(2) Sports Medicine

Sprain

stretching/tearing of a ligament

Strain

hyperextension of the muscle or tendon

ACL tear

sprain

Treatment for sprains and strains

RICES, NSAIDs, rehabilitation, crutches

When to refer for sprains and strains

deformities, significant swelling, worsening of skin color changes, no improvement with treatment

Contusion MOI

direct blow

Contusion sxs

pain, tender, swelling, hematoma

Treatment for contusion

RICES< NSAIDs, heat

When to refer for contusions

use of anticoagulants/antiplatelets, worsening or darkening after healing

Tendonitis MOI

small stresses repeatedly aggravating a tendon

Tendonitis treatment

rest, NSAIDs, exercises, bracing/orthotics

Bursitis MOI

repeated small stresses/overuse

_____ is commonly seen with tendonitis

bursitis

Concussion definition

cognitive and perceptual changes experienced after a blow to the head

Cramp

involuntary and forcibly contracted muscle that does not relax

Spasm

involuntary muscle contraction (flickering)

Cold therapy

10-15 min, 3-4 x/day, vasoconstriction for acute injuries, small burns

Heat therapy

15-20 min, 3-4x/day, vasodilation for chronic injuries

Cold therapy contraindications

raynauds phenomenon, open wounds, impaired circulation

Hot therapy contraindications

with topical agents, open wounds, inflammed areas

NSAIDs should be used ____

on a schedule acutely, then taper PRN

NSAID dosing

600-800 mg q 4 hours

Topical analgesic MOA

counter-irritant, deplete P substance, prevents transmission of pain signals

Topical analgesic examples

menthol (icy hot), camphor (jointflex)

Skeletal Muscle relaxants interrupts ____

spasm-pain-spasm cycle

Muscle relaxants more effective for ____

acute pain

Baclofen (Lioresal) indication/MOA

spasticity: inhibits transmission of mono and polysnaptic reflexes at the spinal cord

Carisoprodol (Soma) indication/MOA

acute musculoskeletal pain: precise MOA unknown, CNS depression

Cyclobenzaprine (Amrix, Flexeril) Indication/MOA

muscle spasm: centrally acting skeletal muscle relaxant, reduces tonic somatic motor activity

Methocarbamol (robaxin) indication/MOA

muscle spasm: CNS depression

Tizanidine (Zanaflex) indication/MOA

spasticity: alpha-2 adrenergic agonist, decreases presynaptic inhibition