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Sportkinesitherapie 1 samenvatting: theorie, praktijk en te kennen artikelen
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  • 2 februari 2024
  • 12 februari 2024
  • 199
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SV: sportkine 1




1

, Inhoudstabel
SV: sportkine 1 ............................................................................................................................ 1
Inhoudstabel............................................................................................................................... 2
THEORIE ...................................................................................................................................... 9
1. Epidemiology of sport injuries ...................................................................................... 10
1.1 Definities ................................................................................................................ 10
2 Load Management ........................................................................................................ 12
2.1 Termen: .................................................................................................................. 12
2.2 Loadability bij kinderen .......................................................................................... 12
2.2.1 Needs analyse ............................................................................................................ 12
2.2.2 Conclusie Load management bij jonge atleten: ........................................................ 16
2.3 Loadability bij revalidatie ....................................................................................... 16
2.3.1 Groei opvolgen ifv blessure bij voetballers ............................................................... 16
2.3.2 Conclusie: loadmanagment in revalidatie ................................................................. 17
2.4 Loadmanagement bij (elite) atleten....................................................................... 18
2.4.1 Mindset...................................................................................................................... 18
2.4.2 Training load effects................................................................................................... 18
2.4.3 Load monitorring methodes ...................................................................................... 18
2.4.5 Bloed monitorring ..................................................................................................... 20
2.4.6 Speeksel monitorring................................................................................................. 20
2.4.7 Load monitorring methodes ...................................................................................... 20
2.4.8 Conclusie: .................................................................................................................. 21
2.5 Samenvatting.......................................................................................................... 21
2.6 Casussen:................................................................................................................ 21
2.6.1 Casus 1: ...................................................................................................................... 21
2.6.2 Casus 2: ...................................................................................................................... 22
2.6.3 Casus 3: ...................................................................................................................... 23
3 Rehabilitating the anterior cruciate ligament: best practices applied to (professional)
soccer players ....................................................................................................................... 25
3.1 Inleiding .................................................................................................................. 25
3.1.1 Anatomie en functie van ACL .................................................................................... 25
3.1.2 Veelvoorkomende blessuremechanisme in voetbal.................................................. 26
3.1.3 Risicofactoren van letsel en herletsel ........................................................................ 27
4 EHBO + assessment/behandelprotocollen in sportrevalidatie ..................................... 36
4.1 Inleiding .................................................................................................................. 36

2

, 4.2 Sportblessures ........................................................................................................ 37
4.2.1 Bleinen: ...................................................................................................................... 37
4.2.2 Snijwonden ................................................................................................................ 38
4.2.3 schaafwonden ........................................................................................................... 38
4.2.4 bloedneus .................................................................................................................. 39
4.2.5 Tandletsels ................................................................................................................. 39
4.2.6 Oog letsels ................................................................................................................. 40
4.2.7 Geslachtsdelen: ......................................................................................................... 40
4.2.8 Flauwvallen: ............................................................................................................... 41
4.2.9 Breuken:..................................................................................................................... 42
4.2.10 Luxaties ...................................................................................................................... 42
4.2.11 Verstuikingen: ............................................................................................................ 43
4.2.12 Spierkrampen ............................................................................................................ 43
4.2.13 spierscheuren: ........................................................................................................... 44
4.2.14 Peesscheur:................................................................................................................ 44
4.2.15 Epilepsie:.................................................................................................................... 44
4.2.16 Hersenschudding: ...................................................................................................... 45
5 hamstringblessures en FAI in hockeyspelers ................................................................. 46
5.1 Hamsteringsblessure .............................................................................................. 46
5.1.1 Anatomie ................................................................................................................... 46
5.1.2 Incidentie ................................................................................................................... 46
5.1.3 Classificaties............................................................................................................... 46
5.1.4 Mechanisme .............................................................................................................. 48
5.1.5 Risicofactoren ............................................................................................................ 49
5.1.5.1 Niet gemodificeerde .............................................................................................. 49
5.1.5.2 Gemodificeerde ..................................................................................................... 49
5.1.5.2.1 Samenvatting: .................................................................................................. 50
5.1.6 Behandeling ............................................................................................................... 50
5.1.6.1 Preventief .............................................................................................................. 50
5.1.6.2 Na scheur ............................................................................................................... 52
5.1.6.2.1 Kenmerken ...................................................................................................... 52
5.2 FAI ........................................................................................................................... 55
5.2.1 Definities .................................................................................................................... 55
5.2.2 Symptomen ............................................................................................................... 56
5.2.3 Etiologie ..................................................................................................................... 57
5.2.4 Onderzoek ................................................................................................................. 57

3

, 5.2.5 Behandeling ............................................................................................................... 59
6 sport-specific rehabilitation of track and field athletes: managing Javeling elbow and
jumper’s knee ....................................................................................................................... 62
6.1 introductie .............................................................................................................. 62
6.2 Javelin Elbow .......................................................................................................... 62
6.2.1 Anatomy and biomechanics of the elbow joint ......................................................... 63
6.2.2 Etiology en pathogenesis of Javelin Elbow ................................................................ 64
6.2.3 Clinical presentation, physical assessment and diagnosis ......................................... 65
6.2.4 Rehabilitation principles ............................................................................................ 66
6.2.5 Progressief oefenprogramma .................................................................................... 67
6.2.5.1 Fase 1: relatieve rust/ gemiddelde beweging (eerste 1-2 weken)......................... 67
6.2.5.2 Fase 2: intermediate phase (3-6 weken) ............................................................... 68
6.2.5.3 Fase 3: gevorderde krachttraining (week 7-…) ...................................................... 68
6.2.5.4 Fase 4: return to sport. .......................................................................................... 68
6.3 Jumpers knee ......................................................................................................... 69
6.3.1 Anatomy and biomechanics of the knee joint ........................................................... 69
6.3.2 Etiology and pathogenesis of jumper’s knee............................................................. 69
6.3.3 Clinical presentation, Physical assessment and diagnosis ......................................... 70
6.3.4 Rehabilitation principles for jumper’s knee............................................................... 72
7 shoulder instability ........................................................................................................ 74
7.1 Definitie .................................................................................................................. 74
7.1.1 Traumatische ............................................................................................................. 74
7.1.2 Atraumatisch ............................................................................................................. 74
7.2 Classificatie ............................................................................................................. 75
7.2.1 Stanmore principes.................................................................................................... 75
7.2.2 Risicofactoren ............................................................................................................ 76
7.3 Assessment ............................................................................................................ 76
7.4 Laxiteit .................................................................................................................... 78
7.5 Instabiliteit ............................................................................................................. 79
7.6 SLAP ........................................................................................................................ 80
7.7 Performance testen................................................................................................ 80
7.8 Neuromusculaire testen:........................................................................................ 81
7.9 ROM ....................................................................................................................... 82
7.10 Neurologisch onderzoek..................................................................................... 82
7.11 Medische beeldvorming ..................................................................................... 82
7.12 Operatie .............................................................................................................. 83

4

, 7.13 Assessment ......................................................................................................... 83
7.14 Management ...................................................................................................... 83
7.14.1 Making sense of pain ................................................................................................. 84
8 Chronic ankle instability ................................................................................................ 86
8.1 Anatomie ................................................................................................................ 86
8.2 Etiologie.................................................................................................................. 87
8.3 Onderzoek .............................................................................................................. 90
8.3.1 Mechanische beperkingen ........................................................................................ 90
8.4 Revalidatie .............................................................................................................. 95
9 Handwrist injuries (bij klimmers) .................................................................................. 97
9.1 Arthrokinematica ................................................................................................... 97
9.2 Common injuries .................................................................................................... 99
9.2.1 Injury classification .................................................................................................... 99
9.2.2 Types of injuries ......................................................................................................... 99
9.2.3 Pulleys ...................................................................................................................... 100
9.2.4 Wrist injuries............................................................................................................ 100
9.2.5 Scaphoid fractur ...................................................................................................... 101
9.2.6 SL ligament .............................................................................................................. 101
9.2.7 TFCC ......................................................................................................................... 103
9.3 General principles ................................................................................................ 105
9.3.1 Return to sport ........................................................................................................ 105
9.3.2 Options for rehab .................................................................................................... 105
10 achillespees tendinopathie en planning en periodisering bij duursporten............. 107
10.1 Inleiding ............................................................................................................ 107
10.2 Achillespees tendinopathie (AT) ....................................................................... 108
10.3 Management .................................................................................................... 109
10.3.1 Stages van de revalidatie ......................................................................................... 109
10.4 Revalidatie vs training ...................................................................................... 113
10.5 Take home ........................................................................................................ 115
11 Energiemanagement in sport .................................................................................. 116
11.1 Inleiding ............................................................................................................ 116
11.2 Algemene energie balans ................................................................................. 116
11.2.1 Slaap ........................................................................................................................ 117
11.3 Voeding ............................................................................................................. 121
11.4 Mentale energie ............................................................................................... 124


5

, 11.5 Stress ................................................................................................................ 127
11.6 Kopman wiel ..................................................................................................... 129
11.7 Conclusie .......................................................................................................... 130
PRAKTIJK ................................................................................................................................. 131
12 Blessurepreventieve screening ................................................................................ 132
12.1 Movement screen (FMS) .................................................................................. 132
12.2 Gerichte screening (Hylyght) ............................................................................ 132
12.3 Gebruik: ............................................................................................................ 133
12.4 Ontwikkeling van blessurepreventieve screening ............................................ 133
12.5 conclusie: .......................................................................................................... 136
13 Cycling (examen: niet alles te kennen, is duidelijk aangegeven) ............................. 137
13.1 Introductie ........................................................................................................ 137
13.2 Overuse injuries................................................................................................ 138
13.2.1 Metatarsalgia ........................................................................................................... 138
13.2.2 Anterieure kniepijn .................................................................................................. 138
13.2.3 Tendinopathie .......................................................................................................... 139
13.2.4 Valscular claudicatio intermittens (EXAMEN!!) ....................................................... 139
13.2.5 Saddle complaints.................................................................................................... 140
13.2.6 Low back pain .......................................................................................................... 141
13.3 Spierpatronen, biomechanica bij fietsers......................................................... 142
13.3.1 Rugpositie ................................................................................................................ 142
13.3.2 Pedalling technique ................................................................................................. 143
13.3.3 Time trail aerodynamics .......................................................................................... 143
14 Corestability bij (Top)sporters.................................................................................. 144
14.1 Joint by joint approach ..................................................................................... 144
14.2 Spierfunctie ...................................................................................................... 145
14.3 Joint by joint + spierfunctie .............................................................................. 145
14.4 Performance pyramid ....................................................................................... 145
14.5 Kinetische keten ............................................................................................... 145
14.6 Spierwerk.......................................................................................................... 146
14.6.1 Vezels ....................................................................................................................... 146
14.7 Parameters ....................................................................................................... 146
14.7.1 Ademhaling.............................................................................................................. 146
14.7.2 High load vs low load ............................................................................................... 146
14.7.3 Richting .................................................................................................................... 146
14.7.4 Duur, sets, reps ........................................................................................................ 146

6

, 14.7.5 Statisch vs dynamisch .............................................................................................. 146
14.7.6 Analytisch vs sport specifiek .................................................................................... 147
14.8 Leidraad ............................................................................................................ 147
14.9 Programma bouwen ......................................................................................... 147
15 Technology in rehab ................................................................................................. 149
15.1 Jump testing ..................................................................................................... 150
15.2 Stretch shorten cycle ........................................................................................ 150
15.3 Chaos model ..................................................................................................... 151
15.4 Neurocognitieve aids ........................................................................................ 151
LITERATUUR ............................................................................................................................ 152
H1: Van Wilgens (2012) A qualitative study on overuse injuries: the beliefs of athletes
and coaches ................................................................................................................. 153
H3: MOON KNEE GROUP: POSTOPERATIEF PROTOCOL ACL ........................................ 154
H3: Aspetar guidelines................................................................................................. 172
H3: Noehren (2020) Who’s afraid of the big bad wolf? Open-chain exercises after ACL
recontractie ................................................................................................................. 176
H3: Chaabon (2023) think outside the box: incorporating secondary cognitive tast into
return to sport testing after ACL recontruction........................................................... 178
H5: Bourne (2018) An evidence-based framework for strengthening exercises to
prevent hamstring injury. ............................................................................................ 180
H5: Martin (2022) Hamstering injuries in sport .......................................................... 181
H5: Martin (2022) Clinical Practice Guidelines: Hamstering Strain Injury in Athletes . 182
H5: Mendiguchia (2017) A multifactorial, criteria-based progressive algorithm for
hamstring injury treatment. ........................................................................................ 184
H5: Griffin (2016) The Warwick agreement on femoroacetabular impingement
syndrome (FAI syndrome): an international consensus statement. ............................ 184
H5: Kemp (2020): Physiotherapist-led treatment for young to middleaged active adults
with hip-related pain: consensus recommendations from the International Hip-related
Pain Research Network, Zurich 2018 ........................................................................... 185
H6: Throwers Ten Exercise Program ............................................................................ 186
H6: Visa-P-meetinstrument ......................................................................................... 188
H6: Malliares 2015 Patellar Tendinopathy: Clinical Diagnosis, Load management, and
advice of challenging case presentations .................................................................... 189
H7: Schwank (2022): Bern Consensus Statementon Shoulder Injury Prevention,
Rehabilitation, and Return to Sport forAthletes at All Participation Levels ................ 190
H7: Delahunt (2018) Clinical assessment of acute lateral ankle sprain injuries (ROAST):
2019 consensus statement and recommendations of the International Ankle
Consortium .................................................................................................................. 192
H7: Martin (2021) lateral ankle sprains revision 2021 ................................................ 194

7

,H8: Garcia Elias (2013): Understanding Wrist Mechanics: A Long and Winding Road 196
H8: Lötters 2018 SMoC-Wrist: a sensorimotor control-based exercise program for
patients with chronic wrist pain .................................................................................. 197
H15: Taberner (2023): Progressing On-Court Rehabilitation After Injury: The Control-
Chaos Continuum (CCC) Adapted to Basketball .......................................................... 198




8

,THEORIE




9

, 1. Epidemiology of sport injuries

1.1 Definities

case 1 individu met een blessure

Prevalence Het aantal huidige gevallen in een
specifieke populatie
Incident Nieuwe episode van letsels

Incidence De frequentie van deze incidenten (=
frequentie van de nieuwe gevallen)
Incidence rate Het aantal nieuwe gevallen in een bepaalde
populatie gedurende een bepaalde tijd.

RR = kijken naar het RISICO
- Kijken naar het risico van de ene groep op het risico van de andere groep.



OR = kijken naar de KANS
- Kijken naar de kans van een gebeurtenis van de ene groep op de kans van een gebeurtenis
van de andere groep




risico = kijken naar u totale groep
kans = kijken naar de kans dat je het niet hebt op dat je het wel hebt

definitie sportsinjury
= schade aan weefsel van het lichaam dat ontstaat als gevolg van sport of lichaamsbeweging
waarvoor vrij moet worden genomen en of medische consultatie nodig is.

Time loss De tijd die je verliest totdat je speelklaar bent
Recovery Wanneer je terug in staat bent om te spelen en
deel te nemen aan wedstrijden
Recurrent injuries Terugkerende blessure op dezelfde plaats nadat
je terug op volledig niveau gespeeld hebt.

Acuut = fractuur, luxatie, botsing, verstuiking,…
Chronisch = tendiopathie, bursitis, stress fracture,…

De termen “acuut” en “chronisch” zijn in de literatuur vrij onduidelijk en worden vaak te pas en te
onpas gebruikt. Let hiervoor op.




10

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