ATR 220
What is the function of the quadriceps muscle group?
extend the knee [ rectus femurs is the only muscle that flexes the hip]
movement by which the angle of a joint is increased?
extension
top foot=
extensors
rotation away from the center of the body?
external rotation
Lateral epicondylitis is also known as?
tennis elbow
what are the 4 s/s of a nerve injury?
tingling, burning, decreased strength, loss of function, numbness
Legal wrong committed against another?
tort
what percentage of tension should you use when making an elastic bandage?
50-75%
Restoring ROM
Injury to a joint will always be assoc. with some loss of motion- due to contarcture of CT or resistance to stretch of musclotendinus unit Athlete will need to engage in dynamic static or PNF stretching activities to improve flexibility
Involves falling on flexed wrist (less common)
Smith fx
you have an athlete who suffered a first time shoulder dislocaiton-what should you do and why?
always treat as a possible fx. consult a physician for further evaluation <-- before, properly splint and support to prevent further damage
what is a contusion and how do they occur?
bruise. impact form an external object that causes soft tissues to be compressed against bone underneath
Young children and adolescents are prone to what type of fracture? why?
greenstick fx- bc they are still growing (bones haveint completely ossified)
Two most common bursa ruptures?
knee and elbow
Pertaining to the por away from the midline?
lateral
Injured from a direct varus (medial) force ?
lateral collateral ligament sprain
a sprain is an injury to a ?
ligament
what is the difference between a ligament and a tendon?
ligament connects bone to bone tendon connects muuscle to bone
nearest to the por
proximal
retrocalcaneal bursitis?
pump bump
movement of tilting the wrists from one side to another?
radial/ulnar deviation radial is close to the thumb
When balance is challenged the response is ?
reflexive and automatic
How is impingement managed conservatively?
PRICE, strengthen rotator cuff muscles and those that move scapula , modify activity that caused problem in the first place
List the s/s of shoulder bursitis.
Pain with motion Tenderness during palpation in subacromial space Positive impingement test
How is achilles tendinitis managed?
PRICE, analgesics (e.g. NSAIDs), non-wt bearing cast for 6 weeks, monitoring their activity, **Getting them a heel lift**
HI for the aged and disabled?
Medicare
where is a common location for tenosynovitis?
achilles, patellar tendon
What are the signs and symptoms for chrondomalacia patella?
*Pain in the anterior aspect of the knee while walking, running, ascending/descending stairs, squating swelling, grinding feeling in knee
List 3 differences b/w a personal trainer (strength/conditioning coach) and an athletic trainer.
1) AT must obtain at min. a bachelors in AT, personal trainer may or may not have high education in health sciences 2) AT must pass a comprehensive exam to have ATC credentials; personal trainer may or may not be required to obtain certification 3) AT must continue education while the latter may or may not participate in continuing education
What is the immediate care for an acromioclavicular sprain?
1) application of cold and pressure to control local hemorrhage 2) stabilization of the joint by a shoulder immobilizer 3) referral to physician for definitive dx and tx
Name 3 things sports medicine team can do to minimize athletic injuries.
1) close communication b/w the coach and AT 2) coach and AT should prioritize education the SA about injury prevention and management 3) Athletics should learn about techniques of training and conditioning that will reduce the likelihood of injury 4) pre-participation physicals 5) monitor environmental conditions 6) monitor equipment
Give 3 examples of an acute injury and how each one might occur.
1) fractures-- sudden stress to a bone 2) dislocation--gymnast dislocates toes due to imapct on low bar 3) ligament sprain--soccer player siddenyl turns ankles in wrong direction
phases of healing response
1) inflammatory response 2) fibroblastic repair 3) maturation-remodeling Improtant bc any interference with the healing process during a rehab program will slow return to full activity
Name three domains of AT and give an example of each.
1) injury prevention- enduring appropriate training and conditioning of the athlete 2) evaluating and dx injuries- recognize the nature and extrent of an injury and refer the athlete to the appropraite medical care 3) Providing initial first aid- CPR/AED skills 4) Clinical eduacation- educating students working under AT 5) org and admin- medical notes 6) proessional responsibilities- taking on different roles in the association
Give 2 examples of a chronic injury and how each one might occur.
1) stress fx-- marathon runners 2) tendinitis-- overuse in repetitive sport mmovements (gymnastics)
Describe the difference b/w a grade 1,2, and 3 hamstring strain and discuss the care for these injuries.
1- light overstretch; some pain/swelling 2- minor tears- point tenderness, swelling, loss of strength--> PRICE 3 - complete tear- no function, discoloration, non-wt bearing [PRICE and Surgery ]
Describe the signs associated with grade 1, 2,and 3 AC joint sprains.
1- point tenderness and pain with movement; no disruption of joint 2- tear or rupture; partial displacement of lateral clavicle; pain, point tenderness, and decreased ROM 3- rupter of AC and CC ligaments w/ dislocation of clavicle; gross deformity, pain, loss of function and instability
Quick screening test
1. Stand in anatomical position- evaluate AC joints, general posture- symmetry 2. look at ceiling, floor and over both shoulders- cervical spine motion 3. shrug shoulders (resist movement)- trapezius strength 4. abduct shoulders to 90 (resist)- deltoid strength 5. shoulder rotation (90/90 field goal position)- shoulder motion 6. elbow flexion/extension (elbow motion) 7. pronation/supination (@90)- elbow and wrist motion 8. spread fingers/ make fist (hand or finger motion and deformities) 9. quad set (knee symmetry) 10. perform a lunge (hip, knee, and ankle motion) 11. perform an overhead squat (hip, knee, back, ankle motion and function) 12. Hamstring weakness (hamstring curl) 13. Heel raise (calf symmetry/strength) 13. stand with back to examiner and foward bend - scoliosis
List 5 important areas that need to be covered in an emergency action plan.
1. emergency equipment (AED, splint kid, spinal board) 2. communication and what needs to be communicated to EMS 3. plan 4. emergency personnell (At, students, strength trainer, EMS, coach) 5. directions to and from the facility 6. phone numbers 7. passcodes to building
It is generally recommended that an athlete with a stress fx stop activity for ~____ days or until pain free. They can then gradually inrease stress in the body part until 100%.
14 days
describe each degree of a sprain and strain.
1= overstitching, no joint instability, sx= min. pain, swelling 2= caused by further but still incomplete tearing of ligament, sx= brusing, med. pain, difficulty wt bearing 3= complete tear or rupture of ligament, sx= pain swelling are severe, unable to bear wt
A rupture of a tendon is a ?
3rd degree strain
For an ankle sprain what degree of elevation is recommended?
90 degrees
List the muscles responsible for dorsiflexion of the foot/ankle.
Anterior Tibialis Extensor Digitorum longus Extensor Hallus Longus (Extends great toe)
Movement of a body part away from the midline?
Abduction
covers accidents on school grounds while students are in attendance?
Accident insurance
Responsible for hiring personnel who will make up the sports medicine team?
Athletic Administrator (A.D.)
Primary assessment of potentially life-threatening conditions?
Activate EMS if any findings present ABCS: Airway, Breathing, Circulation (pulse), Severe bleeding/shock To control bleeding: direct pressure, elevation, pressure joints (upper [brachial artery under biceps] and lower [femoral artery] extremities) To manage shock: S/S= pale, cool, clammy skin weak and rapid pulse, increased and shallow breathing, decreased BP, irritability, restlessness, or anxiety Maintain body temp as close to normal, elevate feet and legs (8-12 in), head injury ( elevate head and shoulders- if neck injury is present, immobilized as found with NO movement!, calm the athlete/client/reassurance, nothing by mouth, keep bystanders away, monotor for changes (vitals if possible)
Splinting Principles
Activate the EMS system Splint the injury in the position it is found Splint one joint above and one joint below the fx site Splint before moving the athlete If compound fx with bleeding/cover wound first before splinting Check signs of circulation and if any neurological sx present
when an individual commits an act that is not legally his or hers to perform?
Acts of commission (malfeasance)
when an individual fails to perform a legal duty?
Acts of omission (nonfeasance)
Movement of a body part toward the midline?
Adduction
Muscle that contracts to cause a specific movement of another body part? ( the quad contracts to extend the knee)
Agonist
Responsible for injury evaluation and immediate care of athletic injuries?
Athletic Trainer
Restoring Muscular Strength, Endurance, and Power
Among the most essential factors necessary when restoring function of a body part to pre-injury status Variety of techniques can be utilized- isometric, progressive resistance, isokinetic, plyometrics Emphasize work through a full ROM
Hamstring opposes knee contraction is an example of a ______ muscle?
Antagonist
Before or in front of?
Anterior
What are the four compartments in the lower leg?
Anterior* (most common in compartment syndrome) Lateral Deep Posterior Superficial Posterior
Rupture of extensor tendon dorsal to the middle phalanx and forces DIP joint into extension and PIP into flexion?
Boutonniere Deformity
hallux valgus deformity of the great toe?
Bunion
Form of reimbursement used by managed care providers in which members make a standard payment each month?
Capitation
How can you help your athletes decrease DOMS?
Cool down, flexibility, Good warm-up the next day.
Compression of median nerve due to inflammation of tendons and sheaths of carpal tunnel; result of repeated wrist flexion or direct trauma to anterior aspect of wrist?
Carpal Tunnel syndrome
deal with problems of a lifetime extensive medical and rehab care caused by permanent disability?
Catastrophic insurance
explain how to manage a torn blister
Cleanse with soap and water, rinse with antiseptic If open, drain using sterile gauze pad Apply antibiotic ointment and cover with sterile dressing Cover skin with friction-proof material (e.g. skin lubricant) cover with adhesive bandage Apply a donut pad
Conducts both individual and team training sessions?
Coach
occurs in lower end of radius or ulna MOI is fall on extended wrist , forcing radius and ulna into hyperextension
Colles fx
Blow to the top of the finger from palmar side- forces 1st or 2nd joint dorsally
Dislocation of phalanges
Impairment of blood supply to anterior surface resulting in degeneration of articular cartilage, and bone creating loose bodies within the joint?
Elbow osteochondritis dissecans
Cause= painful muscle spasm; sweating heavily; imbalance between water and electrolytes S/S= occurs in individuals in good shape that overexert themselves. muscle twitching and cramps usually after midday; spasms in arms, legs, abdomen Tx= consuming extra fluids and maintaining electrolyte balance, light stretching and possible ice massage; return to play unlikely due to cramping Prevention= similar to tx but monitor exertion and intake
Exertional Heat Cramps
Cause= prolonged sweating; inadequate replacements of body fluid losses; diarrhea; intestinal infection S/S= profuse sweating, pale skin, mildly elevated Temp, dizziness, hyperventilation, rapid pulse, performance may decrease; excessive thirst and dry tongue and mouth; core temperature 102 Tx= IV fluid replacement, cool environment; increase fluid consumption to 6-8L/d Prevention= monitor wt before and after exercises. give ISU football protocol during 2/days
Exertional Heat Exhaustion (2nd tier of heat illness)
Cause= thermoregulatory failure of sudden onset; LIFE THREATENING CONDITION S/S= abrupt onset, sudden collapse, LOC, flushed hot skin,shallow breaking, strong rapid pulse, core temperature greater than 104, preceded by headache, vertigo, fatigue, sweating stops Tx= drastic measures need to be taken to cool athlete; strip clothing, submerge in ice bath, transport to hospital immediately Prevention= monitor workouts, heat index, hydration, sun exposure, wt loss, body function
Exertional Heatstroke
Cause= fluid/ electrolyte disorder resulting in low concentration of sodium in the blood; caused by ingestion of too much fluid before, during, and after activities; athlete who ingest large amounts of water and sweat over several hours are at risk S/S= progressively worsening headache, N/V, swelling in hands and feet, lethargy or apathy Tx= do not try to rehydrate, transport to medical facility, sodium levels must be increased and fluid levels must be decreased prevention= hydrate with sports drinks, increase sodium intake, and make sure fluid intake equals fluid loss: FOR ALL: monitor heat index humidity percentage (65% slows/75% stops) urine color sports drinks body weight(3-5% loss) gradual acclimation 10-14 days identify susceptible individuals uniform selection
Exertional Hyponatremia
Mechanisms for injury for Posterior cruciate ligament?
Falling on a bent knee
T or F. All stress fx should be casted?
False
common in youth due to falls and direct blows fracturing ulna or radius singularly is rarer than simultaneous fx to both
Forearm fx (pic on final)
Athletic Injury Management Checklist
General HI Accident Insurance Product Liability Insurance Catastrophic Injury Insurance Personal Liability Insurance
Sprain of UCL of MCP joint of the thumb; mechanism is a forceful abduction of proximal phalanx occasionally combined with hyperextension?
Gamekeeper's thumb
Provides limited protection to someone wo voluntarily chooses to provide first aid?
Good samaritan law
What are s/s of Legg-perthes disease?
Groin pain, limited hip movement and pain, limping, chronic onset*
Occurs as a result of a fall or more commonly contact while athlete is holding an implement?
Hamate fx
List the 3 primary muscles that flex the knee.
Hamstring muscles: Biceps Femoris (lateral) Semitendinosus (medial) Semimembranosus (medial)
Insurance plan that is pre approved except in emergency and at HMO facilities?
Health Maintenance Organization (HMO)
Cause= Rapid physical fatigue in heat and blood pooling in extremities S/S= dizziness, nausea, fainting Tx= lay athlete in cool area, elevate extremities, and consume fluids Prevention= plenty of breaks and monitor work load
Heat Syncope (Fainting)
Slipping of the femoral head?
Hip Dislocation
Caused by a blow to the iliac crest?
Hip Pointer
Which of the injuries discussed in this chapter are life-threatening emergencies and why? [hip chapter]
Hip dislocation- lack of circulation increasing risk of necrosis Femur Fx- blood flow rushes to area increasing risk of shock Pelvic Fx- dt all the pertinent nerves/organs/muscles to the area
Which 3 bones comprise the shoulder joint?
Humerus, clavicle, and scapula
How would you manage myositis ossificans traumatica?
If painful and restricts motion, remove after 1 year; NSAIDs; light massages to work out fluid
What is the treatment for a dislocated patella?
Immobilize in position found Ice Refer to physician as physician may reduce knee (Not AT) Muscle strengthening of thigh, hip, and knee
Also known as runners knee?
Iliotibial band syndrome
Most traditional form of billing for health care?
Indemnity Plan
Providing Correct First Aid and Controlling Swelling
Initial first aid is critical Should be directed towards swelling control Utilize the PRICE principle Coach should be capable of providing first aid regardless of whether an ATC is present
What are the 3 types of ankle sprains?
Inversion (most common) Eversion High ankle (syndysmosis)
Functional Progressions
Involves a series of progressive activities designed to prepare the individual to return to a specific sport/acitivity should be incorporated into tx as early as possible monitor athletes tolerance to advance or not will gradually assist injured athlete in achieving normal, pain-free ORM, strength, and neuromuscular control
Rupture of flexor digitorum profundus tendon from insertion on distal phalanx; often occurs with ring finger when athlete tries to grab a jersey?
Jersey Finger
Often associated with avascular necrosis?
Legg-Perthes disease
For the following stress tests, indicate what structures are tested: Valgus Stress test Varus Stress test Lachman's test Apley's compression test
MCL LCL Anterior cruciate ligament (ACL) Meniscus
Caused by a blow that contacts tip of finder avulsing extensor tendon from insertion; Pain at DIP
Mallet finger
Injured form a direct valgus (lateral) force?
Medial Collateral Ligament Sprain
HI for people with low incomes and limited resources?
Medicaid
Direct axial force or compressive force; fx of the 5th metacarpal are associated w/ boxing or martial arts (boxer's fx)?
Metacarpal fx
failure to use ordinary or reasonable care?
Negligence
Bone formation in muscle?
Myositis Ossificans
what organization is responsible for the minimum standard on equipment?
NOCSAE- National Operational Committee for Standards on Athletic Equipment
Specialized in brain and nerve function injuries?
Neurologist
Mind attempt to teach the body conscious control of a specific movement Relies on CNS Requires repetition of same movement Functional exercises are critical
Neuromuscular control
NSAID
Non-steroidal Anti-Inflammatory Drugs
Secondary assessment: Head To Toe
On the field need to decide the seriousness of the injury and how the athlere should be transported from the field HOP: History [what happened, what athlete heard or felt, check for any neurological sx (numbness, tingling, loss of function) Observation- obvious deformity, swelling ,skin discoloration Palpatation- gentle starting away from injury and gradually move toward injured area, look for point of tenderness or deformities If neurological sx, deformity or extreme points of tenderness splinting/ EMS is necessary
Physician responsible for treating musculoskeletal injuryies and surgery?
Orthopedist
Apophysitis of the tibial tubercle?
Osgood-Schlatter disease
Caused by repetitive stress to the pubic symphysis?
Osteitis Pubis
Stretching techniques that involve combos of alternating contraction and stretches?
PNF (Proprioceptive Neuromuscular Facilitation)
what is the tx for a contusion?
PRICE
Also known as Jumper's knee?
Patellar tendinitis
Allows athlete to train year-round with less risk of injury and staleness- transition peroid, preparatory period, competitiion period
Periodization
In meniscal tears, what area has the greatest chance of healing and why?
Peripheral meniscus tears; more blood flow
covers claims of negligence on the part of the individuals?
Personal liability insurance
Caused by compression of the sciatic nerve?
Piriformis Syndrome
Toward the rear or back?
Posterior
Insurance from an approved provider list?
Preferred Provider Organization (PPO)
Can be performed using a variety of equipment utilizes isotonic contractions to generate force while muscle changes length concentric and eccentric strengthening exercises should be utilized
Progressive Resistance Exercise (PRE)
Uses exercises that strengthen muscles through a contraction that overcomes some fixed resistance produced by equipment such as dumbbells, barbells, various wt machines or exercise tubing (therabands)
Progressive Resistance Exercise (PRE)
Describe the care for a lateral ankle sprain.
Protection Rest Ice Compression Elevation **horse shoe should be placed n lateral aspect of ankle in ace wrap**
List the 4 primary muscles that extend the knee.
Quadricep muscles: Vastus medalis Vastus lateralis Vastus intermedius Rectus Femoris
Criteria for Full Return to Activity
Rehab plan must determine what is meant by complete recovery -athlete is fully reconditioned, achieved full ROM, strength, neuromuscular control, CV fitness and sports specific functional skills -athlete is mentally prepared decision to return to play should be a group decision (sports med team)- team physician is ultimately responsible **
How would you treat osteitis pubis?
Rest, NSAIDs, Ice, gradual return to activity (w/ protection to area)
The body will gradually adapt to specific demands imposed on it?
SAID- Specific Adaptations to Imposed Demands
Caused by force on outstretched hand, compressing scaphoid b/w radius and second row of carpal bones?
Scaphoid fx
Once the On the Field assessment is completed you must determne the following?
Seriousness of the injury Type of first aid and immobilization necessary How to transport athlete to sideline/training room, etc Whether to activate EMS or refer immediately to a physician
Which condition can progress into a stress fx if not properly treated?
Shin splints (medial tibial stress syndrome)-- inflammation of the medial section of the tibia tugs on periosteum of the bone
What usually accompanies a fx of the femur as a result of the pathology and pain?
Shock
Basic Components and Goals of a Rehab Program** (KNOW THESE IN ORDER)
Short term goals: Provide correct and immediate first aid to control swelling Control pain Restore full ROM Restore core stability Restore and increase strength, endurance, and power Re-est. neuromuscular control and balance Maintain levels of cardioresp. fitness functional testing mental readiness
Controlling Pain
Some degree of pain will be experienced- pain will be dependent on the severity of the injury, athlete's response, perception of pain and circumstance PRICE and additional modalities (electrical stimulation, heat, etc) can be used to help modulate pain Pain can interfere with rehab and therefore must be addressed throughout the rehab process
Responsible for teaching proper lifting techniques and conditioning athletes?
Strength/Conditioning Coach
Name 5 ways to prevent injuries to the lower leg and ankle.
Stretch (achilles) Proper Foot wear Adequate strength Preventative bracing and taping Neuromuscular control and balance
List the 4 muscles of the rotator cuff and their functions.
Supraspinatus [abductor] Infraspinatus [external rotator] Subscapularis [internal rotator] Teres minor [external rotator]
List 5 characteristics signs of a compartment syndrome.
Swelling and tightness from increased pressure Deep sensation of pain and aching Numbness Stretching exacerbates the pain Poor circulation --decreased circulatory in sensory (pressure readings done by physician)
When making elastic bandages, all start ____ and work up ____ to the joint?
distally; proximally
individual through expressed or implied agreement, assumes some risk or danger will be involved in a particular undertaking?
assumption of risk
bending toward the dorsum or rear
dorsal flexion
Exercise used as part of a rehab program?
Therapeutic exercise
Functional Testing
Uses functional progression drills for the purpose of assessing the athletes ability to perform a specific activity entails a single max effort to gauge how close the athlete is to full return preseason baseline testing is used to compare to post injury tests could be: shuttle runs, agility runs, figure 8s, cariocca tests, vertical jumps etc
Mechanisms for injury for Lateral Collateral Ligament?
Various force (wrestling)
Mechanisms for injury for Medial Collateral Ligament?
Valgus force (outside tackle)
What activities must be included in a functional examination of the ankle?
Walk on toes, walk on heels, hop on injured ankle with heel touching surface, start or stopping movements (running), multidirectional movements (figure 8s), rapid change in direction
How can you prevent shoulder injuries?
Warm up specific to activity Physical conditioning Strength through full ROM- focus on RC muscles Protective equipment Proper instruction on falling for contact and collision sport athletes Mechanics** -- overuse injuries can come from this or when an athlete gets tired, they can lose thier technique
What are the phases of throwing?
Windup Cocking Acceleration Deceleration Follow-through
Repetitive wrist accelerations and decelerations; Primary cause is overuse of the wrist?
Wrist Tendinitis
Most common wrist injury?
Wrist sprain
Regaining Balance
ability to balance and maintain postural stability is essential to reacquiring athletic skills Program should incorporate functional exercises that involve balance training failure to include this may predispose the athlete to re-injury
What mechanism of injury is associated with rotator cuff strain?
acute trauma (high velocity rotation); occurs near insertion on greater tuberosity
Why do you want to add a horseshoe to the ankle compression?
adds focal pressure point to remove fluid (edema)
continuous long duration sustained activities?
aerobic
Explosive, short-duration burst-type activities?
anaerobic
erect position of body with face directed forward arms at side palms rotated inward?
anatomical position
What direction do more shoulders dislocate?
anterior
What is the most common glenohumeral joint dislocation? How does this occur?
anterior; anterior force on shoulder caused forced abduction, extension and external rotation
Which test is used for glenohumeral joint instability?
apprehension test (crank test)
Appearance of a shoulder dislocation in real life.
assemtry of the shoulder where joint is lower than normal and blade ismore anterior that the other shoudler joint
A rehab plan must incorporate functional activities that incorporate ?
balance and proprioceptive training
Stretches that use repetitive movements (contracting a muscle to stretch antagonist)?
ballistic stretching
results from shearing forces on the skin?
blister
Warm-Up
body warming specific areas for the demands of the sport 10-15 minutes increase elasticitiy of tendons and ligaments
Subluxaton
bone is forced out but goes back into place
Dislocation
bone is forced out of alignment and stays out until placed back
what are 3 common areas where you might see nerve injuries in athletes?
brachia plexus, sciatica nerve, nerves of hand (median, ulnar, radial)
what is myositis ossificans and how it is classified?
calcium deposits that result from repeated trauma
What is an acute injury?
caused by trauma
What are the causes of medial tibial stress syndrome?
changes in running surface shoes-- consider arch supports muscle imbalances Proper foot mechanics (pes planus or pes clavus?
may be due to abnormal patellar tracking?
chrondomalacia
moving limb (shoulder) in circular motion?
circumduction
what are the s/s of a fx clavicle?
clavicle appears lower, supporting arm, head tilted towards injured side to decrease pressure
the foot or hand is wt bearing?
closed chain
What are the 4 sensations of icing?
cold, burning, aching , numbness
Muscle shortens against resistance
concentric
activities that are used to minimize injury and maximize performance
conditioning exercise
What does ice do?
control pain and vasoconstricts (slows blood flow)
List three things that can aggravate or cause myositis ossificans in the thigh.
contusion adding heat hard massage
how would you manage a bruised heel?
decrease wt bearing for 24h, RICE, NSAIDs - resume activity with heel cup or doughnut pad after pain ahs subsided ( wear shock abs shoes)
farthest away from por
distal
Sport specific stretching- ex. leg swings for runners- circumduction of shoulders for throwers?
dynamic stretching
muscle lengthens against resistance
eccentric
High incidence in sports caused by fall on outstretched hand w/elbow extended or severe twist while flexed?
elbow dislocation
Name two other joints that are commonly dislocated in sport.
elbows and fingers
what is the cause of the hallux valgus deformity?
exostosis of 1st metatarsal head; assoc with forefoot , shoes that are too narrow pointed or short bursa becomes inflamed and thickens, enlargin joint, and causing lateral malalignment of great toe
What is the common mechanism for an acute injury to the upper extremity?
falling on outstretched arm
T or F. All stress fx are easily seen on initial X-rays?
false
Which bone in the body is the longest and strongest?
femur
Why do most fx occur at the middle third of the femur instead of at the ends?
femur has anatomical curve that predisposes it to weakness at that area
What s/s will be present in an anterior glenohumeral dislocation?
flattened deltoid contour* proximal humeral head in axilla arm carried in slight abduction and external rotation moderate pain and disability
movement by which the angle of a joint is decreased?
flexion
The two principle movements of the knee are?
flexion and extension
bottom foot=
flexors
what is a bursa and why do we have them?
fluid-filled sac on top of the knee cap
What are 3 common areas stress fx occur?
foot ankle leg
Flash to Bang Method
from the time lightening is sighted: Count the number of seconds until the bang occurs Divide by 5 to calculate the number of miles away that the lightening is occurring **Lightening sighted + Bang / 5 = distance away **When counted to 30(6 miles) you are in inherent danger and need to evacuate. At least 30 minutes should pass before play resumes!*
Medial epicondylitis is also known as?
golf elbow
Why is it true that the greater degree of elevation the more effective the decrease in swelling will be?
heart will slow blood flow to the area
Mechanisms for injury for Anterior Cruciate Ligament?
hyperextension ; planted and twisted - common for women!
explain how you would manage a longitudinal arch strain.
immediate care, RICE, reduction of wt bearing wt bearing must be pain free archtaping may be used to allow pain free walking
Using Therapeutic Modalities
incorporated into rehab program as adjuncts to exercise cryotherapy and thermotherapy ultrasound and electrical stimulation massage and traction require special instruction and specific clinical experience in absence of ATC coach may opt for simple modalities within scope of expertise
Why is flexibility important? what factors affect it?
injury prevention factors: bone structure, fat , skin, scar tissue, injuries
rotation towards the center of the body?
internal rotation
Restore Core Stability
involves strengthening the lumbopelvic region and is critical for dynamic functional strength and movement without prox. core stability, distal extremity function become compromised- core strength and power must be emphasized early in the strength training program
How is a shoulder separation different from a shoulder dislocation?
involves the AC joint where the clavicle meets the acromion
resistance given at a fixed velocity of movement with accomodating resistance?
isokinetic
Muscle contract statically without changing length?
isometric
Muscle shortens and lengthens through complete ROM? e.g. dumbbell exercises via bicep curl
isotonic
What complication can occur with a jones fx?
jog nonunion rate and course of healing is unpredictable (lack of blood flow to area)
where does the most common acute fx of the foot occur?
jones fx- 5th metatarsal
Primary mechanism for controlling balance occurs in?
lower extremity joints
stress fx to the second metatarsal?
march fracture
What is the cause of shoulder impingement syndrome?
mechanical compression of supraspinatus tendon, subacromial bursa, and long head of biceps tendon dt decreased space under coracoacromial arch
pertaining to the por closes to the midline of the body?
medial
list the 4 arches of the foot
metatarsal arch transverse arch medial longitudinal lateral longitudinal
characterized by a short-first metatarsal?
mortons toe
What should you always ice soft tissue on and why?
on a stretch; lengthen tissues
when the foot or hand is not in contact with the ground or some other surface?
open chain
ability to turn and rotate thumbs that it can touch each fingertip of same hand?
opposition (Thumb)
can cause both psychosocial and physiological breakdown?
overtraining
what s/s are present with plantar fasciitis?
pain in ant. medial heel along medial long arch increase pain in morning that loosens after first few steps, pain with forfoot dorsiflexion
Responsible for designing exercises or fitness program for individual clients?
personal trainer
Provide an example of malfeasance.
personal trainer creating a rehab plan (not in their scope of practice)
characterized by pain over the medial heel?
plantar fascitis
movement that decreases the angle b/w the sole of the foot and the back of the leg
plantar flexion
uses a quick eccentric stretch of muscle to facilitate a concentric contraction
plyometrics
List the 5 classic signs of a fx femur.
point tenderness pain deformity loss of function swelling thigh-shortening
The two bursae of the knee that have the highest incidence of irritation in sports are the?
pre patellar and deep infra patellar
liability of any or all parties along the chain of manufacture or any product for damage caused by a product?
product liability
inward rotation
pronation
List the signs of morton's neuroma.
sever intermittent pain from distal metatarsal heads to tips of toes pain is relieved when foot is not bearing wt burningn numbness in forefoot hyperextension of toes on wt beaing increase sx
Maintaining Cardiorespiratory Fitness
single most neglected component of rehab** Alternative activities must be substituted that allow athlete to maintain fitness
What is the avg healing time for small bones vs large boes>
small- 3 wks large- 6 wks
How would you manage an ingrown toenail?
soak in hot water (110-120F) for ~20 min 2-3x/d when nail is soft; use forcepts to insert a wisp of cotton under nail edge and lift from the soft tissue ( pack the nail) contonie this until nail has frown out to be trimmed straight across *proper shoe attire*
usually forms bw the fourth and fifth toes?
soft-corn
Responsible for injury dx and is the supervisor/advisor to the certified athletic trainer and coach?
team physician
passively stretching an antagonist muscle by placing it in a stretch and holding is (20 -30s)?
static stretching
specific length of time to sue for damages from negligence (iowa - 7yrs)?
statue of limitations
List the four main articulations of the shoulder complex.
sternclavicular joint, acromioclavicular joint, scapulothoracic joint, and glenohumeral joint
what position should a muscle be ice in? why?
stretch; lengthen it
What are the steps that can be taken to prevent knee injuries?
stretching *stengthening the quad, hamstrings, and hips-- multidirectional strength *Technique *Balance *Bracing
contusion of distal finger causing blood accumulation in the nail bed?
sublingual hematoma
outward rotation
supination
What are the functions of the pelvis?
support the spine and trunk and to transfer their wt to the lower limbs; serve as a place of attachment for the trunk and thigh muscles and protect pelvic organs (i.e. pelvic floor)
Massage
systematic manipulation of soft tissues of the body involves gliding, compressing, stretching, percussing, and vibrating causes mechanical, physiological, and psychological responses uses: lymph drainage, stretch scar tissue and CT, increase circulation (due to increased metabolism), relaxation
a strain is an injury to a ?
tendon and muscle
Sprain of the metatarsophalangeal joint of great toe
turf-toe
Pronounced cubital valgus may cause deep friction problem; ulnar nerve dislocation; traction injury from valgus force, irregularities w/ tunnel, subluxation of ulnar nerve due to lax impingement or progressive compression?
ulnar nerve injury
Hot Packs
used post-acutely (after swelling stops)-- increases blood flow and facilities reads of injury by-products useful analgesic and for relaxation effects be careful not to use too soon- 72 hours 160F
Ice Packs
uses for min. swelling and analgesia following injury flaked or crushed in wet towel or plastic bag- mold to body elastic wrap 20 minutes compression and elevation
Basic Principles of Conditioning
warm-up/cool down, motivation, overload, consistency, progression, intesity, specificity, individuality, stress, safety
Philosophy of Athletic injury rehab
while the majority of injuries do not involve long-term rehab programs those that do require supervision of highly trained professionals coach should rely on AT to design, implement, and supervise rehab coach is limited in the extent to which he/she can legally be involved in supervising or designing program Swelling and pain control should be provided immediately-coach can be involved initially in application of first aid goal of athlete- return to activity as quickly and as safely as possible must be prudent in decisions regarding aggressiveness of tx/ rehab- a mistake in judgement by the individual in-charge of the rehab could hinder the athlete's return
Mechanisms for injury for meniscus injuries?
wt bearing with rotational force while extending or flexing the knee or loaded pivot