Care & Prevention Exam III

If things around you are spinning

Its dehydration (hydrate or die-drate)

Care for SC joint sprain

-RICE immediately -Immobilization 3-5 weeks

Biceps Tenosynovitis care

-Rest -Anti-inflammatory -Treatment -Stretching -Strengthening the biceps

Boutonniere deformity

-Rupture of extensor tendon over the middle phalanx -Trauma occurs to the tip of the finger which forces the DIP joint into extension and the PIP joint into flexion -Athlete has severe pain and cannot extend the PIP joint

Sternoclavicular Sprains

-Uncommon -Mechanism is an indirect force transmitted through upper arm and shoulder joint by a direct force -Example: blow to poorly padded clavicle or twisting of a backward elevated arm -Depending on direction of force, the medial end of the clavicle can be displaced upward & forward...A/P generally upward-forward

ACL or UCL sprain

-Valgus injury -Fall on outstretched hand -From throwing (common in baseball) -MCL occurs @ cocking phase of throwing

Signs of a thunderstorm

-darkening clouds -high winds -thunder -lightening

Relocation Test

-determines glenohumeral instability -with patient supine, the elbow is flexed at 90 degrees and arm is externally rotated so hand is parallel with head -this test should be followed with an apprehension test

heat cramps

-painful muscle spasms that occur most commonly in the calf and abdomen -Primarily due to excessive loss of water which causes fluid imbalance leading to muscle contractions and cramps

Safe Shelter from Lightening

1. A safe location is any substantial frequently inhabited building. the building should have four solid walls (not a dug out), electrical and telephone wiring, as well as plumbing, all of which aid in grounding a structure. 2. A second option is a vehicle with metal roof and windows closed. Do not touch anything metal while in the car. 3. It is not safe to shower, bathe, or talk on landline phones while inside of a safe shelter during thunderstorms.

NATA RECOMMENDATIONS FOR LIGHTENING SAFETY

1. Establish a chain of command that identifies who is to make the call to remove individuals from the field 2. Name a designated weather watcher (a person who actively looks for signs of threatening weather and notifies the chain of command if severe weather becomes dangerous 3. Have a means of monitoring local weather forecasts and warnings 4. designate a safe shelter for each venue 5. Once activities have been suspended, wait at least 30 minutes following the last sound of thunder or lightening flash prior to resuming an activity or returning outdoors.

Lighening strike survivors first aid

1. survey the scene for safety 2. activate local EMS 3. lightening victims do not "carry a charge" and are ok to touch. 4. if necessary, move victim with care to a safer location 5. evaluate airway, breathing, circulation, and begin CPR if necessary 6. Evaluate and treat for hypothermia, shock, fractures, and/or burns.

Carpal Navicular

Anatomical name for Scaphoid bone

Connective heat exchange

Body heat can be lost or gained depending on temp of circulating medium

Metacarpal fracture

Boxer's fracture is also known as

Posterior

Elbow extensors

Anterior

Elbow flexors

Longitudinal arch taping

Meant to provide temporary external support for the medial longitudinal arch. As the foot bears weight, the tape helps maintain the shape and height of the arch, preventing it from falling medially.

Sling Psychrometer

Measures temp and humidity

Conductive Heat Exchange

Physical contact with other objects can result in either heat loss or heat gain

Boxer Tape Job

Prewrap: - wrist to knuckles to thumb and stop at top of wrist to begin weaving between fingers. -cover again and make it super padded Tape: - Half strips between fingers to disperse pressure -Full tape wrist to knuckles to thumb. -tear off and do it again but lower -"hug" thumb w/tape strips on top and bottom of thumb MCP - close it up and check for capillary refill on fingernails.

evaporative heat loss

Sweat glands in the skin allow water to be transported to the surface where it then evaporates, taking large quantities of heat with it

Radial collateral ligament (RCL)

The lateral collateral ligament (LCL) of the elbow is also called the

Ulnar collateral ligament (UCL)

The medial collateral ligament (MCL) of the elbow is also called the

Apley's (compression or grind) Test

Evaluates meniscus tears -Patient lays prone -flex knee at 90 degrees -The patient's thigh is then rooted to the examining table with the examiner's knee. The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. The process is then repeated using compression instead of distraction -If rotation plus distraction is more painful or shows increased rotation relative to the normal side, the lesion is most likely to be ligamentous[3]. If the rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most likely to be a meniscus injury

FROSTNIP TREATMENT

Firm pressure without rubbing, by blowing hot breath on the spot or fingers in armpits.

Radiant Heat Exchange

Heat from sunshine increases body temperature.

Annular Ligament function

Holds down head of radius

Elbow Sprain Cause

Hyperextension or a force that bends the lower arm outward causing injury to the medial collateral ligament.

Lachman's Test

Identifies integrity of ACL -One hand grabs above knee while other hand grabs below knee with thumb on tibial tuberosity. -On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement, while a damaged one will not.

If you're spinning

It's most likely an equilibrium issue.

Heat exhaustion treatment

Lots of fluids and may even need IV treatment. Place in a cool environment, obtain medical help, & cool body down.

Neurogenic TOS

Most common type of TOS that involves the brachial plexus

Frostnip vs Frostbite

Nip - no tissue injury Bite - tissue injury

Metabolic Heat Production

Normal (metabolic) function results in production and radiation of heat (will increase with intensity of exercise)

Quadricep contusion

"frogged" "dead legged" Typically caused from a blow to a relaxed quadricep. - ice in knee flexion for 15-20mins 2-3 times a day. NO HEAT -bilateral comparison. mark knee joint line with marker and 3", 6", and 9" above it. -Measure circumference at each mark. If there is 1" or greater difference in swelling, this should be treated. - give crutches if they walk with a limp

Sun protection 101

- Athletes, coaches, and trainers spend a lot of time in the sun - Avoid the sun from 10am to 4pm - Use sunscreen and sun protectant lip balm -SPF of at least 15 -Apply 15-30mins before you go out in the sin and reapply every 2 hours even if it is water resistant. -Wear sunglasses (98-100%) UV protection -Wear a broad-rimmed hat and loose clothing -Drink plenty of water -Avoid sun lamps and tanning beds - Monitor the UV index. The UV index is a number from 0-10 however it may go higher than ten at extreme levels. The higher the number, the more

Knee Contusion

- Blow struck against the muscles crossing the knee joint. - Produce all appearances of a knee sprain - If adequate 1st aid is given immediately, the knee usually returns to functional use 24-48 hours

Assessing the Knee Joint

- Get a good history. CURRENT & recurrent. What happened? Have you had this before? - Observation: Do you see any swelling? How is their gait? - Palpation: How does it feel? Bilateral comparison. - Special tests: Valgus/varus: tests integrity of the collateral ligaments. - Lachman's test - Apley's compression - Can they do these tests pain free?

Medial Epicondylitis

- Irritation or inflammation from sports that require forceful flexion of the elbow - Called Pitcher's elbow, golfers' elbow, and javelin throwers elbow - Pain is around medial epicondyle during forceful wrist flexion - Point tenderness w/mild swelling - Passive movement of the wrist seldom is sore but active motion is sore - Conservative management - Treatment: NSAIDS, brace, rehab - NOT AS COMMON

Lateral Epicondylitis

- Most common problem of the elbow occurring in sports - Another name is tennis elbow - Cause is repetitive extension of the wrist - Athlete complains of aching pain in lateral elbow during and after activity - Pain becomes gradually worse with weakness in the hand and wrist (loss of grip strength) - Pain on resisted dorsiflexion or wrist and full extension of elbow - Care: RICE, NSAIDS (nonsteroidal anti-inflammatory drugs), Brace, Rehab (grip strength/forearm strength),

FROSTNIP

- ears, nose, cheeks, chin, fingers, and toes. -Skin initially appears very firm, with cold, painless areas that may peel or blister in 24-72 hours.

Cocking phase of throwing

-Begins when hands separate and ends with maximum ER of the humerus -Arm is brought back while abducted & ER (muscle strains common at this phase) -Usually pectoralis muscles, anterior deltoid, long head of biceps, and IR of the shoulder

Care for AC joint sprain

-Cold/pressure -Stabilize by immobilization -Refer -Treatment/rehab -Grade 3 may require surgery

Collateral Ligament sprain care

-Ice -X-rays -Splinting >Buddy taping >Single finger taping

Shoulder dislocation treatment

-Immediate immobilization by sling -Reduction by physician -Do not attempt reduction -Ice -Rehab/reconditioning while in sling and later without it

Deceleration phase of throwing

-Lasts from ball release until max Internal Rotation -ER of rotator cuff contact eccentrically to decelerate the humerus

1st degree SC joint sprain

-Little pain/disability -Some point tenderness

Acromioclavicular Sprain (AC joint)

-Mechanism could be a fall on tip of shoulder that drives AC down -Blow from behind shoulder (AC forward) -Fall on outstretched hand/elbow pushing AC upward

flash to bang count

-Number of seconds between lightening and thunder divided by 5. This is how many miles away the lightening is. -By the time flash to bang count approaches 30 seconds, all individuals should already be inside a safe structure

TOS symptoms

-Numbness or tingling in arms or fingers -Pain or aches in neck, shoulder, arm or hand -Weakened grip -Discoloration of your hand (bluish color) -Arm pain and swelling -Blood clots -Arm fatigue with activity -Paleness or abnormal color in one or more fingers -Throbbing lump near you clavicle -Cold fingers, hands, or arms -Hand or arm pain -Weak or no pulse in the affected arm

Dislocation of the phalanges

-Occur frequently in sports and are caused by a blow to the tip of the finger by a ball -Force of the injury is usually directed upward from the palmar side, displacing the first or second joint dorsally. -Tears in the capsule -May have rupture of tendon

Wrist tendonitis

-Occurs in weightlifters, rowers, or athletes that perform repetitive wrist accelerations/decelerations -Athlete complains of pain w/use or pain in passive stretching (tenderness and swelling over tendon)

Venous TOS

-One or more veins under clavicle are compressed -Results in blood clots

1st degree AC joint sprain

-Point tenderness/discomfort on movement -No deformity

Wind up phase of throwing

-Prep phase -Lasts from the first movement till the ball leaves hand -Lead leg strides forward -Both shoulders abduct, ER, and horizontally abduct (extension)

Shoulder Impingement treatment

-RICE -Restore normal biomechanics -Rotator cuff strengthening (avoid forward flexion) -Scapular stabilization -Modify activities -Conservative care

Wrist sprain care

-RICE -Splint -NSAIDS -Treat by strengthening wrist and taping

Rotator cuff care

-RICE -Strengthening exercises -Decrease activity -Progressively increase activity -Full RC tears and some partial RC tears require surgery

Carpal Tunnel care

-Rest -Immobilization -NSAIDS -Possible injection -Surgery involves decompression of the lligament

2nd degree AC joint sprain

-Rupture to ligaments -Definite displacement and prominence to lateral end of clavicle -Unable to full abduct in ROM or bring arm across chest

3rd degree AC joint sprain

-Rupture with gross deformity -Pain and loss of motion -Weighted X-Ray

Biceps Bursitis

-Subacromial bursa -Results from trauma or overuse -Motion sore and palpable tenderness -Pos impingement sign -Same treatment as Biceps Tenosynovitis -May need injections

Valgus Stress Test

-Tests integrity of the MCL -patient lies supine -therapist sits on edge of mat -bend knee into 30 degrees of flexion -place one hand at lateral knee and push gently in so knee goes medial -positive test is pain or excessive gapping

Labrum Testing (Clunk test)

-The patient lies in supine position with affected shoulder slightly over the edge of the bed. -The examiner places one hand on the posterior aspect of the GH joint while the other hand holds the bicondylar aspect of the humerus above the elbow. -the examiner then fully abducts the arm over the patient's head while pushing anteriorly on the humeral head and simultaneously externally rotating the arm.

Throwing Technique

-To prevent overuse injuries, it is essential that athletes be correctly taught the appropriate techniques -Relative to the shoulder complex, throwing involves 5 distinct phases

collateral ligament sprain

-Very common -Axial force to the tip of the finger -Athlete has point tenderness -Instability when joint is in 150 degrees flexion

2nd degree SC joint sprain

-Visible deformity -Pain, swelling, point tenderness -Inability to abduct arm in full ROM -Inability to bring arm across chest

Phases of throwing

-Wind up -Cocking -Acceleration -Deceleration -Follow through

Metacarpal Fractures

-most common in 5th metacarpal -Cause is direct axial force from punching the wall or person -Percussion test -Refer to physician for reduction and immobilization lasting 3-4 weeks.

RULES OF HEAT RELATED ILLNESS

1. Push fluids : water is best!! 2. Gradual acclimatation 3. Identify susceptible athletes 4. Keep weight records (weigh before and after practice for at least a couple weeks) Loss of 3-5% of body weight reduces blood volume and could lead to a health threat. 5. Never use rubberized clothing to lose weight Know what to do in an emergency

Check Rein taping

An alternative option for PIP and MCP joint injuries, allowing better grip and control of the ball. There are obvious reductions in stability so athletes will need to weigh up the balance between performance and protection.

Types of Ankle taping

Basket weave & Louisiana

Anchors start

Behind MEDIAL malleolus

Buddy taping

Can be used for minor finger and toe injuries such as sprains or strains. You shouldn't use it if there are any obvious deformities from the injury, such as a bone at an odd angle.

Osgood Schlatter's disease

Common to rapidly growing adolescent's knee Cause is repeated pull of patellar tendon at tibial tubercle or front of the tibia Overtime a bony callus form and enlarges Signs include swelling, hemorrhage, and degeneration at tibial tubercle Severe pain when running and jumping and kneeling. care is conservative

UCL repair surgery

Tommy John procedure is often used to repair the UCL and joint capsule. Palmaris longus is used as a tendon graft.

Gamekeeper's thumb

Torn UCL of the thumb -Mechanism of injury is forceful abduction of proximal phalanx, occasionally may be combined with hyperextension -Stability is reduced -Splinting thumb conservatively 3+ weeks until pain free

Diamond finger taping

Used to treat a jammed finger

All dislocations must be

X-rayed to rule out a fracture

Drop Arm Test

abduction of the arm followed by controlled lowering to assess the possibility of injury to the rotator cuff

Inadequate immobilization

can lead to an unstable joint or excessive scar tissue

PCL injury

o Cause is when injured knee gets hyperflexed from falling with full weight on anterior aspect of bent knee or posteriorly directed force to front of knee. o Feels "pop" to back of knee. o Little swelling, laxity. o Care: PRICE, quad strengthening, and ROM. No surgery o Land with flexed knee on hard surface

LCL injury

o Not as common as MCL injuries. o From impact on medial side of knee. Varus type of motion & internal rotation of the tibia. o Similar signs to MCL o Graded 1, 2, 3

Heat Cramps Treatment

push fluids, mild stretching, ice massage after cramps are out, athlete may or may not be able to continue playing, no salt tablets!!!!

Percussion Test

The patient should not be wearing shoes. The examiner then strikes the heel of the patient. A positive test is reproduction of the patient's worst pain.

Empty Can Test

flexion and internal rotation of the shoulder (arms extended forward and making a thumbs down sign) followed by resistance to observe for weakening of the supraspinatus muscle

MCL injury

o Cause is a medially directed valgus force from LATERAL side or external rotation of the tibia. o MCL tears resulting from rotation combined with foot fixed frequently results in ACL or occasionally PCL. o Graded 1, 2, 3 o Care: PRICE for at least 24 hours o Crutches if unable to walk without a limp o If you have a MCL sprain, valgus stress tests are positive o Knee immobilizer o Isometric exercises o Return to full activity. Don't go beyond 90 degrees of flexion or there will be more stress on the ligaments.

ACL injury

o Non-contact injury!!! o Common injury in sports o ACL is necessary for a knee to function in high performance situations. o More women versus men 3:1 ratio o Cause is unclear o May be isolated or associated with other structures o Athlete hears audible "pop" -immediate disability o Rapid swelling at joint line o Laxity o ACL prevents anterior translation of the tibia. o Pain initially then may feel it is better. o Care: PRICE, reconstructive surgery, 4-6 months of rehab, functional brace, Common mechanism: hyperextension

Meniscal injuries

o Results from WB with rotational force while extending or flexing the knee. o Medial meniscus is more common than lateral, but lateral meniscus injuries are increasing. o Only the outer third of a meniscus has good blood supply. o Difficult to tell if athlete has this o Effusion over 48-72 hours o Joint line pain and loss of motion (positive test is if full knee flexion is painful) Intermittent locking and giving way. Pain when squatting. o Sense of knee collapsing or a popping sensation. PRICE...physician

SPF (sun protection factor)

- Index that indicates the length of protection a sunscreen will provide - Example if a person applies sunscreen with a SPF of 15 they would be protected from the sun 15v times their own natural protection limit - The shadow rule: if your shadow is taller than you are in the early morning/late afternoon, UV exposure is low - If shadow is shorter than you are (midday) you are exposed to higher levels of UV radiation seek shade and protect your skin and eyes.

Patellar tendonitis

- Jumper's knee - Occurs in quadricep tendon. - Inflammation - Vague pain with tenderness - Worsens when engaged in jumping/running - Rest, ice, Anti-inflammatories, patellar tendon strapping, hamstring stretching, massage.

Heat related illness- Hyperthermia

- Major concern in sports - Number of deaths due to hyperthermia - Coaches should have knowledge of temperature and humidity - Coaches should know when they reach dangerous levels and act accordingly. Higher humidity makes it harder to dissipate heat from the body.

Hypothermia

- Many sports played in cold weather do not require heavy protective clothing; thus, weather becomes a factor. Injury susceptible - An athlete may fail to warm up sufficiently or may become chilled because of relative inactivity for varying periods demanded by a particular sport - Low temps alone can cause some problems - If you add wind and dampness the chill factor becomes critical - Air temp @ 50 degrees is comfortable but water at the same temp is not - Muscle fatigue builds up during strenuous activity in cold weather - Small drop in core body temp can cause shivering

Frostbite

- Skin appears pale, hard, cold, and waxy - When rewarming, superficial frostbite at first feels numb, then stings and burns blister later on and painful for weeks - Deep frostbite is serious: tissues are frozen , medical attention - Rewarm area, hot drinks, heating pads, hot water bottles, during rewarming the skin becomes blotchy - Gangrene = tissue death. Body parts may be amputated

Chondromalacia patella

- Softening and deterioration of the articular cartilage on the posterior surface of the patella. - Cause is unknown - Sandpaper roughness on patella. - Thought to be a groove or tracking issue. - More common in women - Pain in anterior aspect of knee while walking, running, ascending, descending stairs or squatting - Swelling around knee cap. - Grating sensation - Conservative care such as quad strengthening, knee sleeves, ice, pain free isometrics.

Cold disorders

- Still need to replace fluids in cold weather - Dehydration reduces blood volume, less fluids are available for rewarming the tissues

Dislocation of the Elbow

- Teach athletes how to fall so they don't hurt themselves - High incidence in sports - Caused by fall on the outstretched hand w/elbow in flexed position - Bones of the forearm can be displaced backwards, forward, and lateral - Deformity of the olecranon process - Tears ligaments w/internal bleeding and swelling - Pain & disability - Care: splint them in the position they're found. Don't let it move o Refer to physician right away o Needs to be reduced usually under anesthesia o Treat as if a fracture o After reduction, physician will put in sling with elbow in flexion around 3 weeks. LONG recovery process.

Varus Stress Test

- Tests integrity of the LCL patient lies supine -therapist sits on edge of mat -bend knee into 30 degrees of flexion -place one hand at medial knee and push gently out so knee goes laterally -positive test is pain or excessive gapping

Acute patellar subluxation or dislocation

- When athlete plants the foot, decelerates, & simultaneously cuts in an opposite direction from the WB foot, the thigh IR while the lower leg ER causing a medially directed valgus force @ the knee. - More females because of anatomical angle of wider pelvis. - Usually, a lateral displacement - Loss of knee function - Pain, swelling, patella is in abnormal position. - 1st time dislocation, always suspect association with a fracture. - Immobilize in position found - Ice & refer. Reduction: Tell them to "make a muscle" on quad and press medially for patella to go back in. The longer you wait, the more likely it won't reduce. - If it's a subluxation they will be sore medially which means they tore the retinaculum (saran wrap material that covers muscle).

Shoulder Contusion

-"shoulder pointer" -pain and restricted arm movement -confused with 1st degree AC separation

Carpal tunnel syndrome

-A condition caused by compression of the median nerve in the carpal tunnel and characterized especially by weakness, pain, and disturbances of sensation in the hand and fingers -Most often occurs in athletes that require repeated wrist flexion, although can also result from direct trauma to anterior wrist.

Thoracic Outlet Syndrome (TOS)

-A group of disorders attributed to compression of the subclavian vessels and nerves. -Can cause shoulder and neck pain and numbness in fingers -Common causes include physical trauma from a car accident, repetitive injuries from job or sports related activities, certain anatomical defects and pregnancy -Treatment consists of PT, pain relief, or surgery

Scaphoid fracture

-Also called "carpal navicular" -Rests in the anatomical snuffbox -Caused by a force on the outstretched hand which compresses the scaphoid between the radius and the second row of carpal bones -Swelling and severe point tenderness in the anatomical snuff box

TOS causes and risk factors

-Anatomical defects -Poor posture -Trauma -Sex: females are more than 3 times as likely to be diagnosed with TOS than males -Age: may occur at any age but more commonly diagnosed in adults between 20 and 50

Important Elbow Ligaments

-Annular ligament -Medial collateral (MCL) -Lateral collateral (LCL)

Scaphoid fracture care

-Apply cold, splint, and refer to physician for X-rays -Usually casted for _____ -Strengthening exercises -Taping

Ganglion cyst care

-Aspiration -Felt pressure pad -Neither method prevents the ganglion from recurring -Surgical removal is the best method if problems persist and effects daily living

Subungual Hematoma

-Associated with contusion of the finger -Painful -Accumulates blood under the fingernail -Treated with ice and releasing the pressure by method of choice

Elbow Sprain Symptoms

-Athlete complains of pain or the inability to throw or grasp an object (loss of grip strength indicates a ligament sprain) -Point tenderness over medial collateral ligament

Shoulder Impingement Syndrome

-Cause involves mechanical compression of supraspinatus tendon, the subacromial bursa, and long head of bicep tendon, all of which are located under the coracoacromial arch. -Repetitive compression eventually leads to irritation and inflammation -Often occurs in repetitive overhead activities

heat exhaustion

-Caused by inadequate replacement of fluids lost through sweating -May collapse, profusely sweating, pale skin, mildly elevated temperature, dizziness, hyperventilation, and rapid pulse. -May begin with heat cramps -Become disoriented and lightheaded. Are you spinning or are things around you spinning? -If you're spinning it could be equilibrium, if things around you are spinning, dehydration. -Athletes in poor physical condition who attempt to exercise in the heat are more likely to get heat exhaustion

Elbow Sprain Care

-Cold and pressure (24 hrs) with sling -Needs to gain full ROM progressively after injury then active exercises until full mobility/strength have returned. -Elbow ABDUCTION = bad

Treatment of Olecranon bursitis

-Cold compress -Modalities -Aspiration by a physician -Needs to be padded for protection when athlete returns to competition.

Biceps Tenosynovitis

-Common injury in overhead activities -Inflammation of the bicep tendon and its synovial sheath -Tenderness in upper arm with warmth and crepitus -Pain on throwing

lightening safe position

-Crouched on the ground, weight on balls of feet, feet together, head lowered, and ears covered. -Assume this position when you feel your hair stand on end, skin tingle, or hear crackling noises. -Do not lie flat on the ground

Mallet Finger

-DIP extension splint for 0-6 weeks -Known as baseball or basketball finger

Wrist sprain

-Difficult to distinguish between wrist sprain and tendon strain in the carpal region -Sprain is the most common wrist injury -Falling on hyperextended wrist is most common cause -On examination there is tenderness, swelling, and limited ROM

Shoulder Impingement Syndrome Signs

-Diffuse pain around acromion when arm is in overhead position -External Rotators are weaker -Tight posterior and inferior capsules -Positive impingement test -Positive empty can test

Signs of anterior shoulder dislocation

-Flattened deltoid contour -Humerus in armpit -Athlete carries arm in slight abduction -Unable to touch the opposite shoulder with opposite hand

Follow through phase of throwing

-Max IR until the end of motion where there is a balanced position -Injuries at this phase are in the middle/inferior posterior capsule or posterior shoulder strains

Wrist Ganglion

-May appear slowly after repeated forced hyperextension of the wrist -Contains a clear fluid that may feel soft, rubbery, or very hard -Ganglion most often appears on the back of the wrist -Has lump at the side -Pain increases with wrist extension

Glenoid Labrum injuries

-Mechanism has been traced to throwing mechanics or an acute injury episode (dislocation) -More common than in past -Clinical labrum testing (clunk/shift felt) -Surgery Goal is to acquire full AROM/strengthening/progressing to sport specific and functional skills.

Heat stroke

-Medical emergency! -cause is unknown -Characterized by a collapse of consciousness, flushed, hot skin, less sweating or lack of, shallow breathing, rapid strong pulse, and most important a core temperature of 106 degrees or higher. -Basically, a breakdown of the thermoregulatory mechanism caused by excessively high body temperature. The body loses the ability to dissipate heat through sweating -Can occur suddenly and without warning -The longer the body temp is elevated, the greater the risk of death.

Olecranon bursitis

-Most frequently injured bursa in the elbow from a direct blow. -Inflamed bursa produces pain, swelling, and point tenderness

3rd degree SC joint sprain

-Most severe -Complete disruption w/gross displacement of clavicle -Swelling and disability -If clavicle is displaced backwards, pressure may be placed on blood vessels, esophagus, & trachea and can be life threatening

Glenohumeral dislocation

-Head of the humerus is forced out of the joint -Mechanism for anterior dislocation is abduction, external rotation, and extension that forces humeral head out of the glenoid. -Rarely dislocates inferiorly or even rarer posteriorly

Elbow

-Hinge Joint -Flexion and Extension only -Bones involved are the humerus, radius, and ulna

Assessing the shoulder complex

-History -Observation (A/L/P) -Palpation -Special tests: >Apprehension test >Shoulder impingement >Supraspinatus muscle weakness >Labrum test >Relocation test

Wrist tendonitis care

-Ice -Massage -NSAIDS -Rest -Wrist splint -When swelling goes down, begin ROM then PRE

Acceleration phase of throwing

-Lasts from max ER until ball release -Arm is brought forward -Injuries at this phase could be tendonitis, synovitis (AC/SC), "little league shoulder" and throwing fractures to proximal humerus -Sometimes divided into subphases I & II

Arterial TOS

-Least common type -One or more arteries under clavicle are compressed -Results in a bulging artery (aneurysm)

Rotator cuff strains

-Main muscle injured is the Supraspinatus -Mechanism involves dynamic rotation of the arm at a high velocity during overhead throwing -May happen as a result of a fall or violent pull to arm in older adults -Uncommon in athletes under age 40 -Pos impingement and drop arm test

Anterior apprehension test (for shoulder dislocation)

The examiner flexes the patient's elbow to 90 degrees and abducts their shoulder to 90 degrees. The examiner then slowly externally rotates the patient's shoulder. The test is considered positive if the patient demonstrates apprehension during shoulder external rotation.

Posterior Apprehension Test (for shoulder dislocation)

The examiner places the tested arm in 90 degrees shoulder flexion, neutral rotation, and 100-105 degrees of horizontal adduction. Next, the examiner places their other hand underneath the patient's scapula for support & applies a force through the long axis of the humerus. Assess the patient's response. A positive test is indicated if the long axis force reproduces a sense of apprehension and increased muscle guarding to prevent posterior shoulder dislocation.