The task related to this assessment is broken down into a number of sections:
Section 1: Identifying factors associated with Michael’s injury
Section 2: Modifying the load on the affected tissue
Section 3: How does Michael increase the capacity of the affected and non-affected tissues to withstand the load of running?
Section 4: Bringing it all together. How does Michael monitor and progress his training load as he prepares for the marathon in 2018?
Section 5: Psychosocial factors associated with injury and rehabilitation
The table below highlights tasks to be completed for each section of the assignment. Remember to scrutinise the assessment rubric to learn what is expected of you.
Review Michael’s subjective and objective information, including the
biomechanical findings (in the folder at the beginning of this assessment)
and Michael’s running diary. Analyse this information and propose factors
that might be associated with his injury. When compiling your answer
calculate the percentage increase in overall running volume from one
week to the next, and Michael’s Acute:Chronic Load Ratio, beginning at
week 4 of his program. Decide if Michael’s running volume might be
associated with increased risk of injury.
To manage Michael’s injury, he needs to modify the load on the affected
tissue and strike a balance between considering the risk of injury, or exacerbating
his symptoms, versus achieving his goal of running a marathon. Can you recommend
methods to help Michael manage the load on the affected tissue? In your answer
consider the following issues:
• Training modifications
• Orthomechanical treatments
• Monitoring pain levels during exercise
The biomechanical examination revealed deficits in muscle strength
(particularly of gastrocnemius, soleus and tibialis posterior) and reduced
ankle and first MTPJ range of motion.
Construct a broad muscle strength program, using resistance training
principles, to increase the capacity of these muscles to withstand the load
of running. In your answer, recommend a specific exercise dosage
(type, sets, repetitions, frequency) and how the exercise is progressed
(i.e. manipulation of the exercise dosage relating to the resistance,
type of exercise, number of sets and repetitions, rest period between
sets and frequency) to achieve a higher level of muscular strength.
In addition, use similar principles of dosage and progression to influence joint range of motion.
Using a table, similar to Michael’s training diary, construct a
week by week plan, for a period of four weeks, that incorporates
your strategies to modify the load, and increase the capacity of
the affected tissue. Consider how you will evaluate Michael’s symptoms,
and how he can monitor his training load to reduce the risk of injury.
Psychosocial factors are important in the experience of pain and level
of function in people with musculoskeletal pain. Discuss the potential
association between Michael’s beliefs, thoughts and fear about his
injury and how this might influence his rehabilitation. Explain how
you might reduce Michael’s fear about his injury.
To help support your responses to each section, consider the following readings:
2. Kulig (2010). Effect of Eccentric Exercise Program for Early Tibialis Posterior Tendinopathy (in key articles folder)
3. P. Brukner & K. Khan (Eds.), Brukner and Khan’s Clinical Sports Medicine (5th ed., pp. 139-151 [Training programming and prescription]; 277-284 [Principles of sports injury rehabilitation). Sydney: McGraw Hill Education.
An older version (Edition 4) is freely available through the LTU library. Refer to Chapter 15 on the Principles of Rehabilitation.
1. Lentz (2010). Pain-Related Fear Contributes to Self-Reported Disability in patients with ankle and foot pain (in key articles folder)
2. Booth (2017). Exercise for chronic musculoskeletal pain: A biopsychosocial approach
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