Term
Grading Ligament Injuries |
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Definition
•I - intrasubstance tear; stable
•II - partial thickness tear; slight laxity
•III - complete tear; unstable, weak
•“Is there an endpoint?”
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Term
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Definition
•Orientation to time and place
•Presence of post-traumatic amnesia
•Ability to follow complex commands
•Changes in appearance (“dazed”)
•Abnormal speech / communication
•Gait or balance difficulties
•Paresthesias / weakness
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Term
Grade 1 Closed Head Injury |
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Definition
•Grade 1 - minor CHI
» No LOC
» No post-traumatic amnesia
» Sx’s (h/a, confusion) < 5-10 minutes
Rx: Observe 20 minutes; if asymptomatic,
may return to play
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Term
Grade 2 Closed Head Injury |
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Definition
•Grade 2 - mild concussion
» No LOC
» PTA < 20 minutes
» Sx’s persist
Rx: Remove from competition; return after asymptomatic for 1 week. If 2nd, wait 2 weeks. If 3rd, out for season.
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Term
Grade 3 Closed Head Injury
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Definition
•Grade 3 - moderate concussion
» LOC < 5 minutes
» PTA < 12 hours
» Sx’s of post-concussive syndrome
Rx: Remove from play; CT or MRI; neurosurgical evaluation; return to play 2 weeks after normal MRI; 2nd out for season
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Term
Grade 4 Closed Head Injury |
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Definition
•Grade 4 - severe concussion or brain injury
» LOC > 5 minutes
» PTA > 12 hours
Rx: Treat presumed spine injury until proven otherwise; CT or MRI; neurosurgical evaluation; close observation
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Term
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Definition
•Upper cervical root neurapraxia
•C5, C6
•“My arm went dead”
•Lateral neck flexion, extremity distraction
•Return to play when asymptomatic
•Rule out cervical disc / stenosis
•Prevention - neck roll in football
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Term
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Definition
•Cuff tears rare in young athletes
•Repetitive overhead activity
•Throwers, tennis, swimmers
•Injection
•Cuff strengthening
•Role of arthroscopy
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Term
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Definition
•Superior Labrum, Anterior to Posterior
•Eccentric contraction of biceps
•Deceleration phase of throwing
•Fall on outstretched arm
•Anterior shoulder pain
•O’Brien’s sign, Speed’s test
•Role of arthroscopy
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Term
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Definition
Lateral Epicondylitis:
“Tennis Elbow”
•Tendinosis, not tendinitis
•Chronic degeneration from overuse
•ECRB
•NSAID’s, forearm strap, ice
•Injections
•Recalcitrant cases - surgical debridement
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Term
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Definition
•Medial epicondylitis +/- avulsion
•Capitellar OCD
•Valgus overload from repetitive microtrauma
•Limit throwing / cross-train
•Avoid extensive chondral injury
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Term
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Definition
FEMORAL NECK STRESS FRACTURE- RUNNERS |
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Term
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Definition
•Something’s wrong!!!
•ACL
•Meniscus
•Chondral fracture
•Not a “sprain”
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Term
Tibial Periostitis:
“Shin Splints” |
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Definition
•DDx: stress fracture, compartment syndrome
•Bone scan, tomogram, MRI
•Ice - 20 minutes before/after stretching
•Stretching - gastroc / soleus, anterior tibialis
•Strengthening - anterior tibialis, peroneal
•Return to sport as tolerated
•Soft orthotics, arch support, compression
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Term
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Definition
•Remember - ankle is a ring
•Deltoid ligament
•LCL - ATFL, CFL
•Syndesmosis - beware
•X-ray: 3 views
•If tender medially but not laterally...check knee!
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Term
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Definition
•Continual intermittent ice / compression
•Elevate; crutches prn
•ROM
•Strengthening at 4 days (peroneals)
•Proprioception - balance board, treadmill
•Agility
•Cast vs. air-stirrup
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Term
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Definition
•Overuse
•“Heel pain”
•Tender along medial border of fascia
•Heel cups
•Stretching
•Cast / boot
•? Injections
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Term
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Definition
•Amenorrhea
•Disordered Eating / Anorexia
•Osteoporosis
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