A Comprehensive Guide to Sports Physiology and Injury Management: an Interdisciplinary Approach

Front-Matter_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Mana
A Comprehensive Guideto Sports Physiology and Injury Management: An Interdisciplinary Approach
Copyright_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Managem
Copyright
Preface_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Managemen
Preface
List-of-Contribut_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury
List of Contributors
Dedication_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Manage
Dedication
Chapter-1---Muscle-form-an_2020_A-Comprehensive-Guide-to-Sports-Physiology-a
| 1 | - Muscle form and function
Neuromuscular control of movement
Skeletal muscle structure
Whole muscles
Muscle arrangements
Microstructure and contractile proteins
The sliding filament theory of muscle contraction
Energy for movement
Contractile properties of muscle
Excitation–contraction coupling
Stretch–shortening cycle
Length–tension and force–velocity relationships
The moment arm influences joint biomechanics
Twitches, summation and tetanus
Chapter-2---Muscle-adaptatio_2020_A-Comprehensive-Guide-to-Sports-Physiology
| 2 | - Muscle adaptations and fatigue
Introduction
Important concepts related to endurance exercise
The endurance training stimulus
The adaptation responses
Mitochondrial biogenesis
Angiogenesis
Muscle adaptations to resistance training
Neural adaptations
Muscle hypertrophy
Other morphological adaptations
Regulation of muscle protein turnover
Mechanotransduction
Transcriptional regulation
Intracellular signalling responses
Satellite cells and myonuclei addition
Muscle fatigue
Fatigue during very intense exercise
Fatigue during prolonged endurance exercise
Chapter-3---The-physiology-of-disuse--i_2020_A-Comprehensive-Guide-to-Sports
| 3 | - The physiology of disuse, immobilization and low-load environments
Introduction
Bone
Articular cartilage
Ligament
Joint capsule
Skeletal muscle
Cardiorespiratory system
Summary
Chapter-4---Strength-and-conditioning--sci_2020_A-Comprehensive-Guide-to-Spo
| 4 | - Strength and conditioning: scientific aspects including principles of rehabilitation
Introduction
The importance of muscle strength
Factors affecting muscle force
Motor unit recruitment
Firing frequency
Modification by muscle and tendon receptors
Cross-sectional area
Muscle architecture
Muscle length and the mechanical model of muscle
Contraction velocity
Basic principles for increasing muscle strength and power
Overload
Specificity
Individuality
Diminishing returns
Reversibility
Development of specific qualities
Designing a ‘strength’ workout
Needs analysis
Training frequency
Exercise selection
Training load and repetitions
Maximum strength
Hypertrophy
Muscular endurance
Power
Recovery
Periodization of training
Summary
Chapter-5---Biomechanics-of-sports-injuri_2020_A-Comprehensive-Guide-to-Spor
| 5 | - Biomechanics of sports injuries, their management and clinical considerations
Introduction
Ankle injuries
Mechanism and clinical presentation
Ankle rehabilitation protocols
Strength training protocols
Effects on measures of impairment
Effect on measures of self-reported function
Multiple treatments and training mode protocols
Effects on measures of impairment
Effects on measures of functional limitation
Summary
Patient disability resulting from ankle disease
Rehabilitation effects on incidence and recurrence
Take-home message
Anterior cruciate ligament injuries
Anatomy
Injury mechanisms and risk factors
Screening and prevention
Treatment
Outcome measures
Consequences
Take-home message
Shoulder injuries
Internal impingement
Rotator cuff tears
Injury mechanism
Management of internal impingement and rotator cuff tears
Instability
Injury mechanism
Management of instability
Take-home message
Chapter-6---Electrophysical-agents_2020_A-Comprehensive-Guide-to-Sports-Phys
| 6 | - Electrophysical agents: physiology and evidence
Introduction
Therapeutic ultrasound
Clinical uses of ultrasound therapy
Ultrasound nonthermal effects and uses
Ultrasound application in relation to tissue repair
Inflammation
Proliferation
Remodelling
Low-intensity pulsed ultrasound (LIPUS) and fracture healing
Pulsed shortwave therapy and other radiofrequency applications
Pulsed shortwave therapy: clinical effects
Non-shortwave radiofrequency applications (Indiba, Tecar)
Laser therapy/Photobiomodulation
Light absorption in the tissues
Laser–tissue interaction
Treatment doses
Clinical applications
Open wounds
Inflammatory arthropathies
Soft tissue injury
Pain
Summary
Shockwave therapy
Microcurrent therapy
Conclusion
Chapter-7---Cryotherapy--physiolo_2020_A-Comprehensive-Guide-to-Sports-Physi
| 7 | - Cryotherapy: physiology and new approaches
Introduction
Heat transfer
Convection
Conduction
Radiation
Evaporation
Conversion
Specific heat capacity
Latent heat of fusion
Evidence base
Dose–response
Skin surface and deep tissue temperature relationship
Effect of cooling on muscle
Effect of cooling on joint position sense
Hindering or optimizing
Cryotherapy modalities and methods
Ice (crushed/cubed/wetted)
Cold water immersion
Cryotherapy and compression
Pitch-side applications
WBC and physiology
WBC and recovery
WBC and injury
WBC and psychology
WBC and systemic pathologies
Chapter-8---Physiology-of-sportin_2020_A-Comprehensive-Guide-to-Sports-Physi
| 8 | - Physiology of sporting and athletic recovery
Introduction
Functional foods
Compression garments
Cold water immersion
Contrast bathing
Whole-body cryotherapy
Sleep
Chapter-9---Making-sense-of-pain-in-sports-p_2020_A-Comprehensive-Guide-to-S
| 9 | - Making sense of pain in sports physiotherapy: applying the Pain and Movement Reasoning Model
Introduction
Reframing the relationship between pain and tissue damage
Reframing the relationship between pain and movement
Central processing to produce pain
Pain and Movement Reasoning Model
Local stimulation
Clinical note
Regional influences
Kinetic chain
Pathoneurodynamics
CNS convergence
Clinical note
Central modulation
Predisposing factors
Activity-dependent plasticity
Cognitive–emotive–social state
Clinical note
Implications for integrated sports rehabilitation
Summary
Chapter-10---The-physiology-o_2020_A-Comprehensive-Guide-to-Sports-Physiolog
| 10 | - The physiology of manual therapy
Introduction
Effects on pain
Mechanical effects
Effects on motor control
Conclusion
Chapter-11---The-physiology-of-a_2020_A-Comprehensive-Guide-to-Sports-Physio
| 11 | - The physiology of acupuncture analgesia
Introduction
Application and mechanisms
Acupuncture analgesia
Layering effect
Inflammation and healing
Summary
Chapter-12---Physiological-determinants-of-endura_2020_A-Comprehensive-Guide
| 12 | - Physiological determinants of endurance performance: maximal oxygen uptake (): Testing, training and practical application
Introduction
Central vs. peripheral considerations
and its association with optimal sports performance
and its association with optimal health
Physiological assessment of
Laboratory-based approaches
Considerations in selection of exercise test modality
Considerations in test protocol selection and design
Identification of peak physiological exertion during laboratory-based exercise testing
Field-based approaches
Walking tests
Running tests
Step tests
Submaximal cycling tests
Nonexercise prediction equations
Exercise training prescription
Dose–response relationships and
Factors confounding and limiting chronic alterations in
Exercise prescription for promoting increases in
Summary
Chapter-13---Ultrasound-imaging_2020_A-Comprehensive-Guide-to-Sports-Physiol
| 13 | - Ultrasound imaging in groin injuries
The rule-out tool
Optimal time to scan
Dynamic review
Full- vs. partial-thickness tears
Scanning planes
Follow up
Imaging
Plain radiographs: are they still helpful
Computerized tomography
Magnetic resonance imaging
Operator experience
Ultrasound
Suspected adductor-related groin pain
Adductor protocol
Suspected inguinal-related groin pain
Femoral region
Inguinal region
Suspected hip-related groin pain
Hip region
Tendinopathy.This can be frequently seen at the adductor longus and rectus femoris tendon insertions. On ultrasound, the tendon ...
Tearing.This appears as a cleft or void within the muscle or tendon structure. In the acute phase, it is usually filled with flu...
Strain.There are varying degrees of muscle strain noted on ultrasound. It is usually depicted as an area of hyperechogenicity in...
Effusion.This is joint fluid and has a hypoechoic appearance on ultrasound. Debris within the fluid can sometimes also be identi...
Calcification.Build up of calcification in tendons can be the result of repeated microtrauma. Echogenic areas are noted within t...
Avulsion.This describes where a small area of bone has been pulled away from the main bone as a result of tendon or ligamentous ...
Myositis ossificans.This is defined as the ‘formation of bone tissue inside muscle tissue after a traumatic injury to the area’ ...
Conclusion
Chapter-14---Conservative-management-o_2020_A-Comprehensive-Guide-to-Sports-
| 14 | - Conservative management of groin injuries: acute and chronic
Introduction
Incidence and epidemiology
Aetiology
Diagnosis
Evolution of the PLAC
Imaging
Muscle function and myokinematics
Adductor muscle function
Abdominal muscle function
Groin function in sport
Running
Change of direction
Kicking
Medical intervention/pharmacotherapy
Rehabilitation
Stages of management in acute setting
Stage 1: bleeding phase (0–48 hours)
Stage 2: inflammatory phase (days 0–5/6/7)
Stage 3: tissue conditioning/remodelling phase
Differences in chronic/acute on chronic presentation
Principles of loading
Adductor loading
Abdominal loading
Bone loading and noncontractile tissue
Stage 4 – sports-specific with return to running phase
Stage 5 – integration back into full training
Summary
Chapter-15---The-surgical-managemen_2020_A-Comprehensive-Guide-to-Sports-Phy
| 15 | - The surgical management of sporting groin injuries
Introduction
Incidence
Aetiology
Presentation and diagnosis
Symptoms
Signs
Adductor injuries
Investigations
Plain X-rays
Radionuclide bone scan
Ultrasound scan
Magnetic resonance imaging
Differential diagnosis
Surgery
Indications for surgery
Surgical technique
Adductor tenotomy
The physiology of wound healing
Outcome and recurrence
Rehabilitation
The multidisciplinary team
Controversies
Summary
Chapter-16---The-sport_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-I
| 16 | - The sporting hip
Introduction
Structure
Joint shape
Labrum
Periarticular mechanics and microinstability
Function
Movement in sport
Return to activity/sport
Pathology
Radiology
Rehabilitation
Chapter-17---Lumbopelvic-dysfunction-in-the_2020_A-Comprehensive-Guide-to-Sp
| 17 | - Lumbopelvic dysfunction in the sporting population: the ‘what’, the ‘why’ and the ‘how’
Introduction
Assessment – identifying the ‘what’
Patient history
Visual assessment and observation
Tests in standing or kinetic tests
Trunk flexion assessment
Trunk extension assessment
Trunk side flexion
Gillet test or stork test
Hip extension test
Palpation
Supine
Prone
Sacral nutation, sacral counternutation or sacral tilt
Patient positioning
Tests in supine lying
Active straight leg raise (SLR)
Passive SLR
Assessment findings – establishing the ‘why’
Prevention – determining the ‘how’
The role of imaging
Conclusion
Chapter-18---Performance-rehabilitation-fo_2020_A-Comprehensive-Guide-to-Spo
| 18 | - Performance rehabilitation for hamstring injuries - a multimodal systems approach
Introduction
Sporting anatomical demands
Classification of hamstring injuries
The importance of adequate rehabilitation
Creating a performance-enhancement environment
Performance-enhancing rehabilitation philosophy
Improving athletic ability
Reducing risk of future injury
Optimizing athlete engagement
Performance rehabilitation: strength
Developing a variety of hamstring strength qualities
Progressive overload
Exercise selection
Explosive strength: plyometrics
Low-threshold plyometrics
High-threshold plyometrics
Lumbopelvic–hip complex
Neuromuscular control (NMC) and neurodynamics
Performance rehabilitation: running exposure
Pool running: the battle with time begins …
Resisted runs and how much resistance is enough
Assisted runs
Change of direction and agility
Deceleration and turning
Acceleration
Agility
High-speed running and sprinting
Return to play
Outcome measures
Conclusion
Chapter---19-----The-management-of-gastrocn_2020_A-Comprehensive-Guide-to-Sp
| 19 | - The management of gastrocnemius and soleus muscle tears in professional footballers
Introduction
Stress/strain concept
Incidence of tears and the football calendar
Assessment and use of radiological imaging
Commonly considered causes
Flexibility
Strength inadequacies
Foot mechanics and orthotic use
Less commonly considered causes
Hydration and its effects on muscle elasticity
Poor training load management
Rehabilitation
Treatment room to gym
Knee-to-wall test/weight-bearing lunge test
Muscle work capacity/calf endurance test
Handheld dynamometry (HHD)
AlterG protocol
What and who are we rehabilitating
Gym rehabilitation to return to play
How to load
Red flags
Deep vein thrombosis
Tumour
Stress fractures
Popliteal artery entrapment syndrome (PAES)
Summary
Chapter---20-----Knee-injuries-in_2020_A-Comprehensive-Guide-to-Sports-Physi
| 20 | - Knee injuries in professional football
Introduction
Epidemiology
The Chelsea FC Medical Department philosophy
Treatment structure
Methods of functional progression
‘Knee-specific’ targeted interventions
Common knee injuries
Medial collateral ligament injuries
Anterior cruciate ligament injuries
Meniscus injuries
Posterolateral corner injuries
On-field rehabilitation
The Injury-Prevention Unit at Chelsea FC
Conclusion
Chapter---21-----The-sporting-ankle--lateral-a_2020_A-Comprehensive-Guide-to
| 21 | - The sporting ankle: lateral ankle sprain, the most commonly incurred lower limb musculoskeletal injury
Introduction
Case description
Injury epidemiology
Mechanism of injury
Clinical assessment: the essentials
Fracture
Ligaments
Physical component of the clinical assessment: the summary
Rehabilitation of the footballer’s ankle
Sensorimotor insufficiencies: the theory
Clinical assessment of sensorimotor insufficiencies
Pain
Swelling
Range of motion: osteokinematics and arthrokinematics
Muscle strength
Static and dynamic postural balance
Range of motion: osteokinematics and arthrokinematics
Muscle strength
Static and dynamic postural balance
Athlete profile
Other ankle joint injuries: a brief commentary
Conclusion and summary
Chapter---22-----The-rehabilitation-of-the_2020_A-Comprehensive-Guide-to-Spo
| 22 | - The rehabilitation of the rugby shoulder: a proposed approach to management
Introduction
Task-based/criterion-based model
Rugby union and its demands on the shoulder
Healthy shoulders
The rotator cuff
Assessment
The role of imaging in the sporting shoulder
The adolescent shoulder
Rehabilitation of the injured shoulder
Rehabilitation pillars
Category 3 and 4 injuries
Category 1 and 2 injuries
Isometric rotator cuff activation
Rotator cuff endurance exercises
Joint position sense (proprioception)
Closed kinetic chain exercises
Eccentric rotator cuff strength
Open kinetic chain exercises
Upper body strength
Horizontal push
Horizontal pull
Vertical push
Vertical pull
Rotator cuff reactive strength
Return to play
Sport- and position-specific skills
Return to contact skills
Outcome measures
Inseason management
Conclusion
Chapter---23-----Assessment-of-t_2020_A-Comprehensive-Guide-to-Sports-Physio
| 23 | - Assessment of the sporting shoulder
Principles
The diagnostic filter
Early identification of serious pathology
History
Age as a predictor of pathology
Mechanism of onset
Instability symptoms
Occupation (sport) and potential sport-specific risk
Pain location
Aggravating factors
Neurological symptoms
Clinical examination
On the field assessment
Deformity.Does the shoulder contour look rounded like the contralateral shoulder or is there a squared-off appearance to indicat...
Bruising.Immediate significant bruising and discolouration after trauma is indicative of bony or vascular injury so should be re...
Wasting.Muscle wasting is rarely seen in those aged under 50 years so should be regarded as significant. It may represent the se...
Swelling.Swelling in the shoulder is rare, and so when present should be viewed as a significant finding. After trauma this usua...
Redness.Redness is a key sign of active inflammation so when present over a joint should raise immediate suspicion of infection ...
Bony tenderness.This should be assessed after trauma. Palpate the length of the clavicle, acromion and scapula spine whilst prom...
Joints.The sternoclavicular (SC) joint, AC joint and glenohumeral joint should be palpated for tenderness, excessive heat, swell...
Range of movement
Clinical tests
The rotator cuff
The belly press test.The patient places the hand on the belly with the elbow at 90 degrees and forward of midline. The tester tr...
The bear hug test.The patient places their hand on their opposite shoulder with the elbow unsupported on the chest. The tester t...
The lift-off test.The patient places their hand behind their back with the dorsum of the hand against the lumbar spine. The test...
Isometric external rotation test.The patient stands with both elbows flexed to 90 degrees and the shoulders in neutral rotation....
External rotation lag sign.If there is considerable weakness of isometric external rotation then passively rotate the shoulder t...
The full can test.The arm is abducted to 90 degrees in the plane of the scapula with the hand orientated so that the thumb point...
The empty can (Jobe’s) test.This is similar to the full can test, however the hand is orientated so that the thumb points toward...
Palpation. AC joint pain is very localized and the joint will be tender to firm palpation
The scarf test.The patient flexes the shoulder to 90 degrees and adducts the hand towards the opposite shoulder. Overpressure is...
Instability testing.If there is a dislocation of the AC joint the tester should offload the weight of the arm and assess whether...
Bateman method.This method of testing the pectoralis major involves the tester standing face-to-face with the patient. First the...
Bicep rupture
Hook test (O’Driscoll et al., 2007).This is performed by placing a hooked finger behind the distal tendon and pulling forward. A...
SLAP tear and proximal biceps tendinopathy
Palpation. The long head of bicep tendon may be tender proximally over the bicipital groove
O’Brien’s active compression test (O’Brien et al. 1998).The patient’s arm is flexed to 90 degrees and adducted 30 degrees with t...
Glenohumeral joint laxity and instability
The sulcus sign (Neer and Foster, 1980).The patient sits with the arm relaxed at their side. The tester applies a downward tract...
The apprehension and relocation tests (Farber et al., 2006).With the patient sitting or supine lying the arm is abducted to 90 d...
Generalized laxity: Beighton score
Differential tests for the neck and neurological screening
Functional assessment
Imaging
Plain film X-ray.Radiography of the shoulder has low radiation exposure and is a cheap, accessible form of imaging. Plain X-ray ...
Ultrasound scan.Ultrasound is often preferred to magnetic resonance imaging for suspected rotator cuff pathology as it has simil...
Computed tomography (CT).A cross-sectional imaging modality using a high dose of radiation mainly to assess bone. This is rarely...
Magnetic resonance imaging (MRI).High-resolution cross-sectional imaging is used to identify rotator cuff/bicep/pectoral tendon ...
Magnetic resonance arthrogram (MRA).This is similar to MRI but with the addition of an injection of a liquid contrast agent into...
Laboratory tests
Bloods and aspiration.If the patient presents with a recent onset of a severely painful, red, hot, swollen joint with systemic f...
Conclusion
Chapter---24-----The-spor_2020_A-Comprehensive-Guide-to-Sports-Physiology-an
| 24 | - The sporting elbow
Introduction
Elbow anatomy
Osteology
Ligaments
Muscles
Biomechanics
Phase I (windup). In this preparatory phase the elbow flexes and the forearm is slightly pronated
Phase II (cocking).The shoulder abducts and moves into maximal external rotation, the elbow flexes to between 90 degrees and 120...
Phase III (acceleration).A large forward-directed force in generated as the extremity moves into rapid elbow extension. Biomecha...
Phase IV (deceleration).Eccentric contraction occurs in all muscles to slow the arm. High torque is generated during this phase,...
Phase V (follow-through). In this final phase the forces are dissipated, and the body rebalances to stop forward motion
Elbow instability
Acute instability
Valgus instability
Lateral epicondylitis
Physiotherapy
Antiinflammatory agents
Bracing
Biological treatments
Surgical treatment
Medial epicondylitis
Tendon ruptures/avulsions
Distal biceps tendon rupture
Triceps tendon rupture
Key messages
Chapter---25-----Hand-and-wrist-in_2020_A-Comprehensive-Guide-to-Sports-Phys
| 25 | - Hand and wrist injuries: a focus on boxing
Introduction
Main injuries occurring at the hand and wrist in boxing
The knuckles: sagittal band injuries
Presentation/testing for sagittal band injuries
Objective measures
Range of motion
Strength (hand function)
Diagnostic work-up (investigations)
Ice and compression
Manual therapy (joint mobilizations)
Electrotherapy modalities
Acupuncture
Soft tissue mobilization
Rehabilitation (exercise therapy)
Antiinflammatories and injection therapy
Surgical intervention
Carpometacarpal joint injuries
Presentation/testing
Strength (hand function)
Diagnostic work-up (investigations)
Ice and compression
Manual therapy
Electrotherapy
Acupuncture
Soft tissue mobilization
Rehabilitation (exercise therapy)
Antiinflammatories and injection therapy
Surgical management
Ulnar collateral ligament injury at the base of the thumb (MCP joint)
Presentation/testing
Objective measures
Diagnostic work-up (investigations)
Surgical management
Conclusion
Chapter---26-----The-cervical-spine--_2020_A-Comprehensive-Guide-to-Sports-P
| 26 | - The cervical spine: risk assessment and rehabilitation
Introduction
Risk assessment of the cervical spine in a sporting context
Headache and dizziness: danger or direction for treatment
How should clinicians proceed
Cervical arterial dysfunction
Internal carotid artery dissection
Clinical presentation
Management
Vertebral artery dissection
Clinical presentation
Management
Ongoing dizziness
Traumatic brain injury
Persistent symptoms
Management
Cervicogenic dizziness
Definitions
Sensorimotor dysfunction
Sensorimotor considerations
Mechanoreceptors, reflexes and the sympathetic nervous system
Possible mechanisms
Clinical examination
1. Smooth pursuit eye movement (in neutral).Examination of oculomotor control includes observation of the eyes following a moving...
2. Saccadic eye movement.The patient is asked to quickly move the eyes to fix his/her gaze between several targets. Targets are p...
3. Smooth pursuit neck torsion test (SPNT).The same as test 1 but with the trunk rotated to achieve 45 degrees of cervical rotati...
Further testing
4. Gaze stability.The patient is asked to maintain visual focus on a target as he/she actively moves the head slowly into variati...
5. Eye–head coordination.The patient initiates eye movement to a point to focus and then, while maintaining focus, moves the head...
6. Optokinetic assessment.The patient is positioned 90 cm away from a wall with a laser pointer attached to his/her head; the pat...
7. Head–body disassociation.The patient is asked to maintain a stable head position, using laser as feedback if necessary, whilst...
8. Postural control system.This includes all the sensorimotor and musculoskeletal elements involved in the control of postural or...
Motor function
Isometric training
Global strength training
Endurance training
Plyometric training
Sensorimotor system training
Mental health perspectives
Summary
Chapter---27-----Management-o_2020_A-Comprehensive-Guide-to-Sports-Physiolog
| 27 | - Management of head injuries
Introduction
Symptoms
Diagnosis and management
Immediate pitch-side recognition of mTBI
Red flags
Clinical assessment
Investigations
Acute management
Treatment of mTBI
Chronic/persistent symptoms
Key points and take-home message
Chapter---28-----A-high-performance-appro_2020_A-Comprehensive-Guide-to-Spor
| 28 | - A high-performance approach to optimizing a major league soccer preseason
Introduction
The foundation: offseason
Strength/power development
Running volumes and intensities
Soccer-specific conditioning
The structure: preseason
Testing
Offseason-to-preseason transition
Preseason: planning the big picture
Phase 1: training overload phase
Phase 2: game overload phase
Phase 3: underload or taper phase
Game progression within ‘big picture’ planning
Monitoring
Strength/power development
Summary
Chapter---29-----An-introduction-to-wo_2020_A-Comprehensive-Guide-to-Sports-
| 29 | - An introduction to working in an elite football academy
Introduction
The interdisciplinary team and the athlete-centred approach
Developing people, not just footballers
Custodians of club culture and values
Environment
Subjective assessment
Pain scales
Objective, observational and behavioural assessment
Rehabilitation planning
Avoiding over medicalization
Taping
Long-term athletic development
Growth and maturation
What ‘age’ is the player
Chronological age
Biological or skeletal ‘age’
Assessment of genital/pubic hair development.The Tanner’s Sexual Maturity Scale was devised to assess physical development in ch...
Magnetic resonance imaging.The use of MRI offers the possibility of estimating biological/chronological maturity without the nee...
Psychological age
The relative age effect and bio-banding
Safeguarding
Creating a safe environment
Transport
Back to basics
Consider environmental factors
Multiple roles of IDT members
First aid
Summary
Chapter---30-----Growing-bones--_2020_A-Comprehensive-Guide-to-Sports-Physio
| 30 | - Growing bones: anatomy and fractures
Introduction
Paediatric long bone anatomy
Bone growth
Salter–Harris classification of physeal fractures
Signs and symptoms
Diagnosis and treatment
Incomplete fractures
Greenstick fractures
Torus (buckle) fracture
Bow fracture
Fracture clinical decision tools
The Ottawa foot and ankle rules
The Ottawa knee rules
Fracture treatment
Chronic fractures affecting the growth plate
Apophyseal avulsion fractures
Pelvic apophyseal avulsion fractures
Avulsion of the tibial spine (tibial eminence fractures)
Signs and symptoms
Treatment
Tibial tubercle avulsion
Signs and symptoms
Diagnostics/imaging
Treatment
Calcaneum avulsion fractures
Diagrammatic overview
Summary
Chapter-31---Growing-bones--Osteochondr_2020_A-Comprehensive-Guide-to-Sports
| 31 | - Growing bones: osteochondroses and serious paediatric conditions
Introduction
Osteochondroses
Nonarticular osteochondroses: traction apophysitis
Apophysitis treatment and management principles
Tibial tubercle traction apophysitis (Osgood–Schlatter disease)
Inferior pole of the patella apophysitis (Sinding-Larsen Johansson syndrome)
Calcaneal apophysitis (Sever’s disease)
Apophysitis of the fifth metatarsal base (Iselin’s disease)
Articular osteochondrosis
Legg–Calvé–Perthes disease
Osteochondritis dissecans (OCD)
Köhler’s disease
Freiberg’s disease
Other ‘not to be missed’ paediatric presentations
Slipped upper femoral epiphysis
Signs and symptoms
Femoroacetabular impingement
Cam morphology.This is more prevalent in males than females (23.9% vs. 9.9%) (P < 0.001) (Li et al., 2017). It is also more prev...
Symptoms and diagnosis
Treatment
Lumbar spondylolysis and spondylolisthesis
Spondylolysis
Spondylolisthesis
Spondylolysis symptoms and diagnosis
Spondylolysis treatment
Spondylolisthesis symptoms and diagnosis
Spondylolisthesis treatment
Bone and joint infections: septic arthritis and acute osteomyelitis
Symptoms
Diagnosis and treatment
Tumours misdiagnosed as musculoskeletal injuries
Bone health, growth, maturation and injuries
Summary
Chapter-32---Cardiac-event-in-_2020_A-Comprehensive-Guide-to-Sports-Physiolo
| 32 | - Cardiac event in the young athlete
Introduction
Sudden cardiac death in athletes
Related cardiac conditions
Who to screen
Screening programme design
Medical history and physical examination
The role of the 12-lead resting ECG
ESC and AHA consensus for PPS in athletes
Ethical perspective
Conclusion
Chapter-33---Developing-speed-qua_2020_A-Comprehensive-Guide-to-Sports-Physi
| 33 | - Developing speed qualities in youth athletes
Introduction
When is it possible to develop speed qualities in children
Does a child have to possess the ‘performance/speed gene’
Accelerated trainability phases
Sampling years: 5–11 years of age
Fun and learning to train phase
What is agility
What is not agility
Why train agility
Agility practice to help reduce injury incidence
How do we train agility
Stage 1: planned movements
Stage 2: reactive movements
Stage 3: small-sided games
Exercise prescription
Measuring heart rate response during the sampling years
Measuring active participation during the sampling years
Specialization years: 10–16 years of age
Training to train phase
Developing speed qualities in boys and girls
Stride characteristics for developing speed
Resistance training
High-speed running
Exercise prescription
Using heart rate to help prescribe practice sessions
Challenges
Conclusion
Chapter-34---Conditioning-for-the-battle-of-m_2020_A-Comprehensive-Guide-to-
| 34 | - Conditioning for the battle of momentum: a practical use of GPS technology for conditioning strategies
Introduction
GPS introduction
1. Data collection stage.The initial introduction of any new technology will naturally allow for an acclimatization period where ...
2. Comparison stage.This stage utilizes the data that has been collected to run comparisons between session types, on sessions ve...
3. Implementation stage.The information gathered is extrapolated to draw meaningful conclusions about training or games. This cou...
Velocity
Acceleration
Impact
Demands
General demands
Running.The need to have highly developed ability to hit top speed and to repeat this often; the need to run typically 6 km over...
Change of direction.The ability to accelerate and decelerate frequently and at high speeds. Typically, these acceleration and de...
Specific demands
GPS: role in planning
GPS: role in conditioning
Worst-case scenarios
Passages of significance
Creating these passages
Repeated high-intensity efforts
Considerations
Conclusion
Chapter-35---Managing-the-ov_2020_A-Comprehensive-Guide-to-Sports-Physiology
| 35 | - Managing the overhead athlete
Introduction: what is ‘the overhead athlete’
Throwing arm pain
Biomechanics of the overhead activity
Preparation phase
Arm cocking stage
Acceleration phase
Deceleration phase
Pathomechanics of overhead activity
Cocking/acceleration phase
Deceleration phase
Adaptations to overhead sport
Scapula
GHJ rotation range of motion
GHJ strength
Elbow range of motion
The kinetic chain (trunk and lower limb)
Total athlete management of the overhead athlete
Offseason management
Inseason management
Assessing the injured overhead athlete
Red flags
Specific versus nonspecific pain
Pain presentation and stage of the disorder
Improvement testing
Contributing factors
Managing the injured overhead athlete
Manage pain
Address contributing factors and return to loading
Planned return to competition and training
Ongoing monitoring and maintenance rehabilitation
Conclusion
Chapter-36---Treatment-and-manageme_2020_A-Comprehensive-Guide-to-Sports-Phy
| 36 | - Treatment and management of soft tissue injuries
Introduction
Classification of injuries
Acute phase
Subacute phase
Chronic phase
Determining the phase
1. What happenedCan the patient explain the mechanism of injury, which will help to determine structures that may have been damag...
2. What did you do immediately following the injuryWas the patient able to continue activities or forced to stop This will then d...
3. Was there swelling and when was it first noticedIf the patient felt throbbing and noticed swelling immediately and that the in...
4. What happened immediately following the injuryWhat did the patient do immediately following the injury Did they receive any tr...
5. How are they now and what are their problemsAt this point it is necessary to determine the degree of disability that the patie...
Acute inflammation. Management strategies will be covered in greater detail after the following two sections
Subacute inflammation. The main aims in this phase of inflammation are to
Chronic inflammation. The aims in this phase of inflammation are to
Treatment and management of acute injuries
Swelling.Damage to the semipermeable membranes of tissues within the area will allow fluid exudate and in some cases blood to en...
Heat.Release of cells into the tissue space promotes cellular activity and metabolism including clotting and laying down of coll...
Pain.As the swelling progresses and the cellular content increases the pressure exerted rises and pain and discomfort are provok...
Discolouration (redness).Increased metabolism and heat also increases circulation to the peripheral vessels thereby giving an er...
Loss of function. As pain and swelling increase, movement within the area becomes impaired and, as such, function is compromised
Compression
Elevation
Cooling
Reduce activity
Stages of rehabilitation
Early-stage rehabilitation
Intermediate-stage rehabilitation
Late-stage rehabilitation
Predischarge stage of rehabilitation
Importance of classification
Take-home points
Chapter-37---The-inseason-strength-programme-_2020_A-Comprehensive-Guide-to-
| 37 | - The inseason strength programme: a professional rugby perspective – programming through the season
Introduction
Adaptive periodization model
Stage 1: general strategy – the alignment process
Strength training philosophy
Strength training model
Foundational strength stream
General strength stream
Rugby strength stream
Philosophical and training alignment
Strength session 1: total-body strength day
Strength session 2: total-body power and upper body strength day
Stage 2: tactical strategy – optimizing the planning process
Stage 3: emerging strategy – optimizing the monitoring process
Stage 4: operational strategy – optimizing the coaching process
Stage 5: learning strategy – optimizing the reviewing process
Conclusion
Chapter---38-----Movement-analysis_2020_A-Comprehensive-Guide-to-Sports-Phys
| 38 | - Movement analysis: science meets practice
Introduction
Why is movement analysis important
What is movement analysis
Terms employed during movement analysis
A description of the movements involved
The planes and axes in which the movement occurs
The muscles producing the movement
Models of analysis
Movement phases
Free body diagrams
Deterministic models
Movement dysfunction
Deficit in limb stability
Deficit in pelvic stability
Deficit in trunk stability
Deficit in shock absorption
Deficit in movement strategy
Muscle imbalances
Identify contracted muscles. Psoas, tensor fascia latae (TFL), biceps femoris, vastus lateralis
Relax contracted muscles. Soft tissue release, foam roller, static or dynamic stretching
Identify, reactivate and strengthen inhibited or weak muscles.Gluteus medius, transversus, multifidus, gluteus maximus, vastus m...
Treat synergistic dominance and reciprocal inhibition.Synergistic dominant muscle could be the biceps femoris, which is overacti...
Implement a core and lumbopelvic stability programme.Transversus activation with dead bugs, bird–dog, bridging, bear-crawls, sta...
Treat the movement pattern with functional exercise (locally then globally).In this case of dynamic knee valgus, the focus will ...
How do we perform movement analysis
Limb stability
Pelvis stability
Trunk stability
Shock absorption
Movement strategy
Hip muscle strength
Muscle function
Postmovement analysis: targeted neuromotor training
Neuroplasticity theory and practical application
Conclusion
Chapter---39-----Conditioning-efficacy--a-roa_2020_A-Comprehensive-Guide-to-
| 39 | - Conditioning efficacy: a road map for optimizing outcomes in performance-based rehabilitation
Introduction
Dynamic knee joint stability
Conditioning efficacy for performance-based rehabilitation
Programme planning and design
Threats to conditioning efficacy
Fatigue
Carry-over effects – exercise-induced muscle damage
Techniques to enhance conditioning efficacy
Specificity
Overload
Progression
Addressing basic principles
Rehabilitating rate of force development
Rehabilitating electromechanical delay
Threats to conditioning efficacy
Speed of muscle activation
Cross-education
Performance demands and injury risks
Threats to conditioning efficacy
Cumulative effects
Training load
Conclusion
Chapter---40-----The--all-around--athlete--key-per_2020_A-Comprehensive-Guid
| 40 | - The ‘all-around’ athlete: key performance considerations for managing injuries related to the ankle, trunk and tendon in female gymnasts
Introduction
Typical age profile of elite gymnasts
The gymnast’s multidisciplinary team
Growth and maturation
Managing ‘load’
Technical training and physical preparation
Nutrition
Psychological stressors
Injury and rehabilitation considerations
Injury epidemiology
Ankle injuries
Key considerations in ankle injuries
Trunk injuries
Key considerations in trunk injuries
Lower limb tendinopathy
Key rehabilitation considerations in tendon injuries
Summary
Chapter---41-----Introduction-_2020_A-Comprehensive-Guide-to-Sports-Physiolo
| 41 | - Introduction to dance medicine
Introduction
Extrinsic demands on dancers
Surfaces
Costumes/shoes
Props/equipment/lighting
Intrinsic demands on dancers
Workload
Injury in dance
Dance terminology
Rehabilitation of a dancer
Return-to-dance criteria
Role of screening in dance
Medical screening
Musculoskeletal screening
Movement testing
Summary
Chapter---42-----Emergency-a_2020_A-Comprehensive-Guide-to-Sports-Physiology
| 42 | - Emergency aid preparation
Emergency action preparation
The Emergency Action Protocol
Background
A guide to the EAP
Doctor’s kit
Physiotherapist’s kit
Prescribing
Extrication
Extrication for non-spinal injuries and cardiac arrest
Extrication for spinal injuries
Handover
Debriefing
Emergency aid qualifications
Conclusion
Chapter---43-----What-s-rehabilitation-without_2020_A-Comprehensive-Guide-to
| 43 | - What’s rehabilitation without patient buy in The importance of psychology in sport injury rehabilitation
Introduction
Psychological responses to injury
Positive response
Models of athletes’ psychological response to injury
Grief response models
The integrated model of response to sport injury and rehabilitation
The Chimp Model
Adherence to injury rehabilitation
Methods to enhance rehabilitation adherence in athletes
Sport psychology skills to integrate into your practice
Goal setting
Outcome goals.These focus on the outcome of an event such as winning a gold medal or a specific result of a competition, and as ...
Performance goals.These are related to personal statistical goals related to the athlete’s own personal previous performance. As...
Relaxation
Progressive muscle relaxation
The relaxation response
Mental imagery
Healing imagery.The athlete images the injured body part healing (e.g., imaging ruptured tissue healing together, imaging a brea...
Pain management.The athlete distracts themselves from the pain by imaging lying on a beach, for example. Ievleva and Orlick (199...
Rehabilitation process.The athlete images themselves undertaking the processes they need to complete in order to fully recover (...
Performance.The athlete images undertaking sport specific-skills (e.g. , imaging training drills, or a competition performance)
Social support
Understanding when to refer
Conclusion
Index_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Management
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y