Athletic Injuries

Derived from Nathan's BOC study sheet/guides

stress fractures occurs____, mainly to the___ (3)

in the weight bearing-bones of lower extremity

femur, tibia, fibula, foot bones

growth plate fractures occur ____ and are common to the population ___

cartilage near the ends of long bones

children under 20 y/o

stress fractures can result from (3)

single traumatic event (fall/MVA), chronic stress, overuse

what is bursitis?

inflammation of the bursae/bursa, a small, fluid-filled sac that acts like cushion between bone and other moving parts

bursitis can be caused by (2)

one-time event like a blow or fall, or repetitive motion

shoulder impingement is when…

top of shoulder blade put pressure on soft tissues beneath it when the arm is lifted

common groups to develop shoulder impingement are (2)

swimmers and repeated overhead movements

shoulder instability is when…

bone is forced out of it’s shallow socket, either partially or completely.

instability leads to __

dislocations; stretching of tendons, ligaments, muscles to be torn; shoulder becomes “loose” and dislocations can occur repeatedly

tennis elbow occurs when

overuse and repr

golfer’s elbow is __ epicondylitis (lateral or medial)

medial epicondylitis

how does one develop golfer’s elbow?

repeatedly using wrist and clenching fingers

little league elbow is….and is caused by….

growth plate injury caused by repetitive throwing in youths

little league elbow will hurt the inside or outside of the elbow?

inside

ulnar collateral ligament injury is caused by…

repetitive throwing, causing pain and decreased throwing effectiveness

patellofemoral pain syndrome is commonly called (2)

jumper’s knee or runner’s knee

patellofemoral pain syndrome is…

pain/tenderness caused by pressure increase between patella and femur

groin pull etiology

quick side-to-side motions can strain the muscles of the inner thigh and lead to groin pull

groin pull are common in which sports (4)

hockey, soccer, football, baseball

hamstring strains are common in which sports (3)

basketball, football, soccer

hamstring strain etiology

running, jumping, sudden starts and stops

which tendon is the largest tendon in the body?

achilles tendon

achillies tendonitis often felt when?

stiffness at back of heel, especially in the morning

symptoms of an acute injury (6)

1. sudden, severe pain

2. extreme swelling/bruising

3. inability to weight-bear

4. ROM decreased

5. extreme weakness

6. bone/joint visibly out of place

pain symptoms of chronic injury due to overuse (2)

1. pain with activity

2. swelling & dull ache with rest

PCP treat…

problems as they arise and coordinate care between different specialized health care providers (non-serious injuries)

orthopaedic surgeons specialize in…

diagnosing and treating injuries to bones, joints, ligaments, tendon, muscles, nerves

(ST, bones, nerves)

physiatrists doctors specialize in…

nonsurgical management of musculoskeletal conditions and can develop a plan of care, rehab included

what is myositis ossificans (MO)

condition where during healing of a bruise, bone forms within a muscle due to calcium deposits, causing a hard bone like structure.

myositis ossificans can take up to …. to heal

2-4 weeks

myositis ossificans commonly seen in which muscle groups (3)

thigh, upper arm, shoulder

myositis ossificans risk factors

repeated trauma to same area, not allowing muscle to heal properly, premature RTP

what is iliac hip contusion

AKA hip pointer is a contusion/bruise on iliac crest

iliac crest contusion can be caused by (2)

direct blow or impact

iliac hip contusion symptoms (6)

pain over iliac crest, bruising, swelling, tenderness, possible spasm, difficulty with movement/bending/twisting

how long may recovery take for hip pointer?

1 week with rest and proper care

sacroiliac joint dysfunction (SI) is…. and can cause pain to the….

inflammation and irritation to the pelvic and joint connecting to the spine

causes pain to lower back, hip, sometimes in leg that can radiate down

SI dysfunction etiology (5)

overuse, arthritis, pregnancy, infection, gait abnormalities, hyper or hypomobility

SI dysfunction is often worse during (2)

morning or periods of inactivity

SI dysfunction differential diagnosis (6)

ankylosing spondylitis, hip osteoarthritis, lumbar spinal stenosis, piriformis syndrome, sciatica

SI dysfunction type of pain feels like… in the…

sharp/stabbing/dull in lower back/buttocks/hip

SI dysfunction can be described feeling as…

pelvis or lower back is giving away; difficulty with balance or coordination

what are the rare symptoms SI dysfunction lead to (2)

leg length discrepancy and bowel or bladder problems

spondylosis etiology/causes (3)

1. age related wear and tear

2. degeneration of discs, bones, joints

3. bone spurs or herniated discs that can compress the spinal cord or nerve roots

a stress fracture in vertebra.

what can happen to ligaments if present with spondylosis condition?

ligament thickening and stiffening, further limiting spinal flexibility

spondylosis signs and symptoms (4)

what movements would be painful

1. pain to neck and back

2. stiffness

3. limited ROM

4. numb/ting/weakness in arms or legs

1. hyperextension of neck, back

2. lateral neck flexion

3. prolonged sitting

what is IT band syndrome

AKA runner’s knee is an overuse injury caused by repetitive knee bending, leading to friction and inflammation where IT band rubs against lateral tibia.

other etiology of IT band syndrome (8)

1. tight IT band

2. muscle imbalances

3. poor running form

4. biomechanical issues

5. training error

6. foot problems

7. worn out shoes

8. running on hard surfaces

IT band syndrome is pain is/to…(4)

1. pain to outer knee

2. pain worsens with activity

3. pain radiates up or down the knee

4. pain lingers after exercise

5. clicking, popping, snapping sensation

to correct IT band syndrome, stretch the…(3) and strengthen the…

stretch the IT band, hip flexor, hamstring

strengthen the gluteus medius and external rotator muscles

blockers exostosis etiology

repetitive blunt trauma to the humerus; basically myostitis ossification to the humerus, upper arm, biceps

which sport and position is most likely to get blockers exostosis

football linemen

blockers exostosis symptoms (5)

pain, tenderness, sensitivity worsen by pressure, change in contour of arm, occasionally swelling or bruising with repeated injury

uncommonly, there could be a movable bone in the arm when the spur breaks off the humerus

if you were born with blockers exostosis, what condition is this called?

osteochondroma

biceps tendon rupture etiology

acute trauma: fall, lifting

chronic issues: overuse, age-related degeneration, underlying conditions

ruptured biceps tendon symptoms (7)

sudden, sharp pain, often accompanied by a popping or tearing sensation, swelling, weakness in shoulder and elbow, noticeable bulge in biceps muscles (popeye deformity)

key differences in thoracic outlet syndrome from brachial plexus injury

results from compression of the nerves of blood vessels at the thoracic outlet/collarbone and first rib

key difference in brachial plexus injury from thoracic outlet syndrome

result from direct injuries to the nerves themselves (direct trauma, falls, car accidents)

common different diagnosis for TOS and brachial plexus injury (4)

carpel tunnel syndrome, cubital tunnel syndrome, cervical spine disease, other nerve entrapment

shoulder tendon synovitis etiology

inflammation of tendon sheath surrounding shoulder tendons like the rotator cuff from overuse or sudden trauma

shoulder tendon synovitis symptoms (5); what is the number one tale-telling sign

1. stiffness

2. *pain abduction between 40 and 120 degrees

3. tenderness

4. swelling

5. clicking or grating sensation when moving the shoulder

6. reduced strength and mobility

causes of shoulder tendon synovitis (2)

1. overuse

2. improper technique

tendonitis vs tenosynovitis

tendon - inflammation of tendons

tenosynovitis - inflammation of tendon sheath, the protective sleeve of tissue surrounding the tendons

bicep long head rupture etiology

acute trauma and chronic degeneration due to overuse or underlying shoulder conditions; often associated with rotator cuff tears, esp in older individuals bicep long head rupture

bicep long head rupture can also be called

popeye deformity can also be called

bicep long head rupture can happen from traumatic injuries such as

1. FOOSH

2. twisiting

3. lifting or catching heavy objects

4. forceful injuries (younger individuals)

what are other factors that can influence bicep long head rupture

1. smoking

2. long-term use of corticosteroids (weaken tendons)

3. diabetes (rare)

4. chronic kidney disease (rare)

5. RO cuff tears

6. SLAP lesions

7. subacromial impingement

RO cuff injury is

the rupture of bicep tendon, often associated with RO cuff tears

SLAP lesion is

involving the labrum and can contribute to bicep tendon issues

bicep long head rupture symptoms

1. sudden, sharp pain

2. audible pop or snap

3. bruising

4. pop eye deformity

5. weakness in shoulder and elbow

6. reduced ROM

7. spasms

8. tingling

bankart lesion etiology

tear in glenoid labrum, the cartilage rim surrounding shoulder socket; primarily caused by traumatic shoudler dislocation, esp anterior dislocation;

mechanism of bankart lesion

shoulder dislocated, and force of dislocation tears the labrum

common causes of bankart lesion

traumatic like falls, car accidents

bankart lesion normally tears at the

anterior-inferior portion of glenoid labrum

what is an associated injury with bankart lesion, and what is it

hill-sachs lesion, indentation of humerus caused by compression against glenoid rim during the dislocation (humerus head also affected)

what is a reverse bankart lesion

occur with posterior shoulder dislocation, damaging the posterior labrum

bankart lesion sign and symptoms

1. pain at front of shoulder (esp with movement of overhead activities)

2. shoulder instability

3. shoulder feels loose or “slipping” out of place during specific movements or positions

4. decreased ROM

5. catching or popping sensation

6. grinding, clicking, locking sensations in joint

common different diagnosis of bankart lesion can be mistaken for

RO cuff tears, SLAP lesions

shoulder structures

shoulder impingement caused by

excessive muscleulature rubbing to the acromion and coracoid, common to overhead athletes

shoulder impingement can lead to

inflammation then tendonitis

shoulder stiffness can often be called

frozen shoulder or shoulder capsulitis

how do you treat frozen shoulder

if no tears to structures: avoid long periods of immobilization in sling and start physical therapy to prevent frozen shoulder from developing.

can be painful and prolong injury

rotator cuff structure is

group of muscles and tendons that hold shoulder joint together, the SITS muscles

colles fracture vs smith fracture

metacarpal bones, how to remember them

smith fracture happen when you fall

onto a flex wrist

colles fractures have a ___ deformity, what does this mean?

dinner-fork, dorsally placed

smith, colles, barton, hutchinson fracture

flexion; extension; fracture at distal radius + dislocation at radio carpal joint; radial styloid process or intra articular fracture of styloid process

barton fracture mechanism

falling on top of bent wrist, the distal radius breaks. can happen with direct impact to wrist also. can be described as volar or dorsal placement

barton fracture, which part of the bone is fractured

radiocarpal joint

colles fracture signs and symptoms

1. severe pain, worsens with movements or pressure

2. swelling

3. deformity

4. bruising

5. limited ROM

6. numbness or impaired sensation

7. tenderness

8. impaired motor function

smith fracture distinction and tale-telling sign from colles fracture is…

acute carpal tunnel syndrome (15% of cases, median nerve is compressed)

hutchinson fracture is injury to what area

fracture of radial styloid process

baseball finger/mallet finger etiology

trauma to extensor tendon at DIP often by direct trauma can sometimes pull off a small piece of bone, causing slight flexion and difficulty straightening.

baseball/mallet finger signs and symptoms

1. swelling

2. redness

3. loss of extension ability

bennett fracture etiology

punching, falls, bike riding, car crashes; can be accompanied by other injuries like trapezium fracture, or UCL injury at the MCP joint (which surgery may be necessary)

caused by axial loading on partially flexed 1st carpal-metacarpal joint (CMC)

bennet fracture signs and symptoms

1. pain

2. swelling

3. bruising at thumb

4. difficulty grasping

5. potential deformity

6. potential misalignment of thumb

7. tenderness

8. joint instability

boutonniere deformity mechanism of injury

DIP hyperextended, PIP stuck in flexion due to injury to extensor

PIP joint flexed inward and DIP extension outward due to injury to extensor at PIP joint, specifically the central slip, or fracture the bone at attachment caused by forceful blow to back of finger of bent finger, or direct injury to extensor tendon

difference between swan neck deformity and boutonniere deformity

swan neck is affected at the base joint (DIP hyperflexed, PIP hyperextendedd) rather than the middle joint (the PIP flexed due to torn extensor), bends inward.