BPK 241 Study Guide - Final Guide: Olecranon, Thenar Eminence, Bruise

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Study Guide for BPK 241 Injury Case Scenarios
Ankle
Inversion Sprain
Hx:
Foot rolls over on outside of foot
Foot in plantar flexion
SSx:
Pain and laxity with ATFL/CFL/PFTL
Positive:
oAnterior drawer
oPosterior drawer
Restricted ROM (especially in PF/INV)
Tx:
If fracture is suspected stabilize joint, NPO, hospital
oOttawa Rules:
Ankle x-rays (pain in malleolar area)
Pain over distal 6 cm inferior/posterior pole of medial/lateral malleolus
Inability to WB:
At all, at time of injury
OR
4 steps at time of examination
Foot x-rays (pain in midfoot area)
Tenderness along the base of the 5th metatarsal (or navicular bone)
Inability to WB:
At all, at time of injury
OR
4 steps at time of examination
If not a fracture: (to do in order)
oRICE
oRehab
Activity Modification/Controlled WB
Initial healing period: partial to non-WB
Combat muscle atrophy, proprioceptive loss, decreased circulation,
tendinitis
ROM
Pain-free
Initial minimization of INV/EVER
towel assisted PF/DF)
INV/EVER exercises
spell alphabet with foot
continued towel pulls in INV/EVER)
Strengthening
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Isometric all 4 ankle movements
Isotonic PF/DF
Resistance INV/EVER
Repetition 2 sets of 10 to 4 sets of 10
Proprioceptive neuromuscular retraining (balance)
Seated rocker board PF/DF
Seated rocker board INV/EVER
Double leg stand eyes open single leg stand eyes open
Double leg stand eyes closed single leg stand eyes closed
Double and single leg exercises on rocker board
Mini trampoline
Running Progression
Pool running
Walking
Running on mini trampoline
Side to side hopping
Karaoke
Ladder work
Running on inside turf of track
Running on harder surface
Running figure eights (gradually making circles smaller)
Running and cutting
Sprinting
Sprinting with cutting
Gradual return to sport
Sport-specific exercise
Walking drills
Jogging drills
Running drills
Drills w/out contact
Drills w/ contact
Return to play
Eversion Sprain
Hx:
Rolling over on inside of foot
Foot in neutral position
SSx:
Pain and laxity with one or both deltoid ligament tests
Positive:
oAnterior Drawer test
Restricted ROM (especially into EVER)
Tx:
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Same for Inversion Sprain
Foot
Plantar Fasciitis
Hx:
Gradual onset
Progressive hell pain
Non-traumatic
Unilateral
Pain is worse in morning
SSx:
Pes cavus or pes planas
Loss of control of arch, through arch support testing on injured side
Possible tightness in gastroc/soleus/FHL
Pain over medial calcaneal tubercle
Occasional pain in entire plantar fascia
Tx:
RICE
Correct biomechanics
Massage with foam roller (or water battle)
Foot strengthening techniques
oTowel stretches
Night splint
Tape job (Low Dye Arch tape job)
Fat Pad Syndrome
Hx:
Gradual or acute
Master runner
SSx:
Pain in general calcaneus
Pain is worse with WB DF
Tx:
Rest
Heel cup
Supportive footwear
Tape (Fat Pad tape job)
Addressing biomechanical issues
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