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KINE 3575
Sep 24, 2023
Uploaded by essaassaf51 on coursehero.com
3 rd degree strain (severe, complete rupture) Visible, apparent swelling Severe pain (possible to have no pain initially) Complete loss of strength Complete loss of range of motion or excessive motion Obvious discoloration (ecchymosis) Muscle bunching Athlete will usually hear snap at time of injury Evaluation of strains - Circumference: measurement of girth and swelling at and around a joint Can be used as a baseline for comparison - Extensibility (placing a muscle on stretch) Done bilaterally starting with the unaffected limb first Degree of pain and restriction is an indicator of the severity of the injury There is pain because you are stretching the injured muscle - Contractability (muscle strength grading (0-5): testing for a weakness in muscle where the muscle cannot contract sufficiently Done bilaterally beginning with the non-injured side first A comparison is made and the muscle strength is graded on a universal scale (no contraction/response=0 - normal and equal response=5) - Palpation Grade Value Movement 5 Normal (100%) Complete range of motion against gravity with maximal resistance 4 Good (75%) Complete range of motion against gravity with some (moderate) resistance 3+ Fair + Complete range of motion against gravity with minimal resistance 3 Fair (50%) Complete range of motion against gravity 3- Fair - Some but not complete range of motion against gravity 2+ Poor + Initiates motion against gravity 2 Poor (25%) Complete range of motion with some gravity eliminated 2- Poor - Initiates motion if gravity is eliminated 1 Trace Evidence of slight contractility but no joint motion 0 Zero No contraction palpated
Dislocations: result from forces causing the joint to go beyond its normal anatomical limits - Second only to fractures in terms of disabling an athlete - The highest incidence of dislocations involve the fingers and shoulder joint, however any joint can be dislocated Subluxations: partial dislocations which spontaneously reduce themselves Nerve injury - Can occur in: Cranial nerves Spinal cord Nerve root (unilateral or bilateral) Plexus Anywhere along the pathway of a peripheral nerve - Entrapment may occur due to a number of different reasons (traction, compression, laceration and degeneration) and may present with or without neurological signs and symptoms - Different classifications of nerve injury depending on the degree of damage Grade 1 (neuropraxia) Mildest, little to no disruption of the nerve sheath and the axon remains intact Followed by rapid and complete recovery (hours, days, months) Problem lies with repeated neuropraxias as scar tissue can build up and disrupt the nerve impulse and pathway Signs and symptoms include: numbness, tingling, weakness, atrophy with prolonged nerve compression or damage Grade 2 (axonotmesis) More significant injury with disruption of the axon and surrounding endoneurial sheath The epi and perineurium remain intact and continuous, and this will allow any healing to commence Although there may be temporary paralysis, the nerve will ultimately regenerate up to 80% This injury can last from months to upward of a year Grade 3 (neurotmesis) Most significant of all nerve injury classifications and involves severe damage or severance of the entire nerve Loss of 60% of the continuity of the nerve Damage to most nerve structures: axon, myelin and surrounding connective tissue Associated with axon degeneration and the little healing which may occur is often blocked by scar tissue or nerve transection Recovery/prognosis is poor à 30-40% Fractures: complete or incomplete break in a bone resulting from the application of an excessive external force - Traumatic or non-traumatic (stress fracture) - Traumatic fracture can cause loss of continuity of bone and can be either partial or complete
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