CSCS Special Populations & Injury Prevention 5 — Questions and Answers
Question 1: Which overuse injury is most associated with excessive tibial internal rotation during the stance phase of running?
- Achilles tendinopathy
- Medial tibial stress syndrome (shin splints) (Correct answer)
- Lateral ankle sprains
- Metatarsal stress fractures
Correct answer: Medial tibial stress syndrome (shin splints)
Excessive tibial internal rotation increases tensile stress on the posteromedial tibial periosteum and deep compartment muscles, causing medial tibial stress syndrome.
Question 2: A collegiate swimmer with shoulder pain during the pull-through phase most likely has weakness in which muscle group that a CSCS should prioritize?
- Anterior deltoid and pectoralis minor
- Serratus anterior and lower trapezius (Correct answer)
- Biceps brachii and coracobrachialis
- Latissimus dorsi and teres major
Correct answer: Serratus anterior and lower trapezius
Serratus anterior and lower trapezius weakness impairs scapular upward rotation, causing impingement of rotator cuff structures during the swimming pull-through.
Question 3: When training clients with rheumatoid arthritis, which general guideline should the CSCS follow regarding flare-up periods?
- Increase training intensity to maintain fitness gains
- Reduce or eliminate exercise involving inflamed joints and focus on range-of-motion only (Correct answer)
- Switch to maximal isometric contractions to avoid joint movement
- Maintain the regular program to prevent deconditioning
Correct answer: Reduce or eliminate exercise involving inflamed joints and focus on range-of-motion only
During active flares, exercising through inflamed joints worsens joint damage; the focus should shift to gentle ROM to maintain mobility without exacerbating inflammation.
Question 4: The functional movement screen (FMS) is best used by a CSCS to:
- Diagnose specific musculoskeletal injuries and pathologies
- Identify movement pattern asymmetries and dysfunctions as starting points for corrective exercise (Correct answer)
- Predict maximum strength and power output potential
- Replace physician clearance for high-risk special populations
Correct answer: Identify movement pattern asymmetries and dysfunctions as starting points for corrective exercise
The FMS identifies asymmetrical or dysfunctional fundamental movement patterns that may elevate injury risk, serving as a baseline for corrective programming.
Question 5: A teenage distance runner develops a stress fracture in the second metatarsal. Beyond biomechanics, the CSCS should flag which underlying systemic risk factor for the medical team?
- Protein overconsumption
- Low energy availability potentially contributing to reduced bone density (component of RED-S) (Correct answer)
- Excessive calcium supplementation
- Overhydration causing electrolyte imbalance
Correct answer: Low energy availability potentially contributing to reduced bone density (component of RED-S)
Stress fractures in young female runners are a hallmark sign of the Female Athlete Triad/RED-S, where low energy availability reduces bone mineral density.
Question 6: For an athlete rehabilitating a grade II lateral ankle sprain, which training intervention should be introduced earliest in the recovery timeline?
- Heavy single-leg calf raises at full load
- Proprioceptive and balance training on the injured limb (Correct answer)
- High-speed agility ladder drills
- Sport-specific cutting maneuvers
Correct answer: Proprioceptive and balance training on the injured limb
Proprioceptive training restores neuromuscular ankle control lost after ligament injury and can begin as soon as weight-bearing is pain-free.
Question 7: When a CSCS programs resistance training for a client with chronic low back pain (non-acute), which approach has the strongest evidence for long-term pain reduction?
- Complete rest from resistance training until pain resolves
- Progressive core stabilization and general resistance training with pain monitoring (Correct answer)
- Isolated lumbar extension machine training only
- Abdominal bracing exercises exclusively in supine positions
Correct answer: Progressive core stabilization and general resistance training with pain monitoring
Progressive resistance training including core stabilization has the strongest evidence for reducing chronic low back pain by improving muscular support and movement control.
CSCS Special Populations & Injury Prevention 5
Which overuse injury is most associated with excessive tibial internal rotation during the stance phase of running?