Information we can gather through stress testing
- Athlete’s ability to move
- ROM
- Pain
- Strength
- Instability
- Pt. tenderness/crepitus
- Functional ability
Functional Testing
- Active ROM
- Passive ROM
- Resisted ROM
Active functional testing
Active testing is done by the athlete.
-Observe quality and quantity of movement attained.
-Note the most painful ranges and do them last.
Passive functional testing
-Passive testing is done by the care-giver.
-Passive testing is intended to test the inert (non-contractile)
tissues of the patient.
-This is best done with the athlete relaxed, and supported.
-Note pain-free ROM, guarding, laxity, etc..
Passive functioning testing end feels
- End feel = sensation examiner gets when joint reaches its end ROM
[Normal EF] : Bone on bone, soft tissue approximation, tissue stretch
[Abnormal EF] : muscle spasm, capsular, bone on bone, empty, spring block
Resisted functional testing
Resisted testing involves both the examiner and the athlete.
-Involves an isometric muscle contraction w/ joint neutral.
-Strength is then evaluated on a scale of 1-5
Resisted functional testing Scale
5=Normal Complete strength and ROM against gravity
4=Good Moderate strength
3=Fair Able to resist against gravity
2=Poor Not able to resist against gravity
1=Trace Slight muscle contraction detectable
0=None Not able to contract at all.
Interpreting you functional testing results
Active ROM will gather basic info about athlete’s abilities.
Passive ROM stresses inert (non contractile) tissues.
Resisted ROM stresses active (contractile) tissues
Many factors affect the tissue ability to absorb force
-Direction of Force: Tension, Compression, Shear, Torsion
-Stress: Force divided by the surface area it is applied through
Ligament Sprains: 1st Degree
-Microscopic stretching of fibers, few torn,
-Some pain and point tenderness
-No loss of structural stability
-No loss of function
Tape and return in 2-3 days
Ligament Sprains: 2nd Degree
-Significant tearing of fibers.
-Significant pain, especially with stretching.
-Significant structural weakening or instability.
-Moderate swelling with slow onset discolouration.
-Loss of function (PWB, NWB)
Support on return, 2-6 weeks
Ligament Sprains: 3rd Degree
-Complete tearing of fibers.
-May present with severe, or no pain at all.
-Loss of structural stability, empty end feel.
-Severe swelling, discolouration.
-Full loss of function.
Surgical intervention, bracing, 3months-1year
Muscle Strains: 1st Degree
- slight muscle tearing (less than a muscle bundle)
- mild weakness
- mild muscle spasms
- mild swelling
- mild pain on contraction
- pain with stretching
- reduced ROM
Tape and return in 2-3 days
Muscle Strains : 2nd Degree
- Muscle tearing (more than a muscle bundle)
- moderate to severe weakness
- mod. to sev. spasms
- mod. to sev. loss of function
- mod. to sev. swelling
- mod. to sev. pain with contraction
- pain with streching
- ROM decreased on swelling
Support on return, 2-6 weeks
Muscle Strains : 3rd Degree
- Most or all muscle fibers are torn or ruptured/tendinous avulsion
- mod. to sev. weakness
- mod. to sev. spasms
- sev. loss of function
- mod. to sev. swelling
- palpable defect
- none to mild pain on contraction
- no pain with stretching
- ROM may increase or decrease, depending on swelling
muscle is now in 2 pieces or almost at that point
Contusions: 1st Degree
- Superficial tissues are crushed and damaged
- mild loss of function
- mild ecchymosis
- mild swelling
Contusions: 2nd Degree
- Superficial and some deep tissues are crushed
- mild to mod. weakness
- mod. loss of function
- mod. ecchymosis
- mod. swelling
- decreased ROM
Contusions : 3rd Degree
- Deeper tissues are crushed (fascia may rupture)
- mod. to sev. weakness
- possible spasms
- sev. loss of function
- sev. ecchymosis
- sev. swelling
- significantly decreased ROM
Contusions : Hematomas
-Contusions disrupt muscle tissue, and this causes bleeding within
the muscle called a hematoma.
-Depth of hematoma will determine how difficult/long it will take
to resolve remember our inflamm stage timeline..
-Hematoma’s must be treated to avoid further complications.
Myositis Ossificans
-Ossification of tissues within the muscle belly.
-Can result in a palpable lump.
-Primarily caused by untreated contusions, and repeated injury
before a previous contusion is healed.
-May also be cause by too aggressive treatment inflamm..
Pes Planus/Cavus
- Flat footed/high arched
- Congenital and also affected by muscles and ligaments.
- Affected by and affects the knee
-Treated with exercises and appropriate footwear
Plantar Fasciitis factors
- Most common hind foot condition(10% of pop.)
Intrinsic factors: High arch, no arch, rigid foot, decrease strength.
Extrinsic factors: Footwear, training habits, training surfaces.
Plantar Fasciitis S/S
- Point tender/med. side of calcaneus
- Localized pain
- Stiff in AM or after inactivity
- unable to walk on toes
- Pain increases with toe extension
Plantar Fasciitis Treatment
- PIER
- Stretch achilles tendon
- Adjust training/footwear
- Tape/orthotics
- Address weakness
- Soft tissue work in the AM
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Lecture 110
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Lecture 222
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Lecture 336
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Lecture 421
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Lecture 528
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Lab 1-34
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Exam #2 Leg Review8
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Conditions of Knee43
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Leg and Knee Anatomy35
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Conditions of Thigh/Glute36
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Conditions of Abdominal and Hip9
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Exam #2 Lab Notes13
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Conditions of the Shoulder43
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Conditions of the Elbow23
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Conditions of the wrist/hand41
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Conditions of the head Concussions21
