SCS Treatment Planning & Protocols 2 — Questions and Answers
Question 1: When developing a return-to-sport protocol after ACL reconstruction, which criterion is most important before initiating plyometric training?
- Limb symmetry index ≥90% on quadriceps strength testing (Correct answer)
- Six months post-operative time frame elapsed
- Full passive range of motion restored
- Pain-free ambulation on all surfaces
Correct answer: Limb symmetry index ≥90% on quadriceps strength testing
A limb symmetry index ≥90% on quadriceps strength testing is the most evidence-based criterion before initiating plyometric loading after ACL reconstruction.
Question 2: A high school soccer player presents with a grade II lateral ankle sprain. Which treatment approach is most appropriate in the first 72 hours?
- PEACE & LOVE protocol with protected weight-bearing as tolerated (Correct answer)
- Immediate aggressive range-of-motion exercises without bracing
- Complete non-weight-bearing with cast immobilization
- Corticosteroid injection to reduce swelling
Correct answer: PEACE & LOVE protocol with protected weight-bearing as tolerated
The PEACE & LOVE protocol (Protection, Elevation, Avoid anti-inflammatory modalities, Compression, Education / Load, Optimism, Vascularization, Exercise) represents current best evidence for acute ankle sprain management.
Question 3: Which periodization model is most appropriate for an athlete returning from a hamstring strain who needs to rebuild maximal strength in 12 weeks?
- Linear periodization progressing from high volume/low intensity to low volume/high intensity
- Undulating periodization alternating intensity daily
- Block periodization with a 4-week accumulation, 4-week transmutation, 4-week realization cycle (Correct answer)
- Concurrent periodization combining strength and endurance in every session
Correct answer: Block periodization with a 4-week accumulation, 4-week transmutation, 4-week realization cycle
Block periodization with distinct accumulation, transmutation, and realization phases is well-suited for athletes rebuilding maximal strength over a defined 12-week window.
Question 4: An SCS is treating a collegiate swimmer with supraspinatus tendinopathy. Which loading strategy has the strongest evidence for tendon rehabilitation?
- Heavy slow resistance training with progressive loading (Correct answer)
- Complete rest until pain resolves
- Ultrasound-guided corticosteroid injection followed by rest
- Passive stretching of the rotator cuff daily
Correct answer: Heavy slow resistance training with progressive loading
Heavy slow resistance training with progressive loading drives tendon adaptation and has the strongest evidence base for managing tendinopathy.
Question 5: A basketball player is cleared to return to sport after a patellar tendon repair. Which functional test best assesses readiness for cutting and jumping activities?
- Single-leg hop for distance with limb symmetry index (Correct answer)
- Isokinetic knee extension at 60°/sec only
- Straight-line sprint over 40 meters
- Six-minute walk test
Correct answer: Single-leg hop for distance with limb symmetry index
The single-leg hop for distance with limb symmetry index directly challenges the repaired tendon under sport-relevant loading and provides a symmetry benchmark.
Question 6: When creating a treatment plan for a wrestler with a cervical strain, which intervention should be prioritized in the acute phase to reduce pain and restore motion?
- Manual therapy (cervical mobilization) combined with therapeutic exercise (Correct answer)
- Rigid cervical collar worn continuously for two weeks
- Cervical traction at high loads immediately post-injury
- Cervical epidural steroid injection
Correct answer: Manual therapy (cervical mobilization) combined with therapeutic exercise
Evidence supports early manual therapy combined with therapeutic exercise for acute cervical strain to reduce pain and restore functional range of motion.
Question 7: A distance runner presents with medial tibial stress syndrome. Which training modification is the highest priority in the initial treatment plan?
- Reduce weekly mileage by 50% and eliminate high-impact surfaces (Correct answer)
- Switch to barefoot running immediately
- Prescribe complete non-weight-bearing for four weeks
- Increase cadence by 30 steps per minute without altering volume
Correct answer: Reduce weekly mileage by 50% and eliminate high-impact surfaces
Reducing weekly mileage by approximately 50% while avoiding high-impact surfaces is the foundational load management strategy for medial tibial stress syndrome.
SCS Treatment Planning & Protocols 2
When developing a return-to-sport protocol after ACL reconstruction, which criterion is most important before initiating plyometric training?