Concussion 6 step process - Answer - No symptoms at rest for 24 hours
- Light aerobic exercise
- Sport specific exercise
- Non contact drills
- Contact practice drills
- Release
Recurring S/S of Concussion during the 6 step process - Answer Any S/S of concussion
at any stage then go back to rest for 24 hours and drop back a step
Spondylolysis - Answer - Injury to the pars interarticularis
- Presents as pain with low back extension
- Acquired stress fracture due to repetitive overload
Spondylolysis TX - Answer - Avoid hyperextension of the back and high impact sports
- Bracing may help symptoms but no change in outcome in studies
, - May return to sports when asymptomatic
- Stretching of ham strings
- Work on core and back strengthening
Spondylolisthesis - Answer - Bilateral pars injury with vertebral slippage
- Back pain with extension
- Hyperlordosis
Spondylolisthesis TX - Answer - Treat symptoms
- Brace may help
- If surgery is required, cannot return to sports activity for at least one year
Low back pain - Answer - Consider nerve root impingement if leg pain is > back pain
- Estimated that 80% of episodes resolve spontaneously within 2 weeks & 90% in 6
weeks
Low back pain Exam - Answer - Examine patient carefully- standing, sitting, supine, then
prone
- Motor strength and DTRs- check bilaterally
- Prone position to palpate SI joints and spine for tenderness
Cauda Equina Syndrome - Answer - Bowel or bladder symptoms, "saddle anesthesia",
loss of anal sphincter tone or incontinence, LE weakness
- Emergency, Refer immediately
S/S of back pain and concerning for malignant process - Answer - Weight loss
- Severe pain for > 6 weeks
- Nocturnal or pain at rest
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