MIDTERMS: LE sports Flashcards
(35 cards)
Q: What is the recommended initial treatment for quadriceps contusion?
A: The PRICEMEM protocol: Protection, Rest, Ice, Compression, Elevation, Manual Therapy, Early Motion, Medications.
Q: What is the most common mechanism of injury (MOI) for an anterior cruciate ligament (ACL) tear?
A: Landing from a jump, pivoting, or decelerating, often in the “Position of No Return”.
Q: What is the primary restraint to posterior tibial translation in the knee?
A: The Posterior Cruciate Ligament (PCL).
Q: A sprinter presents with medial tibial stress syndrome (MTSS) and a stress fracture is suspected. How can you differentiate between the two?
MTSS (Shin Splints): Diffuse pain along the medial tibia, worse with activity, improves with rest.
Stress Fracture: Localized tenderness, pain persists even at rest, positive bone scan or MRI.
Q: A soccer player sustains an ACL tear during a match. Design a phase 1 rehabilitation plan for the first 2 weeks post-operation.
Phase 1 (0-2 weeks) Rehab Plan:
Goals: Reduce swelling, restore knee extension, regain quadriceps control.
Exercise Plan:
Gentle ROM drills (0-100° flexion)
Quadriceps/VMO setting
Supported calf raises
Hip abduction & extension
Gait re-education with PWB-FWB
Q: A basketball player presents with patellofemoral pain syndrome (PFPS). What exercise modifications can be applied to reduce pain during training?
Strengthen quadriceps (esp. VMO) with closed kinetic chain (CKC) exercises.
Avoid deep squats and excessive knee flexion (>60°).
Use McConnell taping or patellar sleeves for support.
Encourage hip abductor strengthening to reduce knee valgus stress.
Q: A patient with a grade 2 ankle sprain wants to return to running. How would you progress their rehabilitation program?
Early Stage (0-2 weeks): PRICEMEM, gentle ROM, isometric strengthening.
Mid Stage (2-4 weeks): Balance exercises (BAPS board, single-leg stance), resistance exercises, ankle proprioception drills.
Late Stage (4-6 weeks): Plyometric training, agility drills, return-to-running program.
Q: Compare and contrast intramuscular vs. intermuscular hematomas in quadriceps contusions.
Intramuscular hematoma: Blood is trapped within the muscle sheath, leading to prolonged pain and swelling.
Intermuscular hematoma: Blood escapes into the surrounding tissues, causing faster resolution of swelling but more bruising.
Q: How does excessive foot pronation contribute to both plantar fasciitis and patellofemoral pain syndrome (PFPS)?
Plantar Fasciitis: Increased tension on the plantar fascia, leading to heel pain and inflammation.
PFPS: Pronation causes knee valgus, leading to improper patellar tracking, increasing anterior knee pain.
Q: A patient with chronic Achilles tendinitis has been doing standard concentric calf raises. Evaluate why they might not be improving and suggest an alternative intervention.
Concentric exercises may not provide enough load for tendon adaptation.
Eccentric calf raises (Alfredson protocol) have been shown to be more effective.
Additional interventions: Foot orthoses, gastrocnemius stretching, and shockwave therapy.
Q: What are the goals of Phase 1 (Acute Stage) rehabilitation for a quadriceps contusion?
Control hemorrhage and reduce swelling (PRICEMEM).
Maintain pain-free ROM.
Use crutches if unable to bear weight.
Q: After ACL reconstruction, a patient has met all rehabilitation criteria at 6 months but still lacks confidence in their knee. What additional interventions could improve their psychological readiness?
Incorporate sport-specific drills to improve familiarity.
Use neurocognitive training (e.g., reaction-based agility drills).
Gradual exposure to cutting and pivoting movements.
Consult a sports psychologist if needed.
Q: A clinician argues that cold therapy (cryotherapy) should no longer be used for acute soft tissue injuries. Critically evaluate this claim.
Pros of Cryotherapy: Reduces pain and swelling in the acute phase.
Cons: May delay tissue healing by restricting blood flow.
Alternative approach: Active recovery with controlled early motion may enhance healing.
Q: Design a preventive training program for ACL injury reduction in female athletes.
Warm-Up: Dynamic stretching, agility drills.
Strength: Hip abductors, hamstrings, and quadriceps eccentric loading.
Neuromuscular Training: Plyometrics, landing mechanics, single-leg stability drills.
Sport-Specific Drills: Cutting and pivoting with proper knee alignment.
Q: A volleyball player has jumper’s knee (patellar tendinopathy) but still needs to train. How can you modify their exercise routine to reduce pain while maintaining strength?
Reduce high-impact activities (e.g., limit deep squats and jumps).
Implement eccentric loading (decline board squats).
Use patellar taping or knee sleeves for support.
Modify jump mechanics to reduce patellar tendon stress.
Q: Modify a balance training program for an athlete recovering from a grade 3 ankle sprain to prepare them for return to sport.
Phase 1: BAPS board, single-leg stance on stable surfaces.
Phase 2: BOSU ball squats, single-leg hopping drills.
Phase 3: Reactive agility drills (e.g., lateral shuffles, jump landings).
Phase 4: Sport-specific cutting and pivoting movements.
Q: What should Phase 3 (Functional Rehab) focus on in quadriceps contusion recovery?
Maintain full ROM and progressive strengthening.
Introduce squats, step-downs, hopping, and running drills.
Increase eccentric quadriceps training.
Q: What are the final return-to-sport goals (Phase 4) for a quadriceps contusion?
Introduce sport-specific drills (kicking, multidirectional movements).
Ensure pain-free function and full muscle power.
Q: What are the key rehabilitation goals for Phase 2 (Subacute Stage) of quadriceps contusion?
Restore full ROM and muscle strength.
Gradually progress to full weight-bearing (FWB).
Begin static muscle contractions and stationary exercises (bike, pool therapy).
Q: What is the primary focus of Phase 3 (3-6 months post-op) ACL rehab?
Achieve full strength and ROM.
Begin jogging and running progression.
Introduce sport-specific agility drills (backward running, lateral movements).
Q: What are the goals of the pre-operative phase of ACL rehabilitation?
Reduce swelling and pain.
Maintain quads strength (VMO activation).
Restore pain-free ROM to prevent post-op stiffness.
Q: What should be achieved in Phase 4 (6-10 weeks - Return to Sport) of PCL rehab?
Ensure high-level neuromuscular control.
Resume sport-specific strengthening and agility drills.
Q: What should be achieved in Phase 2 (2-12 weeks post-op) of ACL rehab?
Achieve full knee extension and flexion to 130°+.
Develop quad/hamstring strength (4+/5).
Improve balance and proprioception.
Progress to mini squats, lunges, leg press, and step-ups.
Q: What are the goals of Phase 1 (0-2 weeks post-op) after ACL reconstruction?
Achieve PWB to FWB as tolerated.
Reduce swelling and inflammation.
Regain knee extension (0°) and flexion to at least 100°.
Perform quadriceps setting, calf raises, and early hip strengthening.
