(H) Sports Med Semester 2 Study Guide

AC Sprain

tear of the ligaments in the the acromioclavicular joint, caused by fall on outstretched arm; AKA separated shoulder

ACL Sprain

Tear in anterior cruciate ligament due to sharp deceleration/rotation; non-contact

Biceps Tendonitis

inflammation of the upper biceps tendon, caused by repetitive overhead movements

Boxer Fracture

commonly occurs while punching immovable objects; fracture of 5th metacarpal (hand)

Elbow Impingement

damage to soft tissue in the BACK of the elbow, due to hyperextension and valgus forces

Elbow UCL Sprain S/S

sudden "pop", pain on medial elbow, point tenderness, tingling/numbness, swelling, instability in overhead throwing

Gamekeeper's Thumb

injury to UCL resulting in a sprain; chronic stretching (AKA skier's thumb - acute)

Golfer's Elbow S/S

pain, point tenderness, weakness, stiffness, swelling, numbness, tingling

How do you tape an ankle?

Heel and lace pads on Achilles and front of ankle. Prewrap. One anchor around the bottom, two around the top. Start covering. One figure eight. Two heel locks on each side (4 total). 3 stirrups, medial to lateral. Cover up.

How do you tape an elbow?

Keep elbow slightly flexed. Apply prewrap from sleeve to half of forearm. One anchor around the distal, two anchors around proximal. Measuring the distance between the two anchors and make a fan on the table. Adhere to arm and cover with tape. Test for hyperextension.

Kleiger Test

external rotation to test for medial ankle sprain or high ankle sprain

Labrum Tear

wear in the cushioning of the elbow due to excessive repetitive action/trauma

Labrum Tear S/S

clicking/locking, deep shoulder pain (worsens with overhead activities)

LCL Sprain

partial/complete tear in lateral cruciate ligament due to varus blow (inside)

MCL Sprain

partial/complete tear in medial cruciate ligament due to valgus blow or sudden twisting movement; meniscus often torn too

Meniscal Tear

chronic wearing of the meniscus (cushioning for the knee) with repetitive stress and a valgus force

Milkin's Test

Tests for UCL Sprain

Objective

Visible deformities, limp, WB, swelling/bruising, TTP, vital signs, ROM, strength testing, special tests

Osgood Schlatters

pulling of the tendon at the growth plate, causing a bony lump on tibial tuberosity; 10-14 year olds

Patellar Tendon Rupture

Tear in the patellar tendon when knee is forced to flex past 60 degrees

PCL Sprain

Tear in posterior cruciate ligament due to falling on bent knee/contact to shinbone; symptoms often minor

Purpose of Drop Arm Test

Rotator Cuff Pathology or strain

Rotator Cuff Strain

chronic injury from repetitive overhead action

Rotator Cuff Strain S/S

dull ache deep in the shoulder, disturbed sleep, difficult to comb hair/reach behind back, arm weakness

S/S for ACL Sprain

"pop", difficulty WB, instability, loss of ROM, swelling

S/S for Gamekeeper's Thumb

pop, difficulty holding a raquet/throwing; pain, clicking/catching

S/S Meniscal Tear

clicking/locking sound, swelling, loss of ROM/strength

S/S of Achilles Tendon Rupture

S/S: "pop" sound in the back of the ankle (snap), extreme pain, swelling/bruising, obvious deformity in some cases, inability WB

S/S Patellar Tendon Rupture

deformity, loss of ROM and strength, difficulty WB, swelling, patella alta

S/S Shoulder Impingement

pain in reaching behind back/overhead motion, dull ache, point tenderness, ROM loss, tinel sign, popping/clicking

Shoulder Impingement

damage to soft tissue in the shoulder (shoulder bones pinch rotator cuff tendons and bursa), due to repeated overhead arm movements

Special Tests for an AC Sprain (3)

O'Brien's Test, Piano Key Sign, AC Sprain Test

Special Tests for Shoulder Impingement (3)

Hawkins Kennedy Test, NEERs Test, Winged Scapula Test

Speeds Test

Tests for biceps tendon pathology/lesions

Subjective

Anything the patient tells you: history, pain scale, how it happened, sensations

Talar Tilt Test

Inversion/eversion ankle sprain; invert/evert food to test for laxity and pain

Tennis elbow

lateral epicondylitis; overloaded tendons due to overuse/muscle sprain

Three Types of Ankle Sprain

Inversion, Eversion, and High Ankle (twisting tears the syndesmosis)

Treatment

PRICE, surgery, immobilization, RTP, tape, rehab, splint, strengthening, referral for imaging, stretching, etc.

Treatment for Achilles Tendon Rupture

often requires surgery; ice, rest, NSAIDs for pain, PT, immobilization devices

Treatment for an ankle sprain

Ankle taping, PRICE method, OTC meds for pain; avoid exercise and heat

Treatment for Morton's Neuroma

changing insoles, ice, cortisone injection, surgery

Treatment for MTSS

tape, PRICE, apply pressure with a lacrosse ball, stretch the calves/shins, foam roller

Treatment for Tib/Fib Fracture

referral for imaging, cast/splint/brace/crutches, PRICE, NSAIDs for pain, rest; some require surgery

Treatment for Turf Toe

Steel inserts, tape, rest, ice

Vastus/Varus Stress Test

Tests for elbow sprain

What are the four special tests for upper extremity fractures?

Percussion, Tuning Fork, Compression, Sulcus

What are the icing guidelines after an injury?

Ice 3-4 times a day for 15-20 minutes for 48-72 hours after injury. Not for snake bites.

What are the only dislocations we can relocate on site?

Shoulder dislocations, finger dislocations

What are the signs and symptoms of an ankle sprain?

Swelling, bruising, difficulty weight-bearing, pain, restricted ROM, instability, "pop"

What are the signs and symptoms of MTSS?

Dull, aching pain in the shins on impact, worsening over time.

What are the symptoms for fractures?

Sudden, severe pain, deformity, tenderness, numbness/tingling, swelling/bruising.

What are the symptoms of a Boxer Fracture?

Swelling, obvious deformity, pain, trouble making a fist.

What are the symptoms of a concussion?

Headaches, nausea, dizziness, balance problems, sensitivity to light/noise, etc.

What are the symptoms of a Labrum Tear?

Pain in hip/groin, worsening after standing/walking; locking/clicking; stiffness.

What are the symptoms of Osteitis Pubis?

Gradually increasing pain in the groin/pelvis while running, doing sit-ups, or squatting.

What are the symptoms of Tennis Elbow?

Pain while opening doors/shaking hands; pain, point tenderness, swelling, weakness.

What are the three categories of joints?

Cartilaginous, synovial, fibrous

What direction do you tape for MTSS?

Lateral to medial.

What does HOPS stand for?

History, observations, palpation, special tests

What does Lachman's Test evaluate?

Stability of ACL/PCL.

What does McMurray's Test evaluate?

Meniscus tear; patient is supine while knee is compressed and rotated

What does Ober's Test evaluate?

Tightness in the IT Band/TFL; does the top leg stay in abduction?

What does Patrick's/Faber's Test assess?

Pain for hip or sacroiliac joint pathology; flexion, abduction, and ER

What does PRICE stand for?

Protection, rest, ice, compress, elevate

What does the Anterior Drawer Test assess?

Lateral ankle stability and laxity; tests for ACL sprain

What does the Apprehension Test evaluate?

Shoulder instability; dislocation/subluxation.

What does the Hamstring ROM Test indicate?

Strain, weakness, contusion, or tightness if ROM is not similar for both legs (flex hips fully)

What does the Patella Apprehension Test test for?

Patellar instability/dislocation; check if the patient is anxious when pressure is applied medially and laterally

What does the Pivot Shift Test assess?

ACL stability; internal rotation and medial force

What does the Squeeze/Bump test assess?

Fracture by hitting the heel and squeezing above and below the pain site.

What does the Thomas Test indicate?

Weak hip flexors if there is decreased extension on one side (pull knees to chest, then release)

What does the Trendelenburg Test assess?

Weakness of the adductors (glute medius); athlete balances on one leg and watches if hips are level (hand)

What does the Valgus Stress Test evaluate?

MCL sprain; apply lateral forces to knee

What does the Varus Stress Test assess?

LCL sprain; apply medial forces to knee

What is a chronic injury?

Slowly developed with repetitive stress over at least 3 months.

What is a Jones Fracture?

A fracture in the base of the fifth metatarsal of the foot; often comes with high ankle sprain

What is a Labrum Tear?

Cushioning/seal of the hip socket is worn down with repetitive stress/trauma.

What is a Menisectomy?

Meniscus tear is trimmed away; faster healing time.

What is a Tibia/Fibula fracture?

A fracture in the shins/thighbones due to ankle sprain or direct blow.

What is an Achilles tendon rupture?

A partial or complete tear in the Achilles tendon, caused by sharp accel/change in direction

What is an acute injury?

Immediate injury from blunt trauma.

What is an Elbow UCL Sprain?

Ulnar collateral ligament sprained by repeated valgus stress.

What is Appley's Test used for?

Meniscus tear; patient is prone while knee is compressed and rotated

What is arterial bleeding?

Bleeding from a ruptured artery, characterized by bright color and spurting flow.

What is external bleeding?

Bleeding from a capillary, vein, or artery.

What is Golfer's Elbow?

Medial epicondylitis; damage to muscles/tendons on medial elbow that control wrists and fingers

What is internal bleeding?

Bleeding that occurs from impact force or a medical condition.

What is Jersey Finger?

Tendons bunched at the base of the finger due to grabbing jerseys; unable to bend fingertips

What is Meniscal Repair?

Meniscus tears sutured together; greater long-term stability, but slower recovery time.

What is Morton's Neuroma?

Nerves pinched by thickened tissue near the third and fourth toes (stabbing pain)

What is MRSA?

A staph infection, ultra-resistant skin bacteria.

What is Osteitis Pubis?

Inflammation of the pubic symphysis, caused by repetitive stress.

What is the Anterior Drawer Test used for?

Knee stability specifically for ACL.

What is the Empty Can Test used for?

Rotator Cuff strength; rotating thumbs down with arms extended

What is the purpose of an ACE wrap?

To minimize swelling, secure cold packs, and provide light joint support.

What is the purpose of the Posterior Drawer Test?

Determines the stability of the PCL.

What is the Thompson Test used for?

To assess Achilles tendon stability; does the foot plantar flex when calves are squeezed?

What is the treatment for Osteitis Pubis?

Rest, OTC meds.

What is Turf Toe?

A tear in the ligaments, joints, and tissue of the big toe, causing pain while pushing off/walking