Kinesiology and Biomechanics 2.3

What makes up a subjective exam?

Mechanism of injury

Loads involved

Types of forces and structures most often affected

What is affected with a tensile force?

Ligaments, tendons, muscles

What is affected with a compression force?

Cartilage, bone

What is affected with a shear force?

Cartilage

What is affected with a rotation force?

Ligaments, cartilage

What is affected with a repetitive force?

Tendon, muscles, bone

What is affected during a 1 degree ligament tear?

0-25% tear, no instability

What is affected during a 2 degree ligament tear?

26-75% tear, some instability

What is affected during a 3 degree ligament tear?

76-100% tear, definites instability

What is the healing time length for a ligamentous injury that is non-surgical?

6 weeks

What is the healing time length for a ligamentous injury that is surgical?

3-6 months

What is affected during a 1 degree muscle strain?

mild, minimal swelling, loss of ROM, & function

What is affected during a 2 degree muscle strain?

moderate, moderate swelling, significant loss of ROM and function

What is affected during a 3 degree muscle strain?

severe, extensive swelling, severe loss of ROM and complete loss of function

What is the healing time length for a muscle strain?

Between 1 week to 6 months

What happens during a lateral ankle sprain?

Inversion and plantarflexion

What ligaments are affected with a lateral ankle sprain?

Anterior talofibular ligament

Calcaneofibular ligament

Posterior talofibular ligament

Where on the ankle is a high ankle sprain?

Above the ankle

What ligaments are affected with a high ankle sprain?

Anterior tibiofibular ligament

Posterior tibiofibular ligament

What is sprained during a high ankle sprain?

Syndesmosis

What ligaments are affected in a 1 and 2 degree lateral ankle sprain?

Anterior talofibular ligament

Calcaneofibular ligament

Are the ligaments torn or stretched in a 1 degree lateral ankle sprain?

Stretched

What ligament is partially torn in a 2 degree ankle sprain?

Anterior talofibular ligament

What ligaments are affected in a 3 degree lateral ankle sprain?

Anterior talofibular ligament

Posterior talofibular ligament

Posterior tibiofibular ligament

Calcaneofibular ligament

Which ligaments in a 3 degree lateral ankle sprain are ruptured?

Anterior talofibular ligament

Calcaneofibular ligament

Which ligaments in a 3 degree lateral ankle sprain are partially torn?

Posterior talofibular ligament

Posterior tibiofibular ligament

What is the most common lateral ankle sprain?

Inversion

Plantarflexion

Rotation

What is the most rare lateral ankle sprain?

Pure inversion

What is another phrase for exercise related leg pain?

Shin splints

What can cause shin splints?

Increased pronation

Improper footwear

Hard running surfaces

Recent increase in activity

What is the anterior pain of the tibia caused by?

Tibialis anterior

Stress fracture

Compartment syndrome

What is the medial pain of the tibia caused by?

Posterior tibialis, soleus, FDL

Stress fracture

Compartment syndrome

What would cause gradual trochanteric bursitis?

Short IT band

Leg length discrepancy (LLD)

Hip IR

Repetitive rubbing

What would cause acute trochanteric bursitis?

Direct injury from a fall

What hip structural alignment would correspond to an anterior labral tear?

Angle of torsion > Retroversion

Which hip structural alignment would correspond to a femoral neck fracture?

Coxa Varum

What phase of healing is considered to be acute?

Inflammation phase

What is the time frame for the inflammation phase of healing?

3 days

What are the characteristics for the inflammation phase of healing?

Area is red, warm, swollen and painful

Pain present at rest and with motion of involved area

Coagulation, WBCs

What are the goals for the inflammation phase of healing?

Rest

Relieve pain

Protect

What phase of healing is considered to be subacute?

Migratory and proliferative phase

What is the time frame for the migratory and proliferative phase of healing?

Between 10 days and 6 weeks

What are the characteristics for the migratory and proliferative phase of healing?

Pain occurs with activity of involved area

Limited ROM and strength

Capillary growth, granulation tissue formation, fibroblast proliferation with collagen synthesis, increased macrophage activity

What are the goals for the migratory and proliferative phase of healing?

Optimal stimulus for regeneration

Protect

Gain motion

What phase of healing is considered to be chronic?

Remodeling/Maturation phase

What is the time frame for the remodeling/maturation phase of healing?

6 weeks to 1 year

What are the characteristics for the remodeling/maturation phase of healing?

Pain may occur after activity

Macrophage and fibroblast activity diminishes

Scar tissue density increases

What are the goals for the remodeling migratory phase of healing?

Increase tissue stress

Full motion

Strengthen

Return to pain-free function

What are the activities of an acute phase I healing?

ROM

Primary healing

What are the activities of a subacute phase II healing?

Controlled ROM

Crutch weaning

Walking

What are the activities of a subacute phase III healing?

Protected activity

Protected light function

What are the activities of a chronic phase IV healing?

Advanced rehab

Return to function

What are the activities of a chronic phase V healing?

Maintain level of activity

Continued rehab

What is does MAHOMEES stand for when discussing treatment areas?

M: modalities

A: assistive devices

H: home exercise program

O: NONE

M: manual therapy

E: exercise

E: education

S: NONE

During which healing phase does scar tissue density increase and macrophage and fibroblast activity diminish?

A) Acute phase

B) Subacute phase

C) Chronic phase

Chronic phase

During which healing phase does swelling and pain occur?

A) Acute phase

B) Subacute phase

C) Chronic phase

Acute phase

During which healing phase does macrophage and fibroblast activity increase?

A) Acute phase

B) Subacute phase

C) Chronic phase

Subacute phase

What clinical sign is most characteristic of a hip labral tear?

A) Lateral hip tenderness

B) Diffuse thigh swelling

C) Anterior groin pain with clicking

D) Pain localized to the sacroiliac joint

Anterior groin pain with clicking

What clinical sign is most characteristic of a trochanteric burstitis?

A) Lateral hip tenderness

B) Diffuse thigh swelling

C) Anterior groin pain with clicking

D) Pain localized to the sacroiliac joint

Lateral hip tenderness

What clinical sign is most characteristic of a hip fracture or major contusion?

A) Lateral hip tenderness

B) Diffuse thigh swelling

C) Anterior groin pain with clicking

D) Pain localized to the sacroiliac joint

Diffuse thigh swelling

What clinical sign is most characteristic of a sacroiliac dysfunction?

A) Lateral hip tenderness

B) Diffuse thigh swelling

C) Anterior groin pain with clicking

D) Pain localized to the sacroiliac joint

Pain localized to the sacroiliac joint

What type of force most commonly affects ligaments?

A) Compression force

B) Tensile force

C) Shear force

Tensile force

What type of force most commonly affects cartilage and bone?

A) Compression force

B) Tensile force

C) Shear force

Compression force

What type of force most commonly results in a cartilage injury?

A) Compression force

B) Tensile force

C) Shear force

Shear force

Which hip condition is most often associated with lateral hip pain that is likely tender with superficial palpation and aggravated by repetitive hip motion?

A) Hip labral tear

B) Femoral neck fracture

C) Trochanteric bursitis

D) Osteoarthritis

Trochanteric bursitis

Which hip condition is most often associated with anterior groin pain with possible clicking?

A) Hip labral tear

B) Femoral neck fracture

C) Trochanteric bursitis

D) Osteoarthritis

Hip labral tear

Which hip condition is most often associated with acute hip/groin pain, often in older adults after trauma?

A) Hip labral tear

B) Femoral neck fracture

C) Trochanteric bursitis

D) Osteoarthritis

Femoral neck fracture

Which hip condition is most often associated with stiffness and groin pain, not localized lateral tenderness?

A) Hip labral tear

B) Femoral neck fracture

C) Trochanteric bursitis

D) Osteoarthritis

Osteoarthritis

Which of the following muscle(s) is most associated with medial tibial stress syndrome?

A) Tibialis anterior

B) Peroneus longus

C) Posterior tibialis

D) Gastrocnemius

Posterior tibialis

Which of the following muscle(s) is most associated with anterior shin pain?

A) Tibialis anterior

B) Peroneus longus

C) Posterior tibialis

D) Gastrocnemius

Tibialis anterior

Which of the following muscle(s) is most associated with lateral lower leg pain?

A) Tibialis anterior

B) Peroneus longus

C) Posterior tibialis

D) Gastrocnemius

Peroneus longus

Which of the following lists correctly includes the six major treatment areas in rehabilitation?

A) Surgery, Imaging, Exercise, Education, Nutrition, Manual Therapy

B) Modalities, Imaging, Manual Therapy, Assistive Devices, Exercise, Education, Home Exercise Program

C) Modalities, Manual Therapy, Assistive Devices, Exercise, Education, Home Exercise Program

D) Assistive Devices, Surgery, Home Exercise Program, Exercise, Manual Therapy, Education

Modalities, Manual Therapy, Assistive Devices, Exercise, Education, Home Exercise Program

In rehabilitation, what can be used to guide appropriate exercise dosing to facilitate targeted improvements during rehabilitation?

A) DOMS

B) Wolff's Law

C) SAID Principle

SAID Principle

What is one of the primary rehabilitation goals during the acute phase of healing?

A) Protect the area

B) Increase tissue stress

C) Full range of motion

D) Initiate sport-specific drills

Protect the area

Which ligaments are most commonly injured in a first or second degree lateral ankle sprain?

A) Anterior talofibular and calcaneofibular ligaments

B) Posterior cruciate ligament and meniscus

C) Medial collateral and deltoid ligaments

D) Anterior and posterior tibiofibular ligaments

Anterior talofibular and calcaneofibular ligaments

Which ligaments are most commonly injured in a high ankle sprain?

A) Anterior talofibular and calcaneofibular ligaments

B) Posterior cruciate ligament and meniscus

C) Medial collateral and deltoid ligaments

D) Anterior and posterior tibiofibular ligaments

Anterior and posterior tibiofibular ligaments

Which exercise mode is best for early joint protection and controlled strengthening after an acute ligament injury?

A) Free weights

B) Sprinting drills

C) Isometric exercises

D) Plyometric training

Isometric exercises