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📖 Theory Guide →
Healing · Acute Injuries · Overuse · Pain · Shoulder · Spine · Hip · Knee · Ankle
Chapter 15 Theory Quiz
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Part B — Fill in the Blank
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Part C — True / False
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Chapter 15 Case Studies
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Case Studies (Multiple Choice)
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Three Stages of Healing (Table 15-1)
| Phase | Time | Physiology | Activity |
|---|---|---|---|
| Inflammation | 3–4 days | Redness, swelling, pain, local heat | Non-weight bearing, active ROM; RICE |
| Repair | 3 days–6 weeks | Initial scar formation | Weight bearing as tolerated; gentle pain-free movement |
| Remodeling | 4 weeks–2 years | Increased scar-tissue strength | Progressive, pain-free exercise |
RICERest/restricted activity · Ice (indirect, ≤20 min, first 24–48 h) · Compression (firm not tight) · Elevation (above heart). Exercise is contraindicated when pain/swelling is present at the injury site.
Strain & Sprain Grading
| Grade | Strain | Sprain |
|---|---|---|
| I | Mild; strength normal | Microscopic tear; RICE |
| II | Moderate; weakness, ↓ROM, limp | Partial tear; RICE + MD eval |
| III | Complete tear; pop, deformation | Rupture; air splint, prompt referral |
Perceived Pain Scale
0–10 scale0 = no pain · 10 = worst pain ever experienced.
Threshold = 3At a pain level of 3, modify or stop the exercise. Assess before AND throughout the session. Pushing through pain can make an acute injury chronic.
Post-Rehab Training by Injury (Table 15-3)
| Injury | Cardio options | Avoid |
|---|---|---|
| Lower extremity | Water exercise, upper-body ergometer, recumbent/stationary bike | Weight-bearing until cleared; any painful movement |
| Upper extremity | Walking, recumbent/stationary bike, elliptical | Running; exercises needing both hands; painful movement |
| Back / spinal | Water exercise, walking, recumbent/stationary bike | Weighted spinal rotation; floor exercises; reps >8–10; painful movement |
Region-Specific Facts
| Region | Key facts |
|---|---|
| Shoulder | Largest ROM, least bony stability; impingement of supraspinatus/subacromial bursa; press in scapular plane (30° anterior); stabilizers = lower trap, rhomboids, serratus anterior; avoid overhead early |
| Elbow/wrist | Lateral epicondylitis = tennis elbow (extensors); medial = golfer's elbow (flexors); ages 30–55; carpal tunnel compresses median nerve |
| Low back | Ages 30–50; up to 80% of adults; 30% of acute → chronic; exaggerated lordosis; do daily endurance exercises (cat-cow, curl-up, bird dog, side bridge) |
| Hip | Ball-and-socket, deep acetabulum; piriformis compresses sciatic nerve; sciatic splits piriformis in ~22%; ~6% of LBP is piriformis; ~2.5M U.S. hip replacements (2010) |
| Knee | Hinge, up to 130° flexion; only popliteus crosses; ITB friction ages 15–50; PFPS/genu valgum/chondromalacia; avoid open-chain knee extension |
| Ankle/leg | MTSS = periostitis (posterior shin); ankle sprains ~2M/yr; lateral/inversion ~75%, 70% recur; Achilles rupture = grade III strain (clients >45) |
Scope & Action
Scope of practiceMovement screening YES; evaluation/assessment/diagnosis of injury NO. Refer to a healthcare provider for pain.
Acute vs chronicAcute = single identifiable onset; chronic = onset over months/years (LBP >6 months).
Don't move an injured client…unless they are in danger. Ice and call EMS as needed; document the injury.
Key Terms
Avascular cartilageCan't heal without blood supply → often surgery; outer ⅓ of menisci is vascular.
Second-impact syndromeLife-threatening result of a second concussion before healing — remove immediately, written clearance.
−itis"Inflammation of" — tendinitis, bursitis, fasciitis, periostitis.
Nucleus pulposusGelatinous disc core that leaks through a torn annulus fibrosus to compress nerves.