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Sports Medicine

Field focused on performance enhancement and injury care & management.

Performance Enhancement

Includes exercise physiology, biomechanics, sports psychology, nutrition, and strength & conditioning.

Injury Care & Management

Involves athletic training, sports physical therapy, sports massage therapy, dentistry, orthotists, and chiropractic care.

Responsibilities of the Athletic Trainer

Includes prevention, clinical evaluation and diagnosis, immediate care, treatment, rehabilitation, reconditioning, organization, administration, and professional responsibility.

Responsibilities of the Team Physician

Includes compiling medical histories, diagnosing injuries, deciding on disqualification and return to play, attending practices and games, and commitment to sports and the athlete.

Warm Up/Cool Down

Essential principles of conditioning.

Motivation

Key principle of conditioning.

Overload

Principle that involves the SAID Principle: Specific adaptations to imposed demands.

SAID Principle

When the body is subjected to stresses and overloads of varying intensities, it will gradually adapt over time.

Consistency

A principle of conditioning.

Progression

A principle of conditioning.

Intensity

A principle of conditioning.

Specificity

A principle of conditioning.

Individuality

A principle of conditioning.

Minimize Stress

A principle of conditioning.

Safety

A principle of conditioning.

Dynamic (Ballistic) Stretching

Involves a bouncing movement using repetitive contractions of the agonist muscle to produce quick stretches of the antagonist muscle.

Static Stretching

Passively stretching a given antagonist muscle by holding it in a maximal position of stretch for an extended period (30-60 seconds, 3-4 times).

PNF Stretching

Involves alternating contraction and relaxation of both agonist and antagonist muscles using a 10-second push phase followed by a 10-second relax phase.

Stretching Neural Structures

Active and passive multiplanar movements create tension in neural structures that can exacerbate pain and limit range of motion.

Stretching Fascia

Can be done manually or using a foam roller.

Isometric Contraction

Muscle contracts to increase tension without changing length.

Concentric Contraction

Muscle shortens in length as it contracts to overcome resistance.

Eccentric Contraction

Resistance is greater than the muscular force, causing the muscle to lengthen while continuing contraction.

Hypertrophy

Enlargement of a muscle caused by an increase in the size of its cells in response to training.

Atrophy

Decrease of a muscle caused by a decrease in the size of its cells due to inactivity.

Isokinetic Exercise

Involves muscle contraction where the length of the muscle changes at a constant velocity.

Circuit Training

Employs a set of exercises consisting of various combinations of weight training, flexibility, calisthenics, and brief aerobic exercises.

Calisthenic Strengthening Exercises

Isotonic exercises graded by using gravity as an aid or resistance.

Plyometric Exercise

Includes exercises that involve a rapid stretch of muscle followed by a rapid contraction.

Nutrition

The science of substances found in food essential to life.

Nutrient-dense foods

Supply adequate amounts of vitamins and minerals in relation to caloric value.

Greenstick Fracture

Incomplete break in bones that have not completely ossified.

Spiral Fracture

S-shaped separation of a bone.

Oblique Fracture

Occurs when one end of the bone receives sudden torsion while the other is fixed.

Transverse Fracture

Occurs in a straight line at right angles to the bone shaft.

Comminuted Fracture

Fracture with 3 or more fragments at the site.

Avulsion Fracture

Separation of a bone fragment at the attachment of a ligament or tendon.

Stress Fracture

Overload caused by muscle contraction; altered stress distribution in the bone.

Inflammatory Response Phase

Lasts for 4 days in the healing process.

Fibroblastic Repair Phase

Lasts from Day 4 to Week 6 in the healing process.

Maturation/Remodeling Phase

Lasts from Week 6 to 2-3 years in the healing process.

Primary Survey

Assesses life-threatening injuries.

Secondary Survey

Recognizes vital signs.

HOPS

History, Observation, Palpation, Special Tests for injury evaluation.

Subjective

Subjective statements provided by the injured athlete

Objective

Result from AT's visual inspection, palpation, and assessment of AROM, PROM, RROM, findings of special tests

Assessment

AT's professional judgement with regard to impression and nature of injury

Plan

First aid treatment, plan of treatment/rehab

Modes of transmission

Human blood, semen, vaginal secretions, cerebrospinal fluid, synovial fluid

Three most significant bloodborne pathogens

HBV, HCV, HIV

Prevention of bloodborne pathogens

Good personal hygiene; HBV can survive for at least 1 week in dried blood or contaminated surfaces

Management of bloodborne pathogens

Vaccination must be made available by employers; 3 doses over a 6 month period

Tibia

2nd longest bone in body; lower 1/3 of shaft is weakest and most common site of fx

Fibula

Arthrodial articulation proximally, syndesmotic joint distally (held by anterior/posterior ligaments)

Medial & lateral malleoli

Lateral extends further distally; bony stability better on lateral side

Talus

Main weight bearing bone of ankle; link between lower leg and calcaneus

Calcaneus

Forms the heel; attachment of supporting ankle ligaments and Achilles tendon

Calcaneal tuberosity

Attachment of plantar fascia

Sustenaculum tali

Articulation with talus

Superior tibiofibular joint

Lateral tibial condyle to head of fibula; diarthrotic (allows gliding motion)

Interosseus membrane

Holds tibia & fibula together, prevents bowing of fibula during weight bearing

Inferior tibiofibular joint

Fibrous articulation; lateral malleolus to distal tibia; reinforced by ankle ligaments

Talocrural joint

True ankle joint - hinge joint (PF/DF); articular facet of distal tibia to superior articular surface/trochlea of talus

Subtalar joint

Eversion/inversion & pronation/supination; talus to calcaneus

Lateral stabilizing ligaments

Anterior talofibular, posterior talofibular, calcaneofibular

Medial stabilizing ligaments

Triangular deltoid ligament - medial malleolus to medial talus, sustentaculum tali of calcaneus, posterior navicular bone

Deltoid ligament

Anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar

Joint Capsule

Thicker medially, thin at the back

Distal femur

Convex lateral and medial condyles to tibial plateau and patella

Menisci

Two oval fibrocartilages that deepen articular facets of tibia, cushion any stress, distribute synovial fluid

Cruciate ligaments

ACL: lateral femoral condyle to anteromedial intercondylar eminence of the tibia; PCL: medial femoral condyle to posterior tibia

Clavicle

6 inches long; only connection of appendicular skeleton to axial skeleton

Clavicle Fracture

Most often fractured at medial 1/3

Scapula Motion

Involved in motion of scapula 30-90° (elevates and rotates)

Scapula Anatomy

Superior and inferior angles; vertebral/medial and axial/lateral borders; spine; subscapular, infraspinous, supraspinous fossas; acromion and coracoid processes; glenoid cavity

Glenoid Orientation

Glenoid is angled 30° from frontal plane and faced downward (plane of the scapula)

Rotator Cuff Muscles

Plane of the scapula places rotator cuff muscles in optimal length/tension

Humerus Orientation

Faces upward, inward, and backward

Anatomical Neck of Humerus

Attachment for GH joint articular capsule

Humerus Tuberosities

Medial →lateral: lesser tuberosity, bicipital or intertubercular groove, greater tuberosity

Surgical Neck of Humerus

Just inferior to tuberosities; fractures here require surgery

Deltoid Tuberosity

Just above midshaft of the humerus

Angle of Inclination

Relationship between shaft of humerus and humeral head in the frontal plane (130-150°)

Angle of Torsion

In transverse plane, relationship between shaft of humerus and humeral head (varies)

Sternoclavicular Joint

Sternoclavicular disc between manubrium and clavicle; acts as shock absorber and axis for rotation

Sternoclavicular Ligaments

4 ligaments: anterior SC ligament, posterior SC ligament, costoclavicular ligament, interclavicular ligament

Degrees of Freedom in Sternoclavicular Joint

3 degrees of freedom: elevation/depression, protraction/retraction, IR/ER

Acromioclavicular Joint

Fibrocartilagenous disc (disappears by adulthood), synovial membrane

Acromioclavicular Ligaments

AC ligament, Coracoclavicular ligament (trapezoid & conoid), Coracoacromial ligament

Subacromial Bursa

Formed by acromion, coracoacromial ligament, coracoid; contains long head of biceps, subacromial bursa, supraspinatus tendon

Degrees of Freedom in Acromioclavicular Joint

3 degrees of freedom: scapular rotation, scapular winging, scapula tipping

Scapulothoracic Joint

Movements: scapular elevation/depression, protraction/retraction, upward/downward rotation

Glenohumeral Joint

Head of humerus →glenoid fossa; ball & socket joint

Glenoid Labrum

Deepens joint in the glenohumeral joint

Glenohumeral Ligaments

Superior, middle, inferior; thickenings in joint capsule

Foramen of Weitbrecht

Space between superior & middle glenohumeral ligaments; often torn in anterior dislocations

Coracohumeral Ligament

Coracoid →superior capsule & supraspinatus tendon →greater tuberosity; limits extension and flexion

Transverse Humeral Ligament

Retains long head of the biceps

Degrees of Freedom in Glenohumeral Joint

3 degrees of freedom: flexion/extension, abduction/adduction, IR/ER (also horizontal)