Spinal Pain in Athletes Flashcards
(26 cards)
What is the common cause of a pars stress fracture?
Extension load with axial compression
What sports is pars stress fracture most common in?
- Gymnastics
- Cricket
- Tennis
- Any sport that involves extension/rotation & axial loading of LSp
What are the risk factors for pars stress fracture in cricket?
- Mixed bowling action (counter rotation of thorax to side on position during delivery stride)
- Crunch factor – excessive trunk LF & pelvis axial rotation
What are the risk factors for pars stress fracture in women’s gymnastics?
- Lots of jumping & extension
- Vault: Lots of extension with axial compression, landing in extension
What are should be considered in the management for female gymnasts with pars injuries?
- Training load
- Technique
- Equipment
- Muscle length/strength
What is the best type of imaging for detecting a pars stress fracture?
CT: Best for bony detail, no radiation, shows bony oedema
What could be included in the OE for a gymnast with a suspected pars stress fracture?
- PAIVMs for thoracic spine
- Psoas, hamstrings, rec fem length
- TA, glut med strength
What are some of the common interventions for spinal pain in gymnasts?
- TA activation
- Maintaining a neutral spine in crook lying
- Single leg squats
- Maintaining a neutral spine in squatting
- Correct landing technique
- Take out hard landings (use mats/foam pits instead)
Why should athletes training at a high load only be prescribed relative rest as a treatment?
- Complete rest for 1-2 weeks would result in large de-training
- When returning to a high training load after a short break, they are at a higher risk of developing stress fractures
What does research show regarding the use of imaging in determining return to sport?
Imaging doesn’t provide great value in determining level of function & readiness to return to sport, - use outcome measures instead
What are the characteristics of rib stress fractures?
- Vague thoracic discomfort
- Progresses to sharp, pinpoint pain
- Exacerbated by cough
What is the common cause of rib stress fractures?
- Not weight-bearing bones, so generally muscular forces (usually serratus anterior/external obliques)
- Common in rowing (amateur & elite)
What is the relationship between the abdominals and the rib cage?
Large contractions of RA can put large forces on the rib cage & cause stress fractures
Why are rib stress fractures more common in elite rowers than amateur rowers?
- Elite have more efficient technique, so can generate more force through the oars
- More force going through the trunk
- Poorer technique = loading the lower limbs more
Which ribs are most commonly affected by stress fractures?
Ribs 4-8, but especially 5th rib (opposing forces of SA & external obliques
What extrinsic factors can contribute to rib stress fractures in rowers?
- Oar shape & size
- Long-endurance rows at low stroke rates of boat speed
- Training level
- Technique
- Dominant side (are they only training one side)
- Position in the boat (7th usually has heavier work load)
- On & off water training: Ergometer, strength & conditioning
What intrinsic factors can contribute to rib stress fractures in rowers?
- CT/CV joints
- Bone density (female athlete triad)
- SA & abdominal muscles
- Other muscles (rhomboids, pec minor)
What are the proposed mechanisms of TOS in sports?
- Tennis: Interscalenes compression due to downward displacement of upper extremity
- Costoclavicular compression: Post-clavicular fractures (e.g. rugby players)
- Pec minor compression in throwers/pitchers
What are the common features of traumatic injuries to the cervical spine in sport?
- Mechanism of injury: CSp hyperflexion
- Level for fracture dislocation: C4/5 or C5/6
- Outcomes: Ranges from complete recovery to death
- Sports: Rugby, gymnastics
What are the extrinsic risk factors for cervical spine injury in rugby?
- Laws of game
- Illegal play
- Match play
- Phase of play (tackle, scrum, ruck)
- Time of season
- Environmental conditions
- Pitch hardness/condition
- Referee’s control of the game
- Coach’s instructions
- Importance of game
What are the player-related risk factors for cervical spine injury in rugby?
- Grade
- Age/maturity
- Experience
- Position
- Skull
- Anthropometric characteristics (body size/shape)
- Congenital abnormalities
- Physiological & psychological characteristics
- Visual acuity
- Information processing ability
- Impairment
- Occupation
- Gender
- Ethnic origin
What is the relationship between head and neck injuries in sport?
- Share same mechanism & often occur simultaneously
- Assess the neck first (cannot move player until neck is cleared)
What are the most common symptoms of concussion?
- Vacant stare
- Headache
- Nausea
- Dizziness
How should concussion be assessed?
- Ask orientation questions that evaluate recently acquired memory (e.g. where are the playing, who are they playing, who won last week)
- Athletes should not return to play until all symptoms of concussion have cleared (follow guidelines)
