Strength Training - Answers - Can be started as early as 7 or 8 years of age
- Must meet Tanner Stage V before moving to maximum weightlifting or power lifting (prevent
injury)
PRICE acronym for injuries - Answers - Protect
- Rest
- Ice
- Compression
- Elevate
Sports Physicals - Answers - Promote health and safety
- Screen for various problems
- May provide a medical home
- Evaluates fitness level for particular sport
- Preventing injuries
Concussion - Answers - Trauma to body or head that causes injury to the brain
- May or may not be symptomatic
- Usually resolves in 7-10 days
- Management/Follow up
- 6 step process
Concussion S/S - Answers - Headache, Confusion
- Amnesia, Dizziness, Balance problems
- Nausea/Vomiting
- Visual disturbances
- Light/noise sensitivity, Ringing in the ears
- Fatigue/excessive, sleepiness/Sleep abnormalities
- Memory/concentration problems
,- Irritability/behavioral changes
Concussion 6 step process - Answers - No symptoms at rest for 24 hours
- Light aerobic exercise
- Sport specific exercise
- Non contact drills
- Contact practice drills
- Release
Recurring S/S of Concussion during the 6 step process - Answers Any S/S of concussion at any
stage then go back to rest for 24 hours and drop back a step
Cervicalgia [Neck pain] causes - Answers - Poor posture
- Whiplash
- Degenerative joint disease
- Radiculopathy is usually triggered from C5-C7 involvement
Radiculopathy - Answers - A range of symptoms produced by the pinching of a nerve root in the
spinal column.
- The pinched nerve can occur at different areas along the spine (cervical, thoracic or lumbar).
- Pain, weakness, numbness and tingling.
Cervicalgia DX - Answers Spurling Test
Spurling Test - Answers - Hyperextend neck - move laterally to affected side & apply gentle
pressure to axial load
- Reproducible radiculopathy = + test results
Cervicalgia TX - Answers - If no findings of trauma or infection- treat conservatively
- Stretching, NSAIDs, therapy, muscle relaxers (short term), massage, chiropractic treatments,
cervical traction
Burners/Stingers - Answers - Terms are used interchangeably
- Symptoms are on same side as injury
- Unilateral pain, burning, paresthesias, weakness
,Burners/Stingers TX - Answers - Remove from play and observe
- If symptoms persist, increase, headaches develop, or neurological s/s initiate diagnostic work
up
Burners/Stingers Prevention - Answers - Proper fitting gear
- Appropriate clothing
- Use proper technique for sports activity
Spondylolysis - Answers - Injury to the pars interarticularis
- Presents as pain with low back extension
- Acquired stress fracture due to repetitive overload
Spondylolysis TX - Answers - Avoid hyperextension of the back and high impact sports
- Bracing may help symptoms but no change in outcome in studies
- May return to sports when asymptomatic
- Stretching of ham strings
- Work on core and back strengthening
Spondylolisthesis - Answers - Bilateral pars injury with vertebral slippage
- Back pain with extension
- Hyperlordosis
Spondylolisthesis TX - Answers - Treat symptoms
- Brace may help
- If surgery is required, cannot return to sports activity for at least one year
Low back pain - Answers - Consider nerve root impingement if leg pain is > back pain
- Estimated that 80% of episodes resolve spontaneously within 2 weeks & 90% in 6 weeks
Low back pain Exam - Answers - Examine patient carefully- standing, sitting, supine, then prone
- Motor strength and DTRs- check bilaterally
- Prone position to palpate SI joints and spine for tenderness
Cauda Equina Syndrome - Answers - Bowel or bladder symptoms, "saddle anesthesia", loss of
, anal sphincter tone or incontinence, LE weakness
- Emergency, Refer immediately
S/S of back pain and concerning for malignant process - Answers - Weight loss
- Severe pain for > 6 weeks
- Nocturnal or pain at rest
Spinal Stenosis - Answers - Narrowing of the spinal canal
- May be due to large herniation with compression
- Worse with extension & better with sitting
- Can create claudication type symptoms in LE
- Older patients (typically) > 50 years
Spinal Stenosis TX - Answers - Epidurals, stretching may help
- SX
Disk Herniation - Answers - Back pain that is exacerbated by flexion and sitting
- May have radiculopathy (greater in adults)
- Typically affects L4-L5 and L5-S1
- + straight leg lift
Disk Herniation TX - Answers - Conservative treatment 1st
- Rest, PT
- If signs and symptoms still persist, consider brief steroid taper
- Surgery for those who have failed conservative treatment and have impaired quality of
life/progressive neurological deficits
Acromioclavicular Separation (AC separation) - Answers - Tenderness and edema at AC joint
- + cross arm test (cannot cross arms over shoulder w/o having pain)
Acromioclavicular Separation (AC separation) TX - Answers - Rest
- Support & Immobilization (1-6 weeks)
- Rehab