© 2005 the mcgraw-hill companies, inc. all rights reserved. the spine pe 236 amber giacomazzi ms,...
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© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
The SpinePE 236
Amber Giacomazzi MS, ATC
© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
Cervical Injuries
• Cervical Sprain “________”– Same mechanisms as a strain but to a higher
degree– Signs and Symptoms
• __________________
– Treatment• Refer to physician• ______________• ______________• ______________
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Cervical Injuries• Stretching of the _____________________• Commonly referred to as a “_____” or a “______”• Dangers—reoccuring stretching—C4-T1
– Signs and Symptoms• _______________• _______________• _______________
– Treatment• ______________• Ice• __________ (____________________)• Prevent (neck roll)
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• Low Back Pain– Cause of Injury
• Congenital anomalies• Mechanical defects of the spine (___________________________)• ___________________
-Signs and Symptoms• Pain, possible weakness, __________, muscle strains and bony defects• ________________________________________________
– Treatment • ________________________________• ________________________– avoid unnecessary stresses and strains
associated with daily living
Lumbar Injuries
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• Lumbar Vertebrae Fracture and Dislocation– Cause
• Compression fractures or fracture of the spinous or transverse processes
• Compression fractures are usually the result of ________ __________________________________
• Fractures of the processes are generally the result of a ______ __________
• Dislocations tend to be rare– Signs and Symptoms
• _________________________• ______________________________________________• Localized swelling and guarding
Lumbar Injuries
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• Treatment– X-ray and physician referral– Transport with _________
_____________________ _____________________
– ____________________
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• Low Back Muscle Strain– Cause of Injury
• ____________________________ generally in conjunction w/ some type of __________
• Chronic strain associated with ______________________
– Signs and Symptoms• Pain may be ______________; pain w/ _____________ and
_________________
– Treatment• RICE to decrease spasm; followed by a __________________
____________________• Elastic wrap/back brace may be useful for support and
compression• Complete bed rest may be necessary if it is severe enough• NSAID’s
Lumbar Injuries
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• Back Contusions– Cause of Injury
• Significant impact or direct blow to the back
– Signs and Symptoms• Pain, swelling, discoloration, ____________ and
point tenderness
– Treatment• RICE for the first ____________• Ice massage combined with gradual stretching• Recovery generally last ___________________
Lumbar Injuries
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• Sciatica – Cause of Injury
• Inflammatory condition of the ___________• Nerve is vulnerable to _______ or _________ that place
abnormal amounts of ____________________________
– Signs and Symptoms• Arises _______________; produces ___________
_______________________• Sensitive to palpation with ________________
intensifying the pain
– Treatment• Rest is essential; acutely – recovery = 2-3 weeks• Treat the cause of inflammation; traction if disk
protrusion is suspected; NSAID’s
Lumbar Injuries
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• Herniated Disk– Cause of Injury
• Caused by ______________ and ___________ due to use (_______ ________________ __________)
– _______________– _______________
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– Signs and Symptoms• _______________________________• Symptoms are worse in the __________• Onset is sudden or gradual, pain may increase after the athlete
sits and then tries to resume activity• _______________________ increase pain, while back
____________ reduces pain• Straight leg raise to _____________ is painful
– Treatment• Rest and ice for pain management• _________________ may be comfortable• _____________________ should be integrated as athlete
improves
Lumbar Injuries
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• Spondylolysis and Spondylolisthesis– Cause of Injury
• Spondylolysis refers to __________________ due to ___________ __________ (stress fracture results)
• ______________________________ is referred to as spondylolisthesis and is often associated with a spondylolysis
– Signs and Symptoms• Pain and persistent aching, _____________ with increased pain
____________ • Frequent need to change position or “____” back to reduce pain• ___________________________________
Lumbar Injuries
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– Treatment• Bracing and occasionally bed rest for 1-3 days will help to
reduce pain• Major focus should be on exercises directed at controlling or
_______________________________• Progressive trunk strengthening, ______________________,
concentration on abdominal work• Braces can also be helpful during high level activities• _____________________
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Sacroiliac Joint Dysfunction
• Sacroiliac Sprain– Cause of Injury
• Result of ____________________ __________, stumbles forward, falls backward, steps too far down, _____ _________________, bends forward with knees locked during lifting
– Signs of Injury • Palpable pain and tenderness over
the joint, _____________ w/ some muscle guarding
• __________________________
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• Care– Ice can be used to
reduce pain– Bracing can be helpful
in acute sprains– ________________
________________ ________________
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Assessment of the Spine
• History– Mechanism of injury (___________________)
• Numbness, tingling, burning?• _______________________________• Do you have equal strength in both sides of the body?
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– Other general questions• _______________________________________• What were you doing when the pain started?• Did the pain begin immediately and how long have
you had it?• ________________________________________• Past history of back pain• Sleep position and patterns, seated positions and
postures
Assessment of the Spine
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• Observations– Body type– Postural alignments
and asymmetries should be observed from all views
– Assess ________ ___________ between anatomical landmarks
Assessment of the Spine
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• Palpation– Should be performed with athlete prone
• Head and neck should be slightly flexed, pillow under hips if suffering from low back pain
– _________________________________ _________________________________ ___________________
– Muscles should also be palpated bilaterally
Assessment of the Spine
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• Special Tests– Test for lumbar spine should be performed
standing, sitting, supine, side-lying and prone– Assess levels of pain and motion restriction
during the following tests• _________________________• _________________________
Assessment of the Spine