CCSP Sports Injury Treatment 3 — Questions and Answers
Question 1: A gymnast presents with a stress fracture of the pars interarticularis (spondylolysis). What is the initial treatment?
- Surgical fusion of L4-L5
- Activity restriction and bracing with core stabilization rehabilitation (Correct answer)
- Epidural steroid injection
- Aggressive spinal manipulation
Correct answer: Activity restriction and bracing with core stabilization rehabilitation
Activity restriction, a thoracolumbar brace, and core stabilization exercises allow pars healing and are first-line for spondylolysis.
Question 2: Which nerve is most commonly injured in carpal tunnel syndrome among cyclists due to handlebar pressure?
- Ulnar nerve at Guyon's canal
- Median nerve at the carpal tunnel (Correct answer)
- Radial nerve at the spiral groove
- Musculocutaneous nerve
Correct answer: Median nerve at the carpal tunnel
Prolonged handlebar pressure on the palm compresses the median nerve at the carpal tunnel, causing cyclist's palsy variant with CTS symptoms.
Question 3: When returning an athlete to play after a concussion, which symptom should immediately halt the return-to-play progression?
- Mild fatigue after 30 minutes of exercise
- Re-emergence of any concussion symptoms at any step (Correct answer)
- Slight headache only during maximum exertion
- Neck stiffness from cervical muscle soreness
Correct answer: Re-emergence of any concussion symptoms at any step
Any concussion symptoms returning at any stage of the RTP protocol require dropping back to the previous asymptomatic step.
Question 4: A swimmer presents with supraspinatus tendinopathy ('swimmer's shoulder'). Which biomechanical correction is most critical?
- Reducing hand entry angle to decrease impingement arc (Correct answer)
- Widening the stroke and breathing less frequently
- Adding resistance paddles immediately
- Switching exclusively to backstroke
Correct answer: Reducing hand entry angle to decrease impingement arc
Correcting hand entry angle reduces internal impingement of the supraspinatus during the catch phase of freestyle swimming.
Question 5: Which injection approach is preferred for plantar fasciitis refractory to conservative care for at least 3 months?
- Corticosteroid injection alone repeated monthly
- Platelet-rich plasma (PRP) injection (Correct answer)
- Prolotherapy with dextrose
- Botulinum toxin injection into the heel
Correct answer: Platelet-rich plasma (PRP) injection
PRP injection has demonstrated superior long-term outcomes compared to corticosteroids for chronic plantar fasciitis by promoting tissue regeneration.
Question 6: A collegiate soccer player with a Grade III AC joint separation. When is surgical referral most clearly indicated?
- Immediately for all Grade III separations
- When there is associated coracoclavicular ligament rupture with significant displacement and athlete's demands require it (Correct answer)
- After 2 weeks of ice and sling only
- Only if there is nerve damage
Correct answer: When there is associated coracoclavicular ligament rupture with significant displacement and athlete's demands require it
Surgical fixation for Grade III AC separations is reserved for high-demand athletes with significant clavicle displacement and failed conservative care.
Question 7: What is the primary goal of the 'relative rest' principle in sports injury management?
- Complete cessation of all physical activity
- Maintaining cardiovascular fitness and tissue perfusion while avoiding aggravating the injury (Correct answer)
- Eliminating all pain before any movement
- Reducing inflammation with NSAIDs only
Correct answer: Maintaining cardiovascular fitness and tissue perfusion while avoiding aggravating the injury
Relative rest allows continued training of uninjured body parts while protecting the injured area to prevent deconditioning and aid healing.
CCSP Sports Injury Treatment 3
A gymnast presents with a stress fracture of the pars interarticularis (spondylolysis).
What is the initial treatment?