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Copyright, iv
Acknowledgements, vii
Contributors, ix
Reviewers, xi
Preface, xiii
Part 1. The Basics, 1
Chapter 1. Foundations Of Musculoskeletal Injury, 3
Musculoskeletal Definition, 4
Hard Tissue, 4
Soft Tissue, 5
Classification and Mechanisms of Musculoskeletal Injury, 9
Acute Injury, 10
Chronic Injury, 12
Soft Tissue Conditions, 12
Muscle Soreness, 12
Tendinopathies, 13
Muscle Contusion and Myositis Ossifican, 14
Strain, 15
Muscle Spasm, 16
Sprain, 16
Dislocation, 16
Bursitis, 16
Neuropathies, 17
Compartment Syndrome, 17
Bone Conditions, 17
Fractures, 17
Conditions of the Apophysis, 18
Conditions of the Epiphysis, 19
Avascular Necrosis, 19
Arthritis, 20
Gender Differences and Musculoskeletal Injury, 20
Chapter 2. The Pre-participation Examination, 25
Goals and Objectives, 26
Professionals Approved to Perform a PPE, 26
Timing and Frequency, 27
Timing for Interscholastic and Intercollegiate Athletes, 27
Frequency for Interscholastic and Intercollegiate Athletes, 28
Timing and Frequency for Nonathletic Populations, 28
Portions of the PPE, 28
Introduction, 29
History, 29
Physical Examination, 30
Variations for Specific Populations, 34
Life Span, 34
Individuals with Special Needs, 38
Disqualification and Legal Consideration, 38
Factors Affecting a Patient’s Ability to Participate, 39
Legal Considerations, 46
Chapter 3. Physical Fitness, 53
Physical Activity, Exercise, and Physical Fitness, 54
Physical Activity, 54
Exercise, 55
Physical Fitness, 55
Health Benefits of Physical Activity and Exercise, 55
Physiological Adaptations, 55
Reduction of Disease Risk, 57
Maintenance of Functional Fitness, 57
Improvement of Psychological Well-Being, 57
Increase in Longevity and Quality of Life, 57
Exercise Variables, 57
Frequency and Intensity, 58
Time (Duration) and Type (Mode), 58
Principles of Training, 59
Progressive Overload, 59
Specificity, 59
Reversibility, 59
Recuperation, 60
Individual Differences, 60
Body Composition, 60
Bioelectrical Impedance, 61
Skinfold Measurements, 61
Body Mass Index, 61
Waist Circumference, 62
Exercise Programming, 63
Warm-Up, 63
Flexibility Exercise, 64
Cardiorespiratory Endurance Exercise, 64
Muscular Strength and Endurance Exercise, 67
Cool-Down, 70
Behavior Modification Principle, 70
Stages of “Readiness to Change” Model, 70
Goal Setting, 71
Overcoming Barriers, 73
Fitness for Special Populations, 74
Obese and Overweight, 74
Elderly, 74
Children and Adolescents, 75
Pregnant Women, 76
Diabetics, 76
Asthmatics, 78
People With Coronary Artery Disease, 79
Chapter 4. Nutrition For The Primary Health Care Provider, 85
Basic Nutrition, 86
Macronutrients, 86
Micronutrients, 93
Water, 95
Nutrition and Body Weight, 96
The Physiology of Weight Control, 97
Using Proper Nutrition to Obtain and Maintain a Healthy Body Weight, 97
What to Eat: Simplified, 101
Additional Issues, 103
Eating Disorders, 103
Female Athlete Triad, 105
Frequently Asked Questions, 105
Can I get rid of fat cells?, 105
I’m genetically predisposed to obesity. Is there anything I can do about it?, 106
How does aging affect body weight?, 106
What is my ideal body weight?, 106
How do I lose weight from my waist, hips, and thighs?, 106
Should I take diet pills?, 107
Does eating a large meal before bedtime cause me to gain weight?, 107
Is cellulite different from fat?, 107
Chapter 5. The Inflammation Process, 113
Inflammatory Process, 114
Reactive Phase, 116
Repair and Regeneration Phase, 119
Maturation Phase, 122
Common Problems of Soft Tissue Healing, 122
Scar Tissue Proliferation and Adhesion Development, 123
Chronic Inflammation, 123
Chapter 6. Therapeutics, 127
Goals of Physical Modality and Pharmacotherapy Interventions, 128
Initial Treatment of Inflammation, 129
Protect, 129
Rest, 130
Ice, 130
Compress, 130
Elevate, 131
Cryotherapy, 133
Physiological Effects on Human Tissue, 134
Treatment Misconceptions, 135
Treatment Parameters, 137
Patient Education, 138
Modes of Application, 139
Contraindications and Precautions, 143
Superficial Thermotherapy, 144
Physiological Effects on Human Tissue, 144
Treatment Parameters, 145
Patient Education, 145
Modes of Application, 146
Contraindications and Precautions, 147
Contrast Therapy, 148
Pharmacotherapy, 148
NSAIDs, 149
Acetaminophen, 151
Opioids, 152
Determining Drug and Dosage, 153
Part 2. Orthopedic Conditions, 161
Chapter 7. Introduction To Orthopedic Evaluation, 163
History, 164
History of the Injury, 164
Pain Assessment, 165
Physical Examination, 166
Observation, 166
Palpation, 167
Range-of-Motion and Strength Testing, 168
Stress and Special Testing, 170
Musculoskeletal Imaging, 173
Plain-Film Radiography, 173
Bone Scan, 174
Computed Tomography, 174
Magnetic Resonance Imaging, 175
Chapter 8. Conditions Involving The Foot, Ankle, And Leg, 179
Anatomy of the Foot, Ankle, and Leg, 180
Bones and Joints (Figs. 8.1 and 8.2), 180
Motions, 182
Ligaments, 183
Muscles and Tendons, 185
Related Structures, 187
Examination of the Foot, Ankle, and Leg, 188
History, 188
Physical Examination, 189
Musculoskeletal Imaging, 192
Conditions of the Foot, 193
Pronation and Pes Planus, 194
Traumatic Fractures, Sprains, and Dislocations, 194
Metatarsophalangeal Joint Sprain of the First (Great) Toe, 196
Metatarsal Stress Fractures, 197
Metatarsalgia, 199
Plantar Fasciitis, 200
Conditions of the Ankle, 201
Lateral Ankle Sprain, 202
Medial Ankle Sprain, 207
Conditions of the Leg, 208
Syndesmosis Sprain, 208
Medial Tibial Stress Syndrome, 210
Anterior Compartment Syndrome, 213
Calcaneal Tendon and Retrocalcaneal Bursa Overuse Pathologies, 215
Calcaneal Tendon Rupture, 217
Lifespan Considerations, 220
Sever’s Disease, 220
Freiberg’s Infraction, 221
Chapter 9. Conditions Involving The Knee And Thigh, 227
Anatomy of the Knee, 228
Bones and Joints (Fig. 9.1), 228
Motions, 229
Ligaments, 230
Muscles and Tendons, 233
Menisci, 233
Related Structures, 234
Examination of the Knee, 235
History, 235
Physical Examination, 235
Musculoskeletal Imaging, 238
Conditions of the Tibiofemoral Joint, 239
Collateral Ligament Sprains, 239
Cruciate Ligament Sprains, 242
Meniscal Tears, 247
Unhappy Triad, 249
Conditions of the Patellofemoral Joint, 250
Mechanical Factors Associated With Patellofemoral Pathology, 250
Chondromalacia Patella, 250
Patellar Tendonitis and Rupture, 252
Acute Dislocation/Subluxation and Chronic Subluxation of the Patella, 254
Prepatellar Bursitis, 256
Conditions of the Thigh, 256
Quadriceps Strain and Contusion, 256
Hamstring Strain, 258
Lifespan Considerations, 260
Sinding-Larsen-Johansson Disease, 260
Osgood-Schlatter Disease (Tibial Tubercle Apophysitis), 261
Salter-Harris Fracture, 262
Chapter 10. Conditions Involving The Hip, Pelvis, And Sacral And Lumbar Spines, 267
Anatomy of the Hip, Pelvis, and Sacral and Lumbar Spines, 268
Bones and Joints, 268
Motions, 272
Ligaments, Bursae, Nerves, and Intervertebral Disks, 273
Muscles and Tendons, 274
Examination of the Hip, Pelvis, and Sacral and Lumbar Spines, 277
History, 278
Physical Examination, 278
Musculoskeletal Imaging, 284
Conditions of the Hip, Pelvis, and Sacrum, 287
Contusion to the Iliac Crest (Hip Pointer), 287
Snapping Hip Syndrome and Greater Trochanter Bursitis, 290
Adductor Strain (Groin Strain), 291
Sacroiliac Joint Dysfunction, 292
Conditions of the Lumbar Spine, 296
General Low Back Pain, 296
Intervertebral Disk Herniation, 297
Spondylolysis and Spondylolisthesis, 300
Lifespan Considerations, 303
Hip Degeneration (Osteoarthritis), 303
Avascular Necrosis, 303
Legg-Calvé-Perthes Disease, 304
Slipped Capital Femoral Epiphysis, 304
Apophyseal Avulsion Fractures, 305
Chapter 11. Conditions Involving The Cervical Spine, Shoulder Complex, And Arm, 311
Anatomy of the Cervical Spine, Shoulder Complex, and Arm, 312
Bones and Joints, 312
Motions, 314
Ligaments, Bursae, Nerves, and Intervertebral Disk, 317
Muscles and Tendons, 318
Examination of the Cervical Spine, Shoulder Complex, and Arm, 322
History, 323
Physical Examination, 325
Musculoskeletal Imaging, 328
Conditions of the Cervical Spine, 329
Cervical Radiculopathy, 329
Brachial Plexus Injury, 331
Conditions of the Glenohumeral Joint, 331
Acute Dislocation of the Glenohumeral Joint, 332
Recurrent Glenohumeral Joint Instability, 337
Conditions of the Acromioclavicular and Sternoclavicular Joints, 338
Acromioclavicular Joint Sprain, 338
Sternoclavicular Joint Sprain, 340
Conditions of the Clavicle, 343
Clavicular Fracture, 343
Osteolysis of the Distal Clavicle, 344
Conditions of the Rotator Cuff and Subacromial Structures, 345
Subacromial Impingement Syndrome, 345
Rotator Cuff Tears, 346
Conditions of the Long Head of the Biceps Brachii Tendon, 350
Tendonitis, Subluxation, and Dislocation, 350
Biceps Rupture, 353
Lifespan Considerations, 354
Adhesive Capsulitis, 354
Chapter 12. Conditions Involving The Elbow, Forearm, Wrist, And Hand, 361
Anatomy of the Elbow, Forearm, Wrist, and Hand, 362
Bones and Joints (Figs. 12.1 and 12.2), 362
Motions, 365
Ligaments, Bursae, and Nerves, 365
Muscles and Tendons, 369
Examination of the Elbow, Forearm, Wrist, and Hand, 371
History, 372
Physical Examination, 373
Musculoskeletal Imaging, 376
Conditions of the Elbow, 378
Collateral Ligament Sprains, 378
Elbow Ulnar Nerve Neuropathies, 380
Dislocation, 381
Olecranon Bursitis, 382
Epicondylitis, 383
Conditions of the Forearm, 386
Fractures and Dislocations, 386
Compartment Syndrome, 388
Conditions of the Wrist, 389
Carpal Fractures, 389
Wrist Sprains, 393
Carpal Tunnel Syndrome, 394
Wrist Ulnar Nerve Neuropathy, 395
de Quervain’s Syndrome, 396
Conditions of the Hand, 396
Traumatic Metacarpal Fractures, 397
Traumatic Metacarpal Sprains and Dislocations, 398
Ulnar Collateral Ligament Sprain of the Thumb’s Metacarpophalangeal Joint, 400
Traumatic Fractures of the Finger Phalanges, 401
Traumatic Phalangeal Sprains and Dislocations, 402
Traumatic Distal Interphalangeal Joint Tendon Injuries, 403
Traumatic Proximal Interphalangeal Joint Tendon Injuries, 404
Lifespan Considerations, 404
Little League Elbow, 405
Part 3. Conditions Involving Other Systems, 411
Chapter 13. Conditions Involving The Head And Face, 413
Anatomy of the Head and Face, 414
Bones and Joints, 414
Scalp, 414
Brain, 415
Eye, 416
Ear, 416
Nose, 417
Mouth, 419
Cranial Conditions, 419
Mechanisms of Injury, 420
Mild Traumatic Brain Injury (Concussion), 421
Postconcussion Syndrome, 428
Second Impact Syndrome, 429
Focal Brain Lesions, 429
Maxillofacial Conditions, 430
Mechanisms of Injury, 430
Conditions Involving the Eye, 431
Conditions Involving the Ear, 433
Conditions Involving the Nose, Mouth, and Jaw, 434
Chapter 14. Conditions Involving The Thorax, Abdomen, And Genitalia, 443
Anatomy of the Thorax, Abdomen, and Genitalia, 444
Bones and Joints, 444
Muscles and Ligaments, 445
Thoracic Cavity, 446
Abdominal Cavity, 447
Genitalia, 448
Conditions of the Thorax, 448
Mechanisms of Injury, 448
Chest Wall Injury, 449
Intrathoracic Injury, 452
Conditions of the Abdomen, 453
Mechanisms of Injury, 454
Abdominal Wall Injury, 454
Intra-abdominal Injury, 456
Conditions of the Genitalia, 461
Mechanisms of Injury, 461
Conditions Involving the Male, 461
Conditions Involving the Female, 463
Chapter 15. Conditions Involving The Skin, 467
Anatomy of the Skin, 468
Functions of the Skin, 469
Mechanisms of Injury, 469
Preventing Skin Infections, 470
Fungal Conditions, 471
Tinea Corporis, 471
Tinea Cruris, 471
Tinea Pedis, 472
Disqualification and Return-to-Ply Decisions for Patients With Fungal Infections, 473
Viral Conditions, 473
Herpes Simplex Virus, 473
Molluscum Contagiosum, 474
Verruca Plantaris, 475
Bacterial Conditions, 475
Impetigo Contagiosa, 475
Folliculitis and Furunculosis, 477
Community-Acquired Methicillin-Resistant, 477
Inflammatory Conditions, 478
Glossary, 483
Index, 495
Index Of Disorders, 511

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