Evidence in Sports Musculoskeletal Rehabilitation

 
MSK Cover-1

Editor:
Robert C. Manske, PT, DPT, MPT, MEd, SCS, ATC, CSCS

July, 2016

This course offers 60 CEU hours upon completion.

Table of Contents

Chapter 1
Translating Evidence in Sports Musculoskeletal Rehabilitation
Jill Thein-Nissenbaum, PT, DSc, SCS, ATC
Associate Professor, University of Wisconsin-Madison, Doctor of Physical Therapy Program
Staff PT, UW Athletics

Mark D. Weber, PT, PhD, SCS, ATC
Professor, University of Mississippi Medical Center

Dan Lorenz, PT, DPT, LAT, CSCS
Director of Physical Therapy, SSOR, Overland Park, Kansas

Objectives
Upon successful completion of this course, the learner will be able to
1. Identify the three domains that comprise evidence-based practice.
2. Understand the different types of experimental designs and identify a strength of each type of study.
3. Explain different statistical terms, including SpPin, SnNout, positive predictive value, negative predictive value, reliability and validity.
4. Identify limitations to evidence-based practice.

Chapter 2
Evidence for Bony, Muscle and Capsular Healing following Sports MSK Injuries
Brandon Schmitt, DPT, ATC
PRO Sports Physical Therapy of Westchester, Scarsdale Athletic Training

Michael J. Mullaney
Research Consultant, Nicholas Institute of Sports Medicine & Athletic Trauma, Lenox Hill Hospital NY, NY
Mullaney & Associates Physical Therapy, LLC
Matawan, NJ

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Understand pathomechanics of musculoskeletal injury and the pathways for tissue healing.
2. Appreciate the continuum of tendon pathology and its implication for treatment.
3. Recognize the characteristics of common pathologies of the musculoskeletal system including bone, tendon, muscle, and capsule tissue.
4. Determine the appropriate course of intervention for various conditions.
5. Integrate the principles of tissue healing into clinical decision making and rehabilitation process


Chapter 3
Cervical, Thoracic, Spine and Rib Injuries: Evidence in Sports MSK Rehabilitation
Jason Brumitt, PT, PhD, ATC, CSCS
Assistant Professor George Fox University (Newberg, OR)

Objectives
Upon completion of this course chapter, the reader will
1. Identify the functional anatomy and kinesiology of the cervical and thoracic spine.
2. Describe muscular dysfunction frequently associated with musculoskeletal diagnoses of the cervical and thoracic spine.
3. Assess muscular performance of the deep cervical flexors (DCF).
4. Prescribe an evidence-based exercise program to improve function of the DCF.
5.  Prescribe therapeutic exercise programs for patients with acute and chronic musculoskeletal conditions of the cervical spine.
6. Prescribe a therapeutic exercise program for patients with acute and chronic musculoskeletal conditions of the thoracic spine.


Chapter 4
Lumbar Spine, Pelvis and Sacroiliac Injuries: Evidence in Sports Rehabilitation
Barbara J. Hoogenboom PT, EdD, SCS, ATC
Professor and Associate Chair, Department of Physical Therapy, Grand Valley State University, Grand Rapids, Michigan

Kelcie Severson, BS, DPT
Grand Valley State University, Grand Rapids, Michigan

Objectives
Upon completion of this course chapter, the reader will be able to
1.  Describe kinetic linking as it applies to the spine and extremities and apply the Panjabi model of spinal stability to examination of and therapeutic interventions for the lumbar spine.
2.  Classify spinal injuries as macro- or micro-traumatic and articulate how this may affect rehabilitation and preparation for return to sport.
3.  Compare a motor control approach to a strengthening approach for treatment of spinal injury and  dysfunction.
4.  Offer specific examples of rehabilitative strategies and interventions for various spinal pathologies  including the herniated lumbar disc, muscle strains, instability, facet dysfunction, sacroiliac joint/pelvic dysfunction, and spondylopathies.
5.  Formulate a comprehensive plan for assessment prior to return to sport after spinal injury.


Chapter 5
Shoulder Injuries: Evidence in Sports MSK Rehabilitation
Robert A. Williams Jr., PT, DPT
Sports Physical Therapy Fellowship, Champion Sports Medicine, Birmingham, AL

Christopher A. Arrigo, MS, PT, ATC
Physical Therapy, Tampa, FL

Kevin E. Wilk, PT, DPT, FAPTA
Associate Clinical Director, Champion Sports Medicine, Birmingham, AL
Director Rehabilitative Research, American Sports Medicine Institute, Birmingham, AL
Adjunct Associate Clinical Professor, Marquette University, Programs in Physical Therapy

Objectives
Upon completion of this course chapter, the reader will
1. Understand the anatomy and biomechanics of the shoulder and apply it to rehabilitation.
2. Be able to perform a thorough objective exam of the athlete’s shoulder, including key special exami-nation maneuvers to test for ligamentous stability and tendon provocation.
3. Understand how to identify common overuse injuries in the shoulder such as impingement, and how to appropriately manage the athlete’s rehabilitation with a specific emphasis on return to sport.
4. Be able to appropriately manage the care of an athlete who has undergone a sports related shoulder surgery, including introducing and advancing an interval throwing program.
5. Understand the common causes of labral injuries to the shoulder and how to manage both operative and  non-operative care.
6. Be able to identify and differentiate the various grades of acromioclavicular (AC) joint sprains.


Chapter 6

Elbow Injuries: Evidence in Sports MSK Rehabilitation
Todd S. Ellenbecker, DPT, MS, SCS, OCS, CSCS
Clinic Director and National Director of Clinical Research, Physiotherapy Associates Scottsdale Sports Clinic
Vice President of Medical Services, ATP World Tour
Scottsdale, Arizona

Blair Bundy, DPT, SCS, CSCS
Director of Performance Enhancement, Physiotherapy Associates Scottsdale Sports Clinic
Scottsdale, Arizona

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Understand the anatomy and biomechanics of the elbow and apply it to sport.
2. Be able to perform a thorough objective exam of the athlete’s elbow and upper quarter, including key special examination maneuvers to test for ligamentous stability and tendon provocation.
3. Identify key differences between throwing athletes with an open and closed physis.
4. Understand how to identify common overuse injuries in the elbow such as humeral epicondylitis, and appropriately manage the athlete’s rehabilitation with a specific emphasis on return to sport.
5. Be able to appropriately manage the care of an athlete who has undergone ulnar collateral ligament reconstructive surgery, including introducing and advancing an interval throwing program.
6. Understand the common causes of various elbow fractures and how to manage both operative and
non-operative care.
7. Understand the common causes of various elbow dislocations and how to manage both operative and  non-operative care.
8. Be able to identify and differentiate valgus extension overload from olecranon stress fractures in throwing athletes and determine an appropriate course of rehab.
9. Understand the management of OCD lesions in overhead athletes.


Chapter 7
Wrist and Hand Injuries: Evidence in Sports Rehabilitation
Chris Juneau, PT, SCS, CSCS
Sports Residency Site Coordinator, Ironman Sports Medicine Institute

Russ Paine, PT
Director, Ironman Sports Medicine Institute

Eric Chicas, PT, SCS
Kevin Maloney, PT, SCS
Jaime Aparicio, PT, SCS
Jason Rivers, PTA
Ironman Sports Medicine Institute, Memorial Hermann Health System, Houston, Texas

David Hildreth, MD
Richmond Bone and Joint Clinics
University of Texas Physicians, Houston, Texas

Objectives
Upon completion of this course chapter, the reader will
1. Identify the most common types of sports related wrist and hand injuries.
2. Review and understand epidemiological incidences of each disorder along with common mechanics
and mechanisms of injury.
3. Identify complications and potential risks associated with each pathology.
4. Identify basic acute management strategies associated with each disorder.
5. Gain insight into pitfalls associated with each condition and pearls for improved management.
6.  Compare and contrast conservative versus surgical management of each and discuss the outcomes
associated with types of management.
7.  Identify outcome expectations, statistics, and long-term strategies related to the pathology.


Chapter 8
Hip Injuries: Evidence in Sports Rehabilitation
Lindsay Becker, PT, DPT, SCS, CSCS
Buckeye Performance Golf, Columbus, OH

David Kohlrieser, PT, DPT, OCS, SCS, CSCS
Orthopedic One, Columbus, OH

Michael Voight, PT, DHSc, OCS, SCS, ATC, FAPTA
Belmont University School of Physical Therapy, Nashville, TN

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Describe normal and abnormal hip anatomy and functional mechanics as related to pathology
2. Identify key components of an individual’s subjective history specific to hip differential diagnosis
3. Understand and be able to correctly perform the components of an evidence-based clinical examination of the hip
4. Interpret findings from evidence-supported clinical testing of the hip
5. Develop rehabilitation programs for non-operative hip conditions based on current evidence.
6. Understand post-surgical concepts and how to best minimize rehabilitation set-backs.


Chapter 9

Knee Injuries: Evidence in Sports Rehabilitation
Robert C. Manske, PT, DPT, MEd, SCS, ATC, CSCS
Professor and Chair, Department of Physical Therapy, Wichita State University
Via Christi Health Orthopedic and Sports Physical Therapy
Wichita, KS

Mark V. Paterno PT, PhD, MBA, SCS
Coordinator of Orthopaedic and Sports Physical Therapy
Acting Scientific Director, Division of Occupational Therapy and Physical Therapy
Associate Professor, Division of Sports Medicine
Cincinnati Children's Hospital Medical Center

Mark Reinking, PT, PhD, SCS, ATC
Dean, School of Physical Therapy, Regis University, Denver, Colorado

Sarah Reinking, PT, DPT, CSCS
Sports Physical Therapy Resident, Division of OT/PT- Sports Medicine and Orthopedics
Cincinnati Children’s Hospital Medical Center – Sports Medicine Biodynamic Center

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Identify general rhabilitation principles to allow a safe exercise progression following traumatic or overuse knee injuries.
2. Identify exercise activities that may cause detrimental stress to soft tissue or bony structures around the knee during rehabilitation following injury.
3. Understand various pathologies of the knee and how they relate to rehabilitation progression.
4. Identify strategies for anterior cruciate ligament prevention.
5. List various categories of patellofemoral pain.
6. Describe treatment progressions for those with patellofemoral pain syndrome.

Chapter 10
Ankle and Foot Injuries: Evidence in Sports MSK Rehabilitation
Walter L. Jenkins, PT, DHS, LATC, ATC
Professor and Chair, Department of Physical Therapy, College of Allied Health Sciences, East Carolina University
Greenville, North Carolina

Bryan Heiderscheit, PT, PhD
Professor, Department of Orthopedics and Rehabilitation, Professor, Department of Biomedical Engineering
University of Wisconsin-Madison, Madison, Wisconsin

D. S. Blaise Williams III, PT, PhD
Associate Professor, Department of Physical Therapy, Director of VCU Run Lab
Virginia Commonwealth University, Richmond, Virginia  

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Distinguish between lesions that may exist in the lower leg, ankle and foot.
2. Distinguish between traumatic and repetitive motion injuries at the lower leg, ankle and foot.
3. Differentiate between lesions involving the muscle-tendon structures or the ligamentous structures at
the lower leg, ankle and foot.
4. Design an evidence-based plan of care utilizing a mechanical approach for foot dysfunction.
5. Analyze a plan of care for best clinical practice for a patient with a repetitive motion injury involving the lower leg, ankle and foot.


Chapter 11
Evidence for Imaging Sports MSK Rehabilitation
Charles Hazle, PT, PhD
Associate Professor, Division of Physical Therapy, University of Kentucky

Terry R Malone, PT, EdD, ATC, FAPTA
Professor, Division of Physical Therapy, University of Kentucky

Michael D Rosenthal, PT, DSc, SCS, ECS, ATC, CSCS, CAPT, MSC, USN
Naval Medical Center, San Diego, CA

Objectives
Upon completion of this course chapter, the reader will:
1.  Identify the appropriate imaging modality for evaluation of selected musculoskeletal pathology in athletes.
2.  Understand the limitations of musculoskeletal imaging as related to athletic injuries and pathology.
3.  Develop an understanding of the American College of Radiology Appropriateness Criteria.
4.  Demonstrate understanding of clinical decision rules to guide selection of musculoskeletal imaging for acute knee, foot and ankle injury.
5.  Demonstrate understanding of evidence-based guidelines for the selection and recommendation of supplemental imaging for musculoskeletal injuries in athletes.


Chapter 12
Alternative Treatments  in MSK Rehabilitation
Phil Page, PT, PhD, ATC, CSCS, FACSM
Director of Research and Education, Performance Health
Baton Rouge, LA

Sue Falsone PT, MS, SCS, ATC, CSCS, COMT, RYT®
Founder, S&F: Structure and Function
Phoenix, AZ

Barton N. Bishop, DPT, SCS, TPI CGFI-MP2, CSCS
Chief Clinical Officer, Sport and Spine Rehab
Rockville, MD

Objectives
Following this SPTS home study course chapter, the participant will be able to
1. Understand the role of evidence and the placebo effect in adjunct and alternative therapies in sports physical therapy.
2. Describe the research supporting adjunct and alternative manual therapies, such as manipulation, instrument-assisted soft tissue mobilization, dry needling, and myofascial rolling.
3. Describe the research supporting adjunct and alternative modality therapies, such as cryotherapy, compression garments, and kinesiology taping.
4. Describe the research supporting adjunct and alternative exercise therapies, such as yoga and Pilates.
5. Describe the research supporting other common adjunct and alternative manual therapies in sports physical therapy, such as nutritional supplements, and injection therapies, such as platelet-rich plasma.

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