CSCS Special Populations & Injury Prevention 3 — Questions and Answers
Question 1: An athlete returns from an ACL reconstruction at 6 months post-op. Which criterion is most critical before clearing them for full sport return?
- Absence of knee swelling
- Limb symmetry index ≥90% on hop tests (Correct answer)
- Full range of motion restoration
- Completion of 6-month time threshold
Correct answer: Limb symmetry index ≥90% on hop tests
A limb symmetry index ≥90% on functional hop tests is a key evidence-based criterion indicating adequate neuromuscular function for safe sport return.
Question 2: Which exercise modification is most appropriate for a client with osteoporosis performing resistance training?
- Avoid all axial loading exercises
- Avoid high-impact twisting and spinal flexion under load (Correct answer)
- Limit training to upper body only
- Use only elastic band resistance
Correct answer: Avoid high-impact twisting and spinal flexion under load
High-impact torsional forces and loaded spinal flexion pose the greatest vertebral fracture risk in osteoporotic individuals.
Question 3: Relative Energy Deficiency in Sport (RED-S) in female athletes is most directly caused by:
- Excessive protein intake relative to fat
- Low energy availability relative to exercise energy expenditure (Correct answer)
- High training volume without adequate sleep
- Iron deficiency anemia
Correct answer: Low energy availability relative to exercise energy expenditure
RED-S occurs when energy intake fails to cover both resting metabolic needs and exercise expenditure, creating a deficit that disrupts hormonal and physiological function.
Question 4: When programming for an athlete with shoulder impingement syndrome, which exercise should be avoided initially?
- Standing cable rows with neutral grip
- Overhead pressing movements (Correct answer)
- Side-lying external rotation
- Prone Y-T-W exercises
Correct answer: Overhead pressing movements
Overhead pressing narrows the subacromial space and compresses the impinged structures, exacerbating symptoms during the acute phase.
Question 5: A master athlete (age 58) shows significantly longer recovery times after intense training. The primary physiological reason is:
- Reduced motivation and sleep quality
- Decreased muscle protein synthesis rate and hormonal anabolic response (Correct answer)
- Lower glycogen storage capacity
- Reduced cardiovascular efficiency
Correct answer: Decreased muscle protein synthesis rate and hormonal anabolic response
Aging blunts the anabolic hormonal response (GH, IGF-1, testosterone) and slows muscle protein synthesis, extending the time needed for tissue repair.
Question 6: During pregnancy, the recommended upper limit for exercise intensity is typically based on:
- Maintaining VO2max at pre-pregnancy levels
- Perceived exertion of 12-14 on the Borg scale or maintaining conversational ability (Correct answer)
- Heart rate not exceeding 120 bpm
- Duration not exceeding 20 minutes per session
Correct answer: Perceived exertion of 12-14 on the Borg scale or maintaining conversational ability
RPE of 12-14 (somewhat hard) or the "talk test" are preferred guides because heart rate targets are unreliable during pregnancy due to cardiovascular changes.
Question 7: The primary injury prevention benefit of eccentric hamstring training (e.g., Nordic curls) in sprinters is:
- Improved hip flexor flexibility
- Increased hamstring peak torque and length in the lengthened position (Correct answer)
- Reduced quadriceps dominance ratio
- Enhanced lumbopelvic stability
Correct answer: Increased hamstring peak torque and length in the lengthened position
Nordic curls strengthen the hamstrings eccentrically at long muscle lengths, which is where most sprinting-related strains occur during late swing phase.
CSCS Special Populations & Injury Prevention 3
An athlete returns from an ACL reconstruction at 6 months post-op.
Which criterion is most critical before clearing them for full sport return?