DPT Sports Rehabilitation & Performance 2 — Questions and Answers
Question 1: A high school soccer player presents with anterior knee pain worsened by stairs and prolonged sitting. Patellar glide testing reveals lateral tilt. Which intervention is MOST appropriate initially?
- Vastus medialis oblique strengthening and lateral retinaculum stretching
- Quadriceps tendon injection with corticosteroid
- Patellar taping with McConnell technique and VMO activation (Correct answer)
- Immediate referral for arthroscopic lateral release
Correct answer: Patellar taping with McConnell technique and VMO activation
McConnell taping combined with VMO activation is the first-line conservative approach for patellofemoral pain syndrome with lateral patellar tilt.
Question 2: During isokinetic testing at 60°/sec, a collegiate sprinter's hamstring-to-quadriceps (H:Q) ratio is 0.48. How should this be interpreted?
- Normal; H:Q ratios below 0.50 indicate excellent quadriceps dominance
- Abnormal; conventional H:Q ratios below 0.60 suggest increased hamstring strain risk (Correct answer)
- Normal; H:Q ratios are only clinically significant above 0.75
- Abnormal; functional H:Q ratios should be calculated instead at higher speeds
Correct answer: Abnormal; conventional H:Q ratios below 0.60 suggest increased hamstring strain risk
A conventional H:Q ratio below 0.60 at 60°/sec indicates relative quadriceps dominance and elevated hamstring strain risk in sprinters.
Question 3: A distance runner reports lateral hip pain that increases with downhill running and prolonged sitting with hips flexed. Ober's test is positive. Which structure is MOST likely involved?
- Piriformis muscle
- Iliotibial band and associated bursa (Correct answer)
- Gluteus medius tendon
- Proximal hamstring tendon
Correct answer: Iliotibial band and associated bursa
A positive Ober's test combined with lateral hip pain aggravated by downhill running is consistent with iliotibial band syndrome and associated trochanteric bursitis.
Question 4: Which periodization model uses sequential training blocks where each block emphasizes a single biomotor quality and builds on the preceding block?
- Undulating periodization
- Linear periodization
- Block periodization (Correct answer)
- Conjugate periodization
Correct answer: Block periodization
Block periodization uses sequential, highly concentrated training phases (accumulation, transmutation, realization) each targeting one primary biomotor quality.
Question 5: A collegiate basketball player post-ACL reconstruction (9 months) passes limb symmetry index testing at 90% but scores poorly on the Y-Balance Test anterior reach. What does this finding most suggest?
- Full clearance for return to sport based on strength symmetry
- Dynamic postural control deficits requiring additional neuromuscular training (Correct answer)
- Ankle dorsiflexion restriction requiring manual therapy
- Hip flexor tightness requiring stretching protocol
Correct answer: Dynamic postural control deficits requiring additional neuromuscular training
Poor anterior reach on the Y-Balance Test despite adequate limb symmetry index indicates residual dynamic postural control deficits that increase re-injury risk.
Question 6: What is the PRIMARY biomechanical advantage of the rear-foot strike pattern in long-distance running compared to midfoot or forefoot strike?
- Reduced patellofemoral joint stress
- Reduced Achilles tendon loading and ankle plantarflexor demand (Correct answer)
- Greater ground contact time enabling more propulsive force
- Lower peak vertical ground reaction force
Correct answer: Reduced Achilles tendon loading and ankle plantarflexor demand
Rear-foot striking shifts load away from the Achilles tendon and calf musculature, reducing plantarflexor demand compared to forefoot or midfoot patterns.
Question 7: A physical therapist is designing a sport-specific warm-up for a collegiate volleyball team. Which sequence BEST reflects current evidence for injury prevention and performance?
- Static stretching → dynamic movement → plyometrics → sport skill
- Aerobic jog → static stretching → strength exercises → sport skill
- Dynamic warm-up → neuromuscular activation → plyometrics → sport skill (Correct answer)
- Foam rolling → static stretching → dynamic movement → sport skill
Correct answer: Dynamic warm-up → neuromuscular activation → plyometrics → sport skill
Evidence supports a progressive warm-up from dynamic movement to neuromuscular activation to plyometrics before sport skill execution for both performance and injury prevention.
DPT Sports Rehabilitation & Performance 2
A high school soccer player presents with anterior knee pain worsened by stairs and prolonged sitting.
Patellar glide testing reveals lateral tilt.
Which intervention is MOST appropriate initially?