SCS Treatment Planning & Protocols 3 — Questions and Answers
Question 1: Which manual therapy technique is most appropriate for a football lineman with limited hip internal rotation due to hip capsular tightness?
- Posterior hip joint mobilization (posterior glide of femoral head) (Correct answer)
- Hip flexor static stretching held for 30 seconds
- Piriformis dry needling only
- Hip distraction with long-axis traction
Correct answer: Posterior hip joint mobilization (posterior glide of femoral head)
A posterior glide mobilization of the femoral head directly addresses the anterior capsular restriction that limits hip internal rotation in athletes.
Question 2: A collegiate volleyball player is diagnosed with a grade I acromioclavicular joint sprain. What is the expected return-to-play timeline with appropriate conservative management?
- 1–2 weeks with progressive overhead loading (Correct answer)
- 6–8 weeks of complete rest
- 3–6 months with surgical stabilization
- Immediate return if pain-free at rest
Correct answer: 1–2 weeks with progressive overhead loading
Grade I AC joint sprains typically allow return to play within 1–2 weeks when managed with protected activity, modalities, and progressive loading.
Question 3: Which outcome measure is most appropriate for tracking functional progress in a baseball pitcher rehabilitating from UCL reconstruction (Tommy John surgery)?
- Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC) (Correct answer)
- DASH questionnaire alone
- Visual Analog Scale for pain only
- Single Assessment Numeric Evaluation (SANE) for shoulder
Correct answer: Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC)
The KJOC score is specifically validated for overhead throwing athletes and captures the sport-specific demands relevant to a pitcher's UCL rehabilitation.
Question 4: A track sprinter develops proximal hamstring tendinopathy aggravated by sitting. Which exercise has the strongest evidence for this condition?
- Nordic hamstring curl with progressive loading (Correct answer)
- Passive prone hamstring stretching
- Standing hamstring curl at low load and high repetition
- Ice massage and complete rest from running
Correct answer: Nordic hamstring curl with progressive loading
The Nordic hamstring curl provides eccentric loading at long muscle lengths, which has the strongest evidence for rehabilitating proximal hamstring tendinopathy.
Question 5: When designing a return-to-throwing program after shoulder surgery, what is the recommended progression criterion between each interval phase?
- Pain-free completion of all throws at the current distance before advancing distance (Correct answer)
- Time elapsed since surgery regardless of symptoms
- Normalization of grip strength to the uninvolved side
- MRI confirmation of tissue healing
Correct answer: Pain-free completion of all throws at the current distance before advancing distance
Pain-free completion of all throws at the current distance is the standard criterion before advancing to the next interval in return-to-throwing progressions.
Question 6: A high school gymnast presents with Sever's disease (calcaneal apophysitis). Which treatment plan component is most critical?
- Activity modification to reduce repetitive heel impact loading (Correct answer)
- Surgical removal of the calcaneal apophysis
- Aggressive stretching of the Achilles tendon without load reduction
- Corticosteroid injection into the apophysis
Correct answer: Activity modification to reduce repetitive heel impact loading
Reducing repetitive compressive and tensile forces at the calcaneal apophysis through activity modification is the cornerstone of Sever's disease management.
Question 7: Which criterion best indicates readiness to progress from phase 2 (strengthening) to phase 3 (sport-specific) in a patellofemoral pain rehabilitation program?
- Pain ≤2/10 with functional activities and quadriceps strength ≥80% of uninvolved limb (Correct answer)
- Complete absence of any pain with all activities
- Four weeks elapsed in phase 2 regardless of strength
- Return of full passive patellar mobility
Correct answer: Pain ≤2/10 with functional activities and quadriceps strength ≥80% of uninvolved limb
Pain ≤2/10 combined with quadriceps strength ≥80% of the uninvolved limb provides both a symptomatic and functional threshold for progressing PFP rehabilitation.
SCS Treatment Planning & Protocols 3
Which manual therapy technique is most appropriate for a football lineman with limited hip internal rotation due to hip capsular tightness?