ATR 292: Picture Portfolio: Winter 2017

1. Ashly Kronberger
ATR 292B
Winter 2017
Picture Portfolio

2. Circular Upper Arm
• Anchor extended end of
the wrap around the distal
upper arm
• Herringbone or spiral
pattern overlapping ½
width
• Apply greatest amount of
tension distally over
inflammation, lesson
compression proximally

3. Shoulder Pointer/
AC Joint Spain
Hold strip on the posterior
shoulder. With one hand, pull
strip over with tension on
tape.
Anchor to anterior shoulder
Technique: Release, stretch,
release sequence

4. Upper Arm Compression
Compression, support, and
immobilization.
Aids in mild to moderate
swelling. Best with 2, 3, 4
inch 5 yard elastic wrap.
Elbow: Placed in a pain free,
flexed position for wrapping.

5. Shoulder Spica
Mild support and shock
absorption
treating/preventing shoulder
pointers & AC joint sprains.
Anchor the extended end of
wrap on the mid/proximal
lateral upper arm and
proceed around.
Direction: Medially to encircle
the anchor.

6. 4S (Spica, Sling, Swath & Support) Wrap
• Mild to moderate support
and immobilization when
treating sprains, strains,
etc.
• Apply 1-2 shoulder spica
patterns with moderate
tension
• Move distally on the
forearm with each pattern
to form a sling.

7. Figure 8 Wrap
• Provide mild/moderate
support and
immobilization
• Treating for SC joint sprain
and stable clavicular
fracture
• Anchor wrap over non
involved shoulder and
continue posteriorly under
the axilla, encircling
anchor

8. Swathe Wrap
• Provide mild/moderate
support & immobilization
by anchoring the arm to
the trunk
• Treating sprain,
dislocation, instability,
subluxation, etc.
• Application lateral to
medial pattern over the
forearm, hand, and fingers
with moderate tension.

9. Slings provide complete
support and immobilize the
shoulder/arm following injury.
Choose brace design
according to the intended
purpose
Sizing according to the length
of forearm from olecranon to
5th MCP joint.
Sling Application

10. Limit hyperextension of the
elbow and stretch on the soft
tissues.
Anchor: 2 of 2-3inch
heavyweight elastic tape
around proximal upper arm.
Mild tension, continue anchor
distally across the cubital
fossa.
Hyperextension
2 Techniques

11. Lateral Epicondylitis Strap
Generally pre-wrap or self
adherent wrap 1-2inches.
Patient Position: Seated,
involved elbow placed in
slight flexion.
Application directly over skin

12. Circular Forearm/Elbow
Provides mild support
Anchors off the shelf pads to
absorb shock preventing
contusion.
Use: 2-3 inch elastic tape
Circular pattern around
forearm encircling anchor

13. Elbow Compression Wrap
Application when treating
contusion, sprain, strain,
rupture, etc.
Control of mild to moderate
swelling & effusion.
Application:
Spiral/herringbone in a distal
to proximal direction,
overlapping by ½ of its’ width.

14. Purpose: Control mild to
moderate swelling when
treating contusion and strain.
Patient Position: Seated with
involved arm at side. Elbow in
a pain free flexed position.
Apply in a distal to proximal
fashion, overlapping by ½
width. Greatest tension distally
over inflammation.
Forearm Compression Wrap

15. Hand/Wrist/Elbow Compression
Purpose: Control 2nd-3rd
degree elbow pathology.
Controls moderate to severe
swelling.
Patient Position: Seated with
involved arm at side. Elbow in
a pain free flexed position.
Apply in a distal to proximal
fashion, overlapping by ½
width. Greatest tension distally
over inflammation.

16. Circular Wrist Taping
Purpose: Mild support, limit
ROM, & anchor protective
padding.
Anchor non elastic tape over
the ulnar styloid process.
Moderate roll tension in a
circular lateral-medial
direction around wrist,
returning to the anchor.

17. Figure 8: Wrap
Purpose: Moderate support,
limit ROM, anchors custom
braces and padding.
Patient Position: Seated with
wrist/hand in neutral and
fingers in Abduction.
Anchor: Styloid process
Motion: Lateral-medial
Tension: Moderate Continue
over thenar web space and
remain proximal to the MCP
joints.

18. Flexion Limiting Fan Taping
Moderate support & limiting
of excessive flexion and
extension
Anchor: Distal forearm and
distal hand, proximal to MCP
joints
Roll tension: Mild
Anchor tape on the dorsal
lateral hand, proceed
proximally across hand &
wrist.

19. X Taping: Wrist (preventing EXT)
Purpose: Moderate support limiting
excessive flexion OR extension.
Anchor 1.5in tape at an angle on
the palmar hand proximal to the 5th
MCP joint.
Roll tension: Moderate
Monitor pain free position of the
wrist at all times
Finish: Medial distal forearm
(ventral) using pattern “X” to
prevent excessive
flexion/extension (extension
shown).

20. Hand/Wrist Compression Wrap
Figure 8 Technique
Purpose: Pressure, lessons
mild-moderate swelling &
inflammation.
Patient Position: Seated with
wrist/hand in pain free
position, fingers in abduction
Anchor: extended end of
elastic wrap on the dorsal
surface of hand distal to the
MCP joints 2-5

21. Figure 8: WRAP
Purpose: Compression &
mild support to anchor
custom made braces.
Patient Position: Seated,
wrist/hand in neutral position,
fingers in abduction
Anchor the wrap directly to
skin over the ulnar styloid
process, applying the figure 8
technique with moderate roll
tension

22. Buddy Tape
Purpose: Mild to moderate
support to collateral
ligaments of the finger(s)
Patient Position: Seated with
the hand and fingers in a
neutral position
Encircle the fingers between
the MCP and PIP joints.
Roll Tension: Moderate

23. X-Tape
Purpose: Provides mild-moderate
support to the collateral ligaments
of the PIP joint.
Apply angled strips over the
lateral and medial joint lines of the
PIP joint forming an X
Each strip should reach proximal
and distal to the PIP joint, but not
over the DIP or MCP joints.
Roll tension: Moderate

24. Thumb Spica
2 Variations
Purpose: Mild-moderate support
and limit excessive
abduction/extension at the MCP
joint.
Application of anchor to the
medial dorsal surface of the wrist
Continue medial to laterally
Direction: Around the wrist to the
MCP joint of the thumb
Roll Tension: Moderate

25. Anchoring Techniques
Aids in limiting joint motion
Equal tension
Strips continue distally
Roll tension: Moderate
Purpose: Additional support
Patient Position: Seated with
hand/thumb/wrist in neutral.

26. Thumb Check Rein

27. Boxer’s Wrap
Purpose: Absorb shock,
prevent contusion
Patient position: Seated with
hand fingers and thumb in
neutral position
Roll tension: Moderate

28. Thorax & Abdomen:
Compression Wrap
Purpose: Control mild to
moderate swelling when
treating contusion and strain.
Patient Position: Standing in
neutral
Apply in a distal to proximal
fashion, overlapping by ½
width. Greatest tension
distally over inflammation.

29. AC Joint: Upper Arm
Purpose: Provide support
and immobilization, limit
ROM.
Patient Position: Seated in
pain free position
Prevention & treatment of
acute & chronic injury.
Custom made design
provides compression,
support, immobilization,
protection, and lessens
ROM.

30. Wrist Hyperflexion/Thumb
Purpose: Mild-moderate
support and limit excessive
hyperflexion
Continue medial to laterally
Direction: Around the wrist to
the MCP joint of the thumb
Roll Tension: Moderate

31. Finger: PIP, DIP, or MCP WRAP
Purpose: Control mild to
moderate swelling when
treating contusion and strain.
Patient Position: Seated with
fingers splayed in a pain free
position
Apply in a distal to proximal
fashion, overlapping by ½
width. Greatest tension
distally over inflammation.

32. Football Shoulder Pad

33. Ice Hockey: Helmet
Determine the helmet size by
measuring the circumference of
head about ½ - 1” above
eyebrow.
Adjust the chin strap so that it fits
firmly under the chin. You want
the helmet to fit snug enough so
that it doesn’t shift, but not to the
point of where it feels
uncomfortable.
If you feel pressure or pinching,
the helmet is too small.

34. Mouth Guard: Stock/Bite & Boil
Fitting snugly over the upper teeth,
mouth guards protect the entire oral
region from traumatic injury,
preserving both the esthetic
appearance and the health of the
smile.
These mouth guards are usually made
from thermoplastic and are easily
located at most sporting goods stores.
First, the thermoplastic must be
immersed in hot water to make it
pliable, and then it must be pressed on
the child’s teeth to create a custom
mold.
Offer more protection

35. Mouth Guard: Custom
Custom mouth guards are made
from exact and precise models of
an individual's own teeth.
They are made of resilient and tear
resistant materials ensuring a
proper fit; are comfortable, easy to
clean, and do not restrict breathing.
A properly fitted mouthguard must
be protective, comfortable,
resilient, tear resistant, odorless,
tasteless, not bulky and have
excellent retention, fit, and
sufficient thickness in critical areas.

36. Crutch Fitting
Patient Position: Standing in
neutral
Elbow in 30 degrees flexion
Adjust appropriately to
patient height

37. Cane Fitting
Patient Position: Standing in
neutral
Cane: Measured to the
greater trochanter
Cane use on affected side to
provide support

38. RICE Application
REST IMMOBILIZATION
COMPRESSION
ELEVATION
Used to provide immediate
treatment of acute injury
Starts the healing process

39. STRETCHING: Upper Trapezius
Gently pull head forward to
chin
“as if patient was nodding”
Hold position 10-15 seconds
Bilateral stretch best

40. STRETCHING: Anterior Scalene
Moving the ear to the
shoulder first then gently
tilting the head backward
Hold several seconds
Repeat bilaterally

41. STRETCHING: Middle Scalene
Moving the ear to the
shoulder
Hold several seconds
Repeat bilaterally

42. STRETCHING: Posterior Scalene
Ear to the shoulder then
slight roll into forward flexion
(assisted)
Repeat bilaterally
Hold 10-15 seconds

43. STRETCHING: Sternocleidomastoid
Rotate the heat to one side
as far as comfortable
Tilt head to the same side as
if trying to reach the ear to
the shoulder
Assisted to endpoint
Hold for 20 seconds
Repeat bilaterally as
tolerated

44. STRETCHING: Cervical Traction
Traction: Slight stretching of
the neck and C spine
Creates space and relieves
compression between
vertebrae
Treat neck pain or stiffness

45. STRETCHING:
Levator Scapulae
Rotate head 45 degrees to
the left. Place left hand
behind head and gently pull it
at an angle toward knee.
Stretch the muscle in this
manner for 5 to 10 seconds.
Stop the movement when
patient feels a slight sting in
the right side of neck

46. STRETCHING:
Suboccipital Extensors
The sub occipital muscles connect
the base of the skull to the top of
the spine and are the only muscles
in the body with an energetic
connection to the eyes
Lengthen the back of the neck as
much as you can without closing
off or creating discomfort at the
front of the throat. Try and have
your eyes facing directly up at the
ceiling or closed.
Long stretch: Hold 2-3 minutes

47. STRETCHING:
Pectoralis Major:
Sternal Head
The pectoralis major is the large,
fanlike muscle that extends from your
breastbone and the top of your
abdominals toward your upper arm. It
sits in front of your rib cage and helps
you to rotate your arm inward as well
as draw your shoulder blades forward.
By stretching the pectoralis major, you
can extend the range of motion in
sideways abduction, extension, flexion
and the rotation of the long bone in
your arm.
When you perform stretches, you can
target different areas of the pectoralis
major by altering the angle of
abduction, or distance away from the
midline of your body.

48. STRETCHING:
Pectoralis Major
Clavicular Head
More abduction with your arms
raised overhead at an angle of
135 degrees will focus on the
muscle’s lower region around
the middle of your rib cage
f you feel a sting in your chest
muscle, release the stretch.
If your shoulders are very
flexible, perform the stretch
with your arms at a higher
level.

49. STRETCHING:
Pectoralis Minor
Location: Hides behind the
pectoralis major, connecting
from the front of your shoulder
blade to your ribs
Function: it basically helps
stabilize the shoulder blade,
while also helping with small
little movements
Detailed Function: stabilizes,
depresses, protracts and
downwardly rotate the scapula

50. STRETCHING:
Rhomboid Major
Gently reach out so that you
feel your shoulder blades
stretching away from each
other.
Gently bend your head
forward.
Hold for 15 to 30 seconds.
Repeat 2 to 4 times.

51. STRETCHING:
Rhomboid Minor
Begin this exercise standing
tall with your back and neck
straight.
Extend both arms outward,
head into flexion, roll
shoulders forward
Hold at a mild to moderate
stretch pain free for 15
seconds and repeat 4 times
on each arm.

52. STRETCHING:
Middle Trapezius
“Chicken wing” Assisted
Hold this position for 10 to 15
seconds.
Go through these stretches
2 to 3 times in one sitting and
repeat throughout the day.

53. STRETCHING:
Serratus Anterior
Draw your right shoulder
blade closer to your spine.
Keep the right palm planted
firmly and turn the body
counterclockwise, toward the
left, until your torso is facing
forward and the right arm is
behind you.
Hold the stretch for 20
seconds, then repeat on the
opposite side.

54. STRETCHING:
Anterior Deltoid
turn your body away from the
arm and keep a slight bend in
your elbow throughout the
stretch.
Keep turning your body until
you feel a stretch in the
front of your shoulder.
Hold and then switch arms.

55. STRETCHING:
Middle Deltoid
turn your body away from the
arm and keep a slight bend in
your elbow throughout the
stretch.
Keep turning your body until
you feel a stretch in the
front of your shoulder.
Hold and then switch arms.

56. STRETCHING:
Posterior Deltoid
Take the arm to be stretched
and place it behind the body
Bend at the waist
Elbows in slight flexion
Hold 20-30 seconds

57. STRETCHING:
Supraspinatus
Patients with Supraspinatus
Tendinitis present with
shoulder pain with movement
and pain at night. They will
also show weakness in the
shoulder and arm.
Hold stretch for 20 seconds.
you feel a stretch in the back
of the shoulder. Hold stretch
for 30 seconds. Rest and
repeat.

58. STRETCHING:
Infraspinatus
Raise the right arm over
head grab right elbow
Pull right elbow over to the
left gently until a comfortable
stretch is felt.
Hold this for 30 - 60 seconds.
Repeat bilaterally

59. STRETCHING:
Teres Minor
Stand with feet shoulder width
apart, chest up and head back
over your shoulders.
Raise the right arm over head
and grab your right elbow with
the left hand.
Pull your right elbow over to
the left gently and bend your
trunk to the left until a
comfortable stretch is felt.
Hold this for 30 - 60 seconds.

60. STRETCHING:
Teres Major
Reach behind with your right
arm bringing your hand
behind your body
you feel a stretch along the
outside of your upper back
Assisted: Allow for a greater
stretch by gently “pulling” the
arm back

61. STRETCHING:
Corocobrachialis
The Coracobrachialis is a deep
muscle within the shoulder that
often gets tight and affects the
shoulder position
instead of bringing your arm
straight out to the side, bring it
back about 45 degrees from
straight out to the side.
You should feel a light stretch
around the bicep area. Look
for a light stretch, hold for a
couple of seconds, and then
return to the start.

62. STRETCHING:
Long Head of Biceps
Symptoms of biceps tendon
inflammation typically include pain
at the front of the shoulder where
the long head of the biceps muscle
attaches.
A test to isolate the biceps tendon
is to get the patient to lift a straight
arm up in front of them against
resistance which should reproduce
pain at the front of the shoulder.
Patient position: Supine with arm
off table in Abduction
Assist in stretch

63. STRETCHING:
Pronator Teres
Externally rotate the arm (roll
the biceps toward the top).
You can also do this exercise
with a firmly planted vertical
pole. Or in Supine with arm
extended
To maximize the stretch,
keep the elbow straight.

64. Pronation refers to the inward
roll of the arm during normal
motion
Supination (or under-
pronation) is the opposite of
pronation and refers to the
outward roll of the arm during
normal motion.
Assure equal bilateral
stretching
Hold 20-30 seconds
STRETCHING:
Supinator & Pronator

65. STRETCHING:
Wrist Extensor Group
With palm facing downward
pull wrist and fingers
downward toward forearm.
Extend or straighten elbow.
Hold stretch. Repeat with
opposite arm.

66. STRETCHING:
Wrist Flexor Group
Keeping your elbow straight,
grasp your right hand with your
left, and slowly bend the wrist
backward until you feel a
stretch along the bottom of
your forearm.
Hold for 15 seconds.
Then bend wrist downward
until a stretch is felt on the top
of the arm, and hold for 15
seconds. Switch arms and
repeat.

67. STRETCHING:
Radial Deviation
Sit with your forearm resting
on a table allow the hand to
rest off the table.
Slowly draw the thumb
upwards towards the
shoulder and hold position.
Do not lift the forearm from
the table.

68. STRETCHING:
Ulnar Deviation
Sit with your forearm resting
on a table allow the hand to
rest off the table.
Slowly draw the thumb
inwards towards the ulna and
hold position.
Do not lift the forearm from
the table.

69. STRETCHING:
Thumb Flexion
Place your forearm and hand
on a table with your affected
thumb pointing up.
With your other hand, hold
your thumb steady just below
the joint nearest your
thumbnail.
Bend the tip of your thumb
downward, then straighten it.
Repeat 8 to 12 times.

70. STRETCHING:
Thumb Extension
Place your forearm and hand
on a table with your affected
thumb pointing up.
Bend the tip of your thumb
towards the pinky finger and
hold.
Repeat 8 to 12 times.

71. STRETCHING:
Thumb Adduction
Place your forearm and hand
on a table with your affected
thumb pointing up.
Bend thumb into AB duction
and hold
Repeat 8 to 12 times.

72. STRETCHING:
Thumb Abduction
Place your forearm and hand
on a table with your affected
thumb pointing up.
Bend the thumb into AD
duction and hold
Repeat 8 to 12 times.

73. STRETCHING:
Thumb Opposition
Place your forearm and hand
on a table with your affected
thumb pointing up.
Splay fingers and allow for
assisted stretch of the first
and 5th fingers into AB
duction
Repeat 8 to 12 times.

74. STRETCHING:
MCP Flexion
Grab the affected finger
below the proximal knuckle.
Stretch gently into a more
EXTENDED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

75. STRETCHING:
MCP Extension
Grab the affected finger
below the proximal knuckle.
Stretch gently into a more
FLEXED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

76. STRETCHING:
DIP Flexion
Grab the affected finger
above the proximal knuckle.
Stretch gently into a more
EXTENDED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

77. STRETCHING:
DIP Extension
Grab the affected finger
above the proximal knuckle.
Stretch gently into a more
FLEXED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

78. STRETCHING:
PIP Flexion
Grab the affected finger
BELOW the proximal knuckle
ant the PIP joint
Stretch gently into a more
FLEXED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

79. STRETCHING:
PIP Extension
Grab the affected finger
BELOW the proximal knuckle
ant the PIP joint
Stretch gently into a more
EXTENDED position.
Hold for 5-10 seconds
Perform 10 reps, 2 to 3 times
daily, resting for a minute
between each set

80. Implementation of PPE
Use protective equipment properly,
• Be aware of when personal protective
equipment is necessary,
• Know what kind of protective equipment is
necessary,
• Understand the limitations of personal
protective equipment in protecting workers
from injury,
• Put on, adjust, wear, and take off personal
protective equipment, and
• Maintain protective equipment properly.

81. Rectal Temperature
Lubricate the end of the probe with a small amount
of lubricating jelly.
Place your athlete on his side
Gently slide the probe of the thermometer into the
rectum about a 1/2 inch.
Stop inserting the thermometer if it becomes
difficult to insert.

82. Select one: Oral Temperature –or-
Tympanic Temperature
Put a new, throw-away cover
over the tip of the
thermometer.
Hold head so it does not
move, or tell the person not
to move his head.
For an adult, gently pull the
ear up and then back.

83. Bulletin Board: PEIF
Rotation 3