...Rehabilitation of Acromioclavicular Joint Separations: Operative and Nonoperative Considerations Mark P. Cote, PT, DPTa, Karen E. Wojcik, MSPT, ATCb, Gregg Gomlinski, MSPT, CSCSb, Augustus D. Mazzocca, MS, MDa,* Acromioclavicular joint (AC) separations are one of the most common injuries seen in orthopedic and sports medicine practices, accounting for 9% of all injuries to the shoulder girdle.1–3 Various operative and nonoperative treatment schemes have been described for the management of AC joint injuries.4–33 Although considerable controversy exists over the efficacy of surgical reconstruction versus nonoperative intervention for grade III type injuries, grade I and II separations seem to respond favorably to conservative management. Conversely, grades IV, V, and VI often require surgical reconstruction. Regardless of the type of injury, rehabilitation as a part of conservative management and postoperative care plays an important role in the management of these injuries. This article presents the authors’ rehabilitation approach to treatment of acromioclavicular separations pre- and postoperatively. CONCEPTUAL FRAMEWORK To provide instruction and insight for rehabilitation clinicians, protocols are often provided for a specific injury or procedure. A protocol is a system of rules or procedures for a given situation. Although intended to be informative, protocols often result in a restrictive list of exercises and arbitrary time frames that a clinician...
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...Joint | Bones | Classification | Movement | Hip | Ilium, Ischium, femur, pelvis | Ball & socketSynovial, multi-axial | Int/Ext rotation,Flex/Extension of hip jointAb, Adduction | Knee | Femur, Tibia**(NO FIBULA)** | Synovial, BiaxialCondyloid Joint*(not modified hinge)* | Flex/ExtenInt/Ext Rotation | Ankle | Tibia, TalusFibula does not form the joint | Synovial, Uniaxial hinge joint | Hinge | Big Toe | Proximal Phalanges1st Metatarsal with proximal phalanges | Synovial BiaxialCondyloid | Flex/ExtenAb, Adduction (axis on the 3rd metatarsal) | Shoulder | Humerus, Scapular | Ball & SocketSynovial Multiaxial | Flex/ExtenAb,AdductionInt/Ext Rotation | Elbow | Humerus, UlnarNO RADIUS | Synovial UniaxialHinge | Flex/Exten | Wrist | Radius, CarpalsNO ULNAR | Synovial BiaxialElipsoid | Flex/ExtenAb,AdductionCOMBINATION MOVEMENT | Knuckle | Metacarpals, Proximal phalanges | Synovial Biaxial,Condyloid | Flex/ExtenAb,Adduction | Things to know for exam: Limitations of movement at a joint: 1. Articular discs 2. Muscle: size and length 3. Ligaments: bone to bone attachment (no function of pulling) 4. Tendon (muscle to bone) 5. Bone on bone (e.g. elbow) 6. Capsule 7. Cartilage: depending on how much cartilage on a joint Factors Increasing stability of the hip: * Articular fit * Acetabular labrum * Strong Capsule * Functions of the muscles around the hip * Bony factors: angle of inclination, increase stability by...
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...Bodyweight Strength Training Anatomy Bret Contreras Human Kinetics Library of Congress Cataloging-in-Publication Data Contreras, Bret, 1976Bodyweight strength training anatomy / Bret Contreras. pages cm 1. Bodybuilding--Training. 2. Muscle strength. I. Title. GV546.5.C655 2013 613.7'13--dc23 2013013580 ISBN-10: 1-4504-2929-7 (print) ISBN-13: 978-1-4504-2929-0 (print) Copyright © 2014 by Bret Contreras All rights reserved. Except for use in a review, the reproduction or utilization of this work in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including xerography, photocopying, and recording, and in any information storage and retrieval system, is forbidden without the written permission of the publisher. This publication is written and published to provide accurate and authoritative information relevant to the subject matter presented. It is published and sold with the understanding that the author and publisher are not engaged in rendering legal, medical, or other professional services by reason of their authorship or publication of this work. If medical or other expert assistance is required, the services of a competent professional person should be sought. Acquisitions Editor: Tom Heine Developmental Editor: Cynthia McEntire Assistant Editor: Elizabeth Evans Copyeditor: Annette Pierce Graphic Designer: Fred Starbird Graphic Artist: Kim McFarland Cover Designer: Keith Blomberg Photographer (for cover and interior illustration...
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...support the entire weight of the body. Types of bones Long Bones: For a bone to be classed as a ‘Long Bone’ the bone must have a body which is longer than it’s width. Examples of long bones are, Femur, Humerus and Tibia. These long bones are hard and provide strength and structure. Short Bones: Short bones are as wide as they are long and help provide support and stability with very little movement. Some examples of short bones are, Carpals and Tarsals which are located in the wrist and foot. They only have a thin layer of compact, but with this they often have large amounts of bone marrow. Flat Bones: Flat bones are strong, flat plates of bone with the main function being to provide protection for the body's vital organs and enabling muscular attachment. Examples of flat bones are the, Scapular (shoulder blade), the Sternum and Cranium. Along with the pelvis and ribs being classed as flat bones as well. Flat bones are a compact bone which provides strength and protection. Finally in adults the highest number of red blood cells are formed in flat bones. Irregular Bones: These bones have a non-uniform shape, therefore they cannot be put into any other category of bone. Examples of these types of bones are, Vertebrae, Sacrum and Mandible. They consist of cancellous bone, with a thin layer of compact bone. Sesamoid Bones: These bones are normally short and irregular, within a tendon. The best example of a sesamoid bone is the Patella (Knee cap) which sits within...
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...Rotator Cuff Repair PATHOPHYSIOLOGY Wells K (2013) defined rotator cuff injury as a condition involving damage to the rotator cuff tendons because of continuous irritation and tear. There are two factors that can predispose a person to this type of injury. The first type is intrinsic factor which means coming from within, this includes poor blood supply to an organ, normal attrition or degeneration with ageing and calcification of tendons. The other factor is called extrinsic factor which means coming from the outside. Some of the factors considered extrinsic are injury from accidents, falls and too much stress on the shoulders as a result of different movements involving exertion (Bilal, 2013). The injury is frequently associated with athletes who move their arms above the head in a repetitive manner like pitching, swimming, tennis and weight lifting (Wells, 2013). Paul’s occupation which is carpentry work and the repeated pitching and lifting of the ball during the rugby game eventually contributed to the irritation of his tendons from excessive pressure on the acromion process or bony knob of the shoulder. This also resulted to the swelling of bursa which is the lubricating sac between the tendons and the bones from subsequent rubbing against the acromion. Consequently, the shoulder becomes painful and if left untreated can lead to a tear in the rotator cuff and eventual injury to the shoulders (NMA News Direct, 2011). Predisposing Factors: Carpentry (repetitive...
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...An Atlas of Surgical Anatomy An Atlas of Surgical Anatomy Surgical commentary by Alain C Masquelet, MD Illustrations by Léon Dorn © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Tel.: +44 (0) 1235 828600 Fax.: +44 (0) 1235 829000 E-mail: info@dunitz.co.uk Website: http://www.dunitz.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publishers nor the authors can be held responsible for errors or for any consequences arising...
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...Blue Box Notes Back Strain, Sprains and Spasms (p. 495) • Warm up and stretching – increase tonus of “core muscles” (anterolateral abdominal wall—transverse abdominis—lumbar stabilization) prevent back strains and sprains • Back sprain – injury to ligamentous or attachment of ligament to bone. o NOT DISLOCATION OR FRACTURE o Excessively strong contractions for extension or rotation of vertebral column • Back strain – degree of stretching or microscopic tearing of muscle fibers o Sports; overly strong contraction o Muscles usually involved with producing movement of lumbar IV joints ▪ ERECTOR SPINAE o Weight not properly balanced on vertebral column o Do NOT use back as lever, crouch and keep back straight ▪ Use muscles of butt and lower limbs • Spasm – sudden involuntary contraction of one or more muscle groups o Protective mech o Attended by cramps, pain, and interference with f(x), producing involuntary movement and distortion Reduced Blood Supply to Brainstem (p. 496) • Winding course of vertrebral arteries through foramina transverasii of the transverse process of the cervical vertebrae and through subocciptal triangle • Problem when arteriosclerosis (hardening of arteries) – reduces blood flow • Symptoms – prolonged turning of the head such as trying to back up in car causes lightheadedness, dizziness, and other symptoms...
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...VACUUMING INTRODUCTION Vacuuming: nearly everyone is doing it! Unlike jumping a horse or throwing a curve-ball, vacuuming does not discriminate or limit itself to highly trained individuals or athletes. A vacuum cleaner, or commonly known as a vacuum, is typically an electric device that by means of suction collects dirt and small particles from a variety of surfaces. All it functionally requires is electricity, a vacuum cleaner appliance and a willing and able individual. This common invention is everywhere; household closets, hotels, general workplaces, restaurants and just about any other place that has carpeting or accumulates dust. 700 B.C. was the first noted appearance of woven forms of floor coverings and one could debate that primitive cleaning methods were developed thereafter (carpetandrugpedia.com). A cleaning method other than the traditional “carpet beater” was born in the mid-1800s. This time is known as the industrial revolution and was a critical in the invention of the vacuum cleaner. Factories were producing thousands of manufactured items and with it came an overwhelming amount of dust, soot and industrial pollution. This was also during the same time that infectious disease was being linked to germs. The need for hygiene and cleanliness was born and gave birth to the idea of the vacuum cleaner. By a patent issue date in 1860, Daniel Hess appears to have invented the first device to have the some of the basic principles of the modern vacuum. The...
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...TENNIS RECOVERY A Comprehensive Review of the Research Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD A United States Tennis Association Sport Science Committee Project Tennis Recovery: A Comprehensive Review of the Research Copyright © 2010 United States Tennis Association Inc. ISBN 978-0-692-00528-6 Editors: Mark S. Kovacs, Todd S. Ellenbecker, W. Ben Kibler TENNIS RECOVERY A Comprehensive Review of the Research A United States Tennis Association Sport Science Committee Project Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD Introduction In the last two decades, physical training and competitive opportunities have increased dramatically in junior, collegiate and professional tennis. This arose due to a multitude of factors, but much of it has stemmed from an increase in knowledge and understanding of scientifically based training programs focused on improving performance. As this focus on performance has increased, the area of recovery has received relatively limited focus. Recovery is a multi-faceted paradigm focusing on recovery from training—session to session, day to day and week to week. Recovery is also vitally important during training as well as in competition between matches and between days during multi-day tournaments. As more information is needed in the area of tennis specific recovery, the Sport Science Committee of the United States Tennis Association (USTA) sponsored an extensive evidence-based...
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...Head-to-Toe Examination Write Up Biographic Data Date: 11/8/13 | Name: L.C. | Gender: Male | Race: Hispanic | Date of Birth: 04/15/1972 | Age: 42 | Marital Status: married | Contact Person: J.C. ( Wife) | Occupation: Aircraft mechanic | Source of Data: Patient | HISTORY Reason for Seeking Care/Presenting Problem Cirrhosis Congestive Heart Failure Coronary Heart Disease Diverticular Disease Depression Diabetes, Type 1 x Diabetes, Type 2 Emphysema Glaucoma Gout Hemophilia Hernia Hypertension Irritable Bowel Syndrome Multiple Sclerosis Osteoporosis Parkinson’s Disease Psoriasis Renal Failure Seizure Disorder Thyroid Disease Venous Insufficiency Vision Disturbance Female: Dysfunctional Uterine Bleeding Other (describe):asthma Fibrocystic Breast Disease Premenstrual Syndrome Male: Prostate Disease Current medications (include prescription, over-the-counter, herbs, and vitamins): Name of Drug | Dosage/Frequency | Last Dose Taken | Reason for Taking | Ventolin INH | 2 puffs PRN | 3 years ago | Asthma | Metformin | 500 mg PO BID | 11/8/13 started on 10/28/13 | Diabetes T 2 | Multivitamin | 1 tab PO daily | 11/8/13 | Supplement | | | | | Allergies to Medication/Foods/Medical Products/Other (e.g., latex, contrast, tape): Allergic To | Type of Reaction | PCN | Hives, difficulty breathing | | | | | | | Current medical treatments (e.g., breathing...
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...²Comminuted fracture- the bone is shattered into many pieces. ³Compression (crush) fracture- generally occurs in the spongy bone in the spine. For eg, the front portion of a vertebra in the spine may collapse due to osteoporosis (a medical condition which causes bones to become brittle and susceptible to fracture, with or without trauma). 4Fracture dislocation- a joint becomes dislocated, and one of the bones of the joint has a fracture. 5Greenstick fracture- the bone partly fractures on one side, but does not break completely because the rest of the bone can bend. More common among children, whose bones are softer and more elastic. 6Hairline fracture - a partial fracture/ crack of the bone. Often this type of fracture is harder to detect. 7Impacted fracture- when the bone is fractured, one fragment of bone goes into another. 8Longitudinal or linear fracture- the break is along the length of the bone. 9Oblique fracture- A fracture that is diagonal to a bone's long axis. ¹°Pathological fracture - when an underlying disease or condition has already weakened the bone, resulting in a fracture (bone fracture caused by an underlying disease/condition...
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...ASSESSMENT Gather Equipment/Provide Privacy/Ensure Proper Lightening Wash Hands Ensure visualization of each body part as its examined Introduce self to patient (my name is….. how are you doing today) General Survey Say all of this… Can you state your age for me? Client appears to be stated age. LOC-Ask client: Can you tell me you name please, DOB, and where are you today, what month and year. Client is alert and oriented x3 -- to person, place, time Client’s skin color appears like pink and evenly pigmented without lesions or redness Client nutritional status appears appropriate for weight, height and body size. Client is sitting upright and appears to be relaxed and comfortable Clients body parts are intact and appear equal without no obvious physical deformities. Client is cooperative and smiling, expresses her feelings appropriate to the situation. Client’s speech is in a moderate tone, clear, and culturally appropriate. Upon general observation clients hearing is intact, she hasn’t asked me to repeat anything. Clients dress is appropriate to the season and client is cleaned and well groomed Ask her to walk a few feet and then walk back… State “ Gait is rhythmic and coordinated, with arms swinging at side., walk is smooth and well balanced” Posterior Lungs – stand behind client State out all parts as you inspect. Inspect rhythm, depth and pattern of breathing. State I’m going to inspect respirations for depth, rhythm, and pattern. Client’s respirations...
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...Spinal canal - enclosed by the spine and contains the spinal cord. Ventral body cavity Thoracic cavity enclosed by the ribcage and contains the lungs and heart. Abdominopelvic cavity Abdominal cavity, enclosed by the ribcage and pelvis and contains the Kidneys, ureters, stomach, intestines, liver, gallbladder, and pancreas Pelvic cavity, enclosed by the pelvis and contains bladder, anus and reproductive system. Pelvic Region and Quadrants Pelvic Regions Abdominal Quadrants Division of anatomical study Neurology Eyes, ears, and throat Internal Cystology Histology Pathology Cytology Cytology – the study of cells. Cytology is that branch of life science, which deals with the study of cells in terms of structure, function and chemistry. Cells are the basis of life. Organelles are...
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...Acquisitions Editor: Crystal Taylor Product Managers: Kelley A. Squazzo & Catherine A. Noonan Designer: Doug Smock Compositor: SPi Technologies First Edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the abovementioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market street, Philadelphia, PA 19103 USA, via email at permissions@lww.com, or via website at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Lambert, Harold Wayne, 1972– Lippincott’s illustrated Q&A review of anatomy and embryology / H. Wayne Lambert, Lawrence E. Wineski ; with special contributions from Jeffery P. Hogg, Pat Abramson, Bruce Palmer. — 1st ed. p. ; cm. Includes index. ISBN 978-1-60547-315-4 1. Human anatomy—Examinations, questions, etc. I. Wineski, Lawrence E. II. Title. [DNLM: 1. Anatomy—Examination Questions...
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...INSTRUCTOR GUIDE Human Anatomy & Physiology Laboratory Manual MAIN VERSION, Eighth Edition Update CAT VERSION, Ninth Edition Update FETAL PIG VERSION, Ninth Edition Update ELAINE N. MARIEB, R.N., Ph.D Holyoke Community College SUSAN T. BAXLEY, M.A. Troy University, Montgomery Campus NANCY G. KINCAID, Ph.D Troy University, Montgomery Campus PhysioEx™ Exercises authored by Peter Z. Zao, North Idaho College Timothy Stabler, Indiana University Northwest Lori Smith, American River College Greta Peterson, Middlesex Community College Andrew Lokuta, University of Wisconsin—Madison San Francisco • Boston • New York Cape Town • Hong Kong • London • Madrid • Mexico City Montreal • Munich • Paris • Singapore • Sydney • Tokyo • Toronto Editor-in-Chief: Serina Beauparlant Project Editor: Sabrina Larson PhysioEx Project Editor: Erik Fortier Editorial Assistant: Nicole Graziano Managing Editor: Wendy Earl Production Editor: Leslie Austin Composition: Cecelia G. Morales Cover Design: Riezebos Holzbaur Design Group Senior Manufacturing Buyer: Stacey Weinberger Marketing Manager: Gordon Lee Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings, 1301 Sansome St., San Francisco, CA 94111. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means...
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