Question | Answer |
What is Anterior Cruciate Ligament Knee Injuries? | Partial or full tear of ACL from a blow to lateral side of knee. Usually has additional injuries to Mdial Collateral Ligament and Medial Meniscus |
What are the contraindications of an ACL injury WITHOUT surgical repair? | No open chain terminal knee extension w resistance to the distal leg; no squatting between 60-90* which causes increased anterior translation of tibia on femur and more stress to ACL |
What are the contraindications of an ACL injury WITH surgical repair? | Up to 10 weeks should be handled by a PT or medical professional; 10-24 weeks: avoid pulling tibia forward on femur manually and avoid open chain high resistance or terminal knee extension. Avoid Feet in Straps or Leg Spring work. |
What is Facet Joint Syndrome? | Segmental hypomobility (facet lock) causing secondaryjypermobile segments w pain and pain referral |
What are the symptoms of Facet Joint Syndrome? | Often occurs with or b/c of disc degeneration; usually painful w extension, esp combined w rotation and sidebending |
What are the contraindication of Facet Joint Syndrome? | Avoid extension of the spine |
What is Herniated Nucleus Pulposis (HNP (herniated or bulging disc)? | Annular fibers weakened, nucleus loses volume and narrows; nucleus may bulge & put pressure on Posterior Longitudinal Ligament; nucleus may bulge into spinal cord or nucleus may be free in neural canal |
What are the symptoms of Herniated Nucleus Pulposis? | peripheral pain or numbness/tingling in buttocks, thigh, calf or toe; may present w a lateral shift; may present w lower extremity weakness and/or loss of deep tendon reflexes |
What are the contraindications of Herniate Nucleus Pulposis? | Avoid all spinal flexion or vertical loading of spine; avoid straight leg raise or strong spinal rotation |
What is spondylolisthesis? | Instability at L5-S1 or L4-L5 due to defect in laminae causing anterior vertebral displacement |
What are the symptoms of Spondylolisthesis? | Aggravated by extension; acute pain w diffuse radiation into buttocks; fractures in laminae can cause serious spinal cord injures |
What are the contraindications of Spondylolisthesis? | Avoid extension of the spine |
What is Stenosis? | Narrowing of spinal canal or nerve root canals, compromising spinal cord or nerve roots; usually in lumbar, can occur in cervical or thoracic |
What are the symptoms of Stenosis? | back pain, tingling, transient motor deficits and intermittent pain in one or mor legs, made worse by standing or walking |
What are the contraindications of Stenosis? | Always avoid extension of spine |
What is a Total Hip Replacement? | Acetabulum and/or Femoral head removed and replaced w mechanical components due to fracture or osteoarthritis |
What are the contraindications of a Posterior approach hip replacement? | Permanently avoid Hip Flexion above 90 degrees; Hip adduction and Internal rotation. Females shoud avoid sitting in crossed leg position which can cause dislocation of hip hip joint & need surgical repair |
What are the contraindications of an Anterior approach hip replacement? | Permanently avoid all hip extension, abductin and external rotation as these positions can cause dislocation of hip joing requiring surgical repair |
What is Adhesive Capsulitis (Frozen shoulder?) | Capsular tightening of the glenohumeral joint |
What are the precautions for Adhesive Capsulitis? | Avoid aggressive stretching of shoulder joint and endrange loading of shoulder joint |
what is Carpal Tunnel Syndrome? | Sensory loss and motor weakness that occurs when median nerve is compressed in the carpal tunnel |
What are the symptoms of Carpal Tunnel Syndrome? | Increasing pain in hand that comes w repetitive use, weakness in thenar muscles, and/or sensory loss in the thumb or 1st and 2nd fingers |
What are the precautins of Carpal Tunnel Syndrome? | Avoid resistance training of upper body, wrist flexion, forearm supination and pressure to the base of palm that occurs in weightbearing during periods of flare-up. |
What is Plantar Fascitis? | Chronic inflammatory syndrome that includes pain on bottom of heel and/or arch, which can radiate throughout bottom of foot toward toes |
What are the symptoms of Plantar Fascitis? | Pain in morning when weightbearing or with onset of activities like walking or running; pain may decrease as activity progresses but returns after resting; common in runners and dancers and overweight people who increase activity level |
What are the precautions for Plantar Fascitis? | Any weightbearing exercise that causes increase in heel or arch pain or shortens calf muscles as in plantar flexion of foot |
What is Rotator Cuff Impingement? | Compression, usually of supraspinatus tendon, infraspinatus tendon or subacromial bursa against acromion of scapula due to compromise of subacromimial space. |
What are the symptoms of Rotator Cuff Impingement? | Pain in glenohumeral joint, deltoid, or biciptal tendon. |
What are the precautions for Rotator Cuff Impingement? | Avoid overhead shoulder positions, internal rotation, or endrange loading of the shoulder joint combined w abduction "impingement position". |
What is Thoracic Outlet Syndrome? | thoracic outlet is the area between the rib cage and clavicle; Blood vessels and nerves coming from the spine may not have enough space as they pass by or through clavicle and upper ribs; 5 entrapment locations |
What are the symptoms of Thoracic Outlet Syndrome? | Numbness, tingling, ablation of pulse, coldness or pain in affected upper extremity |
What are the precautions for Thoracic Outlet Syndrome | Avoid any exercises (especially upper body) that produce the symptoms |
What is Cardiovascular Disease? | Any disease of the heart and blood vessels |
What are the precautions for Cardiovascular Disease? | Drink water before, during and after; no hot rooms, check feet for infection; avoid inversions & high intensity & heavy resistance; move slowly when rising |
What are the contraindications for Cardiovascular Disease? | Stop exercising if unusual symptoms of heart attach or stroke occur; call 911 |
What is Chronic Fatigue Syndrome? | disorder characterized by profound fatigue not improved by bed rest that may be worsened by physical or mental activity |
What are the symptoms of Chronic Fatigue Syndrome? | 4 or more of these symptoms 6 or more months: substl probs w memory or concentration, sore throat, tender lymph nodes, muscle pain, joint pain w/o swelling, headaches, sleep that does't refresh |
What are the precautions for Chronic Fatigue Syndrome? | people still need approp amt of physical activity, but need to be paced carefully. |
What is Fibromyalgia? | characterized by widespread musculoskeletal pain & stiffness, tender points painful when touched, exercise "intolerance", often feel worse after exercising |
What are the precautions for Fibromyalgia? | exercised must be slow, sustained and low-resistance |
What is Diabetes? | reduced insulin secretion or reduced sensitivity to insulin which causes abnormalities to several body systems that, left untreated, can be fatal |
What are the symptoms of Diabetes? | clammy, cold, sweating, shaking, nausea, heart rate increase, loss of consciousness |
What are the precautions for Diabestes (1, 2)? | perform a similar exercise routine every day w/in 1 hr of consuming meal or snack; always carry juice or candy in case of hypoglycemia |
What are the precautions for Diabetes (3, 4)? | Don't inject insulin into primary muscle groups before exercise; it will absorb too quickly, resulting in hypoglycemia; avoid exercise dudring peak insulin activity |
What are the precautions for Diabetes (5, 6) | Check clients' feel before & after activity for cuts, blisters, signs of infection due to decreased sensation of feet; exercises should be performed consistently so regular pattern of insulin dosage & diet can be maintained |
What are the precautins for Diabetes (7)? | Clients should check blood glucose levels before and after exercise; stop if pre = below 100mg/dL or greater than 300 mg/dL |
What is Gastric Reflux? | Backward flow of stomach acid contents into esophagus; also called GERD; =injury to esophagus due to chronic exposure to acid from stomach |
What are the precautions for Gastric Reflux? | avoid food consumption 2hrs before exercise; monitor supine positions, avoid all inversions |
What is Glaucoma? | Normal fluid pressure inside eyes slowly rises, leading to vision loss or blindness; regular aerobic exercise helps avoid buildup of pressure |
What are contraindications of Glaucoma? | Partial and full invesions; valsalva maneuvers (i.e. hold nose and close mouth and press out as if blowing up balloon) |
What is Multiple Sclerosis? | Autoimmune disease that affects central nervous system when myelin sheath that coats nerves is damaged in multiple areas, leaving scars and disrupts ability of nerves to conduct electrical impulses to and from brain |
What are the symptoms of Multiple Sclerosis? | Balance and coordination deficits, dizziness, vertigo, temperature sensitivity, depression, fatigue, cognitive deficits, numbness, pain, spasticity, vision, bladder and bowel dysfunction |
What are the precautins for Multiple Sclerosis? | Avoid over-exertion, heavy resistance training, fatigue, extreme hot or cold. Guard carefully in balance exercises. |
What is Osteoarthritis? | Progressive degeneration of joint structures, results in cartilage degradation, altered joint architecture, affects only few joints; morning stiffness, increased pain w weightbearing and strenuous activity |
What are the symptoms of Osteoarthritis? | loss of mobility, chronic pain, deformity, loss of function, commonly characterized by morning stiffness lasting only 30 mins. |
What are the precautions for Osteoarthritis? | work to point of pain, but not past it; avoid high impact, low-intensity frequent exercises; extend warmup & cool down; modify according to client's response to exercise; take all joints thru range of motion; |
What is Osteoporosis? | low bone mass & deterioration of bone tissue, esp the vertebrae, neck of femur and wrist; increased fracture risk |
Waht are the contraindications of Osteoporosis? | Avoid flexion, rotation, sidebending of spine; NO spine flexion in any postion, no crunches; no hip rotation; Neutral & extension only; focus on thoracic extension |
What are the contraindications for Pregnancy (1)? | Avoid moderate to maximal contractions of adductors due to softening of pubic symphosis joint (Horseback on Barrel or Reformer, Side split, strong Circle work) |
What are the contraindications for Pregnancy (2)? | Avoid inversion in 2nd and 3rd trimesters and post-partum |
What are the contraindications for Pregnancy (3)? | Avoid supine positions after 1st trimester, but working abs in any other position permitted; modify ab and oblique work if any diastasis recti of linea alba |
What are the contraindications for Pregnancy (4)? | Ask client to report dizziness, nausea, vision, headache, vaginal blood, fluid loss, chest pain, muscle weakness, calf pain, uterine contractions or decreased fetal movement and call their doctor. |
What is Rheumatoid Arthritis? | Chronic, inflammatory systemic disease affeting connective tissue |
What are the symptoms of Rheumatoid Arthritis? | Aching, stiffness, progressive deformity that occur in the synovial membrane, articular cartilage and tendon sheaths |
What are the precautions for Rheumatoid Arthritis? | During exacerbation of symptoms, avoid endrange stretching of swollen joints or heavy resistance; avoid exercising to the point of exhaustion or extreme fatigue. |