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Spine Injuries Sports Med
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Cervical Neck MOI Axial Load Flexion Hyperextension
Rotation and Flexion Rotation and Hyper-flexion Lateral Flexion
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Cervical Fracture Gymnasts, hockey, diving, football, rugby MOI S/S TX
Relatively uncommon in athletics but you should always be prepared to handle the situation. MOI Axial loading and flexion, rotation, hyperextension S/S Most common in 4-6 cervical vertebrae Point tenderness, restricted movement Muscle spasms Numbness & pain in extremities, loss of bladder/bowel control TX Rule out spinal injury X-ray, refer to physician
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Cervical Sprain Whiplash
MOI Violent flexion, extension or rotation Affects anterior and posterior ligaments S/S Persistent, tender over transverse and spinous processes Pain occurs a day later TX Refer to rule out a fx Neurological exam PRICE, traction
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Acute torticollis Wry Neck
MOI Pain on one side of the neck upon waking up Synovial lining or capsule is pinched S/S Palpable pt. tenderness and muscle spasm Limited side flexion, and rotation TX X-ray, traction, AROM, PROM, modalities
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Scheuermann’s Disease Thoracic
Gymnastics, butterfly swimming MOI Kyphosis resulting from wedged fx of 3 or more vertebrae Causes nucleolus pulposis to enter into vertebrae S/S Kyphosis and lumbar lordosis but no pain Point tender over spinous processes and back ache at end of day TX Prevent progressive kyphosis Extension exercises, anti-inflammatory
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Lumbar MOI Congenital Idiopathic Mechanical Present at birth Traumatic
Overuse injury Strains, sprains
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Lumbar Strain MOI S/S TX Sudden extension and rotation
Faulty posture, excessive lumbar lordosis S/S Pain with active extension and passive flexion TX PRICE, elastic wrap to compress Stretching, strengthening exercises should not cause pain
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Sciatica Inflammatory condition of the sciatic nerve MOI S/S TX
Nerve compression, irregularities in vertebrae tight piriformis muscle S/S Acute or chronic Sharp shooting pain that follows the nerve pathway Straight leg raise increases pain TX Rest, traction (if necessary), stretching, NSAIDS
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Spondylolysis MOI S/S TX Congenital degeneration of the vertebrae
Appears as a stress fx, most common in boys S/S Asymptomatic until hyperextension or disk herniation TX Bracing, rest, stabilization exercises
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Spondylolisthesis MOI S/S TX One vertebrae slipping on one below it
A complication of spondy higher in girls S/S hyperlordosis TX Bracing, rest, stabilization exercises
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Sacroiliac Pain MOI S/S TX Twisting with both feet on the ground
Falling backward, landing heavily on one leg S/S Point tender on SI joint ASIS and PSIS may be asymmetrical Straight leg raise increases pain after 45 degrees Side bending toward the injury side increases pain TX Modalities, brace, strengthening, stretching, PRICE
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