UNIT 2: Week 6
No description yet. This curated deck is ready for daily study.
Card preview (24)
Pattern of pathophysiology of bone injury
• Bone loading • Bone strain • Bone damage • Damage-related remodelling
How does atraumatic bone pathology occur?
• occurs on a continuum referred to as BSI
What can damage related remodelling of bone lead to?
• Damage repair • Imbalnce between damage and remodelling
How can an imbalance btwn damage and remodelling lead to a bone fracture? (pathology continuum)
• damage accumulates if we dont reduce load • stress reaction occurs • stress fracture occurs = COMPLETE bone fracture
What happens when damage repair of bones occurs?
• osteoblasts build new bone • osteoclasts break down old or damaged bone tissue
Low risk stress fractures examples
• posteromedial tibia • 2nd/3rd metarsals • calcaneus • distal fibula • cuboid • cuneiforms • femoral shaft • pelvis
High risk stress injuries examples
• femoral neck • anterior tibial cortex • medial malleolus • talus • navicular • base of 5th MT • base of 2nd MT • great-toe sesamoids
Factors modifying the load applied to a bone
• biomechanical factors • training factors • muscle strength and endurance • training surfaces and terrain • shoes and inserts
Factors modifying the load applied to a bone: biomechanical factors
• GRF • acceleration/shock to segment • alignment • running/gait kinematics
Factors modifying the ability of bone to resist load
• genetics • diet and nutrition • endocrine status and hormones • PA history • bone diseases • meds influencing bone
What is RED-S?
• relative energy deficiency in sport
Symptoms of RED-S
• decreased endurance performance • increased injury risk • decreased training response • impaired judgement • decreased coordination • irritability • depression • decreased glycogen stores • decreased muscle strength
Why is RED-S relevant to bone injury?
• its a risk factor
Principles for bone rehab
• Relative rest • Early mobilization • Early strengthening
Goal of relative rest with bone injury
• load reduction to achieve pain free gait/ADLs
What are ways someone can work up to pain free gait?
• partial WB • use cushioned shoes/insoles • use stiff or rocker-soled shoes • use ambulation aid • immobilization
What is the only safe and acceptable pain when managing bone stress injuries?
0/10 during, after and the day following loading
What is the duration of the relative rest phase of bone stress injury rehab?
• symptoms vs time based
What is another goal of relative rest of bone stress injury rehab?
• maintain health/fitness/function
How can patients maintain health/fitness/function during bone rehab?
• non WB cardiorespiratory training (rowing, cycling, swimming) • avoid stressing the injury site
Goal of early mobilization with bone rehab
• restore/maintain mobility • consider joint mobility requires for gait
Goal of early strengthening for bone rehab
• restore/maintain strength • consider propulsive muscles required for gait (ie. nonWB–>full WB (open to closed); endurance–> strength FITVP)
What is another goal of early strengthening of bone rehab?
• restore walk–>jog tolerance
Graduated running program to return a runner to 30 min of pain free running: step 1
• Build volume at 50% intensity a. Walk 30 min b. Walk 9 min and jog 1 min c. Walk 8 min and jog 2 min d. Walk 7 min and jog 3 min e. Walk 6 min and jog 4 min