Lower Final Review (All Exams)

Place the following exercises in order of the phase of hip rehab they should be used (phase 2, 3, 4).

-4-way hip with theraband -Lateral shuffle -Box jumps

List 2 non-surgical options (not rehab exercise related) to manage a Morton's Neuroma case in one of your baseball players.

-Add a pad in their shoe. -Orthotics

Pain located on the medial aspect of the pelvis and thigh, may indicate which of the following conditions? Select all that apply.

-Adductor avulsion fracture -Stress fracture -Adductor tear -Gracilis tear

Which of the following are risk factors for developing knee osteoarthritis? Select all that apply.

-BMI -Age -Sex -Activity with increased joint loading -Previous history of injury

Select the following terms that describe the rearfoot position pictured below (select all that apply)

-Calcaneal eversion -Rearfoot valgus

Describe Cam and Pincer lesions, which cause femoral acetabular impingement (FAI).

-Cam lesions are lesions on the femoral neck. -Pincer lesions are lesions on the acetabulum/rim of the acetabulum.

Which of the following are options for surgical fixation of a Lisfranc dislocation? Select all that apply.

-Combination of plating and screws -Dorsal bridge plating -Screw fixation

Your football athlete is progressing through rehab from a Lisfranc sprain. He is ready to begin plyometric exercises. List 3 exercises you would have him do for his first day of plyometric training.

-DL bunny hops -DL box jumps (small box) -DL frog jumps

One of your patients recently tore her ACL. She is preparing for surgery, but her surgeon gave her criteria/goals to meet before he will operate. List (4) of those criteria/goals of "prehab" prior to ACL reconstruction. Roughly how much time will the preoperative phase take?

-Decrease pain -Reduce swelling -Improve kne joint ROM -Improve strength

Which of the following are long-term concerns with rehabilitation following post-surgical repair of a knee dislocation with multi-ligament damage? Select all that apply.

-Diminished vascular status -Gait alterations -Quadriceps function -Loss of knee motion

Your patient reports generalized ankle stiffness after prolonged rest, especially in the mornings, that has gradually gotten worse over time. In addition, they say they have pain with weight-bearing activities, and limited ROM. Which of the following is most likely to be the problem?

-Discoloration -Gross deformities -Swelling -Gait (see if he's compensating, not putting weight on a certain area, etc.)

What is extensor lag? Identify two (2) therapeutic exercises you can use to address it.

-Extensor lag is whenever the patient can passively be put in full extension but actively, they cannot. -Exercises: Seated leg extension and single-leg squat.

The anterior cruciate ligament serves as a static stabilizer against which of the following movements? Select all that apply.

-Hyperextension of the tibiofemoral joint -Internal rotation of the tibia on the femur -External rotation of the tibia on the femur -Anterior translation of the tibia on the femur

What sort of movements or tasks (not sport specific) increase the risk for ACL injury? Explain how biomechanical alterations to these movements can cause injury.

-Improper landing mechanics in jumping. -Landing more "stiff" and without enough knee flexion can cause injury to the ACL. -Landing in a higher valgus postion can cause stress and injury to the ACL.

Which of the following are functions of the menisci? Select all that apply.

-Improve lubrication for the articulating surfaces -Provide shock absorption -Deepen the articulation and fill the gaps that normally occur during the knee's articulation

Which of the following factors cause arthrogenic muscle inhibition of the quadriceps following knee joint injury and/or surgery? Select all that apply.

-Joint Swelling -Joint structure damage -Pain

During motion into knee extension, you notice that the patella translates laterally over the anterolateral femur. What is the name for this observation?

-Knee OA. -Medial Synovial Plica Syndrome -Fat Pad Syndrome

Following the spontaneous reduction of the tibiofemoral joint, you perform a vascular and neurological exam. List (4) components or structures you would test for during this screen.

-L3-S2 Dermatomes -Popliteal artery -Sciatic nerve -L3-S2 Myotomes

Name (4) structures that make up the posterolateral corner.

-Lateral meniscus -PCL -Biceps femoris -Popliteus

One of your female soccer players has a 20 degree Q angle measurement. This is indicative of risk for which of the following? Select all that apply.

-Laterally tracking patella -ACL injury

Which of the following are risk factors to developing trochanteric bursitis?

-Leg length discrepancy -Increased Q-angle -Female

List the palpation sites for the Ottawa Ankle Rules

-Medial malleolus -Lateral malleolus -6cm distal tib-fib -Navicular -Base of the 5th metatarsal.

Which two structures does the deep layer of the MCL attach to?

-Medial meniscus -Anteromedial capsule

Select the appropriate weight bearing restrictions following ACL reconstruction and meniscus repair for a patient within the first 4-6 weeks. Select all that apply.

-No WB flexion during this time frame -WBAT locked in full extension

Select (4) criteria you would include in RTP testing following ACLR For each criteria, indicate why you want to measure it and what an acceptable value would be at the time of RTP.

-No pain or traceable effusion --We don't want the athlete to have swelling or pain going back in sport...if they don't have pain or effusion, then that would be acceptable. -90% strength bilaterally --We want the athlete to have maximal strength to be able to go back to sport and not reinjure themselves. If they have 5/5 MMT and RROM, that would be acceptable. -Able to perform sport-specific drills --We want the athlete to be able to functionaly move and be able to perform the skills needed for the sport. Going through some drills or a full workout routine that is normally incorporated for a practice, would be an acceptable value. -Able to fully complete a functional sports test. --We want the athlete to prove that they're fully capable and functional to go back in the field. Exceeding a score higher than passing on the functional sports test would be an acceptable value for me.

Differentiate between meniscal pathology or patellofemoral joint pathology, based off of the following findings and/or signs and symptoms.

-Pain going down stairs-->Patellofemoral pathology -Localized pain-->Meniscal pathology -No pain or problems when asked to "duck walk"-->Patellofemoral pathology -Locking-->Meniscal pathology -Pain with cutting-->Meniscal pathology

According to the literature, what are the three (3) factors that predict the length of time it takes to return from an acute hamstring injury?

-Pain when walking -Pain when the injury occurred -Pain at the location

Which of the following procedures warrant a delayed return to running, jumping or other impact activities during rehabilitation? Select all that apply.

-Partial meniscectomy -Microfracture -Meniscus repair

Which of the following chronic pathologies could be caused by repetitive flexion and extension? Select all that apply.

-Plica syndrome -IT Band Friction Syndrome -Fat Pad syndrome

Which of the following are possible causes of an intermetatarsal neuroma? Select all that apply

-Poorly fitted shoes -Sprinters with a constant forefoot striking pattern -Hypomobility of the intermetatarsal joints

Precautions during early rehabilitation following surgical correction of FAI include: (select all that apply)

-Restrict hip external rotation -Restrict hip flexion

Choose 2 exercises for intrinsic foot muscle strengthening and explain how you could progress each exercise.

-Short foot exercise --You could get them from seated to standing and even increase reps. -Toe down others up

Which of the following structures offer dynamic support to the medial longitudinal arch? Select all that apply.

-Tibialis posterior -Tibialis anterior

Identify (2) therapeutic interventions for a laterally positioned patella via tight lateral retinaculum and a shortened IT band.

-Trigger Points for peroneals and IT Band -Flexibility exercises for the lower extremity (IT Band, ankle complex, gastroc/soleus, etc.)

Which of the following pathologies commonly involve pain during push off/toe off? Select all that apply.

-Turf toe -Sesamoiditis -Phalangeal fractures

Mark all of the techniques that are the most appropriate goals and/or techniques for the post-operative ACL repairs (3-5 weeks).

-Use CKC exercises like Mini-squats, Step-ups, Leg press, Calf raises, Lunges within safe ranges -Restore normal gait -Emphasize flexion, but don't lose extension

According to the NATA position statement, "Conservative Management and Prevention of Ankle Sprains in Athletes", a grade 3 ankle sprain be immobilized for at least how many days?

10

For how long does a patient who undergoes a labral repair need to wear a post-operative brace?

10-14 days

Running should be initiated in the rehabilitation program following ACLR roughly _____ weeks post-op.

12

In patients who have suffered from a quadriceps contusion, immobilization in _______ degrees of flexion for _____ hours is associated with a faster return to participation (RTP). Correct answer:

120; 24

Normal knee flexion range of motion ranges from 0 to _____ degrees.

135

In approximately how many degrees of freedom should the knee be placed to isolate the MCL for the valgus stress test?

25 degrees

Legg-Calve-Perthes disease tends to develop in patients in which of the following age ranges?

4-10 years

According to the NATA position statement, Conservative Management and Prevention of Ankle Sprains in Athletes, in order to enhance the diagnostic accuracy for a lateral ankle sprain, how long should the clinician delay the evaluation to confirm the diagnosis?

5 days

Normal plantarflexion ROM (from neutral) is:

50 degrees

Which of the following individuals is most likely to develop ischial bursitis?

50-year-old cyclist

Immobilization after a peroneal tendon repair is typically:

6-8 weeks

When rehabbing a patient with chondromalacia, it is important to be mindful of CKC exercises that involve increased compressive forces of the patellofemoral joint. The range with the most amount of forces is _____________ degrees.

60-90

Normal ROM should be completely restored within _______ weeks following meniscus repair.

8-10

According to the NATA position statement, "Conservative Management and Prevention of Ankle Sprains in Athletes", the injured limb's functional performance should measure at least

80 percent of the uninjured limb for return to activity

Weight-bearing activity is restricted following a quadriceps contusion until control of the quadriceps muscle is regained and the patient has how many degrees of pain-free range of motion (ROM)?

90 degrees

Based on the associated CPR, which of the following patients is MOST predisposed to a deep vein thrombosis (DVT)?

A 30-year-old new mother who had a baby 3 weeks ago but recently fractured her femur. She used hormone replacement therapy to get pregnant.

Which of the following athletes is most at-risk to develop sesamoiditis?

A ballet dancer

You suspect on of your football running backs might be experiencing anterolateral rotary instability. Complete the following information based on your evaluation process. A. Mechanism of InjuryList the possible MOI for this individual. B. Signs & SymptomsList (2) symptoms this athlete might be experiencing. C. Special Tests1. List (2) special tests you would perform to determine the presence of ALRI.2. List (3) structures that are likely to be damaged upon positive test findings.

A. Rotational, or direct trauma B. Knee feels like it's "giving out", pain with flexion C. 1. Crossover Test and Anterolateral Drawer Test 2. ACL, LCL, PCL

Modify the following rehab plan by advancing each of the exercises listed below by suggesting a WITHIN exercise advancement: A. OKC knee extension (90°-40°) 2 x 15 at 40 lbs B. Cuff weight Hip Abduction and Adduction 2 x 25 at 10 lbs C. Clamshell - 3 x 15 reps D. Double leg bridging with stability ball under feet - 2 x 20 reps E. Single leg bridging on floor - 2 x 8 reps F. 6 in step - Front step-ups 2 x 15

A. Standing RDL with band (if too easy increase band resistance) B. Cuff weight copenhagens for hip adduction 3 sets of 20 at 15 lbs and standing cable hip abduction (weighted cable around ankle) 3 sets of 20. C. Clamshell w/theraband around knee- 3 x 15 reps (if too easy, get them to side-plank and do clam shells with their arm extended. D. Single leg bridging with stability ball under heel- 3 sets of 15 reps (theraband around knees) E. Single leg briding on floor- 3 x 10 reps (green/blue band around knees and dumbbell on hip) F. 8 in step- Lateral step-ups 2 x 15 (if too easy, give them some weight)

Which of the following ligaments arises from the anteromedial intercondylar eminence of the tibia?

ACL

This condition often develops after an overly enthusiastic athletic endeavor, and the patient will complain of pain in the posterior lower leg with activities requiring eccentric control.

Achilles tendonitis

Place the structures below in their appropriate subsystems of the "foot core": Active subsystem, passive subsystem, neural subsystem

Active subsystem: Intrinsic foot muscles, extrinsic foot muscles Passive subsystem: Ligaments, bones (within the arch), plantar fascia Neural subsystem: Plantar cutaneous receptors, musculotendinous receptors

A patient who complains of sharp groin pain and weakness when moving sideways (shuffle or carioke), but not straight ahead, may have a strain to the:

Adductor muscles

Pain in the medial thigh or groin that is reproduced with changing directions is likely to be:

Adductor strain

With your mouse, select the muscle group that would be weak if the tensor fascia latae and IT band are shortened.

Adductors

Your patient reports generalized ankle stiffness after prolonged rest, especially in the mornings, that has gradually gotten worse over time. In addition, they say they have pain with weight-bearing activities, and limited ROM. Which of the following is most likely to be the problem?

Ankle osteoarthritis

In which direction does the talus glide during plantarflexion?

Anteriorly

The _____________ bundle of the ACL is taut in flexion, which is explained by the _________ position of it compared to the ___________ bundle.

Anteromedial; Posterior; posterolateral

Which of the following describes the hips having an angle of torsion greater than 20 degrees?

Anteverted

A 14-year-old sprinter describes feeling a "pop" in her posterior upper thigh while running and now complains of pain at the ischial tuberosity. Which of the following should the athletic trainer be most concerned about?

Avulsion fracture

Which of the following MOI is most common for a turf toe injury?

Axial load and hyperextension of 1st MTP joint

Which of the following activities would be the most difficult if the PCL was torn?

Backward running

One of your basketball players is choosing to undergo ACL reconstruction surgery. When deciding which graft to use, he is worried about having prolonged anterior knee pain following surgery once he returns to playing. Which graft type is most likely to elicit anterior knee pain post-surgically?

Bone-patellar-bone

One of your track and field sprinters was recently diagnosed with a stress fracture in her second metatarsal. She is still experiencing some pain with weight bearing. Which of the following immobilization options would be most appropriate for her initial management?

Boot; NWB crutches or scooter

Although patients recovering from a hip dislocation can start swimming around 8-12 weeks, which swimming stroke/style must be avoided until week 16?

Breaststroke

Describe the differences in ROM between a patient with CAI and a healthy individual described in the article, "An Updated Model of Chronic Ankle Instability".

CAI patients display greater inversion and less dorsiflexion. CAI patients tend to exhibit greater inversion and plantarflexion during walking. CAI patients consistently land in a more dorsiflexed position.

Which of the following toe presentations is pictured below

Claw toes

Identify the structure that is assessed with the given tests. -Compression Test -Kleiger's Test -Thompson Test -Eversion Talar Tilt Test -Passive Dorsiflexion and Toe Extension -Anterior Drawer -Inversion Talar Tilt Test

Compression Test= Metatarsals Kleiger's Test= Anterior tibiofibular ligament Thompson Test= Achilles tendon Eversion Talar Tilt Test= Deltoid Ligament Passive Dorsiflexion and Toe Extension= Plantar fascia Anterior Drawer= Anterior talofibular ligament Inversion Talar Tilt Test= Calcaneofibular ligament

What test is used to evaluate the lateral translation of the talus in the ankle mortise?

Cotton test

What happens during the terminal swing phase of gait and which muscle group eccentrically contracts at the hip and knee?

Deceleration; hamstrings

Which of the following activities should be AVOIDED in patients with femoral acetabular impingement (FAI)?

Deep Squats

This condition presents with calf pain, edema, tenderness and warmth and is most common after recent surgery, during pregnancy, or after leg immobilization.

Deep vein thrombosis

Which of the following should be avoided during the initial rehabilitation of a syndesmotic ankle sprain?

Dorsiflexion

Which of the following is the most common mechanism of injury for the distal tibiofibular syndesmosis?

Dorsiflexion and eversion

Active great toe ___ produces greater degrees of motion than ____.

Extension; flexion

Name one patient-rated outcome measure that can be used to assess the ankle or lower leg.

FAAM- Foot and Ankle Ability Measure

What is one (1) patient-rated outcome measure (other than the LEFS) that you can use with a patient who has an ankle injury?

FADI

Achilles tendon rehabilitation should have a heavy focus on CONCENTRIC strengthening.

False

Both the figure-of-eight and volumetric measurements to determine the amount of ankle swelling correlate well with patient's level of function.

False

In a type 3 peroneal tendon dislocation, the superior retinaculum is torn from its calcaneal insertion

False

The ankle is in plantarflexion during the terminal stance of normal gait.

False

This condition creates abnormal stresses on soft tissue and bone and often causes groin pain that is exacerbated with hip flexion actitivies, such as squatting or sitting. It is common in young and middle-aged active individuals and is caused by an altering in structure of the femoral head and/or acetabulum.

Femoral Acetabular Impingement (FAI)

What would a positive hip scouring test indicate?

Femoral acetabular impingement

A ballet dancer has localized aching pain in her thigh. Pain is relieved with rest, but she reports frequent night pain. Hopping on one leg increases her symptoms. What condition is this patient likely suffering from?

Femoral stress fractuer

Which of these stretches targets the piriformis?

Figure-4 stretch

Which of the following is the end-feel for knee extension?

Firm

An athlete with a dislocated patella will present with the knee in what position?

Flexion

Posterior glides of the hip help to increase what motion(s)?

Flexion

What combination of movements is used during the anterior impingement test?

Flexion, internal rotation, and adduction of the hip

Which of the following would be considered a patient-oriented outcome for lateral ankle sprains?

Foot and Ankle Ability Measure

________ is more effective than _________ in managing grade 1 and 2 ankle sprains.

Functional rehabilitation; immobilization

A patient states that he felt a sudden "pull" in his buttock. Upon evaluation you note that he experiences pain with active hip extension as well as passive hip flexion, both with the knee flexed.Which of the following muscles is most likely injured?

Gluteus maximus

Hip drop in the non weight-bearing limb during gait is often caused by either a leg-length discrepancy (shorter side shows the dropped hip) or weakness of what muscle?

Gluteus medius

Which hip abductor is an important stabilizer of the pelvis and when weak, causes the patient to walk with Trendelenburg gait?

Gluteus medius

What is one (1) patient-rated outcome measure (other than the LEFS) that can be used to assess function in patients with hip pain?

HOOS

What injury results in an abducted first ray at the metatarsophalangeal (MTP) joint?

Hallux valgus

A patient complains of posterior thigh pain after sprinting. Extending the leg forward during walking makes it feel like it's going to "pull" again. Which of the following conditions is the most likely diagnosis?

Hamstring Strain

Which injury best meets this description? -Patient reports distinct pop or snap sensation (during initial contraction, or while quickly increasing running speed) and cannot continue activity -Divot felt immediately on palpation; likely to be obscured by edema later -Pain with resisted knee flexion and passive hip flexion combined with knee extension -Antalgic gait with shortened swing phase

Hamstring tear

One of your sprinters comes to you complaining of pain during practice. She describes a sudden pain felt during the swing phase of her run. Which muscle group is likely injured due to deceleration in this phase?

Hamstrings

What muscle group provides the most dynamic stability for the knee in patients with an ACL deficiency?

Hamstrings

A soccer athlete is 3 weeks post ACL surgery and is unable to flex his knee past 100 degrees. What series of exercises will help him the most?

Heel slides, patellar mobilizations, and posterior tibia glides

What position should be used when wanting to manual muscle test the gluteus maximus but not the hamstrings?

Hip extension and 90° of knee flexion

Excessive anterior pelvic tilt during gait may indicate tightness of what muscle group?

Hip flexors

A 21-year-old field hockey player complains of constant dull groin pain that is sometimes sharp while playing. She doesn't recall any specific MOI but has played field hockey most of her life. She describes a "clicking and catching" sensation in her hip and says that about halfway through practice her hip seems to start "giving way". You find she has limited ROM due to pain, but strength is WNL. She has a positive hip scouring test as well as anterior impingement test.Which of the following conditions does the patient most likely have?

Hip labral tear

Patients with this condition will complain of aching pain in the groin/medial thigh after activity, morning stiffness, and a gradual onset.

Hip osteoarthritis

Which of the following is the most common Salter-Harris fracture, that involves the physis and metaphysis (above the joint)?

II

What injury is assessed using the Noble's Compression Test?

IT band syndrome

Which of the following should be AVOIDED when treating a patient for greater trochanteric pain syndrome/greater trochanteric bursitis?

ITB stretching

During the midswing phase of gait, which of the following muscles are contracting CONCENTRICALLY?

Iliopsoas

Which is the most appropriate course of action when traumatic compartment syndrome is suspected?

Immediate referral to a hospital emergency department

Which structure should you mobilize in addition to the patella when you are trying to restore flexion and extension range of motion after ACL, PCL, or meniscus surgery?

Infrapatellar fat pad

The foot experiences both pronation and supination throughout the gait cycle. Match the following phases in the gait cycle with the how the foot is positioned.

Initial Contact= Supination Terminal Stance=Supination Loading Response=Pronation Preswing=Supination Midstance=Pronation

Place the following stages of the gait cycle in order from start to end.

Initial contact, loading response, midstance, terminal stance, pre-swing, initial swing, mid-swing, terminal swing

When taking a history for a pelvis/thigh injury, why is it important to ask female patients about their menstrual history?

Irregular or lack of menses can cause decreased bone density, which increases the risk of stress fractures.

Describe how you would progress a patient in need of hip abduction strengthening.

Isolation exercises, active ROM, incorporate cuff weights and therabands, introduce balancing/proprioception by single leg balance, more functional movement/sport specific drills by adding more weights and complex/chaotic exercises.

A softball player is 2 weeks post Achilles tendon repair and is using crutches to partial weight bear on her foot and ankle. She is in a fixed boot (locked out - no dorsiflexion) and uses an ace wrap. Her swelling is moderate and her pain is 4/10. Her AROM is 0 degrees of dorsiflexion, 50 degrees of plantarflexion, 5 degrees of inversion, and 0 degrees of eversion. MMT: 2/5 dorsiflexion, 3/5 plantarflexion, 2/5 inversion, and 2/5 eversion. After watching her walk with the crutches, you feel that pain and weakness may be causing her inability to accept weight and then transfer forces during gait. Which of the following strength exercises would be most appropriate for this patient?

Isometric manual resistance for inversion and eversion in subtalar neutral

During motion into knee extension, you notice that the patella translates laterally over the anterolateral femur. What is the name for this observation?

J sign

Which of the following findings is most indicative of an isolated meniscal tear?

Joint line tenderness

Which patient rated outcome measure includes the following subscales: symptoms, stiffness, pain, activities of daily living, sports and recreation and quality of life

KOOS

Which of the following special tests examines a syndesmosis separation and the integrity of the anterior tibiofibular ligament?

Kleiger test

Which of the following is indicated by a ballotable patella?

Knee effusion

What nerve roots lead to innervation of the knee?

L3-S2

Injury to which of the following ligaments would cause edema instead of effusion?

LCL

When compared to the gold standard of arthroscopy, which test combines sensitivity and specificity, making it the best examination technique for detecting whether or not an ACL sprain is present?

Lachman's test

After a direct blow to the ilium, your patient has paresthesia over the anterolateral thigh. Which nerve do you suspect is involved?

Lateral femoral cutaneous nerve

Lateral thigh paresthesia and pain, especially after prolonged sitting, that gets worse with tight clothing is likely caused by:

Lateral femoral cutaneous neuropathy (meralgia paresthetica)

Which of the following joint mobilization techniques are required to improve hip adduction?

Lateral glide

During the Apley's Compression and Distraction test, your patient experiences pain when you compress and externally rotate the tibia. Which structure might be damaged?

Lateral meniscus

Which of the following represents the restrictions in ROM that are recommended after a hip labral repair for at least the first 2 weeks post-surgery?

Limit flexion to 90 degrees and extension to 0 degrees

What injury is most often caused by an axial load placed on the rearfoot while weight bearing on extended toes, causing a crush mechanism through the long-axis of the foot?

Lisfranc injury

During the early stages of the strengthening program for a Microfracture or OATS procedure, it is important to avoid exercises that involve ____________________________.

Loading of femoral condyles

Which of the following structures make up the "Unhappy Triad"? Select all that apply.

MCL, lateral meniscus, ACL

A fracture of the proximal one-third of the fibula, usually associated with an injury to the distal tibiofibular syndesmosis (interosseous membrane) is called:

Maisonneuve fracture

Typically, where is pain centralized when a patient is suffering from plantar fasciitis?

Medial calcaneal tubercle

Pain in the distal third of the medial tibial border caused by excessive or prolonged pronation in running and which is not associated with a stress fracture is typically:

Medial tibial stress syndrome

A football player underwent an MPFL reconstruction. Identify the phase will he be able to move onto if he has successfully completed the following goals: (1) full non-painful knee range of motion, (2) full weight bearing without antalgia or limp, (3) no increase in pain or swelling, (4) at least 2 quadrants of patellar mobility, and (5) ability to stand on a single leg.

Moderate protection phase

What type of meniscal tear is pictured below?

Oblique

What injury is indicated by an enlargement of the tibial tubercle?

Osgood-Schlatter disease

Which of the following is caused by rotational, tension, or shearing forces placed on the pubic symphysis?

Osteitis Pubis

An injury to what ligament indicates a positive Sag sign?

PCL

Which of the following exercises must be avoided during the first 6-8 weeks of rehabilitation after an Achilles tendon repair?

Passive dorsiflexion stretches

What is the term for the following patellar presentation?

Patella Alta

What is a common tendon used in an MPFL reconstruction?

Patellar

Achilles tendon repair is a procedure using several small incisions to repair the tendon.

Percutaneous

In a patient with a history of lateral ankle sprains resulting in ligamentous laxity and functional instability, which muscles should be the focus for reestablishing neuromuscular control?

Peroneus longus and peroneus brevis

You have been working with a patient with an ankle injury and are currently utilizing the BAPS board for AROM, having them complete towel stretches, performing grade 1 joint mobilizations, and helping the patient with isometric strengthening exercises. In what stage of rehab is this patient?

Phase 2

Which external hip rotator is often involved in the compression of the sciatic nerve?

Piriformis

A rock climber has buttock pain. He is point tender in the midbuttock region over the sciatic notch. ROM testing reveals weakness on active hip external rotation and passive internal rotation. The FAIR test is positive. What condition is this patient most likely suffering from?

Piriformis syndrome

Correct hand positioning for the anterior drawer test includes one hand stabilizing the leg while the other hand cups the calcaneus with the forearm supporting the foot in a

Plantarflexed position.

A patient presents in the athletic training clinic with pain in the shin area. Which of the following would give you the impression that the injury may be a stress fracture?

Point tenderness in the shin

During the screw home mechanism, what muscle is responsible for "unscrewing" the tibia during knee flexion?

Popliteus

Which of the following is the strongest ligament of the knee and the primary stabilizer?

Posterior cruciate ligament (PCL)

Which part of the joint capsule is supported by the arcuate ligament?

Posterolateral

Which of the following phases of gait would elicit the most amount of pain in someone that has plantar fascitis?

Preswing

A basketball player is 1-week post ACL surgery and she presents with an extensor lag of 5 degrees with obvious VMO atrophy. What series of exercises will help her the most?

Prone hangs, Isometric quad/ham co-contractions, and superior patellar mobilizations

_____ gait is common after ACL reconstruction, which is characterized by a lack of _____ ROM during ______ of the gait cycle.

Quad avoidance; extension; initial contact

Stability of the knee may not be fully compromised in a patient with a Grade III PCL sprain if the ________________ muscle(s) has adequate strength and stabilization capabilities.

Quadricep

During the preswing (toe off) phase of gait, which of the following muscles is contracting ECCENTRICALLY?

Quadriceps

What muscle do you heavily emphasize when rehabilitating a non-operative posterior cruciate ligament injury?

Quadriceps

Place the bony structures and joints in their appropriate categories according to regions of the foot

Rearfoot Bony Structures: Calcaneus, Talus Rearfoot Joints: Subtalar Midfoot Bony Structures: Cuboid, Navicular, Cuneiforms Midfoot Joints: Transverse Tarsal, Distal Intertarsal Forefoot Joints: Tarsometatarsal, Intermetatarsal Metatarsalphalangeal, interphalangeal

After an evaluation of a foot injury you determine the patient is in the late fibroblastic phase, which phase of rehabilitation will you use?

Recovery (Active/Resistive - Phase I/II)

Athletic pubalgia is caused by a weakened posterior inguinal wall due to unbalanced tension between the adductor muscle group and what other muscle?

Rectus abdominus

A patient experienced an acute muscular injury to the soft tissue of the anterior hip. Upon manual muscle testing, you find weakness upon hip flexion and knee extension. Based on the results of manual muscle testing, which of the following is most likely?

Rectus femoris strain

____ patellar dislocations have a longer recovery time through rehabilitation than _____ dislocations

Recurrent; first-time

One of your volleyball athletes recently underwent an MCL repair for a Grade III MCL sprain. What is a consideration for rehab within the first 4-6 weeks?

Restrict exercises to the sagittal plane

Palpable pain just anterior to the Achilles tendon indicates irritation to the:

Retrocalcaneal bursa

A patient presents in the athletic training clinic with a bump on the back of the heel. It is red, swollen, and painful to the touch. The patient states that it has been there for a while, but the new shoes he is wearing have irritated it. What does this patient have?

Retrocalcaneal exostosis

______ pes planus is present in weight-bearing and non weight-bearing situations.

Rigid

Tenderness upon palpation of the ischial tuberosity may indicate all of the following, EXCEPT:

Sciatica

Which of the following exercises produces the greatest amount of strain on the ACL?

Seated knee extension with no external resistance

Which of the following occurs when the femoral head remains in acetabulum and the femoral neck displaces anteriorly?

Slipped Capital Femoral Epiphysis (SCFE)

A 19-year-old dancer complains of pain and snapping in the anterior hip during hip flexion and extension. You find mild pain with palpation of the anterior hip, but ROM and strength are both WNL. Which of the following conditions is this dancer most likely suffering from?

Snapping hip syndrome (coxa saltans)

An os trigonum injury forms when _____________ separates from the __________.

Stieda's process; talus

A patient reports to you with pain, mild swelling, and ecchymosis just posterior to the lateral malleolus of her left ankle. She reports feeling a "pop" during an inversion mechanism, but reports no pain when you palpate the ATFL, CFL, and anterior tibiofibular ligament. When you perform MMT you notice some weakness in eversion compared bilaterally, and discover a noticeable 'pop' along the lateral ankle. From which of the following conditions is this patient likely suffering?

Subluxing peroneals

Which of the following tests are used to examine the integrity of the calcaneofibular and deltoid ligaments?

Talar tilt test

Using the Ottawa Ankle Rules to rule out the presence of a midfoot fracture, a clinician would assess

Tenderness over the navicular bone

Using the picture below, which phase of gait is the person's right leg engaged in?

Terminal stance

Which phases of the stance phase of gait are engaged in single limb support? Select all that apply.

Terminal stance and midstance

What anatomical feature likely accounts for the higher incidence of inversion sprain in the ankle joint?

The deltoid ligament on the medial side is strong, thus causing fewer eversion sprains.

Which of the following is the appropriate way to perform a Kleiger test?

The foot and talus are externally rotated while the examiner maintains a stable leg.

What is the windlass mechanism and how does it influence the plantar fascia/plantar fasciitis?

The mechanism is different from the test

What are the midtarsal joint axes? How do these axes function in conjunction with subtalar supination and pronation?

The midtarsal joint axes are the axes that your midtarsals such as your cuneiforms, cuboid, navicular function among. As we know, the subtalar joint works along an oblique axis due to supination and pronation being a combination of movements. In order to perform supination and pronation, the midtarsal joint axes must work along with the subtalar axes by allowing translation and movement.

Explain the differences between the screw home mechanism in open chain and closed chain movements.

The screw home mechanism is whenever the tibiofemoral joint "locks" or "screws" in through extension and flexion. With this mechanism, the tibia externally rotates going into extension to "lock" in the knee. In order to "unlock" the knee, the popliteus activates and unlocks the knee when it goes into flexion. With all this said, depending if the movement is a closed or open chained movement will dictate which structure moves. For example, for an open chain movement, the tibia externally rotates and locks in. However, for a closed chain movement (such as a squat), the femur moves on the tibia and locks in that way.

Describe why a sprain of the tibiofibular ligament can be more disabling than a sprain of the deltoid ligament.

The tibiofibular ligament is the ligament that helps keep the interosseous membrane together which keeps the tibia and fibula together. Think about it, the deltoid ligament has the lateral ligaments, along with other structures in the ankle to help provide movement, stability, and functionality to the ankle mortise. The tibiofibular ligament helps provide external rotation and dorsiflexion/plantarflexion which can be a functional issue. Having a sprain of the tibiofibular ligament would cause more pain in the leg since you consistenly put stress on the tibia/fibula when you're WB.

Which of the following can be used to test the tightness of the rectus femoris?

Thomas test

Which of the following tests are used to examine the integrity of the Achilles tendon?

Thompson test

This condition causes pain in the anterior lower leg with activities requiring eccentric control, and is typically related to high levels of athletic activity.

Tibialis anterior tendonitis

This condition usually results from acquired flatfoot deformity. Pain and swelling along the medial foot and ankle are common.

Tibialis posterior tendonitis

Type the structures that correspond with the names below: Tom

Tom: Tibialis Posterior Dick: Flexor Digitorum Longus And: Tibial Artery Nervous: Tibial Nerve Harry: Flexor Hallucis Longus

A 36-year-old female is complaining of pain while running on the streets in her neighborhood. Pain is located on the posterolateral aspect of her hip near the greater trochanter and is occasionally accompanied by a sharp pain during hip flexion. What condition should be suspected?

Trochanteric bursitis

Females are more likely to develop trochanteric bursitis than males.

True

Insidious onset groin pain is a common symptom of femoroacetabular impingement.

True

When using Ottawa Ankle Rules, negative findings are more accurate than positive findings.

True

Match the following risk factors for ACL injury with their appropriate category (internal risk factors vs. external risk factors).

Turf field=external Type of shoes worn=external Time of the season=External Age=Internal Previous history of injury=Internal Sex=Internal Quadriceps/hamstring strength ratio=internal

You are working with a patient with chronic ankle instability. The patient has completed balancing exercises on both feet on an unstable surface with eyes open. Which of the following is the most appropriate exercise to progress the patient to next?

Two-foot balance on a foam pad with eyes closed

Which of the following describes what occurs during tarsal coalition?

Union of one or more tarsals

Obtaining muscular balance between the _____________ and ______________ muscles is essential during rehabilitation for PFPS to limit long-term issues.

VMO and vastus lateralis

You assess the muscle firing pattern during hip extension on a patient. You find the patient tends to hinge at the lumbar spine when trying to extend the hip. What does this indicate?

Weakness or inhibition of the gluteus maximus

What is the name of the clinical prediction rule (CPR) that is used to determine the likelihood that a patient is suffering from a deep vein thrombosis (DVT)?

Wells CPR

What is patellofemoral pain syndrome? Discuss (2) causes of PFPS.

What is it? -It is a knee pathology that an individual may experience. This is caused by an acute or chronic onset and the patient may report of having pain around their patella or even "under" the patella. This kind of pathology isn't like the meniscus and is more superficial. Causes: -Previous history/trauma -Patellar subluxation

What test can be used as a clinical evaluation tool for the presence of osteochondral defects on the knee's articular surface?

Wilson's test

During a foot exam, you suspect there are two potential differential diagnoses. How can you differentiate tarsal tunnel syndrome from plantar fasciitis?

You can differentiate tarsal tunnel syndrome from plantar fasciitis if they test postitive after performing the Tinel's sign special test.

Trigger points are commonly found in patients with pelvis/thigh injuries. Explain where one is likely to find trigger points related to these injuries, and what you can do to alleviate those trigger points.

You can most likely find trigger points in the gluteus maximus, gluteus minimus, gluteus medius, tensor fascia latae, IT Band, and Adductors. (I'm assuming this is what you're asking for?). In order to alleviate those trigger points, you can manually manipulate your weight and add pressure to the trigger point holding it for at least 30 seconds. You can also have the patient actively go through the ROM of the muscle.

Match the following types of 5th metatarsal fracture with the corresponding zone.

Zone 2= Jones fracture Zone 1= Avulsion fracture Zone 3= Stress fracture

In order to improve dorsiflexion range of motion, joint mobilizations should be applied with a(n)

anterior to posterior force.

Which bony landmark serves as the attachment site for the biceps femoris, a portion of the soleus and the lateral collateral ligament?

head of the fibula

During rehab for turf toe, your patient just completed 3x30s SL stable surface static balance with eyes open. Describe the rest of your progression through SL static balance.

o progress, I would put them on an uneven surface/non-stable surface such as an airex pad, then I could progress to a BAPS board, BOSU, etc. I also would progress by throwing a ball at them different directions.Once they master that, I get them to look left and right by verbally yelling out cues to them while throwing the ball from behind or different directions. (include eyes closed and open as well)

Identify the type of rotary instability using the pictures above

posterolateral

What is the small, fluid-filled sac directly superficial to the patella?

prepatellar bursa

The ____ phase makes up about 60% of one gait cycle, and ____ phase makes up about 4% of one gait cycle.

stance; swing

People who excessively __________ are more predisposed to inversion ankle sprains.

supinate