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Learning PortfolioRyshen Spean AustinHLEX 4522 Senior Seminar / HLEX 4703 InternshipApril 19, 2018 Table of ContentsPersonal Mission Statement & Personal GoalsResumeReference ListCover LetterPortfolio OutcomesProfessionalism and Creativity HLEX 4522 Professional Goals AssignmentDue January 24, 2018 by 11:55pmName: Ryshen Spean-AustinThe Professional Goals assignment consists of two sections. 1) Review the "How to Develop Meaningful Goals and Objectives," "Career Mapping," "Ted Talk: New Kind of Job Market," and select two of the talks found at "Ted Talks: Talks to Help You Find the Right Job."The Ted talks that I watched was the “ why the best hire might not have the perfect resume” and “Why we do what we do”. Both these videos were something I could relate to.Students will develop 3 - 4 professional goals related to their careers and/or professional skills. The goals should be measurable and objective. Please construct 1 goal to be obtained within the next 6 months, 1 goal to be obtained within the next year, and 2 long term goals (5-10 years). Each goal should be 1-2 sentences and contain the following pieces of information. 1. Who will this goal impact? This goal will help me to become more confident in my career.2. What is the specifics of the goal? The specifics is to volunteer where I would potentially work.3. Where will this goal be achieved? My short term goal can be achieved through my internship. 4. When will you achieve this goal? I am hoping in the next 4 months.5. How will you achieve this goal? Through consistency and efficiency. Pushing myself to get work done before due date and being prepared.1 my short term goal- My career goal is to do what I love to do which is working around basketball. I also think I have an advantage because I work with the basketball team. The basketball team also has a athletic trainer who is always with us and that gives me an opportunity to watch and observe him and I can do this on my own time. I think this will be beneficial to me because I get extra time to learn things that I might not know. 2 my long term goal is what will help me prepare for my chosen career. Since I do not know where to start. I would need training to find out what I need to know in order to be successful. Working alongside someone who knows the job requirements.3 my goal will be to create a career plan making a list of things that I will need such as what are the requirements for this job position, working with experienced doctors, nurses or physical therapist, volunteer to become the best at what I do and to help with confidence.HLEX 4522 Mission Statement AssignmentDue January 22, 2018Name: Ryshen Spean-AustinThe product of this assignment is for you to create your own personal mission statement. You will bring a draft of this assignment to class on January 22th. There are two components of this assignment.Review the materials provided in the "Professional Mission Statement, Goals & Christian Professional Philosophy - PowerPoint" and the "Build a Mission Statement" links. Select and review at least 5 of the portfolios and mission statements at of students at List the names of the five students who portfolios you reviewed.Katie Gertler MediaDustin HigginbothamSean McFarlandBaylen WhitfieldJimmy Menk HereCompare and contrast the examples provided. Katie is a digital media: Graphic Designer. Over the years she had discovered that her passion for other media designs such as photography, web design, video and motion graphics. Dustin seems to be talented in a lot of areas such as 3D building, animation, graphic design, Illustration, logo design, photo editing, Photography, and videography.Sean is a photographer, videography, and social media production. His work that I have seen were wedding pictures. Baylen is a photographer, cinematographer, musician, co-producer, and designer.Jimmy is design, development, photograph, audio, animation and video. Photos jimmy takes are of faces and very close images.What stands out to you? What stood out to me about Katie was that she first started her education she wanted to be a graphic designer. But through the years after discovering the other forms of media changing her path into digital media with graphic design.What stood out to me about Dustin’s portfolio is his motivation to improve and challenge himself. Dustin’s portfolio shows me that he put a lot of time into his work that is being advertised.Sean’s picture quality is what stood out to me. His work looks very professional. Sean takes pride in his work.Baylen’s Portfolio statement was short and to the point. Also it was something that I could relate too.Jimmies photos are weird. The photos that I seen look like screenshots from the internet. I don’t see effort being put into his work.Are there components you really like? After looking into Katie’s portfolio of graphic design and I loved seeing her creativity that was put into her designs.Dustin’s art is different. I liked how some designs were actual pictures but were photo shopped with other images which made Dustin’s work unique.Sean’s art, is lifetime memory photos. Baylen’s work seems to be revolved around fashion and models.I don’t like jimmy’s portfolio. I don’t think jimmy put very much work into his portfolio.Are there components that you dislike? There was nothing that I didn’t like. I think everything that I had looked up about Katie was pretty good.Dustin’s art was different I think it was a more of a darker side of art. I’m not sure if I really liked it although there were accouple of visuals that I liked.I have no disagreements with sean’s portfolio.I have no disagreements with Baylen’s portfolioI feel like jimmy’s portfolio is very junk looking his art does not make sense to me.In this part of the assignment you will develop your own personal mission statement which describes your priorities, values, meanings, and/or principles as it relates to your anticipated professional career. Your personal mission statement should be not more than 3 – 4 sentences, should be concise yet complete, and be recognizable by your friends and family as a good description of you. I want to be a helping-hand to those in need as others were to me growing up. Above all, I want to lie my life as an active and authentic follower of Christ who exemplifies integrity and a Christ-like character. I want to honor God in everything I do, think, and say while aiming to excel, go above-and-beyond, and be the best I can be. Through this, I want to be trustworthy in my career, and treat the people around me with respect. Ryshen Spean-AustinP.O Box 242(801)600-7914Houck, AZ 86506rspeanaustin@Summary I want to help those in need as others were to me growing up. I want to be able to help patients with biomechanics, strength, conditioning, rehabilitation and occupational therapy. My desire to fulfill my Kinesiology profession is through my services as a health care provider so that I may be a Christ-centered example.CertificationCertified Nursing AssistantAugust 2011- May2012EducationMidAmerica Nazarene University Bachelor of Science in Kinesiology, Expected May 2019ExperienceKiddie KollegeFebruary 2016-PresentChildcare Supervising kids of the age of 1-3.Keeping track of children’s municating with parents.College Church of the NazareneAugust 2015-PresentChildcare Documenting Care and interactions with children throughout the municating with parents.Taking care of children ranging from 1 to 5 years old.Native American Christian AcademyAugust 2014-June 2015Assistant Dorm Parent grades 7th-8th Cared and provided for basic necessities for household daily life. Guided them through all scheduled meeting and dorm living obligations requisite.Native American Christian AcademyJanuary 2013-June 2015Assistant CookAccommodated head chef with meal preparation and set up for dining hall. Afterwards, expedited clean up and kitchen duties.VolunteerNative American Christian Academy2016, 2017Teaching basketball campAssisted with volunteer kitchen duties.Assisted with teaching in the classroom grades 1st-2nd.Ryshen Spean-AustinP.O Box 242(801)600-7914Houck, AZ 86506rspeanaustin@ReferenceRocky LamarMidAmerica Nazarene University Head Coach1248 South Hallet St. Olathe, KS 66062(913)522-9633rlamar@mnu.edu jolamar55@ Kris MillerNative American Christian Academy Executive DirectorP.O Box 4013 Sun Valley, AZ 86029-4013(210)419-1932krism@naca- Beth GfellerKiddie Kollege Childcare Director1000 East Harold Olathe, KS 66061(816)401-1944msbeth@ Rebecca TippettKiddie Kollege Childcare Assistant Director/Preschool Teacher915 Columbia Ave Leavenworth, KS 66048(757)998-1144Rebeccaelainepeery@ Amanda MalnarCollege Church of the Nazarene Nursery Director2020 East Sheridan Olathe, KS 66062(913)963-9233amalnar@ Cover LetterRyshen Spean-AustinP.O Box 242(801)600-7914Houck, AZ 86506rspeanaustin@MidAmerica Nazarene University Attn: Human Resources2030 East College WayOlathe, KS 66062-1899Dear Mid-America Nazarene University Human Resource Department,I want to first thank you for taking your time to read this and considering my application. I am currently attending MidAmerica Nazarene University getting my bachelor of science in kinesiology in May 2019. This job position will be beneficial because it also leads toward my hopes in my future career. As of right now, I am a Kinesiology major focusing on a career involving basketball. I’ve been blessed with the opportunity to work as manager with the basketball team for the last three years. Through this experience, it’s opened my eyes to what an athletic trainer entails. However, I am currently interning outside of basketball to expand my experience. This opportunity at MNU is also beneficial because it is very life-like and aligns with my vision for the future. Another beneficial thought is I am currently interning with one of the athletic trainers at MNU outside of basketball, so any questions I have later on that I think of regarding athletic training are available to be asked. This is a practice-makes-perfect mentality. Meaning, that I’m getting more first-hand experience, opportunity, and practice outside of my internship.Thank you again for your time and considering my application. I will take the necessary steps to excel and go above and beyond my job description. This is an opportunity that can’t be passed up MNU, has helped further my education, passion, and desire in pursuing my dream in Kinesiology and athletic training.Thank you again,Ryshen Spean-AustinCaption SheetRyshen Spean-AustinService Learning ProjectLearning Outcome #1: Assessing Needs, Assets and Capacity for Athletic Training, Fitness/Health or Recreation/Leisure ProgrammingCompetency 101: Plan Assessment ProcessesDescription: The service learning project was a great experience opportunity to work with work with Coach Rocky Lamar after his knee surgery. This was the first time I worked with a patient in such little time I learned a lot I also learned how to use game ready for the first time. When using game-ready I didn’t know what the machine was for but now that I am in my third year in the kinesiology program I know the importance of game-ready. Ryshen Spean-AustinSociologyProf. Bo CassellNovember 12, 2015Service Learning ProjectWhen the assignment was first given to us I had no idea what I wanted to do but, later that week I had an opportunity to get my hours in for this Service Learning Project. Well the Men’s basketball coach, Rocky Lama had just got a knee replacement done so for a while it was very hard for him to do things around the house because of his knee. Walking up the stairs was very difficult for him to do and I know it was very frustrating for him. All he could do really was to lay in his couch and just to keep his leg elevated so all the pain he was feeling would go away. He could not move as much, just because with every movement he made, that pain would strike him. So the things that he was used to doing in his everyday life, he could no longer do anymore of his routines at this point.Jo Lamar who is Rock’s wife when she got home she would take care of him when he needed something. Everything that needed to be done she took care of that for him. Well something came up with her kids and they needed her to be there. Well now that she had gone there was going to be nobody home to take care of Rocky and Rocky couldn’t go with Jo because of his knee surgery and also the Dr. said so. So I volunteered to take care of Rocky while Jo was gone for about a week.During this time while I was taking care of Rocky it was a very unique and educational learning experience for me. When I first started helpings I thought all I had to do was just to make sure he didn’t fall and die while I was watching him. But there was more to just watching, I had to cook for him, I had to make his ice, get his ice, help with therapy.The cooking part while watching coach Rocky was nothing really. I think the only difficult part about cooking for him was I cooked a different way. I didn’t know what to cook from his refrigerator. Back home it was easy to just open the refrigerator and make stuff that I already know how to cook. At Rocky’s home it was like a foreign county in the refrigerator. There was things in the fridge that I was not use to cooking. Everything I cooked for him that week I had to literally read the instructions.While helping coach Rocky I notice the sociology of the different cultures we both come from through the different types of food we both eat. In our sociology book Stark talks about subculture. “A subculture is a culture within a culture – a distinctive set of beliefs, morals, customs and the like are developed or maintained by some set of persons within the larger society”CITATION Rod07 \p 39 \l 1033 (Stark, 2007, p. 39). As a Native American I can say I have come from a reservation. Now living here in Kansas I see that we live in a culture within a culture. The Native American Reservation and the United States are like brothers and sisters because we all live together but, we also have our differences such as food. It just amazes me how close we live but, have different ways of living life.When I say I had to make his ice I didn’t mean pouring water into little containers to make ice. But there is this machine that takes water and ice and the cold water is transferred through a tub to a flat bag that wraps around certain body parts that need to be iced. . So since Rocky couldn’t move around very much I would get this machine prepared for Rocky before he was ready to use it. This machine worked great with Rocky’s knee. I have never seen a machine like it before so using the machine on Rocky and seeing how it worked was a great experience for me learn. It may seem like it wasn’t much but I can now say I have experience. Since Rocky had to be on this machine 4 times a day we were going through two big bags of ice each day. Every other day I was running to the store to buy ice for this ice machine.In Chapter 2 Stark says “Culture is the complex pattern of living that directs human social life………..Cultures interpret our surroundings for us and give them meaning and allow us to express ourselves”CITATION Rod07 \p 39 \l 1033 (Stark, 2007, p. 39). Since I have been living here in the state of Kansas I have noticed through all the trips to the gas stations that were just around the corner to pick up a bag of ice. People here are but, do not realize how blessed they are. Living on the reservation we have to travel 30 minutes to an hour or Six hours way, just to get the things that we need. A convenient store is not just around the corner, when we need something it’s hard to just leave for one item. So being here I feel like what stark had to say is true the culture you live in directs your social life pattern. Our surroundings may not have meaning until you experience new living conditions which allows you to see things in a different point of view that allows you to express yourself in situations like mine.During the five hours of just helping Rocky with his knee was so amazing I had learned so much in such little time. Each and every one of these jobs were so little but there was so much information through my service. I honestly loved every minute and at the same time as I gave my time I knew I was helping and I felt good about it. Through this experience I believe I have created a tie “….A tie is another word for a link or a relationship, and Granovetter operationalized the strength of a tie as a combination of the amount of time, the emotional intensity, the intimacy (mutual confiding), and the reciprocal services which characterize the tie”CITATION Rod07 \p 35 \l 1033 (Stark, 2007, p. 35)Bibliography BIBLIOGRAPHY Stark, R. (2007). Sociology Tenth Edition. Caption SheetRyshen Spean-AustinIntroduction Needs AssessmentLearning Outcome #1: Assessing Needs, Assets and Capacity for Athletic Training, Fitness/Health or Recreation/Leisure ProgrammingCompetency 1.4: Examine Relationships among Behavioral, Environmental and Genetic Factors That Enhance or Compromise Athletic Training, Fitness/Health, and/or Recreation/LeisureDescription: This project was for me to plan a needs assessment for a high school basketball team. This was also a new scope of practice that was helped me understand the importance of creating a Rehabilitation program for patients. Ryshen Spean AustinPsychology of SportFinal ProjectIntroduction Needs Assessment-I will be using basketball as my sport and the level of the team will be High School.I will be using the mental skills assessment. This will be administered when athletes need help to understand their strengths, weakness, and mental toughness. Basketball is a team sport; athletes who play will have to learn how to utilize their mental skills. In order to do so as a coach, the mission is to educate the athletes as a team. Once the team has understood and are aware of their own mental patterns, we can shift to the acquisition phase. The acquisition phase assists athletes to identify mental skills training tools, skills and allows athletes to have a chance to assess their skills. Then the implementation phase; helps the athletes to use the tools, skills, and build strategies in their game. Implementation plays an important role when the pressure is on in a game knowing how to utilize these strategies will help tremendously in competitive situations. As a coach I would like to take the time to teach mental toughness by using the mental skills training program.Self-Confidence-Self-confidence is the belief that you can handle or realistic belief to achieving the demands and challenges of the game. Performance confidence is based on consistent success on how you have performed in previous games. It also depends on how well you manage your inner critic. Self-confidence during competition is to compete against uncertainty with positive attitude. Imagery-Imagery is the mental practice skill or given task without actually doing it, allowing your mind’s eye to see how you preform. Imagery involves more than visualization such as using all other senses. The most effectiveness when it enhances physical practice when using it correctly and is useful in both precompetitive and competitive situations. Through imagery athletes learn to cope effectively and keeping a positive mind set.Goal setting- Goal setting means achieving a specific level of performance in a certain amount of time. The education phase will help in achieving this goal; it allows athletes to be aware of goal setting and teaches athletes to focus on improving measurable skills. Goal setting is a valuable basic skill the acquisition phase helps when choosing. Implementation focuses on automating goals in higher level of performance it provides focus, facilitates effort, and leads to new skills. Progress MST-Athlete will be tracked at the beginning of practice and a hour after practice. The things that will need to be recorded will be the rate of the athletes mental skill level for the most important part of practice and also how the athletes overall performance during practice.12 Week programWEEK 1AssessmentIdentifying athlete’s mental strengths and weakness.Performance Profiling-To help athletes and teams identify their physical and mental strengths and weaknesses.WEEK 2AssessmentLearning the essentials of realistic belief about achieving successSelf-confidence- Managing emotions, managing anxiety Imagery-Seeing yourself play in your mind Goal setting- Motivation, attitude, commitmentWEEK 3EducationGoal setting-Aim for something that has purpose to the athlete and have a measurable progress to be met.Self-Confidence-Accept anxiety.Imagery- Think of a nice sceneryWEEK 4EducationGoal setting- Choose realistic goals that can be accomplished, set goals in a timely manner learning new skills takes time.Self-Confidence-Realize anxiety can be beneficial to perform well.Imagery- Think of a nice scenery and now think of what it smells likeWEEK 5Education Goal setting-Employing a systematic goal implementation strategy.Learning this new strategy not only will help in sports but also in life.Self-Confidence-Concentrate on what is important in a gameImagery- Think of the scenery scent and feel what is around youWEEK 6AcquisitionGoal setting- Work on guiding athletes to their vision and dreamsSelf-Confidence-Accept negative emotionsImagery- Now imagine yourself playing in a game that you wonWEEK 7AcquisitionGoal setting- Athlete will have 3 long terms goalsSelf-Confidence-Learn how to control and reduce anxietyImagery- How did you perform in the game, correct your mistakesWEEK 8AcquisitionGoal setting- Enhancing athletes focus and concentration that will boost confidence.Self-Confidence-Learn how to turn emotions into good performances Imagery-Prepare to recover from errorsWEEK 9ImplementationGoal setting-Athletes will set goals in practice. Over time skills will be more automatedSelf-Confidence-Regain focus when concentration is overwhelmedImagery-View your performance of how well you did in practiceWEEK 10ImplementationGoal setting-Raising the bar of goal setting. Athletes will challenge themselves.Self-Confidence-Learn to trust yourself, don’t let pass mistakes stop you.Imagery-Use imagery to help you develop mental skills to lower stressWEEK 11ImplementationGoal setting-Goals are better met when team mates are encouraging each other; talk with team mates.Self-Confidence-Maintain confident and self-talk, emotionally feeling betterImagery-while thinking of tough situations and negative thinking appears, maintain self-confidence.WEEK 12ImplementationGoal setting- setting and meeting goals to increase motivation and self confidence.Self-Confidence- Use back up mental performances and have a recovery planImagery- Unexpected competition and through imagery athlete can effectively make a plan to deal with the problem and remain confident Caption SheetRyshen Spean-AustinThe Professional Goals assignment consists of two sectionsLearning Outcome #2: Planning Athletic Training, Fitness/Health, and/or Recreation/Leisure ProgrammingCompetency 2.2: Develop Goals and ObjectivesDescription: I learned the importance of Goal setting also having a goal that is reasonable and having a time when to achieve a goal. I have learned over the years that having goals is important especially in my chosen career. HLEX 4522 Professional Goals AssignmentDue January 24, 2018 by 11:55pmName: Ryshen Spean-AustinThe Professional Goals assignment consists of two sections. 1) Review the "How to Develop Meaningful Goals and Objectives," "Career Mapping," "Ted Talk: New Kind of Job Market," and select two of the talks found at "Ted Talks: Talks to Help You Find the Right Job."The Ted talks that I watched was the “ why the best hire might not have the perfect resume” and “Why we do what we do”. Both these videos were something I could relate to.Students will develop 3 - 4 professional goals related to their careers and/or professional skills. The goals should be measurable and objective. Please construct 1 goal to be obtained within the next 6 months, 1 goal to be obtained within the next year, and 2 long term goals (5-10 years). Each goal should be 1-2 sentences and contain the following pieces of information. 1. Who will this goal impact? This goal will help me to become more confident in my career.2. What is the specifics of the goal? The specifics is to volunteer where I would potentially work.3. Where will this goal be achieved? My short term goal can be achieved through my internship. 4. When will you achieve this goal? I am hoping in the next 4 months.5. How will you achieve this goal? Through consistency and efficiency. Pushing myself to get work done before due date and being prepared.1 my short term goal- My career goal is to do what I love to do which is working around basketball. I also think I have an advantage because I work with the basketball team. The basketball team also has a athletic trainer who is always with us and that gives me an opportunity to watch and observe him and I can do this on my own time. I think this will be beneficial to me because I get extra time to learn things that I might not know. 2 my long term goal is what will help me prepare for my chosen career. Since I do not know where to start. I would need training to find out what I need to know in order to be successful. Working alongside someone who knows the job requirements.3 my goal will be to create a career plan making a list of things that I will need such as what are the requirements for this job position, working with experienced doctors, nurses or physical therapist, volunteer to become the best at what I do and to help with confidence.Caption SheetRyshen Spean-AustinCreation of Emergency Action PlanLearning Outcome #2: Planning Athletic Training, Fitness/Health, and/or Recreation/Leisure ProgrammingCompetency 2.3: Select or Design Strategies and InterventionsDescription: This assignment has made me realize the importance of being aware of your surroundings both in and outside of your facility. Another important thing to beware of, is making sure all employees are all on the same page.Emergency Action Plan Detailed InstructionsCreation of Emergency Action PlanEmergency situations may arise at any time and it’s vital that expedient action be taken in order to provide the best possible care to the athletes, clients or patients of emergency and/or life threatening conditions. The development and implementation of an emergency plan will help ensure that the best care will be anizations have a duty to develop an emergency plan that may be implemented immediately when necessary and to provide appropriate standards of health care to all participants. As injuries may occur at any time and during any activity, the sports medicine team must be prepared. This preparation involves the formulation of an emergency plan, maintenance of appropriate emergency equipment and supplies, utilization of appropriate emergency medical personnel, and continuing education in the area of emergency medicine. Accidents and injuries are inherent with activity participation, and proper preparation on the part of the sports medicine team will enable each emergency situation to be managed properly.For this portion of the project, you will need to create an Emergency Action Plan (EAP) for your athletic training room or healthcare facility that you have been creating. Your EAP should consist of these basic components:Emergency personnel and the roles within the emergency teamReceptionists is responsible for calling 911 and giving detailed instructions on how to get to the facility. Facility Manager will be present at all emergency situations. They will be responsible for getting necessary emergency equipment as for the clinician responsible for the patient is in-charge of alerting all other necessary office personnel and staying until the patient is transported or well enough to go home. Personnel not assisting a patient need to help with the emergency and will be instructed on what needs to be done by the clinic manager. Facility Manager and the Clinic Director will be emailed incident reports within 24 hours of the event also all staff members will be required to obtain and maintain Basic Life Support) and First Aid certification. The Emergency Action plan will be reviewed and scenarios will be practiced to ensure everyone understands their role. Emergency communicationLocal Fire DepartmentLocal Police EMS/Paramedic Emergency equipmentEmergency BagGlovesWound careStethoscopeSphygmomanometerAutomated External Defibrillators (AED)Emergency transportAmbulanceVenue directions with mapOlathe Medical Center is directly across the street from the facility. Caption SheetRyshen Spean-AustinSLAP Lesion & Repair Rehabilitation ProgramLearning Outcome #3: Implementing Athletic Training, Fitness/Health, and/or Recreation/Leisure programmingCompetency 3.1: Implement a Plan of ActionDescription: This assignment taught me how to create a Rehabilitation Program such as; the phases, PT’s position and the execution of an exercise.SLAP Lesion & Repair Rehabilitation Program?????????????0-3 Weeks Post-op???????????????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Passive Pendulum Phase 1ShoulderRange of MotionSupine, shoulder at edge of tableNo Clinician neededPatient will use table to help stablize the uninjured shoulder while the injured side will be relaxed and movements will come from lower extremities and not the shoulder muscles. Arm should move in gentle circular movements. Should be done in 3 to 4 minutes.This is a passive exerciseIsometric shoulder extensionPhase 1Glenohumeral jointstrengthen the shoulder extension muclespatient will stand with her back towards the wall and the pink side of hand will press against the wall.No Clinician neededElbow should remain extended while patient is pressing against the wall Control pain and swelling Medial RotationPhase 1ShoulderTo the range of motion and stretch the shoulder joint.patient stands in front of a table with her back towards the table and then she will hold on to the tableNo Clinician neededThe patient will while still holding on to the counter top she will squat this is to gain flexibility.Help the rcovery for healingRhythmic Stabiliztion 1Phase 1ScapulaThis is a proprioception exercise to help with patients awarnesspatient will stand facing a table and she will place both hands on the table and her arms will be in a scapular plane arms should be at 90 to 100 degrees.clinician maybe behind patient with both hands against shoulder blades as patient resists.Patient will be weight bearing in a closed kinetic chain with eyes closed to maintain stability and resisting the patient at the same time.Do not let the shoulder become stiffPower GripPhase 1HandTo strengthen the flexorsHand will be placed around a ball or putty No Clinician neededPatient will squeeze the ball or puttyProtect where surgery was done????????3-4 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Prone FlyPhase 2Upper Backstrengthen the muscles around the rotator cuff such as the; rhomboids, middle trapezius and spin extensorsPatient will lay prone with arms hanging down to the floor and her head will be off of the tableNo Clinician neededUsing light weight patient lift the weights trying to squeez her scapulas together.Protect the surgery areaBouhler ExercisePhase 2Middle and Lower BackTo strengthen the middle backPatient will lay prone with arms extended above her headNo Clinician neededWhile in this postion the patients goal is to tighten her abdominal mucles so the trunk is stablized.Improve Range of MotionSuperior Capsule stretchPhase 2GlenohumeralMoblity and shoulder extensionPatient is standing and has a rolled towel between her under armsNo Clinician neededThe patient will take her hand that is not injuried and she will pull the injured side in towards the trunk.Light strengthening exerciseWingsPhase 2ScapulothoracicStrengthen rhomboids and trapeziusPatient is standing with elbows flexed at 90 degrees and is holding a rubber bandNo Clinician neededPatients goal is to keep the elbow touching the trunk and the forearm remains to stay at 90 degrees as the patient tries to squeeze her scapulas together.?Wand Abduction stretchPhase 2ShoulderIncrease abductionPatient is standing and with any striaght object patient will place her hand at the end of the object and the non-injured side at the oposite end No Clinician neededpatient will place her hand at the end of the object and the non-injured side at the oposite end and placing some foce at the end of the pole to put the once was injured side into abduction.This releases impingment ????????4-6 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Sleeper StretchPhase 3ShoulderMobility Patient is laying on her side while her hip and knees are flexed to stabalize her body the involved arm is at 90 degreesNo Clinician neededThe patient resists herself by placing her univolved hand over the involved side and pushing towards the surfaceHold for 30 secondsProne Horizontal abductionPhase 3ScapulotharacicStrengthen MusclesPatient is laying prone arms are extendedNo Clinician neededPatient is laying prone on a table and her arms and upper extremities off of the table patient will have weights and will perform abduction scapulae retraction squeeze. Patients elbows are to be extended through the movements.125 degrees elevation and 90 degrees of lateral rotation.Rows with pullysPhase 3ScapulotharacicRhomboidPatient will be sitting down and will have to bands in her hands ready to pull for resistance.No Clinician neededPatient will pull the rubber bands that were in her hands to retract the scapulae and maintaing the elbows to stay close to the trunk.A swiss ball can be used.Dynamic hug with resistance bandPhase 3ScapulotharacicSerratus anteriorPatient is standing with resistant band behing each shoulder blade and both hands have a grip and the elbows are flexed.No Clinician neededThe patient will need to pull the band forward as far as she can.Clinician will need to remind patient to keep her shoulders flexed above 60 degrees.Manual resistancePhase 3ScapulotharacicSerratus anteriorPatient is laying supine with shoulders flexed and elbow extendedClinician will be on the involved side above and paralled to the patients head Patient will resist the clinicians force towards the ceiling the goal here is to have movement coming from scapula as it rolls around the ribs.Clinician will need to remind patient to keep shoulders against the table when performing this exercise.????????6-9 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Push-up PlusPhase 4ScapulotharacicSerratus anterior strengthPatient will stand in front of the wall and will perform a push-up while standingNo Clinician neededPatient will perform a push up while standing this is to work on scapular protraction and trunk. The exercise it to work on patients instabilityPatient needs to be careful not to reinjure their shoulder that had surgery.Isometric Shoulder FlexionPhase 4ShoulderTo provent deconditioningPatient stands in front of wall with elbows extended and shoulders slightly flexedNo Clinician neededPatient will use wall as a resistant as the push against the wall with a fist and thumbs against the wall.Keep elbows extended and keep body stable.Wrist flexionPhase 4wrist FlexorsWrist flexorsPatient will be sitting with a table on the involved side so patient can use as a stableizer. No Clinician neededPatient will need to use weights as a resistance to to help with the flexors to srtengthen. Patients movements will start from wrist flexion to wrist extension.Perform this jexercise at least once a weekPress-Down resistance bandsPhase 4ScapulotharacicScapulaThe elastic band over the head and patient places her hand at the end of the band while patient is standingNo Clinician neededshoulder and elbow needs to be extended before starting this exercise. The goal is to get the scapula to move in a full range of motion.This exercise should be done once a day.Lawnmower ExercisePhase 4ScapulotharacicTrapeziusPatient will stand with a resistant band uner the oposite side of the involved handClinician needs to help guide the patient from a distancePatients hip will be flexed and her upper body will rotate toward the involve shoulder and as the body rotates the elbow will flex moving closer to the trunkAdvance resistant exercise????????Caption SheetRyshen Spean-AustinComprehensive Rehabilitation ProgramLearning Outcome #3: Implementing Athletic Training, Fitness/Health, and/or Recreation/Leisure programmingCompetency 3.3: Train Individuals Involved in Implementation of Athletic Training, Fitness/Health, and/or Recreation/LeisureDescription: This assignment has taught me the entire process when an injury occurs and the process of the surgery. It taught me the rehabilitation after prehensive Rehabilitation ProgramName: Ryshen Spean Austin MidAmerica Nazarene University December 1, 2017Part I – Injury and Surgical OverviewOur patient a 21 year old female. She is a volleyball player whose position is a middle blocker with a SLAP lesion in her right shoulder. She noticed a lot of pain during activities, especially during swinging. She is also experiencing a catching and popping in her shoulder. A SLAP lesion is a tear of the labrum above the middle of the glenoid that may also involve the biceps tendon. In this individual, they do not think that the biceps tendon is involved. The labral tear was caused by overuse. In order to fix this and continue playing, she is going to have arthroscopic surgery to fix the tear and instability. To fix the tear, an anesthesiologist first administers a nerve block while she is still in pre-op. This nerve block lasts between 12-18 hours and helps the patient with pain after the procedure. Once the patient is taken into the surgery room and is placed under anesthesia, the surgeon places a camera into the shoulder by using small incisions. Next, the surgeon looks over the tendons, ligaments, cartilage, and bone of the shoulder completely to get a good look as to what is going on. When the tear is located, additional incisions are made for the instruments that are used to fix the tear. Since the tear is in the superior part of the labrum, the surgeon examines the biceps tendon to make sure that there is no tear with it. Superior tears in the labrum cause instability in the biceps tendon, sometimes causing an injury to that tendon, as well. Once he is done examining the biceps tendon, he moves on and locates the labrum. Depending on the severity of the tear, he has to choose to either replace it all together or to partially replace it and sew it down. He decides to sew down the labrum using implants that are called suture anchors. These anchors go into the bone and the labrum is sewn down with sutures, which hold down the labrum to the socket until it is healed. Once that is complete, the labrum is fixed and the surgeon closes the patient up. The patient is then wrapped in dressings and put into a sling. The patient stays in the sling for 4-6 weeks, and is then examined by the surgeon to ensure that it is healing properly and ready to move on to the next phase, which includes the beginning of physical therapy. Arthroscopic repair is most popular in young athletes because it is less invasive and has a quicker recovery time for wounds. Physical therapy is an option for people with labral tears who do not want to have surgery, but because the patient is a college athlete that does overhead activity the majority of the time, arthroscopic surgery is the best route to take so that there is no further damage to the shoulder. The patient is required to wear a sling for four to six weeks, depending on how the shoulder heals. While the patient is still in the sling, they can still do exercises, but with minimal range of motion and resistance. They are able to do gentle, passive range of motion exercises to keep her shoulder from getting too stiff. The most popular exercise that surgeons prescribe after surgery is the pendulum swing. The patient bends forward at the waist, close to a 90 degree angle, letting their arm dangle in front of them with no resistance. Then they are able to slowly swing it front to back, and then side to side, and then lastly around in a full circle. Research from “Physical Therapist’s Guide to Shoulder Labral Tear,” shows that doing this exercise promotes blood flow and prevents the patient from getting too much scar tissue build up, causing frozen shoulder. Once the patient is out of the sling, research shows that they can start with stretching and little amounts of strengthening. The priority when the patient is out of the sling is to bring the range of motion back to a normal range. Active stretching is always first, and then slowly shifting to passive stretching. Once the patient is back to their normal range of motion, they can begin increasing the exercises and making it more strenuous. Strengthening the shoulder provides stabilization, which takes stress off, of the injured area and promotes better healing to the area. When strength has gotten to a normal point, the patient can begin stability exercises, such as planks on a Bosu Ball. It is crucial for the patient to stabilize the shoulder, especially if they are an overhead athlete. Stabilization is a very important key to have before the patient can return to play. Lack of stabilization can cause the patient to re-injure the labrum or re-injure a different part of the shoulder. Lastly, the physical therapist incorporates exercises that are similar to what she would be doing once she is able to return to play. Using a volleyball while doing exercises helps the athlete stay engaged, while also keeping them involved in their sport. It will also show if the patient is able to do all the activities that is needed for her to be able to return to play. Once the athlete is cleared and able to return to volleyball, they must be extremely careful not to go all out right away. They need to slowly start getting back into the swing of things and then go up from there. Part II – Outcomes and GoalsOverall Goal of the Rehabilitation Program:Return to play Performance-Based Outcome Measures:passive range of motion for shoulder flexion, abduction, adduction, internal and external rotation. You can use dumbbells or Thera bands 2. hand gripping and cervical spine and scapular active range of motion - gripping can be use by play doo or sand bags 3. Shoulders pulleys -it can be supported by bands under your feet. 4 dumbbell and medicine ball exercise 5. High velocity strengthening and dynamic control, compare it to plyometrics and rapid exercise band drills Short-Term Goals: Provide five short-term goals for your athlete, including timeframe.1.Pain management and swelling 2. Activation of the stabilizing muscles of the glenohumeral and scapulo-thoracic joints 3. prevent de-condition “Improve core and hip strength and mobility to eliminate any compensatory stresses to the shoulder “4. Begin early shoulder range of motion 5. slowly start hitting the ball. Long-Term Goals: Provide five long-term goals for your athlete, including plete a full practice 2. restore full range of motion -improve neuromuscular, improve dynamic stability 3. Prevent scar tissue build up 4. regain strengthen - improve strength, power and endurance 5. No apprehension or instability with high velocity overhead movementsPart III – Program Design (2 parts)SLAP Lesion & Repair Rehabilitation Program?????????????0-3 Weeks Post-op???????????????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Passive Pendulum Phase 1ShoulderRange of MotionSupine, shoulder at edge of tableNo Clinician neededPatient will use table to help stablize the uninjured shoulder while the injured side will be relaxed and movements will come from lower extremities and not the shoulder muscles. Arm should move in gentle circular movements. Should be done in 3 to 4 minutes.This is a passive exerciseIsometric shoulder extensionPhase 1Glenohumeral jointstrengthen the shoulder extension musclespatient will stand with her back towards the wall and the pink side of hand will press against the wall.No Clinician neededElbow should remain extended while patient is pressing against the wall Control pain and swelling Medial RotationPhase 1ShoulderTo the range of motion and stretch the shoulder joint.patient stands in front of a table with her back towards the table and then she will hold on to the tableNo Clinician neededThe patient will while still holding on to the counter top she will squat this is to gain flexibility.Help the recovery for healingRhythmic Stabilization 1Phase 1ScapulaThis is a proprioception exercise to help with patients awarenesspatient will stand facing a table and she will place both hands on the table and her arms will be in a scapular plane arms should be at 90 to 100 degrees.clinician maybe behind patient with both hands against shoulder blades as patient resists.Patient will be weight bearing in a closed kinetic chain with eyes closed to maintain stability and resisting the patient at the same time.Do not let the shoulder become stiffPower GripPhase 1HandTo strengthen the flexorsHand will be placed around a ball or putty No Clinician neededPatient will squeeze the ball or puttyProtect where surgery was done????????3-4 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Prone FlyPhase 2Upper Backstrengthen the muscles around the rotator cuff such as the; rhomboids, middle trapezius and spin extensorsPatient will lay prone with arms hanging down to the floor and her head will be off of the tableNo Clinician neededUsing light weight patient lift the weights trying to squeeze her scapula’s together.Protect the surgery areaBouhler ExercisePhase 2Middle and Lower BackTo strengthen the middle backPatient will lay prone with arms extended above her headNo Clinician neededWhile in this position the patients goal is to tighten her abdominal muscles so the trunk is stabilized.Improve Range of MotionSuperior Capsule stretchPhase 2GlenohumeralMobility and shoulder extensionPatient is standing and has a rolled towel between her under armsNo Clinician neededThe patient will take her hand that is not injured and she will pull the injured side in towards the trunk.Light strengthening exerciseWingsPhase 2ScapulothoracicStrengthen rhomboids and trapeziusPatient is standing with elbows flexed at 90 degrees and is holding a rubber bandNo Clinician neededPatients goal is to keep the elbow touching the trunk and the forearm remains to stay at 90 degrees as the patient tries to squeeze her scapula’s together.?Wand Abduction stretchPhase 2ShoulderIncrease abductionPatient is standing and with any straight object patient will place her hand at the end of the object and the non-injured side at the opposite end No Clinician neededpatient will place her hand at the end of the object and the non-injured side at the opposite end and placing some force at the end of the pole to put the once was injured side into abduction.This releases impingement ????????4-6 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Sleeper StretchPhase 3ShoulderMobility Patient is laying on her side while her hip and knees are flexed to stabilize her body the involved arm is at 90 degreesNo Clinician neededThe patient resists herself by placing her uninvolved hand over the involved side and pushing towards the surfaceHold for 30 secondsProne Horizontal abductionPhase 3ScapulothoracicStrengthen MusclesPatient is laying prone arms are extendedNo Clinician neededPatient is laying prone on a table and her arms and upper extremities off of the table patient will have weights and will perform abduction scapulae retraction squeeze. Patients elbows are to be extended through the movements.125 degrees elevation and 90 degrees of lateral rotation.Rows with pulleysPhase 3ScapulothoracicRhomboidPatient will be sitting down and will have to bands in her hands ready to pull for resistance.No Clinician neededPatient will pull the rubber bands that were in her hands to retract the scapulae and maintain the elbows to stay close to the trunk.A swiss ball can be used.Dynamic hug with resistance bandPhase 3ScapulothoracicSerratus anteriorPatient is standing with resistant band being each shoulder blade and both hands have a grip and the elbows are flexed.No Clinician neededThe patient will need to pull the band forward as far as she can.Clinician will need to remind patient to keep her shoulders flexed above 60 degrees.Manual resistancePhase 3ScapulothoracicSerratus anteriorPatient is laying supine with shoulders flexed and elbow extendedClinician will be on the involved side above and parallel to the patients head Patient will resist the clinicians force towards the ceiling the goal here is to have movement coming from scapula as it rolls around the ribs.Clinician will need to remind patient to keep shoulders against the table when performing this exercise.????????6-9 Weeks Post-op???????Exercise/InterventionPhaseBody SegmentPurposePt PositionClinician & Hand PositionExecutionNotations????????Push-up PlusPhase 4ScapulothoracicSerratus anterior strengthPatient will stand in front of the wall and will perform a push-up while standingNo Clinician neededPatient will perform a push up while standing this is to work on scapular protraction and trunk. The exercise it to work on patients instabilityPatient needs to be careful not to reinjure their shoulder that had surgery.Isometric Shoulder FlexionPhase 4ShoulderTo prevent deconditioningPatient stands in front of wall with elbows extended and shoulders slightly flexedNo Clinician neededPatient will use wall as a resistant as the push against the wall with a fist and thumbs against the wall.Keep elbows extended and keep body stable.Wrist flexionPhase 4wrist FlexorsWrist flexorsPatient will be sitting with a table on the involved side so patient can use as a stabilizer. No Clinician neededPatient will need to use weights as a resistance to help with the flexors to strengthen. Patients movements will start from wrist flexion to wrist extension.Perform this exercise at least once a weekPress-Down resistance bandsPhase 4ScapulothoracicScapulaThe elastic band over the head and patient places her hand at the end of the band while patient is standingNo Clinician neededshoulder and elbow needs to be extended before starting this exercise. The goal is to get the scapula to move in a full range of motion.This exercise should be done once a day.Lawnmower ExercisePhase 4ScapulothoracicTrapeziusPatient will stand with a resistant band under the opposite side of the involved handClinician needs to help guide the patient from a distancePatients hip will be flexed, and her upper body will rotate toward the involve shoulder and as the body rotates the elbow will flex moving closer to the trunkAdvance resistant exercise LINK Excel.Sheet.12 "D:\\Therapeutic\\Copy of SLAP Lesion and Repair Rehabilitation Program.xlsx" "Sheet1!R1C1:R38C8" \a \f 5 \h \* MERGEFORMAT Part IV – Return to Sport Assessment5099541828800Movement and/Performance TestsInstructionsPassing Criteria1 overhead internal/external rotation for shoulderWith shoulder and elbow at 90 degree angles, rotate arm back, and then go back. Repeat 3x15 using med. to high resistance band. Shoulder is not hiking, able to do workout without pain/popping or catching of shoulder.2 Kettle bell swingsGrip a kettle bell with both hands, swing kettle bell up above head and then between legs, squatting as the kettle bell goes down. 3 sets of 8 reps. Able to do good amount of weight (at least 8-10 kgs), able to swing through full motion with good ROM, no pain. 3 Slide Board workoutWhile putting hands on slide board, go up into a plank position, stabilizing your body with your hands. Move one arm in circular motion, maintaining balance. Do 10 reps and then switch direction, and then move to next arm. Repeat 3-4 times. Able to maintain balance, not using left shoulder to compensate for right shoulder. 4 I, Y, T, & W’sUsing 5-10lb weights, move arm in a I, Y, T, & W motion. 3x10 each motion. Shoulder is not hiking up, and able to move shoulder with no pain. 5. chin ups/ Pull ups with band support Using a band underneath to help support if you are unable to do chin ups or pull up on your own do 30 x 30 Able to do exercise without pain numbing of the shoulder 00Movement and/Performance TestsInstructionsPassing Criteria1 overhead internal/external rotation for shoulderWith shoulder and elbow at 90 degree angles, rotate arm back, and then go back. Repeat 3x15 using med. to high resistance band. Shoulder is not hiking, able to do workout without pain/popping or catching of shoulder.2 Kettle bell swingsGrip a kettle bell with both hands, swing kettle bell up above head and then between legs, squatting as the kettle bell goes down. 3 sets of 8 reps. Able to do good amount of weight (at least 8-10 kgs), able to swing through full motion with good ROM, no pain. 3 Slide Board workoutWhile putting hands on slide board, go up into a plank position, stabilizing your body with your hands. Move one arm in circular motion, maintaining balance. Do 10 reps and then switch direction, and then move to next arm. Repeat 3-4 times. Able to maintain balance, not using left shoulder to compensate for right shoulder. 4 I, Y, T, & W’sUsing 5-10lb weights, move arm in a I, Y, T, & W motion. 3x10 each motion. Shoulder is not hiking up, and able to move shoulder with no pain. 5. chin ups/ Pull ups with band support Using a band underneath to help support if you are unable to do chin ups or pull up on your own do 30 x 30 Able to do exercise without pain numbing of the shoulder Part V – Injury Prevention, Mobility, Flexibility, and Recovery(Table 4) Movement and/or ConceptInstructionsPerceived BenefitsIYTWThe athlete will be lying on the swiss ball “prone” and then extend the arms in front of you. The thumb will be facing upward to the ceiling. Then try to lift your arms by squeezing your scapula which will be connected with the humerus then with the clavicle. Repeat it again by moving slowly. You will be doing that “I”. “Y” will be the same but just must widen your arms. “T” your palms will be turned to the floor. “W” your palms will be facing on your side. It will help you by stabilizing your shoulder and then gain the range of motion. Thera Bands Shoulder Abduction to 90 degrees; the band will be on the foot while having the other end of the band on you hand and lift the band up to 90 degrees to shoulder level. Internal rotation your elbow will be flex to 90 degrees and keep the elbow next to the side of your body. Hold the band and move in inside the body. External rotation the band will be inside of your body and will be resisting away from your body as your elbow will be position in 90 degrees’ flexion. External rotation at 90-degree abduction the elbow will be bent at 90 degree as you pull up. Your body will be facing the band and you will be squeezing the scapula that your forearm move directly move over your elbow. Also, keep the wrist straight at all time. Next exercise will be shoulder flexion to 90 degrees place the band under your feet and then lift the band straight up in front of you as the thumbs face upward. Next shoulder extension place the band somewhere above your head and grab the band and keep your elbow straight as possible and the arm motion will be extending your arm towards behind you. This will help the athlete maintain the muscle and promote building muscles. This will help the athlete power by the band resistance. It will also help there range of motionT bar The athlete will use it for external rotation, Abduction of the shoulder. In external rotation, the athlete will have both hands on the t bar. One hand will push the other side to stretch. The external the bar will be inside the 2 hand and have a force pushing inside to out of the body. For abduction both hand will be in each end and the force will be the same but you will be pushing sideways trying to go 180 degrees. For flexion, the hands will be both ends again and your motion will be to start from your legs and lift straight up trying to go beyond your head. This will help the athlete to keep and maintain the Range of motion and stability of their shoulder. plank and push-up positionIn pushup position the patient widen their arms wider than in a normal push up. Once the arms are widen then lower your body when it’s 90 degrees of elbow flexion and maintain that position for 30 seconds. Next you can be in a plank position, when in that position the athlete will reach forward with one arm to reach. Also in that position, you can extend your arm sideways, In the plank position the patient will benefits on the stability of the scapula and the muscle build and the increase of the core. In the push-up position, it will be the same benefits. Overhead shrugs / Shrugs In Overhead shrugs the athlete will get dumbbells and lift your arms straight up above your head. Once there the athlete will shrug upward tightening the traps and scapula In normal shrugs, you will lift your shoulders strengthening the muscles. This will benefit the athlete traps muscles to get the support of the shoulders. It will increase the strengthen and Part VI – Summary and ConclusionThere are four different SLAP lesion categories Type I lesion is fraying of the superior labrum where the bicep attaches, Type II lesions are the fraying’s from type I with additional injuries such as labral and bicep tendon detaching from the glenoid, Type III is the superior labrum and bicep tendon tear with margins in the glenoid rim, Type IV tear of the labrum and bicep tendon that detaches from the rim. Our patient is dealing with type IV SLAP lesion. The treatment for type IV lesions is arthroscopic repair of the labrum and bicep tendon. The goal is to get the patient to heal appropriately without causing any additional injuries to surrounding tissues. During the first through third week of from being in the sling the patient is only allowed to remove sling only for taking a shower. During the time while wearing the sling it is to keep the patient from inflammation, swelling and pain. In weeks four patient then can start on light exercises such as squeezing a rubber ball these exercises are not to give the scapular very much motion then gradually working on exercises that involve slight movement which do not exceed range of motion through each phase throughout patients rehabilitation.Caption SheetRyshen Spean-AustinLower Extremity/ACL Injury Learning Outcome #4: Evaluate Effectiveness of Athletic Training, Fitness/Health, or Recreation/LeisureCompetency 4.3: Collect and Analyze Evaluation/Research DataDescription: This research project helped me understand the anatomy and mechanism of a ACL injury.Ryshen Latae Spean-AustinLower Extremity ACL Injury November 29, 2016This article is on Anterior Cruciate ligament Injuries. American Academy of pediatrics discusses diagnosis, treatment and prevention of an ACL injury in adolescents. The injuries that are recorded in adolescents are more likely to be under the age of eighteen years old. The reason children’s number has increased of an anterior cruciate ligament injury is because of the sports that they are in, such as intensive sport training at a younger age. However gender also plays a huge role in the cause of ACL injuries. Girls are at higher risk then boys. The reason for this is because of higher BMI, over pronation, and decreased control of knee motion. When ACL injuries occur surgery may be need, or rehabilitation. To help from injuring your ACL is neuromuscular training.The anterior cruciate ligament is located at the end of the femur and meets at the top of the tibia. There are four main ligaments that connect the femur and the tibia. Such as the medial collateral ligament, lateral collateral ligament, anterior cruciate ligament, and the posterior cruciate ligament. All the ligaments that have been named above all have a specific job in the knee. The medial collateral ligament runs along the inside of the knee also the medial collateral ligament keeps the knee from bending or collapsing inwardly giving it a Varus force. The lateral collateral ligament is on the lateral outside portion of the knee, and its purpose is to keep the knee from bending out giving it a valgus force. The anterior cruciate ligament is in the middle of the knee and its purpose is to keep the tibia bone from moving forward away from the femur. The posterior cruciate ligament works with the anterior cruciate ligament it is also in the middle of the knee like the ACL, this ligament keeps the tibia from moving backwards away from the femur.Anterior cruciate ligament injury during a competitive sport could happen in two different ways. Such as playing in a sport with physical contact. For example, when football players are hit very hard on the side of the knee, when being tackled causes anterior cruciate injuries. In addition, a player’s body position can be associated with an injury being a noncontact anterior cruciate ligament injury. This can happen when “…..the hip is internally rotated, (2) the knee is close to full extension, (3) the foot is planted, and (4) the body is decelerating, leading to apparent valgus collapse of the knee or dynamic knee valgus (page e1440)”. Other causes that increases the risk of anterior cruciate ligament injury, depends on gender girls are at higher risks of encountering an anterior cruciate ligament rupture then boys. There are many reasons why that is, first girls who hit growth spurt increases their chances of a ACL injury because of “…body weight, height and bone length during pubertal development underlie the mechanism of increased risk of ACL injury (page e1441)”. In the studies of the American Academy of Pediatrics during puberty, the bones grow too fast making if challenging for the muscles to control where the knee is going. Body weight is the cause of injury when a person is growing because of the amount of weight forced against the ligaments, muscles and bones. Which makes it hard for the knee to balance when adolescent players make certain movements that could cause an ACL injury.In young boys who are going through puberty their testosterone plays a huge role in the reason why they are at higher risks of encountering an anterior cruciate ligament injury. Puberty in boys increases their strength and muscle coordination. As for boys since their bodies are able to support the new changes, making it easier for them to have more control over their bodies, it is unlikely or it makes them at low risk to rupture their ACL. Unlike girls who grow longer and have nothing to support their unequally balanced portion of their bodies. This is the reason girls are more likely and at higher risk of tearing their anterior cruciate ligament. The neuromuscular factors of anterior cruciate ligament injury such as a quick stop moving and changing directions while running, or landing from a jump that shock the meniscus since the meniscus is a shock absorbing cartilage of the knee cause injury. All the rapid movements that allow the tibia to pull and push put the ligament at stress. In the physical examination, the tests used to rule out any ACL injury is the Lachman test, anterior drawer test and pivot shift test. These tests are to aid while the clinician is diagnosing patients with an ACL tear.The American Academy of Pediatrics studies of treatment say “….standard ACL reconstructions involve the use of drill holes that cross the open physes and may potentially cause growth disturbance, such as shortening or angulation of the child’s leg (page e1442). Surgery is based on the patients skeletal and age after surgery, what is recommended is a nonoperative treatment such as wearing a brace, rehabilitation and staying clear from any sports for many month until cleared to play. American Academy of Pediatrics rehabilitation after an anterior cruciate ligament surgery. “In general, graduated rehabilitation program emphasizing full extension; immediate weight bearing; active range of motion; and strengthening the quadriceps, hamstrings, hip, and core can be started (page e1444).” After three months of rehabilitation continue to exercise to gain back strength and range of motion in six months patient should be able to go back to play sports. When patients are back on sports the brace the player wears is most likely to decrease the chances of another ACL injury. The brace is to brace up the muscle groups involved in cutting, pivoting or jumping.The ways athletes can adapt or to reduce any injury to the anterior cruciate ligament. The athlete can learn to make safer movements with neuromuscular training programs. Neuromuscular control may help with improving and preventing ACL injuries by different types of exercise to strengthen around the ACL. Learning how to stretch properly and balancing. Balance training may have not been so efficient in help reduce injuries of the anterior cruciate ligament but the training that did help reduce anterior cruciate ligament tears was assisting strength. Neuromuscular control was helpful in the sport that American Academy of Pediatrics recorded which the greatest reduction in soccer. I would agree with this entire article after going through direct trauma of a tear in the ACL the procedures that where done we learned in class. Such as the special test that were named in the article like the anterior drawer test and the pivot shift test, all were used to determine the injury. After surgery the rehabilitation is understandable I think it is good to bring back muscle strength to an injured area. I also like that there is a program to assist you in safer movements to reduce injury risks.Reference PageLabella, Cynthia R. "Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention."?Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention | From the American Academy of Pediatrics | Pediatrics. High Wire-hosted Article, 28 Apr. 2014. Web. 02 Dec. 2016Caption SheetRyshen Spean-AustinClinical Application of Therapeutic Modalities Project??Learning Outcome #4: Evaluate Effectiveness of Athletic Training, Fitness/Health, or Recreation/LeisureCompetency 4.4: Interpret Results of the Evaluation/ResearchDescription: This assignment helped me understand the modalities that are used for each phase in the recovery process. The most important fact throughout this assignment is the role modality plays in the healing process.Clinical Application of Therapeutic Modalities Project:??Post-Operative Ulnar Collateral Ligament?Kalyn Martin and Ryshen Spean-Austin?MidAmerica Nazarene University?????????????????????Introduction?Injury to the ulnar collateral ligament of the elbow is common in overhead athletes. The more the athlete throws, the more prone they are to this problem. When researching this topic, it is very common to come across case studies about adolescent baseball athletes who pitch many times a day. Since their bones and soft tissues are not fully formed at this age, the stress placed on the ulnar collateral ligament becomes too much and injury occurs. The injury to the ligament can either be chronic or acute. Chronic injuries mostly occur when an athlete wants to push through the pain and try to keep playing. If the ligament is not torn, conservative treatment is prescribed. The player will come in for treatment three times a week to control the symptoms and to strengthen the muscles surrounding the elbow. The symptoms won’t completely clear up until time is taken completely off of playing and participating in the sport. How much time that needs to be taken off depends on the severity of the irritation to the ligament. Acute injuries (meaning that the ligament was torn while throwing) are more common than chronic injuries. Once the ligament is torn, the athlete has to get it surgically repaired. The ulnar collateral ligament surgical repair is known as Tommy-Johns Surgery. This paper will be covering the modality protocol during rehabilitation for post-Tommy-John Surgery.??Phases?There are four different phases to be considered when discussing most post-surgical rehabilitation protocols. The first is the Immediate Post-Operative Phase. This phase is weeks zero to three. The second phase is the Intermediate Phase. This section consists of weeks four to seven. The third phase is the Advanced Strengthening Phase which is weeks eight to fourteen. The final phase is the Return to Activity Phase lasting from week fifteen to thirty-two. The goals of each phase and which modalities to use during them will be discussed in the upcoming sections.??Immediate Post-Operative Phase??During the first three weeks post-operation, the goals of the rehabilitation are to “protect healing tissue, decrease pain and inflammation, retard muscular atrophy, and protect the graft site to allow healing” (Oh, 2018). Since the incision site from the surgery is not fully healed yet in this stage, being mindful of not opening the wound is necessary. To assist in getting rid of inflammation, cryotherapy is prescribed for this phase. Uses for cryotherapy include “initial management of acute musculoskeletal and soft tissue injuries, spasticity management, myofascial pain syndrome, postoperative pain, tendonitis, bursitis, trigger points, tenosynovitis, capsulitis, and emergent treatment of minor burns” (Perret, Rim, Cristian, 2006). Ice needs to be used on the elbow and at the graft site on the wrist. Using an ice bag or GameReady with no compression would be beneficial to the patient during this time. Compression should not be used right now because it would cause pain and could potentially damage the incision. Ice should not be used if the patient has a cold intolerance or allergy, any type of arterial insufficiency, impaired sensation, or Raynaud’s disease. Another modality that would be beneficial in this phase would be red level laser therapy, also known as low level laser therapy (LLLT). This therapy uses light to stimulate synthesis at the cellular level. It helps to activate growth of the damaged tissues. “LLLT demonstrated effectiveness… due to its biophysical effects on neural tissue which leads to regeneration” (Barbosa et. Al., 2016).??Intermediate Phase?Once the first phase of the rehabilitation protocol is completed and the patient has made the appropriate progress, the Intermediate Phase will begin. The goals of this phase are “gradual increase to full range of motion, promote healing of repaired tissue, regain and improve muscular strength, and restore full function of graft site” (Oh, 2018). Since the swelling should be mostly gone at this point in the rehabilitation process and the patient will start progressing to more difficult exercises, heating the tissue will help get the elbow and surrounding tissues to loosen up. The most beneficial heating modality for this phase would be ultrasound. Ultrasound is used for deep tissue heating. The effects of this modality on joints and connective tissues are “increased tendon extensibility, increased collagenase activity, and decreased joint stiffness…Deep heat such as ultrasound is especially useful when there is an underlying tissue contracture, such as chronic disease or injury states” (Perret, Rim, Cristian, 2006). This will be used at the beginning of a treatment session. After the patient has completed the exercise portion of the rehab session, cryotherapy needs to be done. Using GameReady with low to moderate compression would provide the cold to help with pain and the compression to help push swelling from the activity out. If the clinician really wants to work on getting the most swelling out possible and help control pain, they could use electrical stimulation along with the cryotherapy. Premodulation and Interferential Stimulation can be used for moving swelling and control pain. These currents are indicated for "maintaining range of motion, prevention of joint contractures, increasing local blood blow, muscle reeducation, prevention of disuse atrophy, and decreasing muscle spasms" (Starkey, 2013).??Advanced Strengthening Phase?When the intermediate phase is completed, patient can then begin the advanced strengthening phase. Goals to be accomplished in this phase are "increase strength, power, endurance, maintain full elbow ROM, gradually initiate sporting activities" (Oh, 2018). During this phase patient will continue using ultrasound to build strength, extensibility and decreasing pain. A beneficial modality for this phase would be IFC E-stim. IFC is used for muscle re-education, strengthening and joint ROM. The modality effects "controlling acute and chronic pain, reducing edema, muscle spasm, joint contractures minimizing disuse atrophy, tissue healing and effecting orthotic substitution" (Starkey,2013). The electrical stimulating currents will assist monophasic currents that are applied to the body, these charges depolarize sensory and motor nerve allowing patient to begin shoulder strengthening. When patient has made appropriate progress of strengthening the elbow. Patient will begin a throwing program to gradually return to their sport. The first two weeks of exercising patient will begin to throw a light foam ball to initiate resistant patterns.? At four months patient will then begin the progression program involving sport specific equipment such as a baseball. After each rehab session patients will need to continue using game ready to limit any formation edema and compression to have a deeper effect on tissues.?Return to Activity Phase?Once the third phase of the strengthening protocol is completed, the return to activity phase will being. The goals of this phase are "continue to increase strength, power, and endurance of upper extremity musculature gradual return to sport activities" (Oh,2018). Patient will progress to more challenging exercise such as maintaining full range of motion of the elbow and strengthening the wrist. NormaTec will help surrounding tissues that are swollen, NormaTec massages to help body remove proteins and waste products from the surgical site " This helps reduce pressure on cells and allows them to reproduce faster to heal the body" (Palmer, 2017). Another acceptable modality to use for this phase is HIstological VAriable MAnual Technique also known as HIVAMAT. HIVAMAT is a deep oscillation therapy " A special design makes it possible, using electrostatic attraction and friction, to produce mechanical vibrations in the body, not only at the skin surface but also in deeper tissues" (I.T. 2016). The clinician would apply electrodes to their own arm and the other electrode would be applied to the patient's which join to the equipment. During this procedure clinician will need a vinyl glove before application to act as a capacitive layer between both surfaces. This procedure allows pain reduction of tissue trauma also beneficial for improving wound healing. The final modality to use during this phase is light therapy. "Laser light Therapy has been used for the management of various diseases, such as osteoarthritis, carpal tunnel syndrome, tendinopathy, rheumatoid arthritis, lumbago, non-healing ulcers and epicondylitis" (M.K 2018). The textbook mentions lasers stimulate tissue healing and more adequate in reducing pain. Healing start with phagocytic activity encouraging blood and lymph circulation in the treated area which encourages granulation tissue and capillary growth.?ConclusionThe ulnar collateral ligament of the elbow is a common injury in overhead athletes. These injuries occur from acute or chronic injuries. There are four recovery phases that will follow after surgery from week zero upon release to week thirty-two when the athlete is able to join recreational activities.?The first phase from week zero to week three of recovery is to protect the tissue and manage pain using the method RICE. The second phase is the intermediate phase proceeding within weeks four to seven. At this time the patient will attempt to increase?range of motion and begin strength building with gripping to decrease pain. The use of ultrasound for heat therapy will assist in muscle re-education. Through-out the course of phase three, weeks eight through fourteen, patient will continue using ultrasound to build strength and increase extensibility with intent on reaching?full range of motion. The final phase or the return to activity from weeks fifteen through thirty-two is for the athlete's sport specific exercises that will ultimately get the patient back into their everyday routines and back on the field.??Reference?Barbosa, R. I., de Cássia Registro Fonseca, M., da Silva Rodrigues, E. K., Tamanini, G., Marcolino, A. M., Mazzer, N., & ... Dermid, J. M. (2016). Efficacy of low-level laser therapy associated to orthoses for patients with carpal tunnel syndrome: A randomized single-blinded controlled trial.?Journal of Back & Musculoskeletal Rehabilitation,?29(3), 459-466.??G. T., A. K., & A. G. (2014). Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow. Indian Journal of Orthopaedics, 48(4), 390-393. Retrieved April 18, 2018.??I. T., A. C., & D. M. (2016). Use of the HIVAMAT 200 with manual lymphatic drainage in the management of lower-limb lymphoedema and lipoedema. Journal of Lymphoedema, 11(1), 49-52. Retrieved April 18, 2018.??M. K., Kucuk, A. O., F. A., & M. A. (2018). Effects of low-level laser therapy following surgical extraction of the lower third molar with objective measurement of swelling using a three-dimensional system. Koparal Et Al: Effects of Low-level Laser Therapy, 15, 3820-3826. doi:10.3892/etm.2018.5921??Oh, L. S. (n.d.). Post-operative rehabilitation protocol following ulnar collateral ligament reconstruction using autogenous palmaris longus graft. In?Massachusetts General Hospital. Retrieved April 11, 2018.??Palmer, A., & Gillitte A. ( 2017, November 8). What Does NormaTec Lymphatic Therapy Do? Retrieved Apiril 18, 2018, from , D., Rim, J., & Cristian, A. (2006). A geriatrician's guide to the use of the physical modalities in the treatment of pain and dysfunction.?Clinics in Geriatric Medicine,?22(2), 331-354.?Starkey, C. (2013). Therapeutic modalities (4th ed., p. 277). Philadelphia, PA: F.A. Davis Company.????Caption SheetRyshen Spean-AustinMuscular Analysis ofLearning Outcome #5: Serve as a Resource for Athletic Training, Fitness/Health, and/or Recreation/Leisure Information or ProgrammingCompetency 5.1: Obtain and Disseminate Health-Related InformationDescription: The muscular analysis paper helped me understand the movement of the body and how everything in our body works together to accomplish a simple movement.Muscular Analysis ofHLEX 3543 Kinesiology and BiomechanicsMid-America Nazarene UniversityRyshen Spean-Austin12-5-2017IntroductionOne of my passions and interests that I’ve had for years is basketball, I’ve had the opportunity to be the MNU men’s basketball manager for several years now. Over this time, I’ve seen many different people shoot free throws, not only the MNU men’s team, but also opposing teams. Although a free throw seems to be self-explanatory, there are a lot of non-athletes who have no idea what a free throw is. Performing a free throw involves more muscles than most people realize and requires a lot of practice. My goal is to help others understand the classification of skill, agility, and the actions of primary muscles actions and functions.To begin, when a player is fouled, they have the opportunity to go to the free throw line and shoot a free throw. Depending on the referees call, the player will need to shoot one or two free throws. The calls are based off of the players shot; for example, if the player made their layup and was fouled, then they get to shoot one shot for that foul. If the player was shooting and missed his shot because he was fouled, then he is able to shoot two free throws to make up for his last shot.When a basketball player is ready to shoot a free throw, they will walk to the center of the free throw line, which is the distance from the baseline and the free throw line. In NAIA regulations, the distance from the baseline and free throw line is nineteen feet. From the basket to the baseline, that distance is fifth-teen feet. The regulation of the average height for a basketball hoop is ten feet. This is good information for the athlete to know because it will help with better accuracy of how far to shoot the ball, and to know how much strength to put into the release of the ball from their hands to the basket. On a side note, an interesting fact is the basket itself is big enough to fit three basketballs into the hoop.Now that the distance of the free throw line from the basketball hoop is known, we need to understand the human bodies mechanism of movement when performing a free throw shot. When walking to the free throw line and reaching the line, the athlete will then get into position. The first step into getting into position for the free throw is to have your feet shoulders width apart. From there, the athlete has their knees slightly flexed to approximately forty-five degrees creating almost a sitting position; ankles should be in plantar flexion about twenty degrees from the floor. With that in mind, the hip flexion should be anywhere ranging from one hundred and ten to one hundred and twenty. The trunk, also known as the abdominal section, is slightly bent as well, changing the athlete’s center of gravity. Continuing on, the athlete’s shoulders should be flexed at forty-five degrees and facing squarely towards the basket. Their wrist should be flexed at seventy degrees with their palm up, mimicking someone holding a pizza. When the athlete is ready to shoot the ball, they will place the ball in their dominant hand, because in most cases, the dominant hand is stronger and they need to have all control over the ball. As for the uninvolved hand, it should only be used as a stabilizer to help the ball stay in place as the dominant hand launches the ball to make a free throw shot. In essence, the player holds the ball in their dominant hand like a pizza, and the non-dominant hand rests against like it’s giving it a high-five. As mentioned before, there are a lot of muscles involved in the process of a free throw. To begin, I will start with the lower extremities. These include the foot, ankle, knee and hip. From there, I will work my way up to the upper extremities; which are, the trunk, also known as the abdominal core portion of the body, shoulder, elbow, wrist and fingers.The main part of the lower extremities are the joints of the foot muscles, and the bones. The foot is divided into three segments which are the rear foot, midfoot, and forefoot. What makes up the rear foot is the subtalar joint, and the talocrural joint (which is also known as the ankle joint the talus,) and trochlear surface of talus. From there, the distal phalanx I, interphalangeal, proximal phalanx, metatarsals make up the forefoot. Medial cuneiform, intermediate cuneiform, lateral cuneiform, navicular make up the mid foot. Lastly, the bones of the foot connect to the fibula and tibia. These are the main bones in the lower portion of the leg. These two bones, the fibula and tibia, allow for the muscle to attach to the bones. The branch of these muscles are the anterior & lateral muscles. These break up into small branches and are called Tibialis anterior, Extensor digitorum longus, extensor hallucis longus, peroneus tertius. There is also a main branch muscles in the posterior muscle; smaller branches of this muscle are called Tibialis posterior, Flexor digitorum longus, flexor halluces longus, popliteus, plantaris, soleus, and gastrocnemius. When the joint moves these bones and joints play an important role in positioning the foot for a free throw. As the foot and ankle move into plantarflexion this allows the talus to roll back as it glides forward stopping at ten degrees. The gastrocnemius soleus muscles contract to keep the body from falling and resists gravities force and it also lines with gravity by doing so the gastrocnemius soleus uses the tibia as a leverage creating equilibrium. The gastrocnemius muscle attaches to the calcaneus, the calcaneus acts as a pulley also a lever for the gasrtoc soleus muscle. Knee flexion and extension combined with ankle plantar flexion the gastrocnemius oversees these movements but is also useless when there is tension if in full range of motion. The quadriceps muscles, the rectus femoris, crosses the hip and is a hip flexor as well as a knee extensor. The quadriceps muscles and the rectus femoris muscle are the major muscles to become more active when the knee extensor is placed in an extended position, which allows the rectus femoris to manage to apply maximal torque while in knee flexion. When the Hamstrings and the hip flexors are in their position of flexion then the muscles work together as antagonists which allow our athlete to hop when shooting a free throw this synergist movement allows the limbs to move forward. Another movement performed by the knee and hip is when both joints are extended which is useful when athletes jump and propel as they shoot the body moves up and is relocated forward. This function is able to happen because of the contraction of the quadriceps allowing the hamstrings to stretch over the knees then immediately acting as a hip flexor.The pelvic allows mobility to occur so that it can work with the hip as well as the lumbar and sacrum. The pelvic helps the lumbar spine and sacrum to move smoothly without any problems. Both the hip and pelvic contribute their functions when the is a lateral tilt, anterior and posterior tilt and rotation. The pelvic and hip work together to perform these movements. When standing forward and the pelvis rotates to the medial hip rotators and vise verso when you are in pelvis is in backward rotation then rotates lateral on the hip.Whether the hip function is non-weight bear or weight bearing it will all depend on how the femur or the pelvis is on one another which will determine the function. When weight bearing the femur does not move but the pelvis on the femur and when non-weight bearing the pelvis is stable and the femur moves along the pelvis. Movements that occur at the hip when gluteus Maximus are contracted the pelvis shifts posteriorly and extending of the hip. These motions are functional and stabilized because of the three ligaments that are there in the acetabulum (hip joint) that attaches to the femoral head with these attachments this provides the stability and extension of the joint. These ligaments are iliofemoral, Intertrochanteric and pubofemoral.ReferenceHouglum, P. (2012). Brunnstrom's Clinical Kinesiology, 6th Edition. [Chegg]. Retrieved from , D., Callaghan, M. J., Donmez, G., & Doral, M. N. (2012). Shoulder joint position sense is negatively correlated with free-throw percentage in professional basketball players. Isokinetics & Exercise Science, 20(3), 189-196. Sevrez, V. Bourdin, C. (2015) On the Role of Proprioception in Making Free Throws in Basketball. Research Quarterly for Exercise and Sport. , A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range. doi:0000000/000000000000 or analysis of free throws SheetRyshen Spean-AustinFinal Anterior Cruciate Ligament AbstractLearning Outcome #5: Serve as a Resource for Athletic Training, Fitness/Health, and/or Recreation/Leisure Information or ProgrammingCompetency 5.2: Provide TrainingDescription: The ACL abstract taught me the injury is most significant in females because of wider hips.ANTERIOR CRUCIATE LIGAMENTDominic Harrington, Erin Anderson, Ryshen Spean-AustinMidAmerica Nazarene University INTRODUCTIONIn recent years many anterior cruciate ligament (ACL) injuries have been the focus of many biomechanical studies and is a frequently studied structure of the human musculoskeletal. (Awad, O. B et al., 2017)MECHANISM OF ACL INJURYACL injuries are very common whilst doing activities. However, more females than males have reported ACL injuries when it comes to sporting activities with or without contact. (Kobayashi et al., 2010) In predicting an ACL injury, hearing, or feeling a popping sensation and associated swelling is very important. Dynamic stress is added to the ACL during the ‘Knee in & Knee out’ alignment which results in the injury to the ligament. (Kobayashi et al., 2010) It more often occurs at the weight loading phase with applied stress from that motion that is being performed by the person. There are a few different ways in which an injury to the ACL may occur during activity. Some reports suggested that the injury may occur when the knee has been hyperextended. This is basically when the knee joint is forced to extend beyond its normal range of motion which can cause damage to that Anterior Cruciate Ligament due to the overloading force applied to that area of the knee. This injury may also transpire from a rotational motion of your knee. This is likely to take place without any contact, but the ACL is being overstretched due to forced valgus or external rotation movement. (Kobayashi et al., 2010) When your feet are fixed to the floor or any surface and you try to turn direction but your feet remain in that fixed position. A lot of mechanical stress is being imposed to the knee joint at this point which results in the ACL being overstretched and injured in the process. DIFFERENCES IN INJURY DUE TO SEXKobayashi et al., mentioned that ACL injuries are more common in women and Beaulieu, M. L et al., goes into greater detail of why that may be true. Females are more likely to encounter ACL injuries because of less knee flexion and hip flexion their quadriceps muscles and valgus angles show more range then shown in males, because of biomechanics there is more weight on the ACL. The cause of ACL injuries in sport is the favor of the knee extensors rather than the hip extensors. “Theoretically, if the hip extensors do not contribute to control of the body’s center of mass during landing, females may compensate through an overreliance on their quadriceps (Powers, C. M).” Many different studies have seen that woman tend to have more ACL injuries than men. Melanie L Beaulieu an Scott G McLean. Females suffer 2-5 times as many noncontact ACL injuries as males. Researchers are looking for a better understanding of the aetiology, the study of the causes of diseases, to better screen and prevent this injury in the future. Researchers have found that most ACL injuries occur during quick deceleration while either running and changing direction or landing from a jump. To study this, researchers had to create noninjury scenarios to remain ethical. They focused on joint neuromechanical data found during systematic examinations. The results of these examinations have been inconsistent. Researchers also study the landing mechanics and the differences between sexes. Researchers then took a closer look at the sagittal, frontal, and transverse plane. In the sagittal plane, they found the ACL is the main restraint to anterior tibial translation. That anterior tibial shear force is the most direct way to load the ACL. This can lead to ACL strain during the landing phase. High quadriceps activation can produce an anterior coupled with a small knee flexion angle during landing is the worst-case scenario for sagittal plane-based ACL injury. After examining all of the literature researchers were still unable to support that females are at greater risk of ACL rupture during landing due to knee posture. In the frontal plane, externally applied knee abduction is the worst-case scenario. Evidence in the literature supports greater knee abduction angles in females. In the transverse plane, researchers found most of the cases the knee medially collapsed with combined hip internal rotation, knee abduction, and tibial external rotation. No sex differences were observed in the transverse plane. (Beaulieu, M. L et al., 2012)RECONSTRUCTION AND REHABILITATION OF ACLAmerican Academy of Pediatrics rehabilitation after an anterior cruciate ligament surgery. “In general, graduated rehabilitation program emphasizing full extension; immediate weight bearing; active range of motion; and strengthening the quadriceps, hamstrings, hip, and core can be started (Labella, Cynthia R).” After three months of rehabilitation continue to exercise to gain back strength and range of motion in six months patient should be able to go back to play sport. The ACL contributes to overall stability and mobility of the knee. Rehabilitation has greatly changed in the past years. Clinicians have changed from completely immobilization to minimal range of motion restrictions and immediate muscle activity. In this study it analysis the merit of current reconstruction rehabilitation programs. They evaluated eight rehab components including: bracing, Continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), open kinetic chain (OKC) versus closed kinetic chain (CKC) exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation. The goal of rehab is to repair muscle strength, gain good functional stability, and decrease risk of re-injury. Researchers found that post-operative bracing and continuous motion have no benefit. (Awad et al., 2017) PREVENTION OF ACL INJURYThere are a few ways athletes can adapt to reduce injury to the anterior cruciate ligament. The athlete can learn to make safer movements with neuromuscular training programs. Neuromuscular control may help with improving and preventing ACL injuries by different types of exercise to strengthen around the ACL. Learning how to stretch properly and balancing. Balance training may have not been so efficient in reducing injuries of the anterior cruciate ligament. Neuromuscular control was helpful in the sport that American Academy of Pediatrics recorded which the greatest reduction was in soccer. SUMMARYThe tennis serve is a commonly performed athletic skill and has received some attention in the scientific biomechanical literature. Serve kinematics, kinetics, electromyography, and ball speed have all been observed. It appears that during the tennis serve, the greatest forces and moments are applied at the shoulder joint. Also, the lower- extremities are important to the successful performance of the tennis serve.REFERENCESAwad, O. B., Alqarni, S. M. Hani Mousa Alkhalaf., Faris Ali Alnemer., Khalid Ayed Abdullah Alahmari., Saeed Mubarak Saeed Alshahrani., Sami Aoudah Tami Alahmari., Mohammad Abdul Majeed Abdul Ahad., Haitham Sulaiman A Habtar., Mohammed Ali S Almousa., Abrar Abdulrahman M Alarabi1, Salem Baty D Alshahrani., Fawaz Nawaf Alshaalan., Mohammed Thamer Shaker Alghalibi., Mohammad Abdullah M Alshahrani., Abdullghany Mohammed Dowaikh. (2017). A Systematic Review of ACL Reconstruction Rehabilitation. The Egyptian Journal of Hospital Medicine, 68, 845-864. Beaulieu, M. L., & Mclean, S. G. (2012). Sex-dimorphic landing mechanics and their role within the noncontact ACL injury mechanism: evidence, limitations and directions. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology, 4(1). Kobayshi, H., Kanamura, T., Koshida, S., Miyashita, K., Okado, T., Shimizu, T., & Yokoe, K. (2010). Mechanisms of the anterior cruciate ligament injury in sports activities: a twenty-year clinical research of 1,700. Journal of Sports Science and Medicine, 9.Labella, Cynthia R. "Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention."?Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention | From the American Academy of Pediatrics | Pediatrics. High Wire-hosted Article, 28 Apr. 2014. Web. 02 Dec. 2016Powers, C. M., & Fisher, B. (2010). Mechanisms Underlying ACL Injury-Prevention Training: The Brain-Behavior Relationship. Journal of Athletic Training, 45(5), 513-515Caption SheetRyshen Spean-AustinCrucial Conversations Discussion QuestionsLearning Outcome #6: Communicate and Advocate for Athletic Training, Fitness/Health, and/or Recreation/LeisureCompetency 6.2: Identify and Develop a Variety of Communication Strategies, Methods, and TechniquesDescription: The importance of crucial conversations and understanding strategy to ask yourself what your focus is and do the best to get your point across by using methods such as a goal to keep you from getting sidetracked.Name: Ryshen Spean-AustinCrucial Conversations Discussion QuestionsChapter 3 – Start with the Heart. How to Stay Focused on What You Really WantPlease answer the discussion questions listed below for Chapter 3. Answers to the questions must be written out and turned in on the assigned date. Thought should also be given to these discussion questions and answers. By taking the time to think about each question, you are then able to generate a thorough and complete answer (generally requiring more than a few words or a single sentence). Please be prepared to answer if and when you are called upon in class. In crucial conversations “dialogue is always an option”From your reading, highlight one piece of information that made the greatest impact.“… we do know one thing for certain: Skilled people Start with Heart. That is, they begin high-risk discussions with right motives, and they stay focused no matter what happens.”(Patterson, 2012)What does the expression “work on me first” mean? Why is it important?The book stats that the first step to getting what you want is to realize the problem is not the other person. A healthy critical conversation and meeting everyone’s needs we have to change ourselves and that is how we react to conflict.What’s the meaning of the expression “Start with Heart”?“Starting with heart” means going into a high-risk conversation with the correct motives, and staying focused throughout the entire dialogue. Why is it important to stay focused on what we want?Staying focused helps us from getting side tracked staying focus helps with the goals of our conversations.Why is it important to ask what we want for ourselves, others, and the relationship? What do our wants often change to?It change other people’s perspective whether the person agrees with us or not, but its brought to attention and is not just left alone. So either parties can benefit to change.When we stop, take a breath, and ask ourselves what we really want, how does it affect our immediate physical and emotional response??It helps with gathering yourself from exploding and saying the wrong thing that may trigger someone else’s frustration. This is also a good strategy to ask yourself what your focus is and do the best to get your point across. Critical conversations can be effective for problem solving.ReferenceI. (2016). Crucial conversations: tools for talking when stakes are high by Kerry, Patterson, Joseph Grenny, Ron McMillan, and Al Switzer Caption SheetRyshen Spean-AustinSandwich ApproachLearning Outcome #6: Communicate and Advocate for Athletic Training, Fitness/Health, and/or Recreation/LeisureCompetency 6.3: Deliver Messages Using a Variety of Strategies, Methods and TechniquesDescription: This assignment taught me how to communicate with an athlete to make some changes by starting conversation with encouraging, then adding what the athlete can work on in order to improve their skill and then ending on a positive note that will boost the athlete confidence.Ryshen Spean AustinPsychology of SportsSandwich Approach Start by describing something the athlete did well.“Whoa, you did great keeping your knees bent while you were playing defense. Keep it up”Then provide specific, future-oriented feedback on what the athlete can do to improve.“Next time keep your right knee, right elbow, right pointer finger, right eye lined up when you shot and next time you will do even better.End on a note of encouragement.“You did great making that play to get open for the basketball.”Caption SheetRyshen Spean-AustinProfessionalism and FriendshipLearning Outcome #7: ProfessionalismCompetency 7.3: Communication: written & oralDescription: This assignment taught me the professionalism between employee’s and patients, also how to avoid situation’s that may put you in a bad situation. This assignment was to acknowledge how written or verbal rules could keep professionalism and protect everyone from putting themselves in bad situations.Name: Ryshen Spean-AustinCase StudyChapter 1Professionalism and FriendshipWendy was a certified athletic trainer who worked for a prominent hospital sports medicine center on the East Coast. She had been employed for three years and was considered by her supervisors and peers to be a competent professional. As a major part of Wendy’s responsibilities, she was assigned to provide athletic training services to a large suburban high school in one of the most affluent parts of the metro area. She had held this assignment for the entire three-year period that she had worked for the hospital and had formed close, friendly relationships with the high school staff and students.Jan was Wendy’s supervisor. She and Wendy were good friends who enjoyed doing things together outside of work. Jan also supervised four other athletic trainers who had similar job descriptions and responsibilities. Jan worked in the clinic in the mornings. Each afternoon she visited a different high school, both to provide supervision to the athletic trainer assigned there and to help in any way that was required.Although Jan thought Wendy was a competent athletic trainer, she was concerned about one aspect of Wendy’s job-related behavior. In Jan’s opinion, Wendy had developed a “mothering relationship” with several girls on the high school basketball team. It was not uncommon for Wendy to eat lunch with the girls in the school cafeteria. She often visited the girls’ homes after basketball games. On more than one occasion, she had entertained a few of the girls at her apartment. Jan was becoming increasingly concerned about this pattern of behavior but had not said anything to Wendy yet because she was hopeful that Wendy would take care of the problem herself.One day when Jan was visiting Wendy’s school, she overheard several members of the girls’ basketball team talking about the ski trip being planned at Wendy’s parents’ cabin in the northern part of the state. When Jan heard this, she decided she could no longer ignore the situation. Later that day, she confronted Wendy and asked her about the trip. Wendy explained that she and four of the girls were planning to go cross-country skiing at her parents’ cabin for a weekend in about a month. All of the girls had received their parents’ permission. Jan told Wendy that she did not approve of this kind of relationship with the athletes and strongly discouraged Wendy from taking the trip.Two weeks later, Jan once again approached Wendy regarding the trip. Wendy told Jan that she still had not decided whether to go ahead with the plans or not. “Wendy,” Jan responded, “let me make it clear to you. You will either cancel this trip or accept reassignment to another school effective immediately.” The next day, Wendy told Jan that the trip had been canceled. Unfortunately, so had their friendship.Analysis QuestionsIn your opinion, did Jan act properly in her role as Wendy’s supervisor by forcing her to cancel the ski trip? Why or why not? How would you have handled the situation if you were in Jan’s position? My opinion to this is yes. I think Jan’s reaction was appropriate I also think she should have explained more in detailed of why the trip was not a good idea. Although Wendy’s action I would not consider it being appropriate to taking the girls on a ski trip at her families cabin. I know this maybe common sense but I also think common sense is not common if that employee has a different way of thinking such as the way she might have been raised, so I think it is important to always be clear with an employee whether it is common sense. Explaining the consequences that would have happened to the girls on the trip Wendy would be liable for them.How is Wendy’s behavior toward the girls likely to impact the hospital? How will it impact Jan? How will it impact Wendy? Since Jan is Wendy’s boss anything Wendy does then goes back to Jan and could possibly lead to both losing their careers. Wendy’s relationship with the girls is causing bad judgment. Taking the girls on the trip will be seen as unprofessional and anything could happen and go wrong. Wendy could be impact by lawsuits or losing her job. If anything happened to the girls the parents are the one to make the decisions of any legal actions which would reflect back on Jan and the company,Was Wendy’s behavior ethical? Why or why not? Wendy’s behavior was not ethical because her work environment pertains to what is right and wrong. It would not be appropriate for Wendy to take the girls on the trip.Does a course of action exist that would change Wendy’s behavior and, at the same time, preserve her friendship with Jan? What ethical dilemmas result when supervisors and supervisees form close friendships? The friendship between the two supervisor and supervisee could interfere with the best decisions made by Jan for Wendy’s actions. When working with friends and having to confront them about things they are doing wrong is hard, but both have responsibilities that need to address. I think the way Jan had approached Wendy should have been done differently giving Wendy reasons for not taking the kids may have preserved their relationship.How could this situation have been avoided? What policies should the hospital consider that would address this kind of situation? The hospital could have implemented professional client and clinician’s relationship. Relationships between the client and clinician should just be enough to evaluate and no other relationships outside the work area. There is no professionalism when patients are out with their clinicians.Caption SheetRyshen Spean-AustinSymposium AttendeesLearning Outcome #7: ProfessionalismCompetency 7.4: Organizational integrationDescription: This assignment taught me when making professional phone calls it is important to be organized. Organization helps with communicating information smoothly.MidAmerica Nazarene University SymposiumRyshen Spean-AustinMidAmerica Nazarene University(801)600-79142030 E College Way rspeanaustin@Olathe, KS 66062My name is Ryshen Spean-Austin and I am a student at MidAmerica Nazarene University. As part of my ongoing education I have been challenged to get as many prospective students who have an interest in any type of athletic training education to come and be part of our symposium at MNU.MidAmerica Nazarene University is pleased to invite you to our complimentary Annual Health Symposium on April 24th 2018 at the Cook Center on our campus from 8a.m to 2p.m.This is an opportunity for your kids to get a glimpse of different professional health professions. We will provide guest speakers and free food for students. Students will be free to ask questions during this time.AgendaApril 24th 8a.m.-2:00p.m.8-8:30 Registration8:30-9:15 Speaker 19:20-10:05 Speaker 210:10-10:55 Speaker 311:00-12:00 LUNCH12:00-12:30 Speaker 41:00-1:50 Speaker 5Sincerely,Ryshen Spean-AustinProfessionalism and Creativity542925033623255019675338137554768752371725503872523622005419725136207500507682513620750035147254200524369570041433743790950398145020288256038850183832560293251733550601980034004251304924328612512287253124201119062400372427412763500036576001133475003638550952500001143000167640000116205014192250014573251390649006667504723765006381753219450107632513430240010477519048750023310855743575RestroomRestroomright504825Treatment 00Treatment 2314575305752545243753619500Treatment 00Treatment 45529502562225Treatment 00Treatment right1524000Treatment 00Treatment 26479503114675RehabAreaRehabAreacenter539115043053005391150Hydro TherapyHydro Therapy40100255295900left2457450Exam Room0Exam Room104775812165Staff office0Staff officecenter523875Tapping AreaTapping Arealeft5362575Exam RoomExam Room-1047753714750Exam RoomExam Room6953251647825left2069465left438150center438150 1304925299085012954002667000-2952755467350-26670057531006115050-331470-Outlet-Outlet5886450-3143250042195757811135DrainDrain421005077247755572125-533400550545017621255524500942975558165020002523145752849880Rehab Area0Rehab Area4295140274320Treatment Area0Treatment Area485775019431000484822511715754838700-30480004838700409575center65405Taping TablesTaping Tables3105150-704850002438400-70485042767257144385Ice machineShelvesIce machineShelves27241507115175Hydrotherapy RoomHydrotherapy Room267652570485002857500701040031623007562850PoolPool273367574771250065147822826703Entrance.Entrance.57435753152775184785072390001524000649605014478004324350145732515621001448435-34290019716757667625Toilet00Toilet205740078676503708401120775TableTable10858507600950Sink00Sinkright3027680SinkSinkright2527935SinkSinkright6744020Counter00Counterright4048445Counter00Counter2098671342073Counter00Counter1714515953125Table0Table952503467100TableTable2095501085850160972578581251581150732472515811507867650013430257867650-3714752933700-3810002724150-3524256400800-3429003638550-3714751123950-3714755657850Exam Room00Exam Room-3809992914650Exam Room00Exam Room-381000581025Exam Room00Exam Room-623570-684530Personal Staffroom00Personal Staffroom-353695-7524750013462049530Staff common areaStaff common area603250-739775-36893516446500-352425-295275126365-754380-354330-747395-371475-762000 ................
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