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Head, Shoulders, Knees, and Back

Head, Shoulders, Knees, and Back. Tommy Kern, MD thomas-kern@live.com (918)398-1253. Disclosure. Dr. Kern has made no disclosures of financial interests with any company or companies, and has indicated no conflicts of interest. Objectives.

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Head, Shoulders, Knees, and Back

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  1. Head, Shoulders, Knees, and Back Tommy Kern, MD thomas-kern@live.com (918)398-1253

  2. Disclosure • Dr. Kern has made no disclosures of financial interests with any company or companies, and has indicated no conflicts of interest.

  3. Objectives • Learn everything about Sports Medicine in 1 hour, with detailed analysis of anatomy and human physiology of the brain, shoulder, knee, and back

  4. Objectives • Learn everything about Sports Medicine in 1 hour OR • How to assess and treat a concussion • Practical aspects of evaluation of shoulder, knee, and back pain

  5. What is a concussion? • A biomechanical insult that leads to a neuro-metabolic cascade of events • This basically means: • Swelling and inflammation occur • Metabolic crisis occurs (increase in glucose demand and decrease in energy)

  6. ConcussionsWhich sports have highest risk?

  7. ConcussionsWhich sports have highest risk?

  8. ConcussionsWhich sports have highest risk?

  9. ConcussionsWhich sports have highest risk?

  10. I think that an athlete might have a concussion, what do I do?

  11. I think that an athlete might have a concussion, what do I do?

  12. How do you treat a concussion?

  13. How do you treat a concussion?

  14. To Image or Not To ImageThat is the question

  15. To Image or Not To ImageThat is the question Red Flag Symptoms

  16. Why don’t concussion patients get better?

  17. Why don’t concussion patients get better?

  18. Why don’t concussion patients get better?

  19. Why don’t concussion patients get better?

  20. Why don’t concussion patients get better?

  21. Goals of Concussion Treatment

  22. Goals of Concussion Treatment

  23. Shoulder Exam • Impingement • Rotator cuff tear • Adhesive Capsulitis • AC joint arthritis

  24. Shoulder Anatomy

  25. Shoulder Evaluation • History provides the most information !!!!

  26. History Pain Description: • Location • Injury or not • Acute or chronic • Aggravating and relieving factors • Restriction in ROM

  27. Physical Exam • Inspection/Palpation • Subacromial bursa • AC joint

  28. Physical Exam • Inspection/Palpation • Subacromial bursa • AC joint • Range of motion

  29. Physical Exam • Inspection/Palpation • Subacromial bursa • AC joint • Range of motion • Strength • Rotator cuff • Supraspinatus test

  30. Remember: The function of the RC is to “seat” the humerus Without a healthy rotator cuff, the humerus “floats”, rides up, and compresses / inflames the RC tendons Without it, humerus “floats” in the join

  31. Treatment • RICE

  32. Treatment • RICE • Medication

  33. Treatment • RICE • Medication • Injection

  34. Treatment • RICE • Medication • Injection • Therapy • Rotator Cuff • Scapula • Range of motion

  35. Treatment • RICE • Medication • Injection • Therapy • Rotator Cuff • Scapula • Range of motion • Surgery

  36. Knee Exam • Arthritis • Meniscus tear • Ligament tear • Pes Anserine bursitis

  37. Knee Anatomy

  38. Knee Evaluation • What provides the most information?

  39. History Pain Description: • Location • Injury or not • Locking, catching, shifting, giving out • Aggravating and relieving factors • Ability to weight bear • Most important question?

  40. History Pain Description: • Location • Injury or not • Locking, catching, shifting, giving out • Aggravating and relieving factors • Ability to weight bear • Is it Christiano Ronaldo?

  41. Physical Exam • Inspection/Palpation • Effusion • Joint line tenderness • Pes anserine

  42. Physical Exam • Inspection/Palpation • Effusion • Joint line tenderness • Pes anserine • Stability • Lachman’s • Valgus and Varus stress

  43. Physical Exam • Inspection/Palpation • Effusion • Joint line tenderness • Pes anserine • Stability • Lachman’s • Valgus and Varus stress • Strength • Quadriceps and Patella tendon rupture

  44. Treatment • RICE

  45. Treatment • RICE • Medication • NSAIDs • Tylenol

  46. Treatment • RICE • Medication • Injection

  47. Treatment • RICE • Medication • Injection • Therapy • VMO • Closed chain

  48. Treatment • RICE • Medication • Injection • Therapy • VMO • Closed chain • Advanced imaging

  49. Treatment • RICE • Medication • Injection • Therapy • VMO • Closed chain • Advanced imaging • Surgery

  50. Back Exam • Disc herniation • Lumbar radiculopathy • Lumbar strain • Facet syndrome

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