Traumatic Injuries (Week 7)

Question 1

what is the mechanism of an ankle sprain?

Answer 1

a combination of high force and high strain in a ligament results in failure

Question 2

wha position of the ankle results in high strain of the lateral ligaments? (2 points)

Answer 2

• combination of inversion and internal rotation/forefoot adduction
• planter flexion can increase the strain further, but does not have to be present for failure strain

Question 3

which ligaments on the lateral side of the ankle fail ?

Answer 3

• ATFL (tensile strength much lower than the other lateral ligaments)
• CFL (less often, high load and high ROM strain)

Question 4

state 4 risk factors of ankle sprain

Answer 4

1) previous ankle sprain
2) poor ankle stability
3) poor ankle muscle strength
4. nature of the sport

Question 5

explain how previous ankle sprains can be a risk factor for future sprain

Answer 5

properties of healed ligaments are altered - likely to have reduced stiffness and strength

Question 6

explain how poor ankle stability is a risk factor for ankle sprain (2 points)

Answer 6

• increased laxity (passive range of motion)

- poor proprioception results in slow or inappropriate alterations in balance

Question 7

explain how poor ankle strength is a risk factor for ankle sprain

Answer 7

reduced ability of muscles to absorb forces to control movement of the ankle

Question 8

state 5 preventative techniques of ankle sprains

Answer 8

1) ankle braces
2) mobility exercises
3) balance board exercises
4) strapping and taping
5) strengthening exercises

Question 9

what is the purpose of strapping and taping as a preventative mechanism of injury?

Answer 9

helps with proprioceptive feedback from that joint rather than providing mechanical support

Question 10

explain the ‘contact mechanism’ of an ACL sprain

Answer 10

have an external contact with which forces the knee into an extreme valgus position, which stretches the MCL, which pulls the medial meniscus, which then causes a change in knee orientation and support causes the knee to twist, which ruptures the ACL

Question 11

how does the damage to the lateral meniscus occur during ACL ruptures?

Answer 11

compression

Question 12

what is the position of the foot during contact ACL ruptures

Answer 12

in contact with the ground

Question 13

what two types of motions cause non-contact ACL ruptures

Answer 13

pivot - fixed foot and rotation results in excessive rotation and valgus torque

landing - insufficient knee flexion and weak hamstring result in excessive anterior force

Question 14

explain further the landing cause of a non-contact ACL rupture

Answer 14

landing at an extended knee already puts a lot of strain on the ACL. combining this with weak hamstring muscles plus any degree of valgus will cause knee twist and fail of the ACL

Question 15

state 3 risk factors of ACL ruptures

Answer 15

1) sex
2) previous injury
3) poor neuromuscular control

Question 16

explain how females are at higher risk of an ACL rupture

Answer 16

anatomical, hormonal effect on tissue properties, knee control

Question 17

explain, using 2 points, how poor neuromuscular control increases the chances of an ACL rupture

Answer 17

• imbalance in functional strength of quads and hamstrings (stronger quads bring the tibia forward)
• valgus collapse of the knee on jump landing tasks due to poor control of hip abductors

Question 18

explain the use of a ‘neuromuscular training programme’ as a warm-up (5 points)

Answer 18

1) usually in the form of a warm-up
2) aim to improve the strength in the key muscles
3) appropriate muscle activation
4) focus on movement quality
5) improving balance

Question 19

are ‘neuromuscular training programmes’ in warm-ups useful? (2 points)

Answer 19

• shown to be effective in controlled trials by reducing risk factors
• have to be viewed as performance enhancing as well to be implemented in practice

Question 20

during what activities is a hamstring tear most likely to occur?

Answer 20

running, sprinting, kicking, extreme stretching?

Question 21

what percentage of rugby hamstring tears are due to running?

Answer 21

68%

Question 22

the long head of the bicep femoris is most commonly torn, but why?

Answer 22

due to the combination of origins on the ischial tuberosity and linea aspera of femur, and both inserting on the lateral condyle of the tibia, it ends up being the most strained. and having two heads, the control of that muscle is more complicated than the other hamstring muscles

Question 23

state 4 risk factors for hamstring strains

Answer 23

1) low hamstring strength
2) short fascicle strength
3) flexibility
4) exercise technique

Question 24

what exercise is being implemented across many sports in order to prevent hamstring strains?

Answer 24

Nordic hamstring exercise

Question 25

what is the issue with the Nordic hamstring exercise? (3 points)

Answer 25

1) uptake in many sports is low 2) hamstring incidence remains high 3) highlights the importance of effective implementation strategies