Common Muscle Injuries (The stages have been divided to help the NG identify the components of each but important to note that they are intertwined and often being evaluated/ progressed simultaneously)

(A)Baseline examination

(C) During rehab (objective milestones)if appropriate

(E) Prognosis/maintence/prevention

(B) Assessment/Re-assessment (flows into treatment)

(D) Return to Play/ Performance

  1. Injury type: index vs reccurent
  1. Mechanism of injury
  1. Clinical +/- imaging findings
  1. Aetiology:risk domains, risk and predisposing factors. Load vs Capacity
  1. Patient -Ideas.Concerns. Expectations(I.C.E.)Expectations/Eventual demands of the person's life/sport/competiton. Are they an average Jo or a G.I Joe!!? What do they want to get back to doing? How much time are they willing to dedicate to rehab? This needs to be identified.
  1. Stretch tolerance
  1. Isolated function

1.Palpation/tenderness/plot distance

  1. Dynamic function

Stretch

Shorten

  1. Plyometrics
  1. Running/Fitness (low volume/low intensity then increasing one but not the other then vice versa)
  1. Increasing the above and introduce power
  1. Assess tolerance toward injury mechanism is appropriate and if not reduced to tolerated aspect.
  1. Strength/endurance/control foundations at different lengths
  1. Recovery from rehab as well as recovery from injury

3.Psychological readiness (PROM etc)

  1. Performance (sport/job/hobby) related factors e.g. position/timetable/schedule/performing under fatigue/end of day/early morning
  1. Consensus among key stakeholders:patient, parents, coaches, managers, employers, personal trainers, S&C

Direct trauma/Indirect trauma

speak to classifications, different types

  1. Session 1/Day 1 Management P.O.L.I.C.E (important to clarify what is mean by protection and what is meant by optimal load e.g. optimal load for the muscle injury and the person i.e. condition uninjured body region at the highest possible intensity possible while respecting the person's baseline and respecting the pathology

Objective:

Subjective:

The presenting injury

The history of this injury

The context

Q.Do you remember how or when it happened?

What are your symptoms?

Where are they coming from?

How badly are you affected?

A. Immediate or gradual onset

Stretch or shorten

Has this happened before?

Do you have a Hx of other injuries in this area?

What else is going on (influencing factors/contributing factors)? pre season, stress at work, back from holiday, need a holiday! New gym programme etc

Observation: Skin, muscle bone. Observable difference side to side. Brusing, laceration, difference in muscle bulk (hypertrophy/atrophy)

Palpation: Which muscle is tender? Length of tenderness?Diffuse or local?

Stretch tolerance

Weightbearing

NWB

Isolated function

NWB

WB

Dynamic

Plyometirc

Locomotive

Straight forward case study to be padded out for at least hamstring but likley calf too.