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Sports Medicine Flashcards

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1
Q

Define Sports Medicine

A

Treatment & prevention of injuries related to sports activities

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2
Q

Non-Orthopedic Conditions Seen by Sports Medicine Providers

A 
ID: dermatology
DM
Exercise induced issues
Concussions
Pre-participation assessment
Female triad
Psychology: athlete, parent, coach
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3
Q

Female Triad

A

Eating disorders
Amenorrhea
Osteoporosis

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4
Q

Shoulder Injuries

A

Rotator cuff disease
Degeneration
Instability
Biceps & SLAP tears

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5
Q

Elbow Injuries

A

Medial pain issues

Lateral pain issues

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6
Q

Knee Injuries

A 
ACL
PCL
MCL
LCL
Meniscus
Articular cartilage
Anterior knee pain
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7
Q

Foot & Ankle Injuries

A

Sprains

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8
Q

Risk Factors for Rotator Cuff Injuries

A

Trauma

Repetitive overuse

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9
Q

What tendons are more difficult to repair due to a degenerative tendon?

A

Rotator cuff

Achilles

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10
Q

Non-Operative Treatment of Sports Injuries

A 
Reduce inflammation
Activity shutdown
NSAIDs
Sub-acromial injection
Modalities
PT: ROM & strength
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11
Q

Surgical Options for Rotator Cuff Tears

A

Open repair
Mini-open repair
Arthroscopic repair

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12
Q

Post-Op Course for Rotator Cuff Tears

A 
Sling: 6 weeks
Rehab: 3 months
Golf: 4-5 months
Tennis: 6 months
Swimming: 7-8 months
Full recovery: 1 year
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13
Q

What muscle performs the first 30 degrees of abduction of the arm?

A

Supraspinatus

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14
Q

How does a reverse prosthesis work?

A

Switches abduction force from the supraspinatus to the deltoid

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15
Q

Treatment of Early or Moderate Shoulder Arthritis

A 
Activity modification
NSAIDs
Steroid injections
PT??
Arthroscopy??
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16
Q

Treatment of Severe Shoulder Arthritis

A

Shoulder replacement

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17
Q

Results of Total Shoulder Replacement if a Good Rotator Cuff

A

3% failure
Predictable pain relief
Excellent function

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18
Q

Treatment of First Shoulder Dislocation

A

Reduction: x-ray
Immediate: external rotation brace
Surgical

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19
Q

Pro’s of Open Instability Treatment

A

Higher success rate
Better in ligamentously laxity
Glenoid reconstruction possible

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20
Q

Con’s of Op Instability Treatment

A

Risk of over tightening

Painful post-op

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21
Q

Reasons for Outlet Impingement of the Shoulder

A

Acromion shape/slope
AC joint enlargement
Cuff & biceps problems

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22
Q

Important History for Biceps Disease

A 
Age
Occupation
Injury
Activities
Handedness (R/L)
Chief complaint
Pain: location, duration
Weakness
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23
Q

Biceps Disease Physical Exam Tests

A 
Speed's
Yergason's
Hawkin's
Neer's
Belly press
Lift-off test
Bear hug
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24
Q

Diagnostic Imaging for Biceps Disease

A

MRI: biceps

US

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25
Non-Operative Management of Biceps Disease
Rest NSAIDs PT: rotator cuff strengthening Injections
26
Surgical (Tenotomy or Tenodesis) Indications for Biceps Disease
Subluxation or dislocation of biceps >25% tear Significant inflammation, atrophy, hypertrophy Irreparable rotator cuff tear
27
Tenotomy vs. Tenodesis
Tenotomy: elderly, easier rehab, revision Tenodesis: less than 50, cosmetic/strength
28
Important History for SLAP Tears
``` Age Occupation Injury Activities Handedness (R/L) Chief complaint: instability, pain (location, duration), weakness, mechanical symptoms ```
29
SLAP Tear Tests
O'brien's test | Crank test
30
Non-Operative Management of SLAP Lesions
Rest NSAIDs PT x 3 months Throwing program
31
Indications for SLAP Repairs
``` Young patient (less than 40) Mechanical symptoms Associated instability, internal impingement, acute rotator cuff tear ```
32
Contraindications for SLAP Repairs
Elderly: tenotomy Frozen shoulder Anatomic variant Chronic rotator cuff tear
33
Conditions with Medial Elbow Pain
``` Medial epicondylitis Ulnar neuropathy Flexor pronator strain Zpronator syndrome Medial ulnar collateral ligament Olecrenon stress fracture ```
34
Conditions with Lateral Elbow Pain
Lateral epicondylitis Radial tunnel syndrome Lateral ulnar collateral ligament Capitellar OCD
35
Reason for Lateral Epicondylitis
Overuse injury involving eccentric overload at origin of common extensor tendons Repetitive pronation/supination with elbow extended
36
Presentation of Lateral Epicondylitis
Pain with resisted wrist extension, gripping
37
Treatment of Lateral Epicondylitis
``` Ice NSAIDs Rest Ultrasound Larger racket grip ```
38
Lateral Epicondylitis & Injections
Some benefit | No indication for PRP
39
Medial Collateral Ligament Complex
Anterior bundle Posterior bundle Transverse portion
40
Treatment for Medial Collateral Ligament Tear
Rest Ice NSAIDs Throwing program x 3 months
41
Parts of a Throwing Program
Short toss Long toss Mound
42
Reasons for an ACL Injury
``` Sudden deceleration Twist Pivot Cut Clipping/pile-up Backward fall skiing ```
43
Surgery for ACL Injuries
Reconstruction | Due to synovial environment
44
Reconstruction Tendon Options for an ACL Repair
Patella tendon Hamstring tendon Quadriceps tendon Allograft tendon
45
Conditions with Anterior Knee Pain
Patello-femoral pain Quadricep or patellar tendon pain Osgood Schlatters' disease
46
Treatment for Anterior Knee Pain
Rehab Brace Surgery
47
Age Groups for Osgood Schlatter's Disease
Boys: 12-15 Girls: 8-12
48
Presentation of Osgood Schlatter's Disease
Pain at anterior aspect Worse with kneeling Tender over enlarged tubercle Worse with resisted extension
49
Treatment of Osgood Schlatter's Disease
``` NSAIDs Rest Ice Activity modification Quad/Hamstring strengthening Cast: severe ```
50
Lateral Ankle Ligament Complex
Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament
51
Medial ligament injuries result from what?
Ankle external rotation | Ankle eversion
52
Positions in the Ankle that Provide Little Bony Stability
Plantar flexion | Inversion
53
Predictable Pattern of Ankle Ligament Tears
Anterior tibiofibular ligament calcaneofibular ligament Posterior tibiofibular ligament
54
Risk Factors for Inversion Injuries
Tight Achilles tendon Varus hindfoot Limited subtalar motion
55
Testing for Ankle Instability
Anterior drawar test | Talar tilt test
56
Describe Talar Tilt Test
Ankle in neutral to place stress on CFL Apply varus stress Must block subtalar motion
57
Diagnostic Tests for Lateral Ankle Injuries
``` X-rays: palpable pain on bony areas MRI: chronic pain Radiographic stress test Radiographic anterior drawer: >4 mm abnormal Radiographic talar tilt: >6 mm abnormal ```
58
Treatment of Grade I and II Ankle Sprains
Early weight bearing & ROM show less pain, less atrophy, & earlier return to activities
59
Treatment of Grade III Ankle Sprains
Controversial Early mobilization Cast immobilization Primary surgery
60
When may reconstruction be indicated with chronic ankle instability?
Failure of rehab program of proprioception, muscle strengthening & Achilles stretching
61
Ankle Sprains are a Combination of
Mechanical instability | Functional instability
62
What does mechanical instability include?
Ankle mobility
63
What does functional instability include?
Feeling of ankle giving way
64
Mechanism of Injury for Syndesmotic Injuries (High Ankle Sprains)
External rotation | Dorsiflexion
65
3 Ligaments that Unite the Distal Tibia-Fibula
Anterior tibiofibular Posterior tibiofibular Interosseous
66
Diagnosing Syndesmotic Injuries
Tender over anterior syndesmosis Tenderness at proximal fibula Compression squeeze test External rotation test
67
Compression Squeeze Test for Syndesmotic Injuries
Squeeze at mid-calf | Will cause pain at anterior syndesmosis
68
Treatment of Syndesmotic Injuries
Boot or walking cast 2-4 weeks Rehab Widening noted: surgery
69
Recovery for Surgical Repair of Syndesmotic Injuries
Non-weight bearing cast: 4 weeks Weight bearing immobilization: 4 weeks Screw removal: 10-12 weeks
70
Sequelae of Persistently Painful Sprained Ankles
``` Vague pain Feeling of giving way Problems walking on uneven surfaces Swelling Stiffness Locking ```
71
Define Stress Fracture
Fatigue induce fracture of the bone caused by repeated stress over time
72
Most Common Bones for Stress Fractures
Tibia Metatarsals Navicular Femoral
73
Etiology of Stress Fractures
Osteoblasts overwhelmed Bone & muscles serve as shock absorbers to stress Muscles fatigue- bone may be taxed Female triad
74
Presentation of Stress Fractures
Pain with weight bearing that increases with exercise or activity Resides with rest Localized tenderness Generalized swelling
75
Diagnosis of Stress Fractures
X-rays: may take 10-14 days MRI Bone scan
76
Treatment of Stress Fractures
Rest Unloading of stress area: boot, crutches Gradual return to activities Don't respond: surgery
77
Prevention of Stress Fractures
``` Gradual ramp up of loading activities Strengthening of muscles Replace shoes every 300-500 miles Increase calcium & vitamin D Address female triad ```
78
Treatment of Tibial Stress Fractures
Activity restriction Protected weight bearing IM nail: rare
79
Diagnosis of Femoral Neck Stress Fracture
MRI
80
What type of femoral neck stress fracture requires surgical treatment?
Tension side | Superior-lateral
81
Other Overuse Injuries
``` Little league elbow Rotator cuff tendinitis Greater trochanteric bursitis IT band tendinitis Hamstring tendonitis ```

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