Treatment methods Flashcards
Name the four time phrases of stretching
Acute phase, mid phase, later phase and long term
Describe the acute phase of stretching
Within the first three days no stretching should occur, the focus should be PRICE and complete rest
Describe the mid-phase of stretching
Begins after three days and lasts up to two weeks. Heat therapy and static and passive stretching are proven to speed up recovery. There should be no bouncing or jerky movements
Describe the later phase of stretching
Further two weeks to docus on range of motion, strength and co-ordination. PNF stretches are added for passive and static techniques
What are PNF stretches?
Proprioceptive neuromuscular facilitation stretches, stretching done in a pattern of 10 second stretch, 6 second isometric contraction and then 30 second stretch just beyond the range of motion to increase mobility.
What are the benefits of PNF stretching?
- Retrain and desensitise the stretch reflex
- Increase range of motion
- Decrease sensation of pain
- Strengthen connective tissue
Describe the long term phase of stretching
Active and dynamic stretching to increase range of motion and strength of connective tissue to a greater extent than before the injury occurred
Describe massage as a treatment method
A deep muscle therapy to realign connective tissue fibres and flush toxins from the area which is effective for soft tissue injuries
What is the effect of a deep tissue massage?
- Move fluids and nutrients to the damaged tissue to promote healing and removal of waste products
- Stretch tissues to release tension and pressure to improve elasticity
- Break down previous scar tissue to reduce inflexibility, pain and injury
- Generate heat, circulation and relaxation
What injuries should massages not be used on and why?
Ligament or tendon ruptures, contusions or open wounds as increased bleeding will worsen the injury
What is cold therapy (cryotherapy)?
The use of ice or clod water to reduce tissue temperature, metabolic rate and speed of nerve impulses, vasoconstriction of blood vessels, decreased blood flow, inflammation and swelling
When is cryotherapy used and for long?
Following an acute injury for periods of up to 20 minutes and reapplied every 1-3 hours
Name four methods of cryotherapy
- PRICE
- Immersion
- Cryokinetics
- Cryostretching
When using cryotherapy, when should PRICE be applied and what should be used?
PRICE should be applied as soon as possible and continued for 24-48 hours for acute soft tissue injuries. Ice packs are preferable to maintain effects of gravity
When and why is immersion in cold baths used?
10 minutes at around 10 degrees C to reduce pain and drop in performance due to exercise induced muscle damage
What is cryokinetics?
Ice application followed by rehabilitation exercises to treat ligament sprains
What is cryostretching?
A combination of cold applications and stretching to reduce muscle tension and increase flexibility to decrease pain of muscle damage
When is cold therapy used?
Acute injuries and after exercise to relieve exercise-induced muscle damage
What are the risks of cold therapy?
If used for too long = tissue and nerve damage and skin abrasions from ice exposure on skin
What is heat therapy?
Using heat to reduce muscle tension, stiffness and pain, also vasodilates blood vessels to increase healing and blood flow to damaged area
When is heat therapy used?
Chronic injuries and late stage acute injuries around 48 hours after exercise
What does heat therapy consist of?
Heat packs, hot towels, heat rubs and water immersion for up to 20 minutes and combined with stretching to increase connective tissue elasticity during rehab and pre exercise
What are the risks of heat therapy?
Increased swelling and pain of an acute injury
What is contrast therapy?
The use of alternate cold and hot therapy to increase blood flow and decrease swelling and pain after exercise or in the late stages of injury
When is contrast therapy used?
Once bleeding has stopped and there is no longer any inflammation and following the acute stage of injury (3-5 days)
Name four approaches of contrast therapy
- Immersion to shoulder level post-exercise
- Cold water followed immediately by hot water
- Cold:Warm ratio of 1:3/4
- Accumulating 6-10 mins in cold water
What effect does contrast therapy have on blood flow?
Vasoconstriction and dilation causes a pumping action of blood flow and nutrient delivery to damaged tissues and decreases pain and swelling
What are the risks of contrast therapy?
Can increase blood pressure and can cause pain to skin going from a hot to cold environment immediately (chilblains)
What are anti-inflammatory drugs?
Non steroid Anti Inflammatory Drugs e.g. ibuprofen and aspirin are used to treat acute sports injuries
With acute (1) injuries, chemicals are released by damaged cells causing (2) of blood vessels, increased blood flow and (3) fluid which causes redness, swelling and (4). NSAIDs reduce inflammation by (5), (6) pain signals and reduces (7)
1 - soft tissue 2 - vasodilation 3 - cellular 4 - activate pain receptors 5 - inhibiting chemical release 6 - interfering with 7 - temperature
What are possible side effects of NSAIDs?
Heartburn, nausea, headaches and diarrhoea
Why should long term use of NSAIDs be monitored?
When used to treat chronic injuries it can have consequences such as gastro-intestinal bleeding, shock, anaemia, stroke and heart attack
What is physiotherapy?
Physical methods to treat injuries by qualified physiotherapists
What might physiotherapy consist of?
- (1) and (2) of joints and tissues
- (3) to repair and stimulate tissues
- Exercise therapy to (4)
1 - Mobilisation
2 - Manipulation
3 - Electrotherapy
4 - Strengthen muscles
What might physiotherapy consist of?
- Massage to stretch and relax (1) and increase (2)
- (3) programmes design and advice
- (4) training to release tension and maximise (5) output
1 - tissues 2 - circulation 3 - rehabilitation 4 - posture and alignment 5 - power
What is the first phase of physiotherapy for a dislocated shoulder?
Pain relief, minimise swelling, ice therapy and shoulder sling for support
What is the second phase of physiotherapy for a dislocated shoulder?
Exercises to maintain rotator cuff muscle strength
What is the third phase of physiotherapy for a dislocated shoulder?
Restore range of motion, muscle length, connective tissue mobility and resting muscle tension by using massage, stretching and possibly acupuncture
When is surgery used?
Following serious injury or to eliminate persistent symptoms other treatments have not prevented
What can be done through surgical procedures?
Repair of damaged soft tissue, realignment of bones and repositioning of joints
Name three common surgical procedures
Knee ligament surgery, Shoulder stabilisation surgery and Meniscal tear surgery
What is knee ligament surgery?
e.g. ACL reconstruction - a tissue graft from the patella tendon or hamstring to replace the ACL and restore full function. Most common in skiiers
What is the ACL?
Anterior Cruciate Ligament in the knee
What is shoulder stabilisation surgery?
Used prior to multiple dislocations to stabilise the joint by anchoring the humerus into the scapula and repair the joint capsule. Most common in throwing athletes
What is meniscal tear surgery?
Following cartilage tear in the knee to repair damage, the Meniscus can be resurfaced to remove rough projections and in extreme cases a cartilage implant can be used. Most common in footballers
What is the Meniscus?
A thin cartilage in the knee
What is Arthroscopy?
AKA ‘Keyhole Surgery’, the patient is under general or local anaesthetic so a small incision is made for a camera to be implemented to guide and repair to minimise surrounding damage
What are the benefits of arthroscopy compared to open surgery?
Reduces pain caused, risk of infection and ensures faster recovery
When is arthroscopy used?
Repair cartilage and soft tissue damage
Describe open surgery and its use
An incision is made when the patient is under general or local anaesthetic to open the joint to repair or reconstruct damaged structures
What are the advantages and disadvantages of open surgery?
Greater repair but a greater risk of infection and significant scarring
When is open surgery most commonly used?
Repair fractures and reconstruct ankles
What is the recovery for open surgery?
6 weeks to several months and physiotherapy
