Semester 1 year 1 Flashcards
(176 cards)
1
Q
4 characteristics of muscles.
EEIC
A
Extensibility.
Elasticity.
Irritability.
Contractility.
2
Q
What are tendons?
A
Tissue which connects muscles to bones.
3
Q
What are ligaments?
A
Tissue which spans between articulating bones.
4
Q
Whats does mechanism of injury mean?
A
How we describe an injury as having occured.
5
Q
What are the 2 main categories of injury?
A
Acute and overuse.
6
Q
What is an acute injury?
A
An injury which occurs at a single identifiable traumatic event. Forces apllied is greater than it can withstand.
7
Q
What are the two forces that can cause acute and overuse injuries?
A
Extrinsic and Intrinsic forces.
8
Q
What are extrinsic forces? What is an example of a extrinsic force?
A
Forces which are applied from outside of the body.
E.G. an opponent or object.
9
Q
What are intrinsic forces? What is an example of a intrinsic force?
A
Forces from inside the body.
E.G. contraction of a muscle or joint movements.
10
Q
What is an overuse injury?
A
Excessive tissue stress and injury caused by factors taking their toll over time.
11
Q
What are the extrinsic factors that may cause an overuse injury?
A
Training load. Footwear. Environment conditions. Equipment set up. Ground surface.
12
Q
What are the intrinsic factors that may cause an overuse injury?
A
Age. Gender. Muscular Inbalance. Malalignment. Lack of mobility. Body composition.
13
Q
Common Injury Types
A
How muscle, tendon and ligament injuries are classified.
14
Q
What is a muscle strain/tear? How is it caused?
A
Excessibe forces cause muscle fibres to fail.
Over use (microtears) worsen overtime.
Overstretching
Overexertion
15
Q
What does EAMC mean?
A
Exercise Associated Muscle Cramps
16
Q
What is a cramp?
A
A sudden, painful and involuntary contraction. Often temporary likely tobe cause by fatigue.
17
Q
What is a contusion?
A
Direct compressive force to the muscle.
This causes damage to blood vessels and bruising. (Not always visible.)
18
Q
What is contusion known/described as?
A
Dead leg.
19
Q
What muscles are at greater risk of a strain/tear?
A
Muscles crossing two joints.
20
Q
What are the classifications of muscle strains?
Order least sever to most.
A
Grade I, Grade II and Grade III.
21
Q
What is a grade I strain?
A
Mild. Small number of fibres torn. Minimal loss of function. Fascia intact. Pain/tightness. Minimal bleeding in tissue. Spasm localised.
22
Q
What is a grade II strain?
A
Moderate-Severe Large number of fibres torn. Moderate-severe loss of function. Fascia intact. Pain and weakness. Spasm in surrounding muscle. Bleeding apparent. Painful palpable mass.
23
Q
What is a grade III strain?
A
Severe strain/rupture. Definite gap between muscle. Muscle seperates from bone. Sig. loss of strength and function. Fascia partially/fully torn. Pain Spasm throughout surrounding muscle Bleeding visible distally through tissue.
24
Q
Tendinopathy
A
Clinical syndrome of pain and dysfunction in a tendon.
Often chronic.
25
How is tendinopathy presented as?
Localised pain.
Tenderness to palpation.
Impaired Function.
26
What is localised pain?
Athlete able to pinpoint exactly where the pain is.
| Pain often reproduced when loading the tendon.
27
What is tenderness to palpation?
A focused area of tenderness when palpating the tendon.
| Possibly at bony insertion or mid portion.
28
What is impaired function?
Athlete is not able to perform tasks aswell as they used to. E.G. less strength, speed or jump height.
29
Tendon Strain and Rupture
Occur often at the musculotendious junction (MJT).
| Ruptures likely to be due from degeneration overtime.
30
Common mechanism of injury for ligament sprains
Landing and changing direction.
31
What are the grades of ligament sprains?
Grade I, II and III.
32
What is a grade I ligament sprain?
```
Some collagen disrupted.
Localised tenderness of palpation.
Minimal swelling.
Normal ROM.
Little functional deficit.
```
33
What is a grade II ligament sprain?
```
Most fibres disrupted.
Significant tenderness to palpation.
Considerable swelling.
Increased joint play- endpoint present.
Moderate functional deficit.
```
34
What is a grade III ligament sprain?
```
Complete disruption of collagen fibres.
Audible pop and immediate pain.
Rapid swelling.
Significant joint play- No end point.
Significant functional deficit.
```
35
What is force?
Push or pull acting on a tissue.
36
What is torque?
force acting around an axis to produce rotation of tissue.
37
What are the 5 forces and torque acting on a tissue?
```
Tension
Compression
Bending
Torsion
Shear
```
38
Deformation
Not all forces will cause injury however may cause deformation.
39
What does the stress-strain curve show?
All tissues can tolerate a certain level of deformation before they fail.
40
Stress
Force applied to deform a structure.
41
Strain
Resulting deformation of the structure.
42
Toe Region
Tissue starts to take up the slack.
Fibres begin to straighten.
Crimped state.
43
Elastic Region
Tissue deforms.
| Return to normal force if removed.
44
Yield Point
Tissue deformed in plastic= no elasticity
| Permanent deformation occurs (injury).
45
Plastic Region
Strains and Sprains occur.
| Severity=amount of force and tissue deformation.
46
Failure Point
Complete tissue failure
Grade III
Tissue unresponsive to load=loss of function.
47
What is the soft tissue repair process?
The bodys replacement of destroyed tisssue by living tissue.
48
What are the 4 stages of the soft tissue repair process?
Bleeding.
Inflammation.
Proliferation.
Remodelling.
49
What occurs in the bleeding stage?
Damage to blood vessels.
Muscle>tendon and ligament.
Typically lasts 4-6 hours.
50
What occurs in the inflammation stage?
Essential for repair.
Peaks at 1-3 hours post injury.
Diminishes over 3-14 days.
51
What occurs in the proliferation stage?
Production and laying of scar tissue.
Begins 24-48hours.
Peaks 14-21 days.
Diminishes over 4-6months.
52
What occurs in the remodelling stage?
Organisation of scar tissue.
Scar behaves similarly to injured tissue.
Begins 3-7days.
Diminishes 6-24months.
53
What is scar tissue?
Natural product of the tissue repair process.
Structurally weak.
Restriction in movement.
54
What is the biggest risk factor for injury?
Previous injury.
55
Swelling
Accumulation of fluid in a joint or around tissues.
A common sign of injury.
Caused by tissue irritation/significant vascular trauma.
56
Oedma
Swelling between tissues.
57
What is tissue irritation (insidejoint/oedma) swelling?
1) Inflammation caused by soft tissue damage causes capillary walls to become more permeable.
2) Plasma and proteins leak out of capillariesthrough walls into surrounding tissue.
3) Proteins attract water- increasing swelling.
58
Effusion
Swelling within joints.
59
What is effusion?
| tissue irritation inside a joint
1) synovial membrane irritated meniscus damaged.
| 2) Plasma and proteins leak out of capillaries through synovial membrane into joint space.
60
Significant Vascular Damage
1) e.g. ACL ruptured
2) Blood leaks out of ruptured ACL filling up joint space. (haemarthrosis)
3) plasma and proteins leak out of capillaries through synovial membrane into joint space.
61
What is pain?
A result of sensory and emotional experiences.
| Warning sign to prevent further injury.
62
What are the 3 types of pain?
Nociceptive pain
Neuropathic pain
Central pain
63
Nociceptive pain
Normal response to damaging or potentially damaging stimuli.
| E.G. injury of tissues such as skin and muscles.
64
Neuropathic pain
Pain initiated or caused by damaged disease in the sensory nervous system.
E.G. compressed nerves and nerve lesions.
65
Central pain
Damage/dysfunction to the CNS
Heightened sensitivity of pain.
E.G. result of significant disease or trauma.
66
Pain cells
Nociceptors
67
Where are nociceptors found?
Skin, muscles, joints and bones.
68
What do nociceptors do?
Carry pain from uninjured area to the brain via teh spinal cord.
69
How to decrease pain
1) Decrease sensitivity of nociceptors of injured site.
2) Decrease ability of spinal cord to carry signals to brain.
Achieved by introducing stimulus.
70
Gate control theory
Non-painful input closes "gates" to painful input.
Prevents pain travelling to the CNS.
Non-painful input suppresses pain.
71
What is cryotherapy?
Cold therapy
72
How does cryotherapy reduce pain?
Slows speed of sensory nerve signals.
Activates non-painful nerve cells which interrupt pain signals.
Lessen effects of chemical stimuli that are detected by nociceptors.
73
How does ultrasound reduce pain?
UT energy absorbed may lessen the sensitivity of nociceptors.
74
How does electrotherapy reduce pain?
Electrical stimulation activates non-painful nerve cells which interrupt pain signals.
75
What is ultrasound therapy?
Application of sound energy to soft tissues.
Sound waves travel through skin via gel.
Effect cells involved with pain and tissue repair.
76
Effects of UST on thermal
Promote soft tissue healing process.
Increase extensibility.
Reduce muscle spasm.
Reduce pain.
77
Effects of UST on inflammation and repair
Reduce healing time.
Stimulate production of collagen.
Increase extensibility of scar tissue.
Decrease inflammation.
78
Contraindications to UST
Cancer
Pacemakers
Haemmorrhage
Ischaemic tissue
Venous thrombosis
Dont use on the eye, growth plates or genitals
Application on trunk or pelivis during pregnancy.
79
Sensation Issues- UST
UST produces heat.
Patient must be able to tell the difference between hot and cold.
If machine is dysfunctional patient must be able to tell.
80
Depth of the lesion to be treated.
Superficial (<2cm)=3MHz
| Deep (2-5 or 6cm)=1MHz
81
Pulse Ratio
```
Acute= Pulse 1:4/3 (20%-25%)
Subacute= Pulse 1:3/21 (25%-33%-50%)
Chronic= Pulse 1 2/1/continous (33%, 50%, 100%)
```
82
Intensity required at the lesion
```
Acute= 0.1-0.3 w/cm^2
Subacute= 0.2-0.5 w/cm^2
Chronic= 0.3-0.8 w/cm^2
```
83
Area to be treated in relation to the treatment head size.
E.G 1x 2x 3x etx.
84
What is electrotherapy?
Application of electricity to the body for a therapeutic effect.
Stimulation of tissues.
Applied to the body via electrodes.
85
Why use electrotherapy?
Decrease pain via:
gate control theory
Modulation of pain via brain.
(endorphins and enkephalins)
86
Contraindications of electrotherapy
```
Pacemaker
Trunk or pelvis during pregnancy
eyes, anterior neck
Skin conditon- easily damaged skin
Risk of haemorrhage
Poor blood flow
Venous thrombosis
Active epiphyseal regions in children.
```
87
Sensation issues -Electrotherapy
Skin irritation- pain and/or electrlytic burns.
| Assess patients ability to distinguish between sharp and blunt.
88
Application of interferential therapy.l
Begin with short treatments to gauge the patients response to treatment.
Acute= 5-10mins
Other= 20-30mins
89
AMF
Frequency of electrical current application.
90
Pattern
Rate of change in frequency.
91
Vector
Local or diffuse treatment.
92
Time
How long you want the treatment to last.
93
Carrier frequency
4KHz most common.
94
When is cryotherapy used?
Commonly with acute injuries to decrease pain.
95
Why is cryotherapy used?
Gate control theory.
Slows nerve conduction velocity.
May decrease swelling accumulation.
96
Examples of cryotherapy
```
Freeze gel/spray
Bagged Ice
Game ready
Frozen peas
Ice massage
Ice pack
```
97
Application of cryotherapy
Constant 10-15 minutes of crushed ice.
Every 2-4hours
Damp towel between skin and ice.
Apply for initial 48-72hours.
98
Negative side effects of cryotherapy
Burns, hypothermia, nerve injury and frost bite.
99
5 benefits of applying ice to an acute injury.
```
Lowers sensation
Reduces swelling and heat
Soft tissue healing process
Vasoconstriction
Decrease pain
```
100
PRICE
```
Protection
Rest
Ice
Compression
Elevation
```
101
POLICE
```
Protection
Optimal
Loading
Ice
Compression
Elevation
```
102
Why POLICE?
Too much rest affects tissue mechanics and structure during repair.
103
What should rest be replaced with?
Progressive rehab.
104
Early activity=
Early recovery
105
What does progressive load do?
Restore strength and structure to repairing tissue.
106
Research on POLICE for acute injuries
```
P=
Definetly protect injury
O+L=
Definetly encouraged
I=
Definetly applied
C=
Probably apply compression
E=
Probably elevate
```
107
Contraindication to cryotherapy
```
Cold urticaria (allergic reaction to cold)
Raynauds phenomenon
Poor circulation
sensory impairment
Advanced diabetes
Hypertension
```
108
Thermotherapy
Application of heat to decrease pain and muscle spasm.- Gate controltheory
Not used on acute injuries= incerase inflammation and swelling.
109
Application of thermotherapy
7-9mins to have therapeutic effects on superficial tissue.
15-30mins for deeper tissue.
Most pplications dont warm deeeper tissue.
CW ultrasound best for deeeper tissue.
110
Examples of thermotherapy
```
Jacuzzi
Ultrasound Therapy
Heat rub/spray
Sauna/Steam room
Hot water bottle
Warm bath
Infrared heat lamp
```
111
Contraindications of thermotherapy
```
Acute injury/inflammation
Poor circulation
OverAdvanced arthritus
Areas of poor sensation
Thrombophlebitis (inflamed veins)
```
112
Purpose of athletic taping
Support ligamnets/capsule of injured joints
Support muscle/tendon
Enhance proprioceptive feedback from limb or joint.
Secure padding for compression or protection.
113
Benefits of taping
Give athlete confidence
Increase stability
Incerase joint awareness
Decrease load through muscles and tendons.
114
When is athletic taping applied
Before sport and removed after.
115
What should you do before and after applying tape?
Prepare skin e.g. hair, sweat and clothing.
| Check capillary refill distally.
116
Which tape?
| A muscle injury with swelling.
EAB
117
Which tape?
| A muscle injury with no swelling.
Zinc Oxide
118
Which tape?
| Ligament injury with acute swelling.
EAB
119
Which tape?
| Ligament injury with chronic swelling.
Zinc Oxide
120
Which tape?
| Ligament injury with no swelling.
Zinc Oxide
121
Research into taping.
Tape loses 20-40% of effectiveness after 20mins.
Better tape=more longevity
Restricting movement may affect postural control.
122
Tape and accessories
Zinc Oxide
Cohesive Bandage
Elasticated Adhesive Bandage (EAB)
123
Steps of a lateral ankle sprain taping.
1) Proximal (5cm Zinc) and distal (5cm Zin) anchors.
2) Apply 5cm zinc stirrups x3 medial to lateral.
3) Apply 5cm zinc hprseshoes x3 medial to lateral.
4) Close up with 5cm Zinc.
5) Heel locks if required.
124
Steps of glenohumeral instability taping.
1) Fix 5cm EAB anchor around arm and hyperfix from chest to scapula.
2) Apply 3.8cm rigid zinc tape from arm anterior to posterior over anterior capsule x3.
3) Repeat anterior to posterior over posterior capsule x3.
4) Reinforce tape with 7.5cm EAB lock.
125
Clinical assessment.
Plan management of a patient.
| Involve subjective and objective components.
126
Subjective assessment.
I.E patient or subjective History (SHx)
Information collected from patient via questioning.
Questions focused on background and injury.
127
Objective assessment.
Physical examination.
Visual observation.
Analyse response and reactions to movement and touch.
Confirm thoughts from SHx.
128
Key components of Objective assesssment.
```
Observation and Inspection
Active movements
Passive movements
Resisted movements
Palpation
```
129
SALTAPS
```
See
Ask
Look
Touch
Active movements
Passive movements
Strength testing
```
130
When is SALTAPS used?
Pitchside- a progressive approach
| Not appropiate for head or spinal injuries
131
See
In a good positon to view athletes when competing.
132
Ask
Player responsive?
e.g. what happened?
Where is the pain?
133
Look
Expose injured area and inspect.
Signs of injury e.g bleeding, swelling and deformity.
Comparisons between limbs.
Facial expressions indicates severity.
134
Touch
Carefully palpate exposed area.
Feel for deformity, temperature and swelling.
Lost sensation.
Tenderness and pain.
135
Active movements
Voluntary movements.
Indicates bone, muscle, tendon, ligament integrity.
Assess all available joint movments.
Quality, Pain, ROM and willingness.
136
Passive movements
Only is full active movement is available.
Therapist moves joints through full ROM.
Quality, Pain, ROM and willingness.
137
Strength
Performed if no movemenet limitations.
Therapist applies forceful isometric resistance to joint movements.
Further examination of concentric resistance may follow.
138
Hip Joint
Anatomical rehion comprising of the pelvis and femur.
Synovial ball and socket.
Strong and robust.
Reinforced by strong ligaments.
139
Hip movements
```
Abduction
Adduction
Flexion
Extension
Circumduction
Rotational
```
140
Groin Injuries
Hernia
Pubic Bone Stress Injury
Hip Flexor Strain
Adductor Strain
141
Hip Joint Pain
Labrum tear
Impingement
Osteoarthritis
142
Objective Hip and Groin Assessment
```
Observation and Inspection
Active range of Movement
Passive range of Movement
Resisted range of Movement
Palpation
```
143
What to look for during Observation and Inspection?
```
Expose skin and socks off:
Swelling
Bruising
Scarring
Deformity
Abnormalities
Skin conditons/damage
Facial expressions
Postural abnormalities
```
144
How to perform AROM
```
Instruct patients to move joint.
Demonstrate movement
2-3 reps
QPRW
Compare left and right
Overpressure- Endfeel
Goniometry
```
145
Normal Joint End Feels
```
Hard= Bone on Bone
Soft= Soft tissue approximation
Elastic= Capsule/ligament/muscle stretch
```
146
Palpation
```
Systematic and logical
Tenderness
Swelling
Deformity/abnormalities
Quality of palpation
```
147
Key landmarks of anterior hip
Axis
Pubic tubercle
Greater trochanter
148
Key landmarks of posterior hip
Iliac crest
| Ischial tuberosity
149
Key muscles of hip region
Gluteus maximus and medius
Iliopsoas
Rectus Femoris
Adductor Longus
150
The knee joint
Femur, tibia, fibula and patella.
Synovial hinge joint.
Meniscus increase stability.
151
Thigh region
Quadriceps and hamstrings.
Adductors.
Poduce movement and dynamically stabilise the knee.
152
Knee movements
Flexion and Extension
| Lateral Rotation and Medial Rotation
153
Knee Injuries
Meniscus tear
MCL sprain/rupture
ACL partisl tear/rupture
Patella tendinopathy
154
Assessing knee and thigh region
```
Observation and Inspection
Active range of Movement
Passive range of Movement
Resisted range of Movement
Palpation
```
155
QPRW
Quality
Pain
Range
Willingness
156
Before palpation
Uniform neat
Short nails
Hygiene- washed hands
Consent to palpate
157
Anterior Key Landmarks of knee and thigh region
```
Patella
Patella tendon
Tibial tuberosity
MCL
Meniscus
LCL
```
158
Key muscles of knee and thigh region
```
Vastus Lateralis
Rectus Femoris
Vastus Medialis
Semitendinosus
Semimembranosus
Biceps Femoris
```
159
What is the benefit of optimal loading over prolonged periods of rest?
Earlier mobility= earlier recovery-Quicker tissue healing
| MECHANOTHERAPY
160
How long would you advise the athlete to wait before loading the injured tissue and why?
2-3 days dependant on severity because swelling and inflammation should have reduced.
161
Torque
Force acts around an axis to produce rotation of tissue.
162
Tension
Pushing away muscle.
163
Compression
Pushing together
164
Bending
Move 2 ends together.
165
Torsion
rotate around a bone e.g. change direction
166
Shear force
2 bones rub together. E.g. vertebrae
167
Why do muscles have more bleeding?
They are more vascular.
168
Haemostasis
Bleeding phase.
169
Signs of inflammation
```
Swelling
Tenderness
Bruising
Heat
Redness
```
170
Fibroplasia
Fibre build up. Fibres that have been damaged start to be built up.
171
Angiogenesis
Vessel birth. Vessel build up. Capalliries, arteries and veins.
172
Underwrap
Protect hair before taping.
173
Foam
Protection on bony area or around.
174
Heel and lace pads.
Irritable areas and to protect superior structures.
175
Pre-tape
Adhesive
176
Remover
Tape that you cant cut.
| Spray destroys tape structure.
