CCSP Adjunctive Sports Therapies 5 — Questions and Answers
Question 1: During iontophoresis application on a pitcher's elbow, which parameter determines the total ionic medication dose delivered to tissue?
- Current frequency in hertz
- Current amplitude in milliamps times treatment time in minutes (mA·min) (Correct answer)
- Electrode polarity alone
- Electrode size relative to the treatment area
Correct answer: Current amplitude in milliamps times treatment time in minutes (mA·min)
Iontophoretic dose is calculated as current (mA) × time (min), with a typical therapeutic dose of 40–80 mA·min ensuring adequate drug ion migration.
Question 2: A cross-country skier is treated with cupping therapy for thoracic myofascial pain. The characteristic round skin discolorations post-treatment result from:
- Thermal burns from heat applied inside the cup
- Extravasation of red blood cells into the dermis due to negative pressure (Correct answer)
- Allergic reaction to the cup material
- Increased melanin production triggered by suction
Correct answer: Extravasation of red blood cells into the dermis due to negative pressure
The negative pressure created by cupping draws blood into the local tissue, causing capillary rupture and RBC extravasation that appears as round ecchymotic marks.
Question 3: In aquatic therapy for a post-operative ACL athlete, the primary advantage of exercising in chest-deep water is:
- Increased gravitational load to stimulate bone density
- Approximately 75% reduction in effective body weight reducing joint compressive forces (Correct answer)
- Elimination of proprioceptive input to challenge balance
- Higher resistance than land-based exercise at equivalent speeds
Correct answer: Approximately 75% reduction in effective body weight reducing joint compressive forces
Buoyancy in chest-deep water unloads approximately 75% of body weight, allowing early weight-bearing exercise with significantly reduced tibiofemoral compressive forces.
Question 4: Electrical muscle stimulation (EMS) is applied to a volleyball player's quadriceps post-ACL reconstruction. Which pulse frequency BEST produces a tetanic contraction for strengthening purposes?
- 1–4 Hz (twitch contractions)
- 50–80 Hz (tetanic contraction) (Correct answer)
- 150–200 Hz (high-frequency nerve block)
- 500 Hz (carrier frequency only)
Correct answer: 50–80 Hz (tetanic contraction)
Frequencies of 50–80 Hz fuse individual muscle twitches into a sustained tetanic contraction sufficient to generate therapeutic strengthening forces.
Question 5: A CCSP recommends diathermy for a cyclist's chronic IT band syndrome. The primary advantage of shortwave diathermy over superficial heat is:
- Lower equipment cost and portability
- Ability to heat deep tissues beyond the reach of superficial heat packs (Correct answer)
- Faster application requiring only 2–3 minutes
- No contraindications compared to superficial heat
Correct answer: Ability to heat deep tissues beyond the reach of superficial heat packs
Shortwave diathermy converts electromagnetic energy into heat in deep tissues (up to 5 cm), exceeding the ~1 cm penetration of superficial heat packs.
Question 6: When prescribing eccentric exercise as an adjunctive therapy for Achilles tendinopathy in a distance runner, the evidence-based Alfredson protocol specifies performing the exercise:
- With the knee straight only, stopping at the onset of pain
- With both the knee straight and knee bent, loading through pain (Correct answer)
- Concentrically only to avoid tendon overload
- Exclusively in a pool to minimize ground reaction forces
Correct answer: With both the knee straight and knee bent, loading through pain
The Alfredson protocol requires eccentric heel drops with both straight and bent knee to target the gastrocnemius and soleus separately, and uniquely instructs the athlete to train through pain.
Question 7: A sports chiropractor uses myofascial release on a gymnast's hip flexors before competition. The therapeutic goal of sustained manual pressure applied to a myofascial restriction is to:
- Rupture adhesions through high-velocity force
- Engage the tissue barrier and wait for a neurological or viscoelastic release (Correct answer)
- Increase intramuscular temperature above 40°C
- Stimulate the Golgi tendon organ to produce reciprocal inhibition
Correct answer: Engage the tissue barrier and wait for a neurological or viscoelastic release
Myofascial release applies sustained, gentle pressure at the tissue barrier, waiting for a neurological unwinding or viscoelastic creep response to release the restriction.
CCSP Adjunctive Sports Therapies 5
During iontophoresis application on a pitcher's elbow, which parameter determines the total ionic medication dose delivered to tissue?