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Injury/Conditions Project

This article discusses various musculoskeletal and inflammatory conditions such as arthritis, enthesitis, epiphysitis, fibrositis, lymphangitis, lymphadenitis, myositis, peritendinitis, and calcific tendinopathy. It covers their definitions, causes, symptoms, management, and differential diagnoses.

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Injury/Conditions Project

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  1. Injury/Conditions Project Emily Carr

  2. General Musculoskeletal & Inflammatory Conditions

  3. Arthritis • Definition: degeneration of joint surfaces • Etiology: weight-bearing activities, over-use, repeated trauma • S/S: swelling, redness, p!, inability to function, stiffness obvious deformity; most symptoms are more noticeable in the morning • Mgmt.: exercise, weight control, modification of activity, prescription/OTC medications, glucosamine sulfate • D/D: exostosis, apophysitis • References: • Prentice WE. Principles of athletic training: a competency-Based approach. New York, NY: McGraw-Hill Education; 2015. • Starkey C, Brown SD. Examination of Orthopedic & Athletic Injuries. 4th ed. Philadelphia, PA: F.A. Davis Company; 2015.

  4. Enthesitis • Definition: inflammation at the attachment of muscle or tendon to bone • Etiology: repetitive biomechanical forces • S/S: inflammation, p! • Mgmt.: NSAIDs • D/D: tendonitis • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Kehl AS, Corr M, Weisman MH. Enthesitis: New Insights Into Pathogenesis, Diagnostic Modalities, and Treatment. Arthritis & rheumatology (Hoboken, N.J.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195265/. Published February 2016. Accessed December 3, 2017.

  5. Epiphysitis • Def: inflammation of the epiphysis or the cartilage that separates it from bone • Etiology: overuse, stress • S/S: inflammation, p! • Mgmt.: referral • D/D: epiphyseal plate fracture • References: • Diagnosing And Treating Distal Tibia Epiphysitis. Diagnosing And Treating Distal Tibia Epiphysitis | Podiatry Today. https://www.podiatrytoday.com/diagnosing-and-treating-distal-tibia-epiphysitis. Published November 28, 2017. Accessed December 8, 2017. • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996.

  6. Fibrositis • Def: inflammation of fibrous connective tissue • Etiology: infection • S/S: spontaneous p!, tendinitis • Mgmt.: referral • D/D: depression, polymyalgia • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Müller W. The fibrositis syndrome: diagnosis, differential diagnosis and pathogenesis. Scandinavian journal of rheumatology. Supplement. https://www.ncbi.nlm.nih.gov/pubmed/3317808. Accessed December 8, 2017.

  7. Lymphangitis • Def: inflammation of lymphatic vessels • Etiology: spread of infection (streptococcal bacteria) through lymphatic system • S/S: red streaks on skin along course of vessels, warmth, raised border around affected area, chills, fever, p!, swelling • Mgmt.: hospitalization, monitor vital signs, affected area should be elevated w/ warm moist compress, antibiotics, fluid intake • D/D: bacteremia • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. New York, NY: McGraw-Hill Education; 2015.

  8. Lymphadenitis • Def: inflamed & swollen lymph glands • Etiology: bacterial, fungal, or viral infection • S/S: inflammation of nodes, PT, redness/red streaking of skin • Mgmt.: antibiotics, pain relief, fever reducer • D/D: lymphadema • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Lymphadenitis 101: What You Should Know About Enlarged Lymph Nodes. Johns Hopkins Medicine Health Library. https://www.hopkinsmedicine.org/healthlibrary/conditions/infectious_diseases/lymphadenitis_134, 80. Accessed December 8, 2017.

  9. Myositis • Def: inflammation of muscle and/or its surrounding tissue • Etiology: repeated trauma causing irritation • S/S: crepitus, p!, inflammation • Mgmt.: rest, ice • D/D: tendonitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996.

  10. Peritendinitis • Def: inflammation of the peritendinous layer of thick tissue • Etiology: over-use, repetitive motions • S/S: localized p!, changes in movement patterns, crepitus • Mgmt.: avoid aggravating motions/activities, correcting imbalances, gradual RTP, rest • D/D: tenosynovitis • References: • Prentice WE. Principles of athletic training: a competency-Based approach. New York, NY: McGraw-Hill Education; 2015. • Starkey C, Brown SD. Examination of Orthopedic & Athletic Injuries. 4th ed. Philadelphia, PA: F.A. Davis Company; 2015.

  11. Calcific Tendinopathy • Def: calcium formation w/in a tendon • Etiology: develops w/ long term tendinopathies • S/S: p! w/ active contraction, decreased ROM and strength • Mgmt.: avoid aggravating motions/activities, correcting imbalances, gradual RTP • D/D: myositis ossificans • References: • Prentice WE. Principles of athletic training: a competency-Based approach. New York, NY: McGraw-Hill Education; 2015. • Starkey C, Brown SD. Examination of Orthopedic & Athletic Injuries. 4th ed. Philadelphia, PA: F.A. Davis Company; 2015.

  12. Apophysitis • Def: inflammation of an apophysis, “growing pains” • Etiology: over-use; muscle and tendon pulling on the bony prominence • S/S: pain during activity • Mgmt.: rest, ice, stretching, anti-inflammatory medications • D/D: bursitis • References: • Prentice WE. Principles of athletic training: a competency-Based approach. New York, NY: McGraw-Hill Education; 2015. • Starkey C, Brown SD. Examination of Orthopedic & Athletic Injuries. 4th ed. Philadelphia, PA: F.A. Davis Company; 2015.

  13. Avulsion Fracture • Def: fracture in which the tendon/muscle/ligament pulls off a piece of the bone that it is attached to • Etiology: repeated trauma, forceful contraction • S/S: palpable deformity, crepitus, p!, swelling, inflammation • Mgmt.: RICE, NSAIDs, referral, splinting • D/D: dislocation • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  14. Heterotopic Ossification (Myositis Ossificans) • Def: abnormal ossification involving bone deposition w/in muscle tissue • Etiology: single traumatic blow or repeated blows to the quads • S/S: warm, firm, swollen, palpable, painful, mass • Mgmt.: RICE, protected rest, referral • D/D: bruising • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  15. Neuritis • Def: inflammation and infection of a nerve • Etiology: trauma, compression • S/S: slight p!, paralysis • Mgmt.: referral • D/D: nerve entrapment • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  16. Osteomyelitis • Def: inflammation and infection of a bone • Etiology: pus-forming organisms, trauma to surrounding tissues • S/S: p!, inflammation, crepitus, swelling • Mgmt.: rest, ice, NSAIDs, referral • D/D: osteochondritis • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  17. Periostitis • Def: inflammation of the periosteum of a bone • Etiology: stress, overuse • S/S: p!, inflammation, crepitus, swelling,, • Mgmt.: rest, ice, NSAIDs • D/D: tendonitis, stress fracture • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  18. Radiculitis • Def: p! that radiates along a nerve • Etiology: inflammation • S/S: radiating p! • Mgmt.: NSAIDs, heat/cold therapy, rest • D/D: nerve pathology • References: • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015. • Radiculitis Symptoms and Causes. Atlantic Spine Center. http://www.atlanticspinecenter.com/conditions/radiculitis/symptoms-causes/. Accessed December 8, 2017.

  19. Synovitis • Def: inflammation of a synovial sheath • Etiology: overuse • S/S: crepitus, inflammation, local swelling • Mgmt.: limited activity, RICE, NSAIDs • D/D: tenosynovitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  20. Tendinopathy • Def: injury to a tendon • Etiology: overuse • S/S: crepitus, inflammation, local swelling • Mgmt.: limited activity, RICE, NSAIDs • D/D: peritendinitis, tendinitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  21. Tenosynovitis • Def: inflammation of the tendon synovial sheath • Etiology: overuse • S/S: crepitus, inflammation, local swelling • Mgmt.: limited activity, RICE, NSAIDs • D/D: peritendinitis, tendinitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  22. Osteochondral Fracture • Def: fracture of the cartilaginous covering of a bone • Etiology: joint instability • S/S: deep aching p!, swelling, instability and stiffness, crepitus, clicking • Mgmt.: referral, NSAIDs, surgery, limited weight bearing • D/D: severe joint instability, strain/sprains • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  23. Osteochondral Defect • Def: fragmentation of cartilage and underlying bone • Etiology: lateral compressive forces, inadequate blood supply, • S/S: dull, activity related, and poorly localized p!; locking; decreased motion; swelling; tenderness • Mgmt.: rest, referral • D/D: fracture, avascular necrosis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996.

  24. Complex Regional Pain Syndrome • Def: overactivity of the sympathetic nervous system • Etiology: unknown, trauma to a nerve • S/S: p! sx completely out of proportion, reduced joint ROM • Mgmt: desensitization. Increase joint ROM, reduce p! • D/D: malingering • References: • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  25. Head & Face

  26. Malignant Brain Edema Syndrome • Def: intracranial clot • Etiology: clot, intracranial swelling, head trauma • S/S: neurological deterioration • Mgmt: immediate referral • D/D: subdural hematoma • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  27. Second Impact Syndrome • Def: pt suffers one head trauma then suffers another close after • Etiology: rapid swelling and herniation of the brain after a second head injury • S/S: LOC, dilated pupils, loss of eye movement, respiratory failure • Mgmt: immediate referral • D/D: subdural hematoma • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  28. Mandibular Fracture • Def: fracture of the maxilla • Etiology: severe blow to the lower jaw • S/S: deformity, malocclusion, p!, bleeding, lower lip anesthesia • Mgmt: referral • D/D: broken nose, concussion, TMJ dysfunction • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  29. Maxillary Fracture • Def: fracture of the maxilla • Etiology: severe blow to the upper jaw • S/S: p! while chewing, malocclusion, nosebleed, double vision, numbness • Mgmt: referral • D/D: broken nose, concussion, TMJ dysfunction • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  30. Zygoma Fracture • Def: fracture of the zygoma • Etiology: blunt trauma to the cheekbone • S/S: deformity, epistaxis, diplopia, numbness • Mgmt: referral, cold application • D/D: broken nose, epistaxis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  31. LeFort Fractures • Def: transfacial fracture • Etiology: blunt trauma • S/S: severe headache, nausea, deformity • Mgmt: referral • D/D: concussion • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  32. Tongue Laceration • Def: cut tongue • Etiology: trauma • S/S: swelling, bleeding • Mgmt: referral • D/D: n/a • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  33. Septal Hematoma • Def: hematoma located on the nasal septum • Etiology: broken nose • S/S: blockage in breathing, nasal congestion, swelling • Mgmt: referral for drainage • D/D: broken nose • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  34. Tympanic Membrane Rupture • Def: ruptured ear drum • Etiology: contact and collision sports, water polo and diving; fall or slap to unprotected ear • S/S: loud pop, p!, nausea, vomiting, dizziness, hearing loss, visible rupture • Mgmt: most heal on own, referral • D/D: otitis media • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  35. Chalazion • Def: swollen sebaceous gland • Etiology: infection • S/S: erythema, painful pustule • Mgmt: resolves on its own, warm compress • D/D: conjunctivitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  36. Hordeolum • Def: swollen sebaceous gland • Etiology: infection • S/S: erythema, painful pustule • Mgmt: resolves on its own, warm compress • D/D: conjunctivitis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  37. Ruptured Globe • Def: disruption of the integrity of the outer membranes of eye • Etiology: penetrating trauma • S/S: p!, blurred vision, bleeding • Mgmt: referral • D/D: corneal laceration • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  38. Hyphema • Def: blood in the anterior chamber of the eye • Etiology: blunt trauma to the eye • S/S: p!, blurred vision, blood pooling • Mgmt: referral • D/D: dislocated lenses, cataract • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  39. Traumatic Iritis • Def: inflammation of the iris • Etiology: trauma • S/S: p!, inflammation, photophobia • Mgmt: referral • D/D: periorbital contusion • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Cuppett M, Walsh KM. General medical conditions in the athlete. 3rd ed. St. Louis, MO: Elsevier/Mosby; 2012.

  40. Foreign Body Embedment • Def: foreign object getting stuck in the upper or lower eyelid • Etiology: turf beads, dust, puncture wound • S/S: p!, disability • Mgmt: removal w/ sterile q-tip • D/D: corneal abrasion/laceration, eyelid laceration • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  41. Nasal Fracture • Def: fracture of the nasal bone • Etiology: direct blow, lateral force • S/S: hemorrhage, swelling, crepitus • Mgmt: control bleeding, referral, reduction • D/D: maxilla fracture, epistaxis • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  42. Spine

  43. Vertebral Dislocation/Subluxation • Def: dislocation/subluxation of the vertebrae • Etiology: violent flexion and rotation • S/S: p!, numbness, muscle weakness or paralysis • Mgmt: rest, referral, immobilization • D/D: fracture • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  44. Vertebral Fracture • Def: fracture of the vertebrae • Etiology: compression, forced flexion, direct trauma, violent torsion • S/S: p!, loss of ROM in spine, direct or indirect tenderness, rapid swelling, bony deviation, numbness • Mgmt: rest, referral, immobilization • D/D: dislocation, herniated disc • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  45. Intervertebral Disc Herniation • Def: slipped disc • Etiology: trauma, abnormal stress • S/S: p!, PT, numbness, muscle weakness, sensory • Mgmt: rest, referral • D/D: fracture, dislocation • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  46. Nerve Root Compression • Def: compressed nerves • Etiology: trauma • S/S: numbness, paresthesia, p!, loss of function, tenderness, muscle weakness • Mgmt: rest, referral • D/D: fracture, dislocation • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  47. Spinal Cord Injury • Def: damage to the spinal cord and its nerve roots • Etiology: laceration by bony fragments, hemorrhage, contusion, neuropraxia, shock • S/S: some form of paralysis or change in senses • Mgmt: rest, referral • D/D: fracture, dislocation, contusion • References: • Anderson MK, Barnum M. Foundations of athletic training: prevention, assessment, and management. Philadelphia: Wolters Kluwer Health; 2017. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

  48. Spondylitis • Def: arthritis of the spine • Etiology: unknown • S/S: p! longer than 3 mo., stiffness, radiating p!, limitation in ROM, PT of SI joint, • Mgmt: rest, ice, immobilization, anti-inflammatories • D/D: fractured vertebra, dislocated vertebrae • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Current allergy and asthma reports. https://www.ncbi.nlm.nih.gov/pubmed/25447326. Published January 2015. Accessed December 7, 2017.

  49. Spondylosis • Def: general term for age-related wear and tear of the spinal discs • Etiology: repeated minor trauma, chronic discopathy • S/S: increased back p! w/ activity, radiating p!, loss of function, hypalgesia • Mgmt: rest, immobilization, NSAIDs • D/D: nerve pathology, herniated disc, fracture • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Zheng B, Hao D, Guo H, He B. ACDF vs TDR for patients with cervical spondylosis - an 8 year follow up study. BMC surgery. https://www.ncbi.nlm.nih.gov/pubmed/29183306. Published November 28, 2017. Accessed December 7, 2017.

  50. Spondylolysis • Def: degeneration of vertebrae • Etiology: congenital weakness, sudden trauma such as hyperextension • S/S: persistent aching p! across LB, LB fatigues easily • Mgmt: rest, immobilization, NSAIDs • D/D: nerve pathology, herniated disc, fracture • References: • Gallaspy JB, May JD. Signs and symptoms of athletic injuries. London: Mosby; 1996. • Prentice WE. Principles of athletic training: a competency-Based approach. Singapore: McGraw-Hill Education; 2015.

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