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15 Pages

Exercise Science
Course Code
ES 300

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Elbow Pathology and Managmnet • Elbow Structure o Muscular- moderate o Ligament- moderate o Skeletal- weak The elbow will take the excess stress from the shoulder and wrist joints. • Olecranon Bursitis o Etiology: direct blow o Signs and Symptoms: Pain, swelling, point tenderness Swelling spontaneously without usual pain o Management Acute – Compression Chronic – Superficial Therapy Aspiration may be necessary • Ulnar Collateral Ligament Sprain o Etiology- Valgus force from repetitive trauma o Pain along medial aspect: tenderness over MCL. Associated paresthesia o Management: Surgical intervention (Tommy John procedure) o ulnar collateral ligament (UCL) of the elbow is critical for valgus stability of the elbow and is the primary elbow stabilizer. o Elbow Injuries in young athletes are generally chronic from repetitive overhead activities. High velocity pitcher= more injury ULC o Of 9 pitchers who had elbow injuries, 4 had an elbow muscle strain and/or joint inflammation, and 5 had an ulnar collateral ligament sprain or tear. Surgery was required for 3 of the 5 • Lateral epicondylitis (Tennis Elbow) o Etiology: Repetitive Microtrauma o Decreased ROM; pain w/MMT wrist extension o Management: Use of counter force / neoprene sleeve, ART Tennis Elbow • Medial Epicondylitis “golfer’s elbow” o Etiology: Forceful flexion of wrist & valgus torque of elbow o Pain produced with forceful flexion or extension o Management: Curvilinear brace below elbow- gripless training • Little League Elbow o Etiology: Repetitive throwing (not type of pitch). Disorders of growth o Slow onset; flexion contracture, tight anterior joint capsule & weak triceps o Locking or catching sensation o STOPACTIVITY o Throwing with good technique to prevent recurrence Increase intensity and increase length of the season= little league elbow o throwing motion, valgus stress is placed on the elbow. o tension on the medial structures (ie, medial epicondyle, medial epicondylar apophysis, medial collateral ligament complex) o compression of the lateral structures (ie, radial head, capitellum). • Elbow Dislocation: o Fall on an outstretched hand with elbow extended or severe twist while flexed o Displaced backward, forward, or laterally o Radial head fracture involved o Management: REFER. • Elbow Fracture: o Fall on flexed / outstretched or direct blow o May not result in visual deformity o Surgery to stabilize but Stable fractures do not require surgery The Forearm, Wrist, Hand, & Finger • Blood and Nerve Supply o Three major nerves: Radial, Median, Ulnar o Ulnar and Radial arteries- Branches of the Brachial Artery • Forearm Fracture o Common in youth o Volkman’s Contracture: Permanent fx o Audible pop or crack o Edema, ecchymosis w/ possible crepitus • Colles’ Fracture o Out for 4-10 weeks o FOOSH o Lower end of the radius o Damage to median nerve o Lower epiphyseal separation in children • Wrist Sprains o hyperextended, violent flexion or torsion o May disrupt blood supply • Scaphoid Fracture o FOOSH, compressing scaphoid o Often fails to heal o Presents like wrist sprain o Pain with radial flexion o Must be splinted and referred • Mallet Finger o Baseball or Basketball finger o Blow to tip of finger o Avulsing extensor tendon o Pain at DIP • Jersey Finger o Rupture of FDP tendon from insertion o Ring finger when athlete tries to grab a jersey o DIP cannot be flexed, remains extended o MUST BE SURGICALLY REPAIRED • Gamekeepers Thumb o Sprain of the UCL of MCP joint of the thumb o Forceful abduction with hyperextension o Surgery • Metacarpal Fracture o Direct axial force or compressive force o Fractures of the 4th/5th metacarpal = Bar room fx o Fractures of the 2nd/3rd metacarpal = Boxer’s fx • Bennett’s Fracture o carpometacarpal joint of the thumb o Axial and abduction force to the thumb o Referred! Odds And Ends • The unhappy Triad o Medial meniscus, MCLACL • transverse humeral ligamentis made up of Extensions of the Subscapularis and Supraspinatus tendon • 198 aspiring Olympic athletes revealed that over 98% said that they would take illegal performance-enhancing drugs if it would guarantee victories and if they would not be caught. • Newborns/ those that cannot communicate: have to rely on secondary information, visual inspections, palpation, and usually follow up tests like x rays/MRI/CT scan depending on the injWah I hate finals • Replacement of bench press/ OH press o 3:1 or 4:1 in favor of pulling versus pushing o This in combination with proper rotator cuff mechanics would allow for the inclusion of these lifts in programming OH press will have better translation into everyday activities as well as sport Microcycle- per wek Mesocycle- ¾ months macracycle- year Max strength- 1RM Speed strength- how fast 1RM is completed strength endurance- 8 reps reactive strength- plyometrics Cervical Spine Pathologies • responsible for the most information exchange outside of the brain. • Hyperextension Tucked chin-prevent injury with cervical extension. but more force is put on thoracic vertebra • Hyper flexion: tremendous loading on vertebra compression fractures happen more in thoracic then cervical • Lateral Flexion Injury: -Nerve root damage on stretching side: -Disk herniation on flexed side -either side had strain/sprain • Rotation with Extension -Significant anterior muscle issues • Flexion with Rotation -not many fractures, just sprain and stains. Upsets vagal stimulation • Cervical Sprain/Strain - most common neck injury in both athletic and non-athletic populations -Whiplash -action of levator and trapezius -localized pain on one side of neck – delay of pain - Typically will resolve within 72 hours • Cervical Radiculopathy - Cervical nerve root impingement results from -Disc herniation -Nerve entrapped between bony structures -Forced hyperextension or axial loads can contribute - Pain that extends from the neck into an extremity -Athletes often feel relief by holding the affected extremity over their head, taking pressure off the irritated nerve root - X-rays cervical spine rarely show the source of the pain, MRI can easily confirm the diagnosis. - Athletes with signs and symptoms of cervical radiculopathy, such as numbness or weakness of a limb, are closely monitored by their athletic trainer and physician. + symptoms beyond 2 to 3 months= surgery • Transient Quadriplegia - more serious but temporary injury to the cervical spinal cord. - Nerve dysfunction(both arms) (one or both legs) (one arm and one leg same time) - typical episode lasts less than 15 minutes but can take up to 48 hours to gradually resolve. - complete return of motor function and sensation and full, pain-free range of motion of the spine. - Athlete should be treated with all the precautions for a cervical spine injury -40% chance of second episode reoccurrence -if no evidence of abnormal motion between the vertebrae or spinal cord compression, athletes return to sporting activities without increased risk of permanent nerve injury. • Cervical dislocation o Violent flexion and rotation o pain, numbness, weakness, or paralysis o More likely to cause cord injury than fracture! • Cervical Fracture o Axial load, cervical flexion these finals will o Numbness in trunk/limbs, weakness/paralysis make my head fall o Loss of bladder and bowel control off o Rust Sign: holds their head to make sure it does fall off o Treat as unconscious athlete until otherwise ruled out • Acute Torticollis o “Wryneck” o Unilateral pain upon wakening o Synovial membrane impingement within facet o 2-3 Days o Chiro Face Pathologies • Nasal Injuries o Direct blow o Control bleeding and refer • Epistaxis o Nosebleed o Direct blow, sinus infection, low humidity, allergies, or a foreign body o Bleeding from anterior aspect of septum o Presents with minimal bleeding and resolves spontaneously o Management:  Sit up right  Pressure on affected nostril and ipsilateral carotid  Gauze between upperlip and gum • Mandible Fracture o Direct blow o Lower lip anesthesia • Auricular Hematoma o Compression or shear injury (single or repeated) o Subcutaneous bleeding o Physician aspiration • Rupture of the Tympanic Membrane o Fall or slap to the unprotected ear/ sudden underwater variation o Loud pop, pai
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