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47 Cards in this Set
- Front
- Back
What are 3 types of ankle sprains? |
Inversion Sprain Eversion Sprain High Ankle Sprain |
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Treatment for Achilles tendinitis |
•Anti-inflammatory medications •Agressive stretching •Reducing tendon stretch by structural faults (Orthotics, Mechanics, Flexibility). |
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Causes of Medial Tibial Stress Syndrome (Shin Splints) |
•Stress Fracture •Muscle Strains •Repetitive Microtrauma •Weak Muscles •Improper Footwear |
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Causes of Medial Tibial Stress Syndrome (Shin Splints) |
•Training Errors • Varus Foot •Tight Heel Cord •Pronated Feet •Forefoot Supination |
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Achilles Tendon stretching (Preventing Injury) |
A tight heel cord may limit dorsiflexion and may predispose athlete to ankle injury
Should routinely stretch before and after practice
Stretching should be performed with knee extended and flexed 15-30 degrees |
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Strength Training (Preventing Injury) |
Static and dynamic joint stability is important in prevention injury Develop a balance in strength throughout the range |
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Neuromuscular Control Training (Preventing Injury) |
Can be enhanced by training in controlled activities on uneven surfaces or a balance board |
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Footwear (Preventing Injury) |
Can be an important factor in reducing injury Shoes should not be used in activities they were not made for |
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Preventive Taping and Orthoses |
Tape can provide some prophylactic protection However, improperly applied tape can disrupt normal biomechanical function and cause injury Lace-Up braces have even been found to be effective in controlling ankle motion |
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History |
Past HistoryMechanism of injuryWhen does it hurt?Type of, quality of, duration of pain?Sounds or feelings?How long were you disabled?Swelling?Previous Treatments? |
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Observations |
Postural deviations? Genu Valgum (Knock Kneed) or Genu Varum (Bow Legged)? Is there difficulty with walking? Deformities, asymmetries or swelling? |
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Observations |
Color and texture of skin, heat, redness? Patient in obvious pain? Is a range of motion normal? |
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Palpation |
Begin with bony landmarks and progress to soft tissue Attempt to locate areas of deformity, swelling and localized tenderness |
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Percussion/bump and Compression tests (Special Test - Lower Leg) |
Used when fracture is suspected Percussion test is a blow to the tibia, fibula or heel to create vibratory force that resonates w/in fracture causing pain Compression test involves compression of the tibia and fibula either above or below site of concern |
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Anterior drawer test(Ankle Stability Tests) |
Used to determine damage to anterior talofibular ligament primarily and other lateral ligament secondarily A positive test occurs when foot slides forward and/ or makes a clunking sound as it reaches the end point |
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Talar tilt test or Inversion/Eversion Stress Test |
A test performed to determine extent of inversion or eversion injuries With foot at 90 degrees calcaneus is inverted and excessive motion indicates injury to calcaneofibular ligament and possibly the anterior and posterior talofibular ligaments If the calcaneus is everted, the deltoid ligament is tested |
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Functional Tests(While weight Bearing) |
Walk on toes (Plantar Flexion)Walk on heels (Dorsiflexion)Hops on both anklesHops on injured ankle alone |
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Functional Tests(While weight Bearing) |
Start and stop joggingStart and stop runningChange direction rapidlyRun figure eightsSport specific tests |
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Ankle Injuries: Sprains |
Single most common injury in athletics caused by sudden inversion or eversion moments |
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Inversion Sprains |
Most common and result in injury to the lateral ligaments Anterior talofibular ligament is injured with inversion, plantar flexion and internal rotation Occasionally the force is great enough for an avulsion fracture to occur w/ the lateral malleolus |
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Inversion Sprains |
The foot is forcefully inverted or occurs when the foot comes into contact w/ uneven surfaces |
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Eversion Ankle Sprains -Etiolog(5-10% of all Sprains) |
Bony protection and ligament strength decreases likelihood of injury Eversion force resulting in damage to deltoid and possibly fx of the fibula Deltoid can also be impinged and contused with inversion sprains |
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Syndesmotic Sprain -Etiology |
(High Ankle Sprain) Injury to the distal tibiofemoral joint (anterior/posterior tibiofibular ligament) Torn w/increased external rotation or dorsiflexion
Injured in conjunction w/ medial and lateral ligaments
May require extensive period of time in order to return to play |
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Grade 1 Ankle Sprains |
•Mild pain and disability; weight bearing is minimally impaired; point tenderness over ligaments and no laxity. |
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Grade 2 Ankle Sprain |
•Feel or hear pop or snap; moderate pain w/difficulty bearing weight; tenderness and edema •Positive talar tilt and anterior drawer tests •Possible tearing of the anterior talofibular and calcaneofibular ligaments |
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Grade 3 Ankle Sprains |
•Severe pain, swelling, hemarthrosis, discoloration •Unable to bear weight •Positive talar tilt and anterior drawer •Instability due to complete ligamentous rupture |
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Ankle Fracture/Dislocations |
•Cause of Injury: Number of mechanisms-often similar to those seen in ankle sprains •Signs of Injury: Swelling and pain may be extreme with possible deformity
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Ankle Fracture/Dislocations (Treatment) |
•Splint and refer to physician for X-ray and examination •RICE to control hemmorrhaging and swelling •Once swelling is reduced, a walking cast brace may be applied, w/ immobilization lasting 6-8 weeks •Rehabilitation is similar to that of ankle sprains once range of motion is normal |
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Tibial and Fibular Fracture |
Causes: •Result of direct blow or indirect trauma •Fibular fractures seen with Tibial fractures or as the result of direct Trauma |
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Tibial and Fibular Fractures |
S/S •Pain,swelling, soft tissue insult •Leg will appear hard and swollen (Volkman's contracture) •Deformity -May be open or closed |
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Tibial and Fibular Fractures (Treatment) |
Care: •Immediate treatment should include splinting to immobilize and ice, followed by medical referral •Restricted weight bearing for weeks/months depending on severity |
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Stress Fracture of Tibia or Fibula |
Cause: •Common overuse condition, particularly in those with structural and biomechanical insufficiencies •Result of repetitive loading during training and conditioning |
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Stress Fracture of Tibia or Fibula |
S/S: •Pain with activity •Pain more intense after exercise than before •Point tenderness, difficult to discern bone and soft tissue pain •Bone scan results (stress fracture vs. periostitis) |
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Stress Fracture of Tibia or Fibula (Treatment) |
•Eliminate offending activity •Discontinue stress inducing activity 14 days •Use crutch for walking •Weight bearing may return when pain subsides •After pain free for 2 wks athlete can gradually return to activity •Biomechanics must be addressed |
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Acute Patellar Subluxation or Dislocation |
Cause: •Deceleration w/ simultaneous cutting in opposite direction (Valgus force at knee) •Quad pulls the patella out of alignment •Some athletes may be predisposed to injury |
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Acute Patella Subluxation or Dislocation |
Cause: •Repetitive subluxation will impose stress to medial restraints •More commonly seen in female athletes |
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Acute Patella Subluxation or Dislocation |
S/S: •W/ subluxation, pain and swelling, restricted ROM, palpable tenderness over adductor tubercle •Dislocations result in total loss of function •First time dislocation = assume fx |
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Acute Patella Subluxation or Dislocation |
Care: •Immobilize and refer to physician for reduction •Ice around the joint •Following reduction, immobilization for at least 4 weeks w/ use of crutches |
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Acute Patella Subluxation or Dislocation |
Care: •After immobilization period, horseshoe pad w/ elastic wrap should be used to support patella •Muscle rehab focusing on muscle around the knee, thigh and hip are key (straight leg raises are optimal for the knee) |
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Osgood-Schlatter Disease and Larsen-Johansson Disease |
Cause: •An apophysitis occurring at the tibial tubercle -Result of repeated pulling by tendon -Begins cartilagenous and develops a bony callus, enlarging the tubercle •Resolves w/ ageing |
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Osgood-Schlatter Disease and Larsen-Johansson Disease |
S/S: •Both elicit swelling, hemmorrhaging and gradual degeneration of the apophysis due to impaired circulation •Pain with activity and tenderness over anterior proximal tibial tubercle |
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Osgood-Schlatter Disease and Larsen-Johansson Disease |
Care: Conservative: •Reduce stressful activity until union occurs (6-12 months) •Padding may be necessary for protection •Possible casting, ice before and after activity •Isometerics |
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Functional and Prophylactic Knee Braces |
•Used to prevent and reduce severity of knee injuries •Provide degree of support to unstable knee •Can be custom molded and designed to control rotational forces and tibial translation |
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Shin Splints |
Medial Tibial Stress Syndrome |
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Patellar Tendonitis |
Jumpers or Kickers Knee |
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Shin Contusion |
Cause: •Direct blow to lower leg (impacting periosteum anteriorly) |
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Iliotibial Band Friction Syndrome |
Runner's Knee |