-painful directions is recommended (with minimal weight bearing)

20
Q

How long does Phase I of healing usually last?

A

48-72 hours

21
Q

When is Phase II of healing?

A

72 hours - 6 weeks

22
Q

During Phase II we must be careful not to overdo it or what can happen?

A

A return to acute inflammation

23
Q

What is the primary goal of treatment in the repair phase?

A

Loading the tissue (without overloading) to ensure the maximum amount of collagen is laid down in the correct direction

24
Q

When does phase III of healing take place?

A

6 weeks - 2 years depending on severity

25
Q

What is the dominant activity during the remodeling phase?

A

The body redirects the fibers of the healing tissue to orient them along the lines of greatest stress

26
Q

What are the goals of soft tissue manipulation (fluid)?

A
  • Mobilization of fluid
  • Reduction of edema
  • Increase local blood flow
27
Q

What are the goals of soft tissue manipulation (pain)?

A
  • Reduce pain
  • eliminate MFTP (myofascial trigger points)
  • elimination of adhesions
28
Q

What are the goals of soft tissue manipulation (muscle)?

A
  • Decrease muscle soreness / stiffness
  • Increase ROM
  • Facilitate relaxation
  • Reduce spasm / hypertonicity
  • Restore balance to a motion segment
29
Q

What are local contraindications to soft tissue work?

A
  • acute inflammation
  • acute circulatory disturbance
  • acute dermatological problems
  • fever (systemic infection)
  • local infection (pus)
  • new burns
  • abdominal tumor or aneurysm
30
Q

What are the 8 parts of a rehab program?

A
  1. Neutral pelvis, abdominal bracing, hip hinging
  2. Directional preference
  3. Posture and breath training
  4. Return to activity
  5. Floor exercises for stability
  6. Weight bearing exercises
  7. Balance global muscles
  8. Proprioceptive / balance training
31
Q

What is the purpose of hip hinging?

A

Avoiding end-range load during activities of daily living

32
Q

What is directional preference?

A

Exercises and advice to modify daily activities to prevent load in the direction of mechanical sensitivity

33
Q

What are the 3 exercises most commonly prescribed to work the “physiological corset?”

A
  • Quadruped
  • Curl up / dead bug
  • Side bridge
34
Q

What are the weight bearing exercises commonly prescribed to most patients?

What is their purpose?

A
  • Double and single leg squats
  • Lunges

To

  • Reinforce core stabilization
  • Build endurance and coordination of anti-gravity muscles
35
Q

Rehab step 7 - balance large, global muscles - has 3 goals:

A
  • Stretch tight muscles
  • Activate inhibited muscles
  • Build endurance
36
Q

Proprioceptive / balance training is performed on?

A 
Unstable surfaces: 
- foam pad 
- rocker boards 
- gym ball 
Etc.
37
Q

What STM techniques are appropriate during the Acute phase?

A
  • Reciprocal inhibition
  • MTFP (referring TP only)
  • Post Isometric Relaxation (in certain circumstances)
38
Q

What treatment techniques are appropriate during the Repair phase?

A
  • Pin & Stretch
  • Post Isometric Relaxation
  • MFTP Release
  • Cross Fiber Friction

And techniques that also work for the Acute phase:
- Reciprocal Inhibition

Rehab Principles (6 decks)

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