Orthopedic Injury Rehabilitation: Phases, Treatments, and Exercise Guidelines

What is the difference between macrotrauma and microtrauma?

Macrotrauma is a sudden, specific, high-force episode causing acute injury; microtrauma is the accumulation of repeated low-level forces causing chronic/overuse injury.

What types of physical harm does injury cause?

Tissue damage, bleeding, swelling, loss of function.

What psychological issues can arise from an injury?

Common issues include anxiety, depression, anger, and lowered self-esteem due to loss of physical capacity.

What happens during the inflammation phase of healing?

Tissue damage triggers pain, swelling, and redness; immune cells clean up debris.

What happens during the repair phase of healing?

Fragile scar tissue (type 3 collagen) is laid down to bridge the gap.

What happens during the remodeling phase of healing?

Scar tissue strengthens, contracts, and converts to strong type 1 collagen.

What should be integrated during the inflammation phase?

Protection and pain control, with gentle, non-stressful isometric exercises for surrounding uninjured areas.

What should be integrated during the repair phase?

Controlled, submaximal movement; introduce mobility and low-intensity isometrics/isotonics to promote proper fiber alignment.

What should be integrated during the remodeling phase?

Progressive tissue loading; increase intensity and complexity; focus on strength, power, and return to activity.

What is an indication in treatment?

A specific reason that a certain treatment or exercise should be used because it's appropriate and beneficial.

What is a contraindication?

Specific reasons why a treatment/exercise should not be used because it may cause harm to the client.

What is a precaution in exercise?

Condition or circumstance requiring that an exercise be used with caution, monitoring, or modification to minimize risk.

What are some causes of lower back pain?

Degenerative disc disease (DDD), disc herniation, muscle strains, poor posture, and deconditioning.

What are some logical treatments for low back pain?

Multimodal treatments including core stabilization exercises, flexibility, patient education, and low-impact aerobics.

What type of treatment does low back pain respond well to?

Active rehabilitation and core stability training.

How are the bodies of the vertebrae connected?

By the intervertebral discs and ligaments.

What movements should clients with a herniated disc avoid?

Excessive spinal flexion (bending forward) and rotation.

What are contraindicated exercises for resistance training with a back issue?

Heavy unsupported squats/deadlifts, unsupported overhead lifting, and traditional full sit-ups/twists that cause pain.

What are the recommendations for aerobic exercise with back pain?

Low-impact activities focusing on maintaining a neutral spine.

What are muscle strains?

A stretch or tear of muscle fibers; action includes stopping activity, applying first aid (RICE/POLICE), and referring to a medical professional.

What is spondylolysis?

A stress fracture or defect in the pars interarticularis of a vertebra.

What is spondylolisthesis?

Forward slippage of one vertebra over another.

What is the best way to treat spondylolysis and spondylolisthesis?

Conservative treatment focusing on avoiding hyperextension and strengthening the core stabilizers.

What exercises are recommended for torn rotator cuff tears?

External and internal rotation (light resistance) and scapular stabilization exercises.

What happens during shoulder impingement syndrome?

Rotator cuff tendons are pinched between the humerus and acromion during arm elevation.

What do rowing exercises focus on?

Latissimus dorsi, rhomboids, middle/lower trapezius, and posterior deltoids.

What shoulder exercise should be done with caution?

Upright row, as it can increase impingement risk.

What is glenohumeral joint instability?

Excessive or abnormal movement of the humerus head within the shoulder socket.

What happens during a rotator cuff tear?

Tendons of one or more of the SITS muscles are damaged.

What percentage of injuries are ankle injuries?

15-20%.

What should a personal trainer do when a client has an ankle injury?

Stop exercise, provide basic first aid, and refer the client to a medical professional.

What are ankle contraindications and indications when someone has an ankle injury?

Contraindications: high-impact movements; indications: non-weight-bearing range of motion and low-impact aerobics.

What are three injuries that can occur with the knee joint?

ACL sprain/tear, meniscal tear, patellofemoral pain syndrome (PFP).

What two exercises are important for knee pain?

Quadriceps strengthening (closed-chain) and hip (gluteal) strengthening.

What happens during ACL reconstruction?

The torn ligament is surgically replaced with a graft.

What types of exercises are appropriate for someone with knee pain?

Closed chain exercises and low-impact aerobics.

Why is total knee arthroplasty needed?

To replace the damaged joint surfaces with artificial implants.

What is the primary cause of knee arthroplasty?

Severe osteoarthritis (OA).

What exercises are recommended for someone who has hip arthroplasty?

Low-impact aerobics and gluteal/quadriceps strengthening; avoid specific movements based on the surgical approach.

What muscles are used during the curl-up?

Rectus abdominis, external obliques

What muscles are used during the roman chair back extension?

Erector spinae, gluteus maximus, hamstrings

What muscles are being used during the bent over barbell row?

Latissimus dorsi, biceps, rhomboids, trapezius (middle/lower)

What muscles are used during the Lat Pulldown?

Biceps brachii, brachialis, brachioradialis

What muscles are used during the low pulley seated row?

Latissimus dorsi, biceps, rhomboids, trapezius (middle/lower)

What muscles are used during the arm curl?

Biceps brachii, brachialis, brachioradialis

What muscles are used during pushdowns or dips?

Triceps brachii

What muscles are used during the Machine standing Heel raise?

Gastrocnemius, soleus (gastrocnemius emphasized)

What muscles are used during the seated calf machine?

Soleus (emphasized)

What muscles are used during the bench press?

Pectoralis major, anterior deltoid, triceps brachii

What muscles are used during the flat dumbbell fly?

Pectoralis major

What muscles are used during the Leg Press?

Quads (vastus lateralis, medialis, intermedius, rectus femoris) & gluteus maximus

What muscles are used during the Back Squat?

Quads (vastus lateralis, rectus femoris), gluteus maximus, adductor magnus

What muscles are used during the forward lunge?

Quads, gluteus maximus, hamstrings (lesser degree)

What muscles are used during the Romanian Deadlift?

Hamstrings, gluteus maximus, erector spinae

What muscles are used during the Leg Extension?

Quadriceps

What muscles are used during the Leg Curl?

Hamstrings

What muscles are used during the Overhead shoulder press?

Anterior and middle deltoid, triceps brachii

What muscles are used during the Upright Row?

Deltoids, trapezius

What muscles are used during the lateral Raise?

Middle deltoid

What are 4 mental benefits of exercise?

Reduced anxiety/stress, improved mood, enhanced self-esteem, improved cognitive function

Define state anxiety and provide examples.

Temporary emotional state tied to a specific situation (ex: fear of a test)

Define trait anxiety and provide examples.

Stable personality characteristic reflecting a general tendency to be anxious

What exercise type reduces anxiety?

Moderate-intensity aerobic exercise (20-60 min)

What are some mechanisms for the anxiety-reducing effect of exercise?

Distraction from worry, release of endorphins/endocannabinoids, enhanced sense of control/competence

How can exercise influence cognitive levels?

Increases blood flow/oxygenation to the brain and affects neurotransmitters, leading to improvements in attention and focus

What are the benefits of goal setting?

Increased motivation, enhanced self-confidence, and a clear guide for action

Define process goals and provide examples.

Focuses on actions/behaviors (ex: 'I will perform my mobility routine daily')

Define outcome goals and provide examples.

Focuses on competitive results against others (ex: 'I will finish first in my age group')

Define performance goals and provide examples.

Focuses on achieving an internal standard (ex: 'I will lift 250 lbs')

What is the difference between task-involved goals and ego-involved goals?

Task-involved goals focus on effort and mastery; ego-involved goals focus on outperforming others.

What does the acronym SMART stand for in goal setting?

S-specific, M-measurable, A-achievable, R-relevant, T-time bound

What is the difference between positive reinforcement and negative reinforcement?

Positive reinforcement adds a desirable stimulus to increase behavior; negative reinforcement removes an undesirable stimulus to increase behavior.

What is the self-determination theory (SDT)?

Motivation driven by the innate needs for autonomy (control), competence (mastery), and relatedness (connection).

What is the difference between intrinsic motivation and extrinsic motivation?

Intrinsic motivation is participation for inherent pleasure; extrinsic motivation is participation for external rewards or to avoid punishment.

Define the transtheoretical model and describe its steps.

Precontemplation: no intention to change; Contemplation: intending to change; Preparation: intending to change soon; Action: actively engaging in new behavior; Maintenance: consistently performing new behavior.

What is self-efficacy?

Clients' belief in their capability to successfully perform a specific task or behavior.

What are strategies to increase motivation/self-efficacy?

Create successful experiences, use positive reinforcement, promote goal-setting, and encourage self-monitoring.

What are some strategies for motivating the client?

Provide frequent feedback, create a supportive environment, assist with goal setting, and promote autonomy.

What are the two types of arthritis and how do they differ?

Osteoarthritis (OA): degenerative joint disease; Rheumatoid arthritis (RA): autoimmune disease causing systemic inflammation.

What are the indications and contraindications of exercise for osteoarthritis?

Indications: low-impact aerobic exercise, resistance training, flexibility; Contraindications: high-impact activities, heavy loading, exercise during painful flare-ups.

What are contraindication and indication exercises for rheumatoid arthritis?

Indications: low-impact aerobics, flexibility, moderate resistance training; Contraindications: high-impact activities, aggressive resistance training, exercise during severe flare-ups.