Inhoudsopgave
1 EPIDEMIOLOGIE.................................................................................................................................................................... 3
2 FIRST AID IN SPORT INJURIES................................................................................................................................................ 4
MOST COMMON INJURIES: SKIN............................................................................................................................................................5
MOST COMMON INJURIES: HEAD...........................................................................................................................................................5
MOST COMMON INJURIES: OTHERS........................................................................................................................................................7
3 SPORTSPECIFIEKE PHYSIOTHERAPY....................................................................................................................................... 8
1. INTRODUCTION.............................................................................................................................................................................. 8
2. EVALUATION OF CONTROL OF MOVEMENT...........................................................................................................................................8
A) Introduction Movement Stability Dysfunction.........................................................................................................................8
B) Functional muscle classification..............................................................................................................................................8
C) Proprioception, pain and recruitment.....................................................................................................................................9
D) Dysfunction of global muscles.................................................................................................................................................9
E) Dysfunction of local muscles..................................................................................................................................................10
F) New model of muscle classification.......................................................................................................................................10
G) Model of movement dysfunction..........................................................................................................................................11
3. DYNAMIC STABILITY AND MUSCLE BALANCE.......................................................................................................................................12
4. CASUS LRK DANSER......................................................................................................................................................................14
4. LOW BACK PAIN................................................................................................................................................................. 14
CORE STABILITY PROGRAM................................................................................................................................................................. 15
PARAMETERS................................................................................................................................................................................... 15
GUIDELINES..................................................................................................................................................................................... 16
PROGRESSION.................................................................................................................................................................................. 16
TAKE HOME.................................................................................................................................................................................... 16
5. OVERUSE INJURIES: SWIMMERS SHOULDER (TH)................................................................................................................ 17
INTRODUCTION................................................................................................................................................................................ 17
SWIMMER’S SHOULDER..................................................................................................................................................................... 17
PATHO-ANATOMIE............................................................................................................................................................................17
DYSFUNCTIES................................................................................................................................................................................... 18
PARTICIPATIE................................................................................................................................................................................... 18
6. HAMSTRING INJURIES IN SPORT (TH)................................................................................................................................. 19
1. INTRODUCTION............................................................................................................................................................................ 19
2. RESEARCH................................................................................................................................................................................... 20
3. BUILD THE PROGRAM.................................................................................................................................................................... 21
4. TAKE HOME MESSAGE................................................................................................................................................................... 22
7. ACL INJURY IN SPORTS (PR)................................................................................................................................................ 22
1. PREVENTIETRAINING..................................................................................................................................................................... 22
2. KLINISCH ONDERZOEK....................................................................................................................................................................23
2. OPERATIE................................................................................................................................................................................... 23
3. BEHANDELING..............................................................................................................................................................................23
4. PROTOCOLLEN BEHANDELING..........................................................................................................................................................24
5. TAKE HOME MESSAGE................................................................................................................................................................... 27
8. HEUP IMPINGEMENTS........................................................................................................................................................ 28
1. HEUPKLACHTEN BIJ JONGE ATLETEN................................................................................................................................................. 28
2. CAM VS PINCER TYPES................................................................................................................................................................28
3. OORZAKEN.................................................................................................................................................................................. 29
4. WARWICK AGREEMENT ON FAIS.....................................................................................................................................................29
5. BEHANDELING..............................................................................................................................................................................30
Conservatieve behandeling........................................................................................................................................................30
Chirurgische behandeling...........................................................................................................................................................31
Post-operatieve kinesitherapie..................................................................................................................................................31
9. OVERUSE INJURIES: TENDINOPATHY.................................................................................................................................. 32
, 1. HEALTHY TENDON........................................................................................................................................................................ 32
Histologie...................................................................................................................................................................................32
Structuur en functie....................................................................................................................................................................32
2. TENDINOPATHIE........................................................................................................................................................................... 33
Histopathologie..........................................................................................................................................................................33
Mechanismes algemeen............................................................................................................................................................33
Continuum model tendon pathology.........................................................................................................................................33
Management..............................................................................................................................................................................35
10. PRAKTISCHE IMPLICATIE: TENDINOPATHY (PR)................................................................................................................. 36
DEFINITIE........................................................................................................................................................................................ 36
KRACHT-LENGTE RELATIE (SPIER-PEESEENHEID).......................................................................................................................................36
ASSESSMENT................................................................................................................................................................................... 37
ADAPTATIE / BEHANDELING................................................................................................................................................................37
11. RUNNING & OL................................................................................................................................................................ 38
1. INTRODUCTION............................................................................................................................................................................ 38
2. COMMON RUNNING INJURIES......................................................................................................................................................... 38
Injuries Calf Complex..................................................................................................................................................................38
Medial Tibial Stress Syndrome...................................................................................................................................................40
Fasciitis Plantaris........................................................................................................................................................................40
3. THERAPEUTISCHE MODALITEITEN.....................................................................................................................................................40
Educatie......................................................................................................................................................................................40
Manuele therapie.......................................................................................................................................................................41
Oefentherapie............................................................................................................................................................................41
Taping........................................................................................................................................................................................41
12. LRK BIJ GYMNASTEN EN ACROBTICS................................................................................................................................. 42
1. LRK ALGEMEEN........................................................................................................................................................................... 42
2. KLINISCH REDENEREN + SCREENING..................................................................................................................................................42
Anamnese...................................................................................................................................................................................42
3. KLINISCHE ASSESSMENT................................................................................................................................................................. 42
Inspectie.....................................................................................................................................................................................42
Lengtetesting/ flexibiliteit..........................................................................................................................................................42
Specifieke testen........................................................................................................................................................................42
4. MANAGEMENT............................................................................................................................................................................ 44
13. OVERUSE INJURIES LOWER LIMB...................................................................................................................................... 45
1 MECHANISME............................................................................................................................................................................... 45
2 COMMON LL OVERUSE INJURIES.......................................................................................................................................................46
3 CONCLUSIE................................................................................................................................................................................... 47
14. TECHNOLOGY IN REHAB................................................................................................................................................... 48
15. CURSUS............................................................................................................................................................................ 48
BEIGHTON SCORE............................................................................................................................................................................. 48
,1 EPIDEMIOLOGIE
Definities zijn belangrijk voor communicatie en vergelijkingen
Playing related mscuculosletal disorders (PRMD) -> Pijn, verminderde coördinatie etc
Prevalence = the proportion of a population found to have an injury/ disease
Incidence rate = incidentie / 100h sport -> of 1% is 1 injury per 100 atleten = # nw subjects experiencing an
injury at a given period of time
Relative risk (RR) = incidentie risicogroep / incidnetie ppl not at risk
Injury = incident required time of playing or incident requiring medical consultation -> gwn pijn of zwaar
gevoel na zware training/ match is geen injury
Time loss = niet kunnen spelen/ trainen of aan wedstrijd meedoen
Recovery = herstelperiode tot terug op veld
Recurrent injury = terugkerende injuries
Flint et al (conclusie kennen) -> voor een acuut of overuse injury bestaat geen eenduidige definitie
Van Wilgen et al (paper in detail bekijken) -> intrinsieke vs extrinsieke factoren
Personal factors Environmental factors
Fysiek Situational: materiaal, ruimtes, kledij
Techniek (beweging uitleggen/ tonen/ trainings- Sociaal: sociale druk, peers, audiance, coach,
veranderingen teamdruk
Behavioral: prestatiedruk, mental health, Training: veranderingen, intensiteit, load,
competitiviteit technieken
Hereditair: genetische aanleg Coach: communicatie, druk, interactie
Registration of sport injuries
-> vaak retrospecttief onderzoek van insurance data (verzekering) wat geen goede info geeeft (underestimation)
Moeilijkheid ligt in taboesfeer van pijnklachten of i njuries -> zorgt voor uitgestelde zorg en vaak onzekerheid
door zelfstandige statuut
-> Bij prospectief onderzoek -> opvolgen van teams (heel time consuming) doorheen het wedstrijdseizoen
Statement on methods in sport injury research from 1st METHODS MATTER meeting -> what is/ are the
problems with research in sports injuries?
-> geen universele definitie van sportinjuries -> range van definities is handig voor onderzoek maar moet
telkens goed gedefinieerd worden. Ook voor healing proces geen consensus
-> verschillende doelen: expliciteit, description, causale explanation, prediction
-> rationale en theoretische achtergrond
-> inapproriate use of statistics -> een cross ectioneel onderzoek kan geen xausaal effect verklaren en bij
correlaties is het belangrijk om zoveel mogelijk/ alle factoren mee in rekening te brengen
-> multifactorieel effect
Zie TABEL (infra) -> EXAMEN
Estimation costs of sport injuries = sportafhankelijk
WHO guidelines voor bewegingsgoals halen voor gezondheidsvoordeel MAAR bij teveel ook kans op letsels
, 2 FIRST AID IN SPORT INJURIES
First aid = eerste hulp/ assistance bij plots injury voor hulp arriveert -> doelen = oreserve life, preventie van
verslechtering en promote recovery -> Eerste hulp moet zsm gebeuren -> eerste 48 u zijn essentieel
Stappen
Check surroundings (bescherm pt en uzelf) -> Call for help -> Care for the person (gerust stellen,
laten stil liggen etc)
Verschillende methodes
- SALTAPS -> alle stapjes overlopen en kijken hoe ver je geraakt
See
Ask
Look – tekens van bloeding, ontsteking, vervorming
Touch
Active movement
Passive movement
Skills - kan pt staan, lopen, springen etc
- (PR)ICE
Ice Compresison Protection/ Rest (+ optimal loading)
Immobilisation Elevation
- is intussen PEACE & LOVE geworden (peace voor acuut en love voor recovery)
1 EPIDEMIOLOGIE.................................................................................................................................................................... 3
2 FIRST AID IN SPORT INJURIES................................................................................................................................................ 4
MOST COMMON INJURIES: SKIN............................................................................................................................................................5
MOST COMMON INJURIES: HEAD...........................................................................................................................................................5
MOST COMMON INJURIES: OTHERS........................................................................................................................................................7
3 SPORTSPECIFIEKE PHYSIOTHERAPY....................................................................................................................................... 8
1. INTRODUCTION.............................................................................................................................................................................. 8
2. EVALUATION OF CONTROL OF MOVEMENT...........................................................................................................................................8
A) Introduction Movement Stability Dysfunction.........................................................................................................................8
B) Functional muscle classification..............................................................................................................................................8
C) Proprioception, pain and recruitment.....................................................................................................................................9
D) Dysfunction of global muscles.................................................................................................................................................9
E) Dysfunction of local muscles..................................................................................................................................................10
F) New model of muscle classification.......................................................................................................................................10
G) Model of movement dysfunction..........................................................................................................................................11
3. DYNAMIC STABILITY AND MUSCLE BALANCE.......................................................................................................................................12
4. CASUS LRK DANSER......................................................................................................................................................................14
4. LOW BACK PAIN................................................................................................................................................................. 14
CORE STABILITY PROGRAM................................................................................................................................................................. 15
PARAMETERS................................................................................................................................................................................... 15
GUIDELINES..................................................................................................................................................................................... 16
PROGRESSION.................................................................................................................................................................................. 16
TAKE HOME.................................................................................................................................................................................... 16
5. OVERUSE INJURIES: SWIMMERS SHOULDER (TH)................................................................................................................ 17
INTRODUCTION................................................................................................................................................................................ 17
SWIMMER’S SHOULDER..................................................................................................................................................................... 17
PATHO-ANATOMIE............................................................................................................................................................................17
DYSFUNCTIES................................................................................................................................................................................... 18
PARTICIPATIE................................................................................................................................................................................... 18
6. HAMSTRING INJURIES IN SPORT (TH)................................................................................................................................. 19
1. INTRODUCTION............................................................................................................................................................................ 19
2. RESEARCH................................................................................................................................................................................... 20
3. BUILD THE PROGRAM.................................................................................................................................................................... 21
4. TAKE HOME MESSAGE................................................................................................................................................................... 22
7. ACL INJURY IN SPORTS (PR)................................................................................................................................................ 22
1. PREVENTIETRAINING..................................................................................................................................................................... 22
2. KLINISCH ONDERZOEK....................................................................................................................................................................23
2. OPERATIE................................................................................................................................................................................... 23
3. BEHANDELING..............................................................................................................................................................................23
4. PROTOCOLLEN BEHANDELING..........................................................................................................................................................24
5. TAKE HOME MESSAGE................................................................................................................................................................... 27
8. HEUP IMPINGEMENTS........................................................................................................................................................ 28
1. HEUPKLACHTEN BIJ JONGE ATLETEN................................................................................................................................................. 28
2. CAM VS PINCER TYPES................................................................................................................................................................28
3. OORZAKEN.................................................................................................................................................................................. 29
4. WARWICK AGREEMENT ON FAIS.....................................................................................................................................................29
5. BEHANDELING..............................................................................................................................................................................30
Conservatieve behandeling........................................................................................................................................................30
Chirurgische behandeling...........................................................................................................................................................31
Post-operatieve kinesitherapie..................................................................................................................................................31
9. OVERUSE INJURIES: TENDINOPATHY.................................................................................................................................. 32
, 1. HEALTHY TENDON........................................................................................................................................................................ 32
Histologie...................................................................................................................................................................................32
Structuur en functie....................................................................................................................................................................32
2. TENDINOPATHIE........................................................................................................................................................................... 33
Histopathologie..........................................................................................................................................................................33
Mechanismes algemeen............................................................................................................................................................33
Continuum model tendon pathology.........................................................................................................................................33
Management..............................................................................................................................................................................35
10. PRAKTISCHE IMPLICATIE: TENDINOPATHY (PR)................................................................................................................. 36
DEFINITIE........................................................................................................................................................................................ 36
KRACHT-LENGTE RELATIE (SPIER-PEESEENHEID).......................................................................................................................................36
ASSESSMENT................................................................................................................................................................................... 37
ADAPTATIE / BEHANDELING................................................................................................................................................................37
11. RUNNING & OL................................................................................................................................................................ 38
1. INTRODUCTION............................................................................................................................................................................ 38
2. COMMON RUNNING INJURIES......................................................................................................................................................... 38
Injuries Calf Complex..................................................................................................................................................................38
Medial Tibial Stress Syndrome...................................................................................................................................................40
Fasciitis Plantaris........................................................................................................................................................................40
3. THERAPEUTISCHE MODALITEITEN.....................................................................................................................................................40
Educatie......................................................................................................................................................................................40
Manuele therapie.......................................................................................................................................................................41
Oefentherapie............................................................................................................................................................................41
Taping........................................................................................................................................................................................41
12. LRK BIJ GYMNASTEN EN ACROBTICS................................................................................................................................. 42
1. LRK ALGEMEEN........................................................................................................................................................................... 42
2. KLINISCH REDENEREN + SCREENING..................................................................................................................................................42
Anamnese...................................................................................................................................................................................42
3. KLINISCHE ASSESSMENT................................................................................................................................................................. 42
Inspectie.....................................................................................................................................................................................42
Lengtetesting/ flexibiliteit..........................................................................................................................................................42
Specifieke testen........................................................................................................................................................................42
4. MANAGEMENT............................................................................................................................................................................ 44
13. OVERUSE INJURIES LOWER LIMB...................................................................................................................................... 45
1 MECHANISME............................................................................................................................................................................... 45
2 COMMON LL OVERUSE INJURIES.......................................................................................................................................................46
3 CONCLUSIE................................................................................................................................................................................... 47
14. TECHNOLOGY IN REHAB................................................................................................................................................... 48
15. CURSUS............................................................................................................................................................................ 48
BEIGHTON SCORE............................................................................................................................................................................. 48
,1 EPIDEMIOLOGIE
Definities zijn belangrijk voor communicatie en vergelijkingen
Playing related mscuculosletal disorders (PRMD) -> Pijn, verminderde coördinatie etc
Prevalence = the proportion of a population found to have an injury/ disease
Incidence rate = incidentie / 100h sport -> of 1% is 1 injury per 100 atleten = # nw subjects experiencing an
injury at a given period of time
Relative risk (RR) = incidentie risicogroep / incidnetie ppl not at risk
Injury = incident required time of playing or incident requiring medical consultation -> gwn pijn of zwaar
gevoel na zware training/ match is geen injury
Time loss = niet kunnen spelen/ trainen of aan wedstrijd meedoen
Recovery = herstelperiode tot terug op veld
Recurrent injury = terugkerende injuries
Flint et al (conclusie kennen) -> voor een acuut of overuse injury bestaat geen eenduidige definitie
Van Wilgen et al (paper in detail bekijken) -> intrinsieke vs extrinsieke factoren
Personal factors Environmental factors
Fysiek Situational: materiaal, ruimtes, kledij
Techniek (beweging uitleggen/ tonen/ trainings- Sociaal: sociale druk, peers, audiance, coach,
veranderingen teamdruk
Behavioral: prestatiedruk, mental health, Training: veranderingen, intensiteit, load,
competitiviteit technieken
Hereditair: genetische aanleg Coach: communicatie, druk, interactie
Registration of sport injuries
-> vaak retrospecttief onderzoek van insurance data (verzekering) wat geen goede info geeeft (underestimation)
Moeilijkheid ligt in taboesfeer van pijnklachten of i njuries -> zorgt voor uitgestelde zorg en vaak onzekerheid
door zelfstandige statuut
-> Bij prospectief onderzoek -> opvolgen van teams (heel time consuming) doorheen het wedstrijdseizoen
Statement on methods in sport injury research from 1st METHODS MATTER meeting -> what is/ are the
problems with research in sports injuries?
-> geen universele definitie van sportinjuries -> range van definities is handig voor onderzoek maar moet
telkens goed gedefinieerd worden. Ook voor healing proces geen consensus
-> verschillende doelen: expliciteit, description, causale explanation, prediction
-> rationale en theoretische achtergrond
-> inapproriate use of statistics -> een cross ectioneel onderzoek kan geen xausaal effect verklaren en bij
correlaties is het belangrijk om zoveel mogelijk/ alle factoren mee in rekening te brengen
-> multifactorieel effect
Zie TABEL (infra) -> EXAMEN
Estimation costs of sport injuries = sportafhankelijk
WHO guidelines voor bewegingsgoals halen voor gezondheidsvoordeel MAAR bij teveel ook kans op letsels
, 2 FIRST AID IN SPORT INJURIES
First aid = eerste hulp/ assistance bij plots injury voor hulp arriveert -> doelen = oreserve life, preventie van
verslechtering en promote recovery -> Eerste hulp moet zsm gebeuren -> eerste 48 u zijn essentieel
Stappen
Check surroundings (bescherm pt en uzelf) -> Call for help -> Care for the person (gerust stellen,
laten stil liggen etc)
Verschillende methodes
- SALTAPS -> alle stapjes overlopen en kijken hoe ver je geraakt
See
Ask
Look – tekens van bloeding, ontsteking, vervorming
Touch
Active movement
Passive movement
Skills - kan pt staan, lopen, springen etc
- (PR)ICE
Ice Compresison Protection/ Rest (+ optimal loading)
Immobilisation Elevation
- is intussen PEACE & LOVE geworden (peace voor acuut en love voor recovery)
