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SPORTS MEDICINE 5
Dr. Jesse Noel Conjares 17 JAN 2018
LEGEND
Lecture Powerpoint, Audio, Handouts, Upper batch trans, Transer’s
note, Textbook
Transcribed by: Kathryn Bernabdon, Arwan Heussaff Checked by: Ange Encina Page 1 of 10
ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
SOURCES OF ATP
CREATINE PHOSPHATE SYSTEM
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ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
E. TAPERING
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ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
Strength Training
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ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
Muscle strain
Contusion
Laceration
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ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
E. GOLFER’S ELBOW
Kapag ang inflammation ay long standing na, nagkakaroon ng
calcification/calcium deposition, the tendon will become Medial epicondylitis
heterogenous, magiging weak na siya, dun sa site na weak yung o Overuse syndrome
napuputol. o Pain and/or tenderness over the medial elbow esp on
Management resisted wrist flexion
Rest – pain goes away at rest o Flexor-pronator group stabilize the elbow vs. valgus
Anti-inflammatory medications stress
Steroids
The Rotator cuff (your SSIT muscles) covers the superior surface Management
of the humeral head. Supraspinatus, Subscapularis, Rest – pain goes away at rest
Infraspinatus and Teres Minor. When it pulls, the head goes into Anti-inflammatory medications
the socket. Steroids
You can rehabilitate the shoulder to increase stability. You Apply heat or cold? Answer: There’s no rule. Basta kung ano
strengthen the rotator cuff but of course only up to a certain extent. yung nagbebenefit sa patient. Huwag niyo lang ipapahilot.
You cannot rehab ligaments. Ligaments kapag napunit, hihintayin
mo lang mag-heal. F. LIGAMENT INJURY
Rotator Cuff Disease, may acute onset and may chronic. Both Sprains account to up to 45% of all musculoskeletal injuries.
manifest pain and impaired tears in the rotator cuff. Most commonly Ligaments are static joint stabilizers while allowing joint
impaired is the SUPRASPINATUS muscle. What does it do? It motion together with muscle, tendon, bone and cartilage.
abducts (first 15 degrees of abduction). All of these will cause Injury to one without adequate healing may cause
limitation of motion. Painful on ABDUCTION of the shoulder degeneration in the other stabilizers resulting in arthroses.
Intrasubstance tears of extra-articular ligaments heal better
FROZEN SHOULDER – a description of the condition of the than intra-articular ligaments.
shoulder na ‘hindi mo magalaw’… frozen. May be due to several 3 phases of healing: inflammatory, repair (within 3 days up to
case. Pwedeng may rupture, inflammation, tear etc. several weeks), remodelling (after several weeks up to
several months)
Long standing inflammation will cause calcium deposit-radio Minimally vascular, may contain nerve endings for pain and
opaque proprioception.
Short term immobilization for pain control followed by early
Usual diagnosis on x-ray- Calcific tendonitis
mobilization optimizes recovery. Others require
reconstruction.
Treatment: REST- mainstay on particular tendon, ANTI-
Examples: distal radio-ulnar joint, wrist, ankle sprains, ACL,
INFLAMMATORY MEDICATION, STERIODS
MCL
D. TENNIS ELBOW You need to rest it. If its severe you can repair
There are ligament injuries na cannot be repaired kaya
Lateral epicondylitis reconstruction na
o Overuse of wrist extensors usually seen in racket No excercises to strengthen ligaments.
sports and throwing, use of wrist swinging tools, Management
sweeping Short term immobilization
o Pain and/or tenderness on the lateral elbow esp on
resisted wrist extension (Cozen’s test) ACL INJURY
Problem dito is overuse and inflammation Indirect injury from a non-contact pivoting motion common
Management in high demand sport as soccer, basketball and football
Rest – what I do is casting, above elbow, kasi you have to More than half associated with injuries to articular cartilage,
remove the use meniscus, collateral ligaments – unhappy triad, ACL, MCL
Medicine – bigyan mo ng steroids tyaka medial meniscus tear
Higher incidence in females: smaller ligaments, increased
general ligament laxity, increased knee laxity, increased
valgus knee loading when landing
History of a popping sound followed by pain, swelling,
limitation of motion, joint line tenderness and limp
X-rays needed asap to rule out fractures
Diagnosis can be mainly from clinical and functional
evaluation, more conclusive after a few days when pain and
swelling subside
Lachman test is the most sensitive
MRI not needed for a diagnosis
Treatment dependent on patient’s needs. E.g. Young active
patients will require reconstruction to return to sports.
Transcribed By: Kathryn Bernabdon, Arwan Heussaff Checked by: Ange Encina Page 6 of 10
ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
G. HEAD INJURY
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ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
Each muscle has both fast and slow twitch fibers. Distribution
of fast and slow twitch fibers are genetically determined.
Training can selectively improve the fibers. Endurance
athletes have a higher percentage of slow twitch fibers.
Strength athletes have more fast twitch fibers.
Endurance training: decreased loads, more repetitions
inc efficiency of slow twitch fibers
Inc mitochondrial and capillary density
Inc oxidative capacity
Strength training: increasing loads, less reps
o Inc number and cross-sectional area of fast twitch fibers
(hypertrophy)
Aerobic training for healthy adults at least 3x a week for 20-
60min at 60-90% of max heart rate* lowers incidence of back
injury.
Target training heart rate (for safety): 50-75% of max heart
rate
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ORTHOPEDICS I Module No. 3
SPORTS MEDICINE 5
Dr. Jesse Noel Conjares 17 JAN 2018
Appendix
Transcribed by: Kathryn Bernabdon, Arwan Heussaff Checked by: Ange Encina Page 9 of 10
ORTHOPEDICS I SPORTS MEDICINE Module 3, Lecture #5
Transcribed By: Kathryn Bernabdon, Arwan Heussaff Checked by: Ange Encina Page 10 of 10