Muscle Hypertrophy and Achilles Tendinopathy Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary principle for muscle hypertrophy according to the summary?

Reduce comfort during workouts.

More volume leads to more hypertrophy. (correct)

Train with low volume.

Focusing solely on aerobic activities.

Which approach is recommended for loading to strengthen bones?

Begin with slow, higher reps and progress to fast reps. (correct)

Load moderately and slowly at all times.

Train consistently at the same intensity.

Focus exclusively on endurance training.

What is indicated about training to failure in the context of muscle loading?

Training to failure is crucial for muscle growth.

Training volume should always be maximized.

Consider keeping 1-3 reps in reserve. (correct)

It is essential to push beyond personal limits.

How is the likelihood ratio (LR) calculated according to the diagnostic interpretation?

Probability of a finding in patients with a disease compared to those without. Signup and view all the answers

What does the phrase 'loading should exceed activity' refer to?

More of the same training will not result in stronger bones. Signup and view all the answers

What is the primary goal of load management in the treatment of Achilles tendinopathy?

To enable continued activities Signup and view all the answers

What test is commonly associated with diagnosing an Achilles tendon rupture?

Thompson test Signup and view all the answers

What treatment approach is taken for managing subclinical tendon pathology in Achilles tendinopathy?

Progressive loading and controlled motion Signup and view all the answers

Which of the following is NOT a recommended strategy for treating Achilles tendon issues?

Inactivity and rest for all patients Signup and view all the answers

When are forces on the Achilles tendon typically the greatest?

During rapid running Signup and view all the answers

What is a recommended heel lift height to reduce load on the Achilles tendon?

6-9 mm Signup and view all the answers

Which modification should be avoided to help reduce strain on the Achilles tendon?

Hill running Signup and view all the answers

In a biomechanically informed rehabilitation program, which type of exercises should be prioritized first?

Heavy resistance training Signup and view all the answers

Which shoe feature is mentioned as a beneficial option for managing Achilles tendon loads?

Rocker sole Signup and view all the answers

Which of the following activities should be reduced to aid in recovery from Achilles tendon issues?

Jumping exercises Signup and view all the answers

At what age does the risk for tendon issues notably increase?

<blockquote> 40 years old </blockquote> Signup and view all the answers

Which demographic is more commonly affected by tendon problems?

Males Signup and view all the answers

What is the sensitivity of the Royal London Hospital Test?

0.54 Signup and view all the answers

What does a positive result in the pinch test indicate?

Pinch pain decreases with dorsiflexion Signup and view all the answers

Which nerve involvement is assessed through hip flexion pain?

Sural nerve Signup and view all the answers

What are the criteria for a positive likelihood ratio (LR) in the context given?

+LR ≥ 5.0, -LR ≤ 0.2 Signup and view all the answers

What is the minimal clinically important difference (MCID) for Achilles tendinopathy according to the given data?

6.5 points Signup and view all the answers

Which of the following is NOT a component of the sural nerve provocation test?

Ankle hyperextension Signup and view all the answers

What pain level is considered safe during tendon-loading exercises?

0-3/10 Signup and view all the answers

What is the acceptable pain level range during tendon rehabilitation?

3-5/10 Signup and view all the answers

Which phase involves bilateral to unilateral progression in plyometric exercises?

Phase III Signup and view all the answers

What is the recommended action if a patient experiences pain greater than 5/10 during exercises?

Adjust the exercise intensity downwards Signup and view all the answers

What is the main observation regarding prior Achilles tendon pain and future injury risk?

It does not impact the risk of future ruptures Signup and view all the answers

What does the pain monitoring model indicate for levels of 6-10/10?

It is categorized as excessive pain Signup and view all the answers

During which phase should heavy slow resistance exercises be continued?

Phase IV Signup and view all the answers

What is the best barometer for assessing recovery during tendon rehabilitation?

Increase in usual pain upon waking Signup and view all the answers

What is one of the primary functions of the foot and ankle during movement?

Base of support Signup and view all the answers

Which technique involves the subtalar joint locking out during movement?

Windlass mechanism Signup and view all the answers

What type of examination is scheduled for Tuesday, 12/3?

Mobilization techniques Signup and view all the answers

What specific physical activity has a measured speed of 1.3 m/s?

Walking Signup and view all the answers

Which of the following is NOT one of the diseases discussed in the foot and ankle schedule?

Arthritis Signup and view all the answers

What is the primary focus during the lab session on 11/21?

Tendinopathy examination Signup and view all the answers

Which muscle forces are measured as part of the data on muscular contributions to running?

Calf and thigh muscles Signup and view all the answers

What is the purpose of the lab scheduled for Wednesday, 12/04?

Proprioception skills check Signup and view all the answers

Which date corresponds to the FOOT AND ANKLE WRITTEN EXAM?

Tuesday, 12/10 Signup and view all the answers

What is the significance of the rigid lever arm function of the foot and ankle?

To assist in propulsion Signup and view all the answers

Study Notes

Foot and Ankle Pathology: 2024

Presented by Evie Tate, DPT, CSCS and Rich Willy, DPT, PhD, School of Physical Therapy and Movement Science, University of Montana
Course material includes lectures and labs covering foot and ankle pathologies.
Topics include: tendinopathies, fasciopathy, tendon rupture, tendon ruptures and ankle sprains, ankle sprain and fracture, bone stress injuries, foot injuries, mobilization, taping, bracing, and case studies.
Schedule includes dates, times, and activities for each lecture/lab session.
A 14-hour lecture session is scheduled.
A 10-hour lab session is in the schedule.
2-hour exam is scheduled.
A written exam for Foot and Ankle is scheduled on Tuesday, 12/10.

Foot and Ankle: Important Points

The foot and ankle play a vital role in movement, supporting a significant portion of total body weight during walking and running.
The foot and ankle possess three crucial functions: base of support, adaptive mechanism, and rigid lever arm (for toe-off).
The subtalar joint unlocks, enabling the windlass mechanism, for toe-off.
Muscle forces are substantial during running, with the soleus muscle significantly more active than other muscles.
Plantarflexor muscle forces are high due to various anatomical and biomechanical factors.
Internal torque in the foot and ankle almost always exceeds external torque.
Dorsiflexion dominates stance phases of both walking and running.
Tissue homeostasis is vital in injury prevention, and stress shielding is as detrimental as tissue overload.
Loading stimulates cell response in muscles, bones, tendons, and cartilage.
Simple, capacity-building exercises are more effective than complex, unstable-surface exercises for improving force production and strength.

Quiz

The highest Achilles tendon loads occur during the impact or midstance phase in running.

Tendinopathy

Loss and disruption of collagen structure, thinning of collagen fibers, and fatty infiltration are key characteristics in tendinopathy.
Insertional vs. mid-substance tendinopathy requires different treatment approaches.
Insertional tendinopathy often arises due to compression, and there are other sources of compression to be considered.

Paratenonitis

Paratenonitis or inflammation of the connective tissue sheath, the paratenon, that surrounds the tendon is a condition involving the tendon sheath, characterized by pain that improves with hopping.

Achilles Tendinopathy Risk Factors

Reduced plantarflexor strength
Loss of tendon stiffness
Systemic contributors
Psychological factors
Previous history of injury
Male gender >35 years of age
Fluoroquinolone use
Family history.

Clinical Reasoning Framework: Achilles Tendinopathy

Subjective factors, including patient history and symptoms.
Objective factors including provocative tests and physical measurements.

Clinical Reasoning Framework (General)

Subjective data (patient history, symptoms).
Objective data (provocative tests, measurements).
Pre-test hypothesis
Tests to rule in/out hypothesis
Post-test hypothesis.

Treatment Framework

Adaptations in load to address the demands on the damaged tissue.
Use of mechanotherapy.
Gradually return to activities.

Most common pathologies

Tendinopathy (Achilles, plantar fasciitis).
Fractures (unimalleolar, bone stress, tibial), nerve injury (tarsal tunnel).
Tendon rupture (Achilles)
Ligament sprain (lateral ankle).
Muscle strain/tears (medial gastrocnemius)

Relevant Outcome Measures

VISA-A
ATRS
FAAM
LEFS, for outcome assessment in foot and ankle injuries.

Red Flags

Bilateral lower-leg pain with associated neural/paresthesia presentations.
DVT
Rule out plantar fasciopathy, and sural nerve pain.
Unilateral leg pain due to lumbar radiculopathy
Calf strain/Tennis leg
Heel pad syndrome/calcaneal stress fracture
Popliteal artery entrapment syndrome.

Severs Disease

A condition in adolescents (7-15 years) characterized by pain in the heel, often exacerbated by weight-bearing activities.
Diagnosis often entails evaluating active plantarflexion and passive dorsiflexion, as well as assessing ROM and potential shortened ankle plantarflexors with loading activities.
Heel Squeeze test.

Sever's Disease: Treatment

Heel lift (10-12 mm) to reduce plantarflexor loads.
Limit activities that exacerbate pain.
Active calf stretching
Soft tissue mobilization of the calf muscles.
Team approach.

Differentiation Tests (for various injuries)

Special or provocative tests, crucial for distinguishing between conditions with similar symptoms.
Always rule out other possible diagnoses before definitive treatment decisions.

Treatment of Specific Condition

Address specific etiology and underlying pathology for each diagnosis.
Utilize load modifications, mechanotherapy, and graded exposure to increase tissue tolerance.

Foot and Ankle Specific Outcome Measures

Clinicians should utilize clinical findings to grade the condition.
Assessment of level of function, presence of hemorrhaging.
Point tenderness (for e.g. ATFL or CFL).
Total ankle motion, swelling with figure-8 test.
Grade based on pain.

Treatment Goals (for various injuries)

Protective phase (immediate post-injury) involves protecting injured structures from re-injury, pain management, swelling control, assessing range of motion, and neuromuscular control/strength.
Subacute/Maturation phase, involve gradual movement to progressively bear weight with supports, then strengthening. Re-establishing ROM, proprioception, and agility, including functional, sport-related skill development.

Physical Agents

Cryotherapy (cold), Diathermy (heat), Electrotherapy (other interventions), Low-level laser therapy, Should NOT use Ultrasound.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your understanding of key concepts related to muscle hypertrophy and the treatment of Achilles tendinopathy. This quiz covers principles of loading, diagnostic interpretations, and treatment strategies. Enhance your knowledge about effective rehabilitation and injury management techniques.