2Signs and Symptoms Pain Swelling Heat Redness Loss of function Depends on severity of injury
3Treatment R.I.C.E. and possible NSAIDs Range of Motion (Stretching!) Strength and EnduranceNeuromuscular Control & BalanceFunctional and Sports Specific ProgressionsMaintain Cardio FitnessAll depend on severity.Begin rehab as soon as possible.
4What are the two categories of acute muscle injuries? ContusionsStrains
5How does one receive a contusion? Sudden traumatic blow to the body
6What is typical in cases of severe contusions? the athlete reports being struck by a hard blowthe blow causes pain and a transitory paralysis caused by pressure on and shock to the motor and sensory nervespalpation often reveals a hard area, indurated because of internal hemorrhageecchymosis, or tissue discoloration, may take place
7What is a strain?A stretch, tear, or rip in the muscle or adjacent tissue such as the fascia or muscle tendon
8How are strains most often produced? Abnormal muscular contraction
9What is the cause of abnormal muscular contraction? It is fault in the reciprocal coordination of the agonist and antagonist muscles take place. The cause of this fault or un-coordination is a mystery. However, possible explanations are that it may be related to:a mineral imbalance caused by profuse sweatingto fatigue metabolites collected in the muscle itselfto a strength imbalance between agonist and antagonist muscles.
10What is a grade 1 (or 1st degree or 1°) strain? Slight over-stretching to mild tearing (20%) of the muscle fibers. It is accompanied by local pain, which is increased by tension in the muscle, and a minor loss of strength. There is mild swelling, ecchymosis, and local tenderness.
11What is a grade 2 (or 2nd degree or 2°) strain? Moderate tearing (20% - 70%) of the muscle fibers. It is similar to a grade 1, but has moderate signs and symptoms (moderate loss of strength, moderate swelling, ecchymosis, and local tenderness).
12What is a grade 3 (or 3rd degree or 3°) strain? Has signs and symptoms that are severe (severe swelling, ecchymosis, and local tenderness) with a loss of muscle function and, commonly, a palpable defect in the muscle.
15What is a cramp?A painful involuntary contraction of a skeletal muscle or muscle group.
16Cramps have been attributed to what? A lack of water or other electrolytes in relation to muscle fatigue.
17What is a spasm?A reflexive reaction caused by trauma of the musculoskeletal system
18List and define the two types of spasms or cramps: clonic – alternating involuntary muscular contraction and relaxation in quick successiontonic – rigid muscle contraction that lasts a period of time.
19What are the four specific indicators of possible overexertion? acute muscle sorenessdelayed muscle sorenessmuscle stiffnessmuscle cramping
20List and define the two types of muscle soreness: Acute-onset muscle soreness – which accompanies fatigue. This muscle pain is transient and occurs during and immediately after exercise.Delayed-onset muscle soreness (DOMS) – becomes most intense after 24 to 48 hours and then gradually subsides so that the muscle becomes symptom-free after 3 or 4 days. (This second type of pain is described as a syndrome of delayed muscle pain leading to increased muscle tension, swelling, stiffness, and resistance to stretch).
21What are the possible causes for delayed-onset muscle soreness? It may occur from very small tears in the muscle tissue, which seems to be more likely with eccentric or isometric contractions.It may also occur because of disruption of the connective tissue that hold muscle tendon fibers together.
22What is muscle stiffness? Muscle stiffness does not produce pain. It occurs when a group of muscles have been worked for a long period of time. The fluids that collect in the muscles during and after exercise are absorbed into the bloodstream at a slow rate. As a result, the muscle becomes swollen, shorter, and thicker and therefore resists stretch.
23What can be done to assist in reducing muscle stiffness? Light exerciseMassagePassive mobilization
24What is muscle guarding? Following injury, the muscle that surrounds the injured area contract, in effect, splint that area, thus minimizing pain by limiting movement. (Quite often this splinting is incorrectly referred to as a muscle spasm)
25The suffix “itis” means inflammation: Myositis/Fasciitis - inflammation of the muscle tissueTendinitis – inflammation of a tendonTenosynovitis - Inflammation of the synovial sheath surrounding a tendonBursitis – inflammation of the bursaPeriostitis – inflammation of the bone covering
26What are the major acute injuries that happen to synovial joints? SprainsSubluxationsDislocations
27What is a sprain?Stretching or total tearing of the stabilizing connective tissues (ligaments)
28What is a grade 1 (or 1st degree or 1°) sprain? Slight over-stretching to mild tearing (20%) of the ligament. It is characterized by some pain, minimum loss of function, mild point tenderness, little or no swelling, and no abnormal motion when tested.
29What is a grade 2 (or 2nd degree or 2°) sprain? Moderate tearing (20% - 70%) of the ligament. There is pain, moderate loss of function, swelling, and in some cases slight to moderate instability.
30What is a grade 3 (or 3rd degree or 3°) sprain? It is extremely painful, with major loss of function, severe instability, tenderness, and swelling.
31What is a subluxation?Partial dislocations in which an incomplete separation between two articulating bones occurs.
32What is a dislocation (luxation)? Total disunion of bone apposition between articulating surfaces
33What are several factors that are important in recognizing and evaluating dislocations? Loss of limb functionDeformitySwellingPoint tenderness
34What is an acute bone fracture? A partial or complete interruption in a bone’s continuity
35What is a stress fracture? Rhythmic muscle action performed over a period of time at a sub-threshold level causes the stress-bearing capacity of a bone to be exceeded
36What are the typical causes of stress fractures in sports? Coming back into competition too soon after an injury or illnessGoing from one event to another without proper training in the second eventStarting initial training too quicklyChanging habits or the environment
37Strains Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentGroin Strain (Hip)Running, Jumping, Twisting (ER)TypicalTypical, May need crutches, compression wrap during activityQuadriceps Strain (Thigh)Sudden stretch from knee flexionHamstring Strain (Thigh)Sudden stretch from knee extensionGastrocnemius Strain (Leg)Quick starts & stops, jumping, sudden knee extension.Typical, heel wedge, compression wrap during activityAchilles Tendon Strain (Ankle)Usually after ankle sprains or sudden excessive ankle dorsiflexion.Typical, heel lift, compression wrap during activityAchilles Tendon Rupture (Ankle)Sudden pushing-off action of the forefoot with the knee being forced into complete extension.Typical, hears a pop, indentation at site, positive Thompson’s TestRICE, X-ray to rule out fracture, possible surgical repair, immobilization for 4 to 6 weeks, begin rehab. Heel lifts in both shoesLongitudinal Arch StrainRepetitive contact with a hard playing surface. It may appear suddenly or slowly over time.Typical, Reduce weight bearing activity, possible arch support tapingMetatarsal Arch StrainExcessive pronation and weak intertarsal ligaments will allow the foot to abnormally spread resulting in a fallen archTypical, orthotic or pad to elevate the fallen arch.Patellar Tendon RuptureSudden powerful contraction of the quadricepsTypical, Defect can be palpated, athlete cannot extend the knee, swelling, initial significant pain followed by a feeling that the injury is not seriousTypical, surgery
38Strains Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentElbow strainExcessive resistive motion, repeated microtearsTypicalLumbar strainSudden extension on an overloaded, unprepared, or underdeveloped spine, usually in combination with trunk rotation; chronic strain, commonly associated with faulty posture that involves excessive lumbar lordosis.Neck and Upper Back strainTurn the head suddenly or forced flexion, extension, or rotationTypical, muscle guarding and reluctance to move the neck in any directionTypical, possible soft cervical collarCervical sprain (Whiplash)Turn the head suddenly or forced flexion, extension, or rotation, but much more violently than the cervical strainTypical, muscle guarding and reluctance to move the neck in any direction; this pain may persist much longer than that of the cervical strain.Typical, X-rays to rule out fracture. and possible soft cervical
39Sprains Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentHip SprainSudden stretch from knee flexionTypicalTypical, May need crutchesMCL Sprain (Knee)Direct blow (valgus force), severe outward twistTypical, positive valgus stress testLCL Sprain (Knee)Direct blow (varus force)Typical, positive varus stress testACL Sprain (Knee)Direct blow, rotation, hyperextensionTypical, positive anterior drawer test, positive Lachman’s testTypical, crutches, immobilization, physician referral, possible surgeryPCL Sprain (Knee)Direct blow, knee flexion, landing on a flexed kneeTypical, positive posterior drawer testInversion (Lateral) Ankle SprainFoot inversion, plantar flexion, adductionTypical, positive anterior drawer test, positive Talar tilt testTypical, possible crutches, possible immobilization, possible physician referral, possible surgeryEversion (Medial) Ankle SprainFoot pronation, hypermobility, depressed medial longitudinal archSyndesmotic (High) Ankle SprainExternal rotation, forced dorsiflexionTypical, may take months to healSprained Toes or Turf ToeForce against an unyielding objectTypical, Valgus & Varus Stress Tests, Anterior & Posterior Drawer TestsTypical, tapeAcromioclavicular (AC) SprainDirect ImpactTypical, immobilization, possible physician referral
40Sprains Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentElbow sprainHyperextension or valgus forcesTypicalWrist sprainFall on hyperextended wrist; any abnormal, forced movement of the wristFinger sprainFinger fracturesDirect trauma or violent twistingLumbar sprainForward bending and twists while lifting or moving some objectSacroiliac sprainTwisting with both feet on the ground, stumble forward, fall backward, step too far down and lands heavily on one leg, or bends forward with the knees locked while liftingTypical, associated muscle guarding. Possible asymmetry with the ASIS and/or PSIS, difficulty with forward bending, straight leg raising increases pain after 45º, as well as side bending toward the painful side.Typical, Bracing may be helpful. Joint should be mobilized to correct existing asymmetry
41Bursitis Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentTrochanteric BursitisRepetitiveTypical, pain may radiate to the knee causing a limpTypical, May need crutches, NSAIDs and analgesics.Patellar BursitisContinual kneeling, overuseTypical, ballotableTypical, eliminate the cause, NSAIDsShoulder bursitisOveruseTypical, positive impingement testTypicalOlecranon BursitisDirect force, overuse
42Dislocations and Subluxations InjuryMechanism of Injury (Etiology)Signs & SymptomsTreatmentShoulder dislocation/subluxationForced abduction, external rotation, direct blowTypical, possible deformity, unable to touch opposing shoulder (Apley’s scratch testTypical, Immediate immobilization, RICE, pillow under the arm for comfort, physician referral, x-rays to rule out a fractureElbow dislocationFall on the outstretched hand with the elbow in a position hyperextension; or a severe twist while it is in a flexed position.Typical, Rupturing or tearing most of the stabilizing ligaments, profuse hemorrhage and swelling. Severe pain and disability, possible radial head fracture.Typical, sling, physician referralLunate DislocationForced hyperextensionTypical, difficulty in executing wrist and finger flexion. There may be numbness or even paralysis of the flexor muscles because of lunate pressure on the median nerveTypical, possible physician referralFinger dislocations/subluxationsDirect trauma or violent twistingTypicalLumbar Vertebrae DislocationCompression fracture may occur as a result of hyperflexion of the trunk; falling from a height and landing on the feet or buttocks; direct impact from a sudden blowTypical, X-ray, physician referral, put athlete on a spine boardCervical dislocationViolent flexion and rotation of the headPoint tenderness, restricted movement, cervical spasm, cervical pain and pain in the chest and extremities, numbness in the trunk and/or limbs, weakness or paralysis in the trunk and/or limbs, loss of bladder and/or bowel controlC-spine, Physician referral
43Contusions Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentHip Contusion (Hip Pointer)Direct blowTypical, spasms, transistory paralysis, unable to rotate the trunk or to flex the thigh without painTypical, physician referral to r/o fracture, 1 to 2 days bed rest, ice massage, ultrasound, NSAIDsQuadriceps ContusionTypical, transitory loss of functionTypical, RICE with the knee in flexion, NSAIDsJoint ContusionTypicalTypical, possible physician referral, return to activity with protective padding when initial pain and irritation subsides.Shin contusionBlow to the anterior aspect of the lower leg.Typical, rapid hematoma formation, can be associated with compartment syndrome or fracture.Typical, NSAIDs and analgesics, maintaining compression is critical (may have to aspirate hematome), ROM exercises and PRE within pain limits, doughnut padding and orthoplast shell for protection.Calcaneal ContusionOccurs by impact from running or jumpingTypical, moderate activity with the protection of a heel cup or doughnut may resume if pain when walking has subsided by the 3rd day, shock absorbent footwear shoe be worn.Finger contusionsDirect traumaRib contusionTypical, Sharp pain during breathing, point tenderness, pain when the rib cage is compressedTypical, possible bed rest and cessation of sports activities
44Fractures Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentFemoral Stress FracturesRepetitiveTypical, Groin pain along with an aching sensation in the thigh that increases with activity and decreases with rest. Standing on one leg may be impossibleTypical, Rest, for 2 to 5 months, x-rays and possible bone scan, swimmingAcute Femoral FractureDirect TraumaTypical, pain over the fracture site, deformityIce, Treat for shock, verify neurovascular status, splint, physician referralPatellar FractureDirect or indirect traumaTypical, Hemorrhage and joint effusionTypical, physician referralAcute Leg FractureDirect traumatic blowTypical, Soft tissue insult and hemorrhaging, intense pain and disability, leg appears hard and swollen.Splint and ice, refer to a physicianTibia or Fibular Stress FractureRepetitive or OveruseTypical, positive percussion or compression test, positive x-ray or bone scanTypical, NSAIDs, no activity for at least 14 days, possible cast and/or crutches, weight bearing when pain subsides, correct biomechanics, running may resume when the athlete is completely pain free.Ankle Fracture (misnomer)Forced abduction or planting in combination with forced internal rotation, trauma.Typical, possible deformityTypical, x-ray examination, a walking cast or brace may be applied once swelling is reduced, for 6 to 8 weeks, PNF exercises, isometrics (during immobilization), PRE, and balance activites up to 4 weeks.
45Fractures (cont.) Injury Mechanism of Injury (Etiology) Signs & SymptomsTreatmentTalus FractureOccurs either laterally from a severe inversion and dorsiflexion force or medially from an inversion and plantar flexion force with external rotation of the tibia on the talus.Typical, History of repeated trauma to the ankle, feels pain on weight bearing, complaint of snapping or catching, intermittent swelling, anteromedial or anterolateral joint line of the talar dome is tender when palpated.Typical, X-ray is essential for an accurate diagnosis, non-surgical management for a non-displaced sub-chondral compression fracture, protective immobilization, non-weight bearing progression to full weight bearing depending on symptoms, if conservative treatment fails surgery may be required, expect to resume activity 6 to 8 months after surgery.Calcaneal FractureOccurs most often after a jump or fall from a height. An avulsion fracture can also occur with this injuryTypical, inability to bear weightTypical, X-ray is essential for an accurate diagnosis, non-surgical management for a non-displaced fracture, protective immobilization, non-weight bearing progression to full weight bearing depending on symptoms,Calcaneal Stress FractureOccurs from repetitive impact during heel strike and characterized by a sudden onset of constant pain in the plantar-calcaneal area.Typical, Feels pain on weight bearing, pain tends to continue after exercise stops, bone scan may be required.Typical, Conservative management for the first 2 to 3 weeks, rest, active ROM exercises of the foot and ankle, non-weight bearing cardiovascular exercises, may resume activities within pain limits when pain subsides, must wear a cushioned shoe.Jone’s FractureInversion and plantar flexion of the foot, direct forces, or repetitive stress.Typical, Immediate swelling and pain over the 5th metatarsal, high non-union rate, coarse of healing is unpredictable.Typical, Crutches with no immobilization, gradually progress to full weight bearing as pain subsides, return to activity is possible in 6 weeks, non-union may cause re-fracture to occur.
46Fractures (cont.) Injury Mechanism of Injury (Etiology) Signs & SymptomsTreatmentMetatarsal Stress Fracture (March Fracture)Most commonly involves the shaft of the 2nd metatarsal (March fracture). Occurs in the runner suddenly changing training patterns, such as increasing mileage, running hills, or running on a harder surface. An atypical condition such as a structural forefoot varus, hallux valgus, or a short 1st metatarsal will predispose to a 2nd metatarsal stress fracture. A stress fracture of the 5th metatarsal at the insertion of the peroneous brevis tendon can occur, but should not be confused with a Jones fracture.TypicalTypical, Bone scan is the best way to detect this injury, 3 or 4 days of partial weight bearing after two weeks of rest, return to running should be gradual, orthotics can help to reduce stressPhalangesOccurs by either kicking an object, stubbing a toe, or being stepped on. Dislocations are less common than fractures.Typical, deformity. Stiffness and residual pain may last for several daysTypical, buddy tape, possible physician referralClavicular FractureFall on the outstretched, a fall on the tip of the shoulder, or direct impact.Typical, Clavicle appears slightly lower than the opposite side. possible deformityTypical, Sling and swathe, treat for shock, X-ray, immobilization for 6 to 8 weeks. After immobilization, begin gentle isometrics and mobilization exercises. May require surgery.Scapular FractureDirect impact or force transmitted through the humerus to the scapula.Typical, Pain during shoulder movementTypical, Sling, x-ray, begin overhead strengthen in 1 week.Fracture of the HumerusDirect blow or fall on the outstretched armTypical, inability to move armTypical, Sling and swathe, treat for shock, physician referral, immobilization for 6 to 8 weeks
47Fractures (cont.) Injury Mechanism of Injury (Etiology) Signs & SymptomsTreatmentForearm fractureDirect trauma or fall on the outstretched armTypical, Audible pop or crackTypical, sling, physician referralColle’s FractureFall on an outstretched armforcing the radius and ulna into hyperextension, or falling on the backward handTypical, Possible silver fork deformity, and possible median nerve damageScaphoid (Navicular) FractureForce on the outstretched armTypicalTypical, splint, physician referralHamate fractureFall or from contact from a sports implementLumbar Vertebrae FractureCompression fracture may occur as a result of hyperflexion of the trunk; falling from a height and landing on the feet or buttocks; direct impact from a sudden blowTypical, X-ray, physician referral, put athlete on a spine boardCervical fractureAxial loading; sudden forced hyperextensionPoint tenderness, restricted movement, cervical spasm, cervical pain and pain in the chest and extremities, numbness in the trunk and/or limbs, weakness or paralysis in the trunk and/or limbs, loss of bladder and/or bowel controlC-spine, Physician referralRib FractureDirect or indirect trauma, violent muscular contractionsTypical, Sharp pain during inspiration, possible crepitus during palpationTypical, physician referral, rest and immobilization
48Tendinitis Injury Mechanism of Injury (Etiology) Signs & Symptoms TreatmentOsgood-Schlatterrepetitive stress at the tibial tuberosityTypical, hemorrhage, gradual degeneration, severe pain when kneeling, running, or jumping, point tendernessTypical, reduce irritating activities, cast may be required, isometric strengthening for quads and hamstringsLarsen Johanssonrepetitive stress at the inferior patellar polePatellar Tendinitis (Jumper’s or Kicker’s Knee)Repetitive running, jumping, and kickingTypical, Pain and tenderness at the posterior, inferior patellar poleTypical, thermal agents, ultrasound, brace (counter-force) massageRunner’s (Cyclist’s) KneeRepetitive, overuseTypical, Malalignment and structural asymmetries of the foot and lower leg. Contributes to iliotibial band friction syndrome and pes anserinus tendonitis or bursitisTypical, Correction of foot and leg alignment problems, RICE, proper warm-up and stretching, avoidance of aggravating activities, NSAIDs.Achilles TendinitisExcessive tensile stresses placed on it during repetitive movements and presents with a gradual onset.Typical, uphill running and hill workouts aggravate the condition, weak gastrocnemius-soleus complex, morning stiffness, discomfort walking after prolonged sitting, tendon is warm and painful upon palpation, palpable crepitus with active plantar and dorsiflexion, pain on passive stretching, chronic inflammation.Typical, may be resistant to quick resolution, address structural faults (i.e. footwear, orthotics, etc.) ultrasound to increase blood flow, friction massage may be helpful, strengthening of the gastrocnemius-soleus unit. May be resistant to quick resolution, address structural faults (i.e. footwear, orthotics, etc.) RICE, ultrasound to increase blood flow, friction massage may be helpful, strengthening of the gastrocnemius-soleus unit.
49Tendinitis (cont.) Injury Mechanism of Injury (Etiology) Signs & SymptomsTreatmentAnterior Tibialis TendinitisCommon when running downhill for extended periods of time.TypicalTypical, avoid hillsPosterior Tibialis TendinitisOveruse injury among runners with hypermobility or pronated feetTypical, Swelling of the medial malleolus area, edema and point tenderness behind the medial malleolus area, pain can become more intense during resistive inversion and plantar flexionTypical, non-weight bearing short-leg cast with the foot in inversion may be used, Low Dye taping or orthotic can be used to correct pronation.Peroneal TendinitisProblem in athletes with pes cavus where the foot tends to excessive supinate.Typical, Pain of the lateral malleolus area when rising on the ball of the foot, tenderness behind the lateral aspect of the calcaneous distally beneath the cuboid.Typical, tape with elastic tape, appropriate warm-up and flexibility exercises, Low Dye taping or orthotic can be used to prevent excessive supination.Wrist tendinitisRepetitive pulling movements
50Chondramalacia (Patellofemoral Arthralgia) Etiology:Abnormal patellar trackingSigns & Symptoms:Pain in the anterior aspect while running, walking, ascending stairs, and squatting. Recurrent swelling, grating sensation during flexion and extension, patellar grind test produces crepitus.Treatment:Avoid irritating activities, pain-free isometric exercise to strengthen the quads, anti-inflammatories, orthotics to correct pronation and reduce tibial torsion, possible surgery.
51Patellofemoral Stress Syndrome (PFSS) (Patellofemoral Arthralgia) Etiology:Hamstrings, gastrocnemius, IT band, or lateral retinaculum tightness; increased Q angle, foot pronation, patella alta, VMO insufficienciesSigns & Symptoms:Tenderness over the patellar lateral facet, swelling, dull ache in the center of the knee, patellar compression will elicit pain and crepitis, positive apprehension testTreatment:Strengthen VMO; stretching for hamstrings, gastrocnemius, and IT band; orthotics and/or taping to correct alignment
52Cramps and Spasms Etiology: Excessive loss of fluids through sweating, inadequate muscle coordination.Signs & Symptoms:Pain, tonic contraction.Treatment:Athlete should relax, gradual stretching, ice or gentle ice massage.
53Medial Tibial Stress Syndrome Etiology:Repetitive microtrauma, weak leg muscles, inadequate footwear, inappropriate training, malalignment problems.Signs & Symptoms:Grade 1: pain after activityGrade 2: pain before and after activity, but does not affect performanceGrade 3: pain before, during, and after activity, affects performanceGrade 4: constant pain that makes performance impossiblePain is along the lower medial anterior tibialis.Treatment:Physicians referral to rule out other problems, RICE, NSAIDs and analgesics, ice massage, modify activity, correct biomechanics, orthotics and/or arch taping.
54Lateral Epicondylitis (Tennis Elbow) Etiology:Repetitive microtrauma, hyperextension activitiesSigns & Symptoms:Aching pain over the region during and after exercise, pain worsens with continued activity, weakness in the hand and wristTreatment:RICE, NSAIDs and analgesics, immobilization, strengthening and stretching exercises, correct biomechanics, counterforce brace
55Medial Epicondylitis (Pitcher’s Elbow, Racquetball Elbow, Golfer’s Elbow, Javelin-Thrower’s Elbow) Etiology:Repeated forceful extension of the wrist and valgus torques of the elbow.Signs & Symptoms:Pain, possible radiating pain, point tenderness, mild swelling, AROM produces pain.Treatment:RICE, NSAIDs and analgesics, immobilization (sling), strengthening and stretching exercises, correct biomechanics, counterforce brace. For severe cases, splint and complete rest for seven to 10 days.
56Carpal Tunnel Syndrome Etiology:Repetitive wrist flexion, direct traumaSigns & Symptoms:Sensory or motor deficits; tingling, numbness, and paresthesia over the thumb, index and middle fingers, and palm of the hand; muscular weaknessTreatment:RICE, immobilization, and NSAIDs. Surgical decompression may be necessary
57de Quervain’s Disease (Hoffman’s Disease) Etiology:Constant wrist movementSigns & Symptoms:Aching pain which may radiate into the hand or forearm, positive Finklestein’s test; point tenderness and weakness during thumb extension and abduction; there may be a painful snapping and catching of the tendonsTreatment:Immobilization, rest cryotherapy, NSAIDs, ultrasound, ice massage
58Wrist Ganglion Etiology: Appears slowly after a wrist sprain Signs & Symptoms:Occasional pain with a lump at the site. Pain increases with useTreatment:RICE, pressure with a felt pad, ultrasound, possible surgical removal
59SciaticaEtiology:Torsion or direct blow to the back causing inflammation or compression of the sciatic nerveSigns & Symptoms:Pain may be abrupt or gradual, produces a sharp shooting pain that follows the nerve pathway along the posterior and medial thigh; there may be tingling and numbness along its path; nerve may be extremely sensitive to palpation; straight leg raises intensifies pain.Treatment:Rest is essential. Stretching of a tight piriformis muscle may decrease symptoms; NSAIDs and RICE, surgery may be necessary.
60Brachial Plexus Neurapraxia (Burner or Stinger) Etiology:Stretching or compression of the brachial plexusSigns & Symptoms:Burning sensation, numbness, tingling, and pain extending from the shoulder down to the hand with some loss of function of the arm and hand that lasts for several minutes.Treatment:RICE; strengthening exercises; Athlete may return to full activity once symptoms have completed resolve and there are no associated neurological symptoms.