PCE Review (Updated 2026) QUESTIONS AND ANSWERS WITH
PCE Review (Updated 2026) QUESTIONS AND
ANSWERS WITH
What is the timeline of inflammation and what are three key factors of it? -
Answer 24hrs to 3-4 days
- Myofiber rupture and necrosis
- Hematomas
- Inflammatory cell reaction
What is the timeline of repair phase and what are 4 key factors to know? -
Answer 5-14 days
- Phagocytosis of necrotic fibers
- Regeneration of myofibers
- Formation of scar tissue
- Capillary ingrowth
What are the timelines for remodeling and 3 key factors to know? - Answer
14-21 days (can take up to 2 years)
Maturation of myofibers
Contraction and organization of scar tissue
Recovery of function
What is a contusion?
What causes it?
What is the Rx for initial and recovery time?
What are the common complications? - Answer Muscle injury caused by
sudden external force that results in deep muscle bleed
Rx 1st 48 hrs - PRICE, no HARM (heat, alcohol, running, massage)
- Put muscle on as much stretch as possible, crutches if necessary, gentlre ROM
Recovery time:
1st gr - 2-3 wk
2nd gr - 4-6 wk
3rd - 8wk
Complications - Compartment syndrome & myositis ossificans
Where do the majority of muscle strains occur?
When do the majority occur? - Answer In biarticular muscles at the muscle
tendon junction
Occur during eccentric loading or high intensity activities
- terminal swing phase of high speed running, concurent hip flexion & knee
extension as examples
What are risk factors for muscle strains?
What is the grading for muscle strains? - Answer Risk factors - prior injury,
age, unaccustomed activity, training errors, biomechanics
Grade 1 - microscopic tearing, pain/tightness, no weakness
Grade 2 - partial, macroscopic tear - pain & structural change, laxity, weakness
Grade 3 - complete tear - painless, weak, may lump
What is the Rx for muscle strains? - Answer Acute - PRICE
Repair - Modalities, stretch, strength
Remodeling - strength & stretch
RTP
What is a laceration and what is the Rx? - Answer Cutting of the muscle fibers,
require surgical repair w/ sutures
Inflammation phase - optimize gait, posture, and positioning
Repair phase - gradual ROM & strength
Remodeling - gradual increase load and velocity
What are the two kinds of muscle weakness to differentiate? - Answer
Weakness w/o pain (neurological or severe muscle damage) vs weakness w/ pain
(contractile lesion)
When do DOMs start? - Answer 72 hours after exercise
What nerves are involved (and nerve roots) for pelvic floor dysfunction?
How to assess it? - Answer Pudendal nerve (S2,3,4 from sacral plexus)
Ax - digital, EMG, manometer, dynamometer, real time US, MRI, biofeedback
What are key markers of Chronic Pelvic Pain?
What are the causes?
What is the age range?
What should be assessed?
What is the rx? - Answer Pain >3mo, between diaphragm & knees
Causes - MSK, neuro, gynecological, urogenital
Age - 25-35
Ax - urogenital s/s, lumbar/pelvic/groin mechanical presentation, core activation
Rx - decreased pelvic floor resting tone, increased pelvic floor proprioception,
increased motor control, decreased pain sensitization
What is pelvic girdle pain?
What are the risk factors?
What are the causes? - Answer Pelvic girdle pain is pain in the pelvic region
associated with 50% of pregnancies where there is weakness/laxity of the PFM
during pregnancy/child birth
Risk factors - previous hx of back pain/trauma
Causes - laxity, asymmetry, inadequate motor control
What are the signs/symptoms of pelvic girdle pain?
What should be the ax for pelvic girdle pain? - Answer Symptoms - pain
(ant/lat/post pelvic, groin, ant/post thigh, abdomen, coccyx) - w/ sustained
positions or transitional movements
Signs - posture (locked knees, L spine lordosis, thoracic kyphosis, FHP); asymmetry
(standing & supine); gait (shuffling, waddling, leg drop)
Ax - ASLR w/ force/form closure
Hip quadrants (ER/IR)
SIJ stability -> P4, Gaenslen's, FABERS, palpation
TOP spinous processes
TOP piriformis
Resisted hip ADD/ABD
What is the rx for pelvic girdle pain? - Answer Education - position and
movement strategies for pain management
Posture - lumbar support, soften knees, pillow for neck at night
Manual tx
Exercise - stabilize, symmetry
Movement strategies - use glutes (no rotation)
What is the condition progression for pelvic girdle pain? - Answer Cystocele -
herniation of bladder into vagina
Rectocele - herniation of rectum into vagina
Uterine prolapse - herniation of uterus into vagina
What are the grades of ligament sprains?
What ax?
What rx? - Answer Grade 1 - minor rupture, stable
Grade 2 - partial rupture, some laxity, no gross instability
Grade 3 - complete rupture, gross instability
Ax - Stability testing, laxity & end feel; pain
Rx -
Acute - PRICE
Repair - stability w/ muscle strength, DTFM, modalities, progressive loading
Remodeling- DFTM, progressive load, sport/function
What is the MOI, S/S, Dx, & RX for Syndesmotic Sprains? - Answer MOI -
planted foot + IR of leg (ER of talus); hyper DR + inversion; falls, twisting, MVA
Ligaments affected - AITFL, PITFL, interosseus, possible others
S/S - limited swelling, antalgic gait, TOP @ Injury site (AITFL, PTFL, ant distal
tib/fib)
Dx - ER stress test, squeeze test, crossed leg test, ant/post translation of fibula;
squat test; heel thump test
Rx - Phase1 (0-2wks) protection phase - PRICE, modalities, light ROM, NWB w/
crutches
Phase 2 (2-4 wks) regain mobility, increase strength, joint mobs, PWB ambulation
Phase 3 - increase function, unilateral balance & strength
Phase 4 - RTP, cutting, jumping, strengthening
What is a tendon?
What happens w/ loading tendons? - Answer Tendon is composed of
tenocytes and ECM (collagen, glycosaminoglycan)
Loading tendons - increased collagen synthesis, cellular proliferation, alignment