DPT Sports Rehabilitation & Performance 5 — Questions and Answers
Question 1: A gymnast presents with wrist pain on the dorsoradial aspect, worse with weight-bearing on an extended wrist. Positive scaphoid shift (Watson) test. Which diagnosis is MOST likely?
- De Quervain tenosynovitis
- Scapholunate ligament instability (Correct answer)
- Triangular fibrocartilage complex (TFCC) tear
- Distal radius stress fracture
Correct answer: Scapholunate ligament instability
A positive Watson test (scaphoid shift test) indicates scapholunate dissociation, common in gymnasts due to repetitive axial loading through an extended wrist.
Question 2: During the late cocking phase of pitching, which muscle group undergoes the greatest eccentric demand to decelerate horizontal abduction and external rotation?
- Anterior deltoid and coracobrachialis
- Posterior rotator cuff (infraspinatus, teres minor) and posterior deltoid (Correct answer)
- Subscapularis and pectoralis major
- Serratus anterior and lower trapezius
Correct answer: Posterior rotator cuff (infraspinatus, teres minor) and posterior deltoid
The posterior rotator cuff (infraspinatus, teres minor) and posterior deltoid eccentrically decelerate the massive external rotation and horizontal abduction forces generated during late cocking.
Question 3: An athletic trainer refers a cross-country runner with recurrent tibial stress fractures. DEXA scan shows low bone mineral density. Labs reveal low estrogen and a history of disordered eating. This presentation is BEST described as:
- Overtraining syndrome (OTS)
- Relative energy deficiency in sport (RED-S)
- Female athlete triad (Correct answer)
- Hypothalamic amenorrhea only
Correct answer: Female athlete triad
The simultaneous presence of disordered eating, menstrual dysfunction (low estrogen), and low bone mineral density constitutes the Female Athlete Triad, a specific syndrome within the broader RED-S framework.
Question 4: A physical therapist is progressing an athlete through plyometric training. Which variable should be manipulated LAST to ensure safe progression?
- Movement complexity
- Training volume (foot contacts per session)
- Intensity (drop height, box height) (Correct answer)
- Training frequency
Correct answer: Intensity (drop height, box height)
Intensity (increased drop heights, box heights, or depth jumps) carries the greatest injury risk and should be progressed only after volume, complexity, and frequency are well-tolerated.
Question 5: A football lineman returns from a Grade III ankle sprain. Single-leg balance time on the injured side is 12 seconds vs. 28 seconds on the uninjured side. This deficit MOST reflects impairment in which system?
- Articular cartilage integrity
- Ankle proprioception and mechanoreceptor function (Correct answer)
- Peroneal tendon strength
- Medial longitudinal arch stability
Correct answer: Ankle proprioception and mechanoreceptor function
Severe ankle ligament disruption damages joint mechanoreceptors, impairing proprioceptive input and significantly reducing single-leg static balance performance.
Question 6: When applying the acute:chronic workload ratio (ACWR) model, what ratio range is associated with the 'sweet spot' of optimal load and lowest injury risk?
- 0.5–0.8
- 0.8–1.3 (Correct answer)
- 1.3–1.5
- Above 1.5
Correct answer: 0.8–1.3
An ACWR of 0.8–1.3 represents the 'sweet spot' where the athlete is training consistently without excessive acute spikes that overload tissue capacity.
Question 7: A physical therapist is treating a collegiate soccer player with a first-time lateral ankle sprain (Grade II). In addition to PRICE in the first 48 hours, which early intervention has the strongest evidence to prevent chronic ankle instability?
- Prolonged immobilization in a cast for 4–6 weeks
- Early protected mobilization and balance/proprioception training (Correct answer)
- Surgical reconstruction of the ATFL and CFL
- Taping alone without active rehabilitation exercise
Correct answer: Early protected mobilization and balance/proprioception training
Early protected weight-bearing combined with proprioceptive and balance training reduces the risk of chronic ankle instability and accelerates return to sport after lateral ankle sprain.
DPT Sports Rehabilitation & Performance 5
A gymnast presents with wrist pain on the dorsoradial aspect, worse with weight-bearing on an extended wrist.
Positive scaphoid shift (Watson) test.
Which diagnosis is MOST likely?