DPT Sports Rehabilitation & Performance 4 — Questions and Answers
Question 1: A sprinter sustains a Grade II proximal hamstring strain. During the early rehabilitation phase, which exercise is MOST appropriate to initiate pain-free lengthening under load?
- Nordic hamstring curl at full range
- Standing hip hinge (Romanian deadlift) at limited range of motion (Correct answer)
- Seated leg curl at 90° knee flexion
- Supine hamstring stretch held for 60 seconds
Correct answer: Standing hip hinge (Romanian deadlift) at limited range of motion
The Romanian deadlift (hip hinge) allows progressive eccentric hamstring loading in a lengthened position at a controlled range, which is appropriate in early-to-mid hamstring strain rehab.
Question 2: Which landing strategy is MOST associated with reduced ACL loading during a single-leg drop landing?
- Increased knee flexion angle and reduced hip flexion at initial contact
- Greater trunk flexion, hip flexion, and knee flexion at initial contact (Correct answer)
- Reduced ankle dorsiflexion to absorb ground reaction forces distally
- Increased quadriceps activation to protect the joint
Correct answer: Greater trunk flexion, hip flexion, and knee flexion at initial contact
Greater trunk, hip, and knee flexion at initial contact distributes landing forces across multiple joints and reduces anterior tibial shear force on the ACL.
Question 3: A collegiate tennis player is evaluated for lateral elbow pain. Cozen's test and Mill's test are both positive. The MOST likely diagnosis and initial intervention are:
- Medial epicondylitis; wrist flexor stretching and strengthening
- Lateral epicondylitis; wrist extensor eccentric loading and equipment modification (Correct answer)
- Triceps tendinopathy; elbow extension strengthening
- Posterior interosseous nerve entrapment; neural mobilization
Correct answer: Lateral epicondylitis; wrist extensor eccentric loading and equipment modification
Positive Cozen's and Mill's tests confirm lateral epicondylitis (common extensor tendinopathy), managed with wrist extensor eccentric loading and racket grip/tension modification.
Question 4: In the return-to-sport continuum after lower extremity injury, which stage follows 'return to training' and precedes 'return to competition'?
- Return to participation
- Return to performance (Correct answer)
- Return to play
- Return to full training load
Correct answer: Return to performance
The Ardern et al. framework places 'return to performance' between full training and competition, emphasizing sport-specific performance benchmarks must be met before competitive return.
Question 5: A distance runner with chronic exertional compartment syndrome (CECS) of the anterior compartment reports symptoms onset at mile 2 of every run. Intracompartmental pressure post-run is 30 mmHg (normal <20 mmHg). Conservative management has failed. What is the next appropriate step?
- Prescribe custom orthotics and continue activity modification
- Recommend surgical fasciotomy referral (Correct answer)
- Initiate aggressive foam rolling and cross-training only
- Begin blood flow restriction training to reduce compartment pressure
Correct answer: Recommend surgical fasciotomy referral
Fasciotomy is the definitive treatment for CECS when conservative management fails and post-exercise pressures remain elevated above 20 mmHg.
Question 6: Which principle of training states that adaptations are specific to the type of stress applied (e.g., speed, force, energy system)?
- Overload principle
- Reversibility principle
- SAID principle (Specific Adaptation to Imposed Demands) (Correct answer)
- Progressive overload principle
Correct answer: SAID principle (Specific Adaptation to Imposed Demands)
The SAID principle holds that the body adapts specifically to the demands placed upon it, requiring sport-specific training stimuli to elicit sport-relevant adaptations.
Question 7: A physical therapist uses blood flow restriction (BFR) training for a post-operative ACL reconstruction patient at 4 weeks post-op. What is the PRIMARY rationale for BFR at this early stage?
- BFR eliminates risk of re-injury by limiting joint loading
- BFR enables hypertrophic stimulus at low loads (20–30% 1RM) when high loads are contraindicated (Correct answer)
- BFR accelerates graft ligamentization through increased joint compression
- BFR improves cardiovascular fitness without any muscular adaptations
Correct answer: BFR enables hypertrophic stimulus at low loads (20–30% 1RM) when high loads are contraindicated
BFR training induces muscle hypertrophy and strength gains at 20–30% 1RM by causing metabolic stress and motor unit recruitment, which is safe when high loads are contraindicated early post-op.
DPT Sports Rehabilitation & Performance 4
A sprinter sustains a Grade II proximal hamstring strain.
During the early rehabilitation phase, which exercise is MOST appropriate to initiate pain-free lengthening under load?