Traumatic soft tissue injury

What does the 'L' represent in the injury management acronym POLICE?

Optimal Loading.

Which injury management acronym is currently promoted by the NICE (2020) guidelines?

PRICE.

According to Bleakley et al (2012), what is the recommended duration and frequency for applying ice to an acute injury?

15−20 minutes every 2−3 hours.

In the context of exercise prescription, what does the 'Intensity' factor describe?

How much load or effort is required.

What percentage of ligament fiber involvement defines a Grade 1 sprain?

Less than 5% of fibers.

How is a Grade 2 ligament sprain defined in terms of fiber damage?

A tear of up to 95% of fibers with part of the ligament remaining intact.

Which grade of ligament injury is confirmed as a complete rupture (100% fibers torn)?

Grade 3.

What are the three common clinical presentations of a Grade 2 or 3 ligament sprain?

Significant swelling, pain, and an inability to weight bear.

Compared to males, how much more likely are females to sustain an ACL rupture in cutting or pivoting sports?

4−6 times more likely.

By what percentage can neuromuscular training reduce ACL incidence in females under 18 years old?

72%.

What term describes the accumulation of blood in the knee joint following an ACL injury?

Hemarthrosis.

Which clinical test for ACL injury has a reported sensitivity of 94.4?

Anterior Drawer test.

What is the reported sensitivity of the Lachman test for diagnosing ACL injuries?

93.5.

What is considered a normal result (in mm) for the Anterior Drawer test?

6mm.

Which specific injury should a clinician be wary of as a potential false positive for an ACL tear?

A PCL tear.

In ACL rehabilitation, what is the purpose of quadriceps activation exercises following effusion?

To reduce reflex inhibition.

What range of knee flexion is recommended for OKC knee extensions in an ACL deficient knee to reduce shearing forces?

30−100∘.

How long after activity do tendons typically provide feedback or a pain response?

24 hours.

What is the primary goal in the management of Achilles tendinopathy?

To restore pain-free function.

How often should a pathological tendon be loaded during rehabilitation?

Daily.

Which assessment for Achilles tendinopathy involves palpating the tendon while the patient performs ankle movements?

Royal London Hospital Test.

What is the specific focus of Stage One in Achilles tendinopathy management?

Isometrics to manage pain and reduce compression.

In Achilles tendinopathy rehab, what occurs during the 'Energy Storage' stage?

Faster, end-of-range eccentric movements with compression.

What is the typical age range for individuals who sustain an Achilles tendon rupture?

30−50 years old.

Which clinical test is used to identify a complete Achilles tendon rupture?

Thompson's test.

What is a significant medical risk specifically associated with surgical management of an Achilles rupture compared to non-operative care?

Infection.

What percentage of total ankle sprains recorded in emergency departments are lateral ankle sprains?

91.74%.

Which age group has the highest incidence of ankle sprains (20.20%)?

18−25 year olds.

What clinical tool has 100% sensitivity for identifying fractures in children with ankle injuries?

Ottawa Ankle Rules.

Weakness in which muscle group is a predictor of non-contact lateral ligament sprains?

Hip abductors.

What is the standard girth measurement technique for assessing ankle swelling?

Figure of 8.

Which movement should be tested last during PROM for a suspected lateral ankle sprain?

Inversion.

What are the specificity and sensitivity values for the Anterior Drawer test of the ankle?

Specificity 0.84 and sensitivity 0.96.

In the early phase of lateral ligament sprain rehab, what is the purpose of isometrics?

To stimulate the ankle evertors.

What is the primary goal of the advanced phase of lateral ankle ligament rehabilitation?

To increase loading of the ankle evertors and develop functional stability.

Where does a rotator cuff tear commonly occur relative to the distal attachment on the humerus?

1−1.5cm proximally in the 'critical zone'.

What is the 'critical zone' in the shoulder rotator cuff?

A hypovascular area proximal to the distal attachment on the humerus.

Why does smoking delay the healing of a tendon to bone after rotator cuff surgery?

It lowers the amount of hydroxyproline required for collagen helix formation.

Which rotator cuff muscle initiates the first 15−20∘ of shoulder abduction?

Supraspinatus.

Which clinical test for rotator cuff tears has 100% sensitivity and specificity?

Drop arm test.

What is the 'Hornblower's sign' used to assess in the shoulder?

Teres minor integrity.

In the early phase of rotator cuff management, which type of ROM exercises are used to progress towards active flexion?

Active assisted exercises.

Why are eccentric exercises preferred in the intermediate phase of rotator cuff rehab?

To reduce superior migration of the humeral head.

What is the goal of the advanced phase of rotator cuff management?

To build functional strength and improve the strength of scapular stabilisers.

Which age group is most commonly affected by lateral epicondylitis?

35−54 years old.

What is the ratio of frequency between lateral and medial epicondylitis?

Lateral is 7 times more frequent.

Lateral epicondylitis occurs in what percentage of tennis players?

50%.

What three special tests are used to assess for lateral epicondylitis?

Maudsley's, Cozen's, and Mills' tests.

Which combination of treatments has the most beneficial effects for managing lateral elbow pain?

Manual therapy in conjunction with eccentric strength training.

What is the reported re-injury rate for hamstring muscle strains?

12−31%.

What clinical symptom might indicate an avulsion of the hamstring origin?

Pain on sitting.

Which passive measurement is used to assess hamstring flexibility during an assessment?

Popliteal knee angle.

At what three angles should resisted isometric knee flexion be tested in prone for hamstrings?

0∘, 45∘, and 90∘.

List two common exercises used in the intermediate or advanced phases of hamstring rehabilitation.

Bridges (e.g., on a gym ball) and Romanian Deadlifts.