PAS Rehabilitation & Recovery Protocols 3 — Questions and Answers
Question 1: A client with anterior pelvic tilt and lumbar hyperlordosis begins a rehabilitation program. Which combination of interventions is most appropriate?
- Strengthen hip flexors and stretch glutes
- Inhibit hip flexors and strengthen glutes and deep abdominals (Correct answer)
- Strengthen lumbar erectors and stretch hamstrings
- Inhibit glutes and strengthen quadriceps
Correct answer: Inhibit hip flexors and strengthen glutes and deep abdominals
Anterior pelvic tilt is driven by overactive hip flexors and underactive glutes/deep abdominals, so the protocol addresses both sides of the imbalance.
Question 2: In the context of PAS recovery protocols, what does the term 'tissue tolerance' refer to?
- A client's pain threshold during massage
- The maximum mechanical load a healing tissue can safely accept at a given stage (Correct answer)
- The number of sessions required before discharge
- A muscle's ability to resist fatigue
Correct answer: The maximum mechanical load a healing tissue can safely accept at a given stage
Tissue tolerance is the maximal mechanical stress a healing structure can withstand without re-injury at a specific point in its repair timeline.
Question 3: Which soft tissue technique is most appropriate during the acute phase of an overuse injury to reduce hypertonicity without further tissue trauma?
- Deep transverse friction massage
- High-intensity myofascial release
- Light effleurage and gentle cross-fiber stroking (Correct answer)
- Instrument-assisted soft tissue mobilization (IASTM)
Correct answer: Light effleurage and gentle cross-fiber stroking
Light effleurage and gentle cross-fiber stroking promote circulation and reduce tone without adding mechanical stress to acutely inflamed tissue.
Question 4: A postural alignment specialist is working with a client post-ACL reconstruction. At what stage is it appropriate to introduce lateral agility drills?
- Immediately after surgical clearance at 6 weeks
- During the acute phase when swelling is still present
- After the client demonstrates controlled single-leg squat without valgus collapse (Correct answer)
- Before quadriceps strength testing is performed
Correct answer: After the client demonstrates controlled single-leg squat without valgus collapse
Lateral agility drills require adequate single-leg stability; introducing them before the client can control knee valgus significantly increases re-injury risk.
Question 5: Which breathing pattern abnormality is commonly associated with thoracic kyphosis and should be addressed in a rehabilitation program?
- Diaphragmatic breathing with full lateral rib expansion
- Apical (chest) breathing with reduced diaphragmatic activity (Correct answer)
- Nasal breathing with prolonged exhalation
- Pursed-lip breathing during resistance exercises
Correct answer: Apical (chest) breathing with reduced diaphragmatic activity
Thoracic kyphosis compresses the thoracic cavity, promoting apical breathing and reducing diaphragmatic excursion, which must be corrected to restore thoracic mobility.
Question 6: What is the SAID principle and how does it apply to rehabilitation programming?
- Specific Adaptation to Imposed Demands — training must mimic the stresses of the target activity (Correct answer)
- Slow and Intentional Daily Discipline — recovery requires consistent low-intensity work
- Sequential Activation of Inhibited Deficits — muscles must be activated in a fixed order
- Static Alignment and Integrated Dynamics — posture must precede movement training
Correct answer: Specific Adaptation to Imposed Demands — training must mimic the stresses of the target activity
SAID states that the body adapts specifically to the type of stress placed on it, so rehabilitation exercises must progressively replicate the demands of the client's functional goals.
Question 7: During shoulder rehabilitation following a rotator cuff strain, in which position should early strengthening exercises begin to minimize subacromial impingement risk?
- Full overhead (180° flexion)
- Mid-range with the arm below 90° of elevation (Correct answer)
- Behind-the-back extension
- Horizontal adduction across the chest
Correct answer: Mid-range with the arm below 90° of elevation
Exercises below 90° of shoulder elevation reduce subacromial compressive forces, making this the safest range for early rotator cuff loading.
PAS Rehabilitation & Recovery Protocols 3
A client with anterior pelvic tilt and lumbar hyperlordosis begins a rehabilitation program.
Which combination of interventions is most appropriate?