DPT Sports Rehabilitation & Performance 3 — Questions and Answers
Question 1: A swimmer presents with impingement symptoms and weakness in external rotation. Which muscle is MOST critical to address for restoring dynamic glenohumeral stability?
- Deltoid anterior head
- Infraspinatus and teres minor (Correct answer)
- Subscapularis alone
- Pectoralis minor
Correct answer: Infraspinatus and teres minor
Infraspinatus and teres minor provide the primary external rotation force couple and posterior rotator cuff depression necessary for dynamic glenohumeral stability during overhead motions.
Question 2: When performing a drop vertical jump screen, a female athlete demonstrates a valgus collapse greater than 10° at initial contact. Which combination of strength deficits MOST likely contributes to this pattern?
- Weak ankle dorsiflexors and plantarflexors
- Weak hip abductors, external rotators, and knee extensors (Correct answer)
- Weak hip flexors and knee flexors
- Weak tibialis posterior and peroneals
Correct answer: Weak hip abductors, external rotators, and knee extensors
Dynamic valgus during landing is primarily driven by weakness of hip abductors, external rotators, and insufficient eccentric knee extensor control.
Question 3: A collegiate pitcher reports progressive posterior shoulder tightness and loss of internal rotation. GIRD (glenohumeral internal rotation deficit) is noted at 25°. What is the FIRST intervention priority?
- Strengthen external rotators with side-lying ER exercises
- Perform posterior capsule and posterior rotator cuff stretching (sleeper stretch) (Correct answer)
- Refer for surgical posterior capsule release
- Apply scapular stabilization exercises exclusively
Correct answer: Perform posterior capsule and posterior rotator cuff stretching (sleeper stretch)
GIRD is primarily managed with posterior capsule stretching such as the sleeper stretch to restore internal rotation range and reduce impingement risk.
Question 4: Which concept describes the accumulation of subclinical tissue damage exceeding the tissue's capacity to recover between training sessions, ultimately resulting in overuse injury?
- Relative energy deficiency in sport (RED-S)
- Cumulative microtrauma model
- Tissue homeostasis threshold theory
- Acute:chronic workload ratio imbalance (Correct answer)
Correct answer: Acute:chronic workload ratio imbalance
An elevated acute:chronic workload ratio (>1.5) indicates recent training load spikes that exceed the tissue's prepared capacity, directly linking load management to overuse injury risk.
Question 5: A football linebacker presents with a Grade II medial collateral ligament sprain. At 3 weeks post-injury, which criterion is MOST important before initiating sport-specific agility training?
- MRI confirmation of complete ligament healing
- Full pain-free range of motion and >80% quadriceps limb symmetry
- Absence of effusion and full pain-free ROM with valgus stress test negative (Correct answer)
- Return of full strength in hip abductors
Correct answer: Absence of effusion and full pain-free ROM with valgus stress test negative
Before agility training after MCL sprain, the clinician must confirm absent effusion, full pain-free ROM, and a negative valgus stress test indicating adequate ligament healing.
Question 6: An athlete is being tested for reactive strength using a drop jump protocol. Which variable BEST captures the efficiency of the stretch-shortening cycle?
- Peak ground reaction force
- Reactive strength index (jump height / ground contact time) (Correct answer)
- Rate of force development during concentric phase
- Peak power output from a force plate
Correct answer: Reactive strength index (jump height / ground contact time)
Reactive strength index (RSI = jump height ÷ ground contact time) quantifies stretch-shortening cycle efficiency by rewarding both high jump height and minimal contact time.
Question 7: A cyclist presents with anterior knee pain localized to the inferior patellar pole. Ultrasound confirms patellar tendinopathy. Which loading strategy has the STRONGEST evidence for tendon remodeling?
- Complete rest followed by gradual return to cycling
- Heavy slow resistance training and isometric loading protocols (Correct answer)
- Eccentric-only decline squat protocol performed daily
- Corticosteroid injection combined with stretching
Correct answer: Heavy slow resistance training and isometric loading protocols
Heavy slow resistance training and isometric loading are currently supported by the strongest evidence for stimulating tendon remodeling and reducing pain in patellar tendinopathy.
DPT Sports Rehabilitation & Performance 3
A swimmer presents with impingement symptoms and weakness in external rotation.
Which muscle is MOST critical to address for restoring dynamic glenohumeral stability?