PHTY206 Lecture 8: Principles of management of overusechronic injuries

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Principles of management of overuse/chronic injuries
Understand the aetiology (cause) of overuse/chronic injuries
o Overuse injuries: an injury of the MS system that results from exposure to a repetitive
force beyond its abilities to withstand such a force
Understand what & how risk factors may contribute to the development of overuse/chronic
injuries
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o Intrinsic
Age
Gender
History of previous injury
Biomechanics/alignment
Aerobic fitness
Limb dominance
Flexibility
Muscle strength
Foot morphology
o Extrinsic
Skill level
Shoe type
Playing surface
Equipment
Use of tape/brace
Training errors
Level of competition
Discuss principles of physiotherapy management for overuse/chronic conditions as they relate
to stages of healing or classification, and discuss common modalities used in physiotherapy
management of overuse/chronic conditions
o Phase 1 and 2
Treat and train while deloading tissues
EPAS: e.g. ice after exercise
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o Phase 3 and 4
Cease activity that produced/aggravates pain/injury
Attend to pain +/- inflammation as priority
Deload tissues to relieve pain and encourage normal function
o Predisposing factors
Example hip strength and activation
Exercise related leg pain
Patellofemoral pain
Achilles tendinopathy
ITB friction syndrome
Example training errors
Excessive volume
Too high of a training intensity
Rapid increases in volume/intensity
o Orthoses
An appliance to support, align, correct deformity or motion of parts of the body
May be custom made or fabricated
Efficacy
Tibial stress fractures in military
Posterior tibial stress syndrome in military
Lower limb overuse conditions
No significant difference between custom or prefabricated orthoses
Plantar fasciitis
Reduces pain and improves function
Patellofemoral pain
Reduces pain, stiffness, improves function
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