English in Kinetotherapy PDF

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ADINA RDULESCU
ENGLISH IN KINETOTHERAPY
A PRACTICAL ENGLISH HANDBOOK
FOR INTERMEDIATE STUDENTS
Universitatea SPIRU HARET

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Descrierea CIP a Bibliotecii Naionale a Romniei

RDULESCU, ADINA
English in Kinetotherapy A practical English Handbook. FOR
INTERMEDIATE STUDENTS / Adina Rdulescu. Bucureti,
Editura Fundaiei Romnia de Mine, 2004
124 p.; 20,5 cm
ISBN 973-725-165-2
811.111.615.825
Editura Fundaiei Romnia de Mine, 2003

ISBN 973-725-165-2
Redactor: Andreea DINU

Tehnoredactor: Marcela OLARU
Coperta: Marilena Gurlui BLAN
Bun de tipar: 16.12.2004; Coli tipar: 7,75

Format: 16/6186
Splaiul Independenei, Nr. 313, Bucureti, S. 6, O. P. 83
Tel./Fax.: 410 43 80; www.spiruharet.ro
e-mail: contact@edituraromaniademaine.ro

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UNIVERSITATEA SPIRU HARET

FACULTATEA DE EDUCAIE FIZIC I SPORT
ADINA RDULESCU
ENGLISH IN KINETOTHERAPY
A PRACTICAL ENGLISH HANDBOOK
FOR INTERMEDIATE STUDENTS
EDITURA FUNDAIEI ROMNIA DE MINE

Bucureti, 2004
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CONTENTS
Cuvnt nainte 7
UNIT 1
THE MAIN PARTS OF THE BODY
Imperative sentences used in relaxation training techniques ... 9
Prepositions . 13
UNIT 2
THE SKELETAL SYSTEM
Interrogative pronouns and adverbs used before the verb to be 17
Asking questions . 21
UNIT 3
THE MUSCULAR SYSTEM
Adjectives basic knowledge 29
Describing a certain muscle ... 33
UNIT 4
EXAMINING THE PACIENT
Polysemantic words .. 38
Therapist-patient discourse greetings, identification and
introductory dialogues 42
UNIT 5
TYPES OF INJURIES
Passive modal constructions .. 48
Therapist-patient discourse patients symptoms and complaints 51
Formal and informal medical terms 51
Present Tense Simple and Present Perfect .. 53
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UNIT 6
THERAPEUTIC EXERCISES
Word formation derivation . 59
Therapist-patient discourse recommending different
therapeutic exercises .. 63
UNIT 7
THERAPEUTIC PROCEDURES IN HANDLING THE
PATIENT
Passive verbal constructions .. 69
Therapist-patient discourse positioning and handling the
patient . 72
UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE
DISORDERS
Pronouncing tongue-twisters .. 78
Therapist-patient discourse - describing symptoms and
recommending therapeutic exercises .. 79
UNIT 9
POSTURAL PROBLEMS
Conditional clauses . 89
Therapist-patient discourse improving communication ... 94
UNIT 10
REVISION EXERCISES 99
Glossary .. 113
Bibliography . 123

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CUVNT NAINTE
Specificul studierii limbilor strine n cadru universitar este

reprezentat de trecerea de la studierea limbii strine la modul general
la aprofundarea ei pe diverse domenii de specialitate. n funcie de
specializarea pentru care studenii opteaz, ei vor studia, n cazul
nostru, engleza economic, juridic, tehnic, medical etc. Studiul
limbilor strine aplicate pe un anumit domeniu de specialitate n
cazul nostru fiind vorba de engleza n kinetoterapie, o ramur a
englezei medicale presupune din partea studenilor un nivel mediu
de cunotine de limba englez, stpnirea unor tehnici de munc
individual i, de asemenea, a unui nivel mediu de cunotiine
generale pe domeniul respectiv de specialitate.
Manualul de fa se adreseaz studenilor seciei de
Kinetoterapie, din cadrul Facultii de Educaie Fizic i Sport a
Universitii Spiru Haret Bucureti, att anului I ct i anului II de
studiu. El rspunde unei nevoi reale aceea de a avea un instrument
practic de lucru pentru desfurarea activitii de seminar.
Contientizarea avantajelor pe care le presupune stpnirea
unui limbaj de specialitate ntr-o limb strin, dintre care amintim:
posibilitatea consultrii unei bibliografii de specialitate n limba
respectiv, participarea studenilor la conferine internaionale,
publicarea unor materiale n revistele de specialitate i, poate cel mai
important, posibilitatea de a lucra ntr-o clinic sau cabinet de profil
cu personal i clieni strini fie n Romnia fie peste hotare a
constituit motivaia principal pentru meninerea interesului
studenilor fa de aceast disciplin de studiu i pentru obinerea
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unui certificat de competen lingvistic pe specialitatea englez

medical, eliberat n cadrul Centrului de Limbi Strine al
Universitii Spiru Haret.
Manualul este structurat pe 10 capitole (Units), axndu-se pe
trei componente principale: 1) un corpus de texte de specialitate,
care-i asociaz diverse exerciii de vocabular, traduceri de text i
exerciii de redare selectiv a informaiei prezentate; 2) o selecie a
unor probleme de gramatic a limbii engleze, efectuat n funcie de
criteriul frecvenei anumitor structuri gramaticale n limbajul medical
i 3) un set de ,,discursuri kinetoterapeut-pacient, axate pe tematica
fiecrui capitol, avnd ca scop familiarizarea studenilor cu utilizarea
unui limbaj oral, informal, care completeaz limbajul formal n care
sunt redate textele de specialitate. Selectarea acestor texte din diverse
materiale atlase de anatomie, cursuri de kinetoterapie etc. a avut ca
intenie creearea unui cadru ,,profesionist de lucru, precum i
stimularea interesului studenilor pentru consultarea unor materiale
de specialitate n limba englez. i, nu n ultimul rnd, exerciiile de
la fiecare sfrit de Unit create your own dialogues, consider
yourself as a kinetotherapist etc. testeaz capacitatea studenilor de
a se exprima liber i firesc n limbajul de specialitate asimilat, ntr-un
context socio-profesional artificial creat n sala de seminar, prin ceea
ce n metodica limbii engleze se numete Role playing.
Cu dorina i sperana c acest manual va rspunde nevoii
practice a studenilor de a aprofunda limba englez pentru o viitoare
practic kinetoterapeutic, constituind n acelai timp un stimulent
pentru o perfecionare permanent, prin consultarea unei bibliografii
actualizate n limba englez, nchei prin a le mulumi studenilor din
primele generaii cu care am lucrat pentru ajutorul pe care mi l-au
acordat n vederea conturrii suportului teoretic i practic al acestui
manual, prin simpla lor participare activ la seminariile de limba
englez.
Autoarea

English in Kinetotherapy. A practical English handbook 9
UNIT I
THE MAIN PARTS OF THE BODY

Imperative sentences used in relaxation training techniques
Prepositions
1. Read the following texts containing relaxation techniques and

write down the new words:
Trainers introduction: This relaxation procedure is one that has

been practised for many years now. It has been studied by researchers
and found to be effective. You will feel very relaxed and calm as a
result. It is not the same as hypnosis and you will not lose
consciousness at any point.
The procedures: Make yourself as comfortable as you can become
aware of the surface underneath you let your body settle into it
notice how it supports you notice the points of contact between you
and the floor: your head shoulders spine ribs hips heels
elbows forearms and hands feel your body sinking into the
surface you are lying on feel your body getting heavier as the
tension ebbs away feel at peace. Take one good breath and as you
let it out, feel it carrying all your tensions away then let your
breathing settle into a gentle rhythm
As you lie or sit, reflect on the idea that you are going to give the next
half-hour to yourself. No telephone can ring for you; no doorbell
disturb you; no one will call your name. You may hear sounds around
you: voices, horns, sirens, bangs and revs think of them as being
outside your world. With these thoughts in mind, draw an imaginary
circle around yourself, about three feet from the centre. Create an
imaginary bubble think of the interior as your space your own
private space. Feel how safe it is safe to get in touch with yourself.
Turn your thoughts inward.
Trainers termination of the procedure: I am going to bring this
relaxation session to an end Id like you gradually to become aware

10 ADINA RDULESCU
of the room feel the floor/chair underneath you open your eyes
give your limbs a few gentle stretches have the feeling that you are
alert and ready to carry on with your life
With your eyes open, raise your eyebrows feel the tension and
release the tension frown feel the tension and release it shut
your eyes tightly feel the tension and let it go with your eyes
still closed, spend a few minutes releasing tension in this part of your
face
Close the jaws firmly, noticing the sensations you get from the
action hold it and discontinue let your jaw drop feel the
tension leaving you and continuing to leave you then repeat the
action. Next, bare your teeth feel the tension in the cheeks hold
it for a few seconds and release the tension. Make a tight O
with your lips hold it, while you register tension in the lips and
cancel the action.
Press your tongue against your teeth feel the pressure and release
it Now pull the tongue back towards the throat. Feel the muscles
drawing it back and note the sensations you get from this action
and release it
(R. A. Payne Relaxation Techniques)
2. Read the text again, select the words that designate: a) parts of
the body, b) verbal constructions expressing commands and
c) prepositions or other words indicating direction and place them
in three different columns.
3. Using the vocabulary practice below write the Romanian

equivalents for the terms indicating parts of the body.
VOCABULARY PRACTICE
4. Pronounce and learn the names of the main parts of the human
body. For some notions two alternative terms have been provided:

The head:
- eyes, eyelids (pleoape), eyelashes (gene), eyebrows (sprncene);
- nose, nostrils (nri);
- ears, ear lobe;
- mouth, lips (buze), gum (gingie), tooth - teeth, tongue (limb), jaw
(falc), upper jaw /maxilla (maxilar), under jaw (mandibul);
- forehead (frunte), cheek (obraz), cheek bone (os maxilar), chin
(brbie), dimple (gropi n obraz), dimple in the chin /fossette
(gropi n brbie).
The neck:
- throat;
- Adams apple/thyroid cartilage;
- hollow of the throat (scobitura gtului);
- nape of the neck (ceafa).
The body:
- shoulder, shoulder blade/scapula (omoplat);
- limb (membru), arm/upper limb (bra), armpit/axilla (axil), forearm
(antebra), hand, elbow (cot), crook of the arm (ndoitura braului),
palm, wrist/carpus (ncheietura minii), fist (pumn), fingers thumb
(degetul mare), forefinger (deget arttor), middle finger, ring finger
(deget inelar), little finger, finger tip (vrful degetului), finger pad
(pernia degetului), fingernail (unghie), knuckle (articulaia degetului);
- biceps, thorax/chest (torace), breast (piept), nipple (mamelon),
abdomen, stomach, waist (talie), navel/umbilicus (buric), bottom
(ezut), buttocks (fese);
- hip (old), leg, thigh (coaps), calf (gamb), shin/cannon bone
(tibia, fluierul piciorului), knee (genunchi), patella/knee cap (rotul),
ankle (glezn), instep (scobitura gleznei), sole (talp), heel/calcaneus
(clci), toes (degete de la picioare).
5. Choose the right word that best completes the sentence:

1. I cant move my left hand; I have problems with my ...
a) fingers b) armpit c) wrist d) fists

12 ADINA RDULESCU
2. It is not polite to talk to somebody when you have your

. in your pockets.
a) fingers b) hands c) palms d) arms
3. He has had this nasty habit of biting his . ever since he
was a kid.
a) tongue b) toes c) fingers d) nails
4. This old lady cant hear you very well; she has got an
infection.
a) ear b) throat c) tooth d) eye
5. He fell and hurt his really bad, as he was not wearing
his knee-pads when roller skating.
a) ankles b) legs c) knees d) toes
6. The underside both of a foot and a shoe is called a ..
a) heel b) sole c) shin d) toe
7. I ate an icecream yesterday and now I have a sore
.
a) neck b) eye c) jaw d) throat
8. You should not drink so much coffee on an empty
..
a) stomach b) waist c) abdomen d) throat
9. Nobody is perfect and carelessness is his Achilles...
a) toe b) arm c) heel d) head
10. He is walking on the tips of his so as not to awake
the baby.
a) feet b) toes c) fingers d) sole
6. Match up the following words with their definitions:
1. wrist a. the thick, fleshy part of the back of the

leg, between the ankle and the knee
2. forehead b. large muscle at the front of the upper
arm, which bends the elbow
3. hip c. the small depression beneath the arm
where it joins the shoulder

4. tongue d. a thin, horny, translucent plate covering

part of the dorsal surface of the end joint of
each finger
5. calf e. the part of the face between the natural
hairline and the eyes; formed skeletally by
the frontal bone of the skull
6. armpit f. part on either side of the body below the
waist where the bone of a persons leg is
joined to the trunk
7. nostril g. the joint between the forearm and the
hand
8. thigh h. the back part of the human foot from the
instep to the lower part of the ankle
9. fingernail i. part of the body below the chest and the
diaphragm, containing the stomach, the
bowels and the digestive organs
10. heel j. organ of taste that aids the mastication
and swallowing of food
11. abdomen k. either of the two external openings of the
nose
12. biceps l. part of the human leg between the knee
and the hip
VOCABULARY PRACTICE
Prepositions
Here is a list of the most commonly used prepositions of place and
position:
above = deasupra, de deasupra, mai sus de

across/along = de-a lungul, transversal
around/round = de jur mprejurul
below = dedesubt, sub (fr a indica contact cu suprafaa superioar)
beneath/underneath = dedesubt, sub (indicnd existena unei
suprafee superioare de protecie, separare)

14 ADINA RDULESCU
between = ntre (dou obiecte)

behind = n spatele, napoia
in front of = n faa
in = n, n interiorul
into = n, nspre interior (indicnd ptrunderea, strbaterea spaiului)
on = pe, deasupra
onto = pe, deasupra (indicnd micare pentru atingerea poziiei)
over = peste, deasupra
through = prin, printre
under = dedesubt, sub (indicnd contact cu suprafaa superioar)
Other words indicating movement and direction:

-WARDS class (wards = spre, ctre, indicnd direcia)
Backward (s) = napoi, invers, pe spate
Downward (s) = descendent, spre partea inferioar
Forward (s) = nainte, n fa
Inward (s) = nuntru, ctre interior
Leftward (s) = ctre stnga, dinspre stnga
Outward (s) = ctre/spre exterior, n afar
Towards = spre, ctre, n direcia
Upright = drept, vertical
Upward (s) = ascendent, spre partea superioar
Sideways = lateral, oblic, ntr-o parte
Pair work
7. Read the following commands to your deskmate and ask
him/her to follow your indications and practise the exercises.
Then, change activities:
Place your hands around your ankles.

Rest your elbows on your thighs.
Place your fingertips on your shoulder.
Bend your body sideways and give it a good stretch.
Lift your arms above your head.
Spread your arms sideways and lower them to your sides.

Clasp both hands behind your head.

Arch your body backwards.
Stretch your arms upwards.
Bend your knees forwards.
Hold your head forward and up.
Raise your arms above your head and turn the palms towards the
ceiling.
Lean your forearms vertically on the wall. With your heels on the
ground and your knees straight, let your hips sink forwards.
8. Read the following sentences and translate them into

Romanian:
Without moving your head, turn your eyes upwards behind your
closed lids.
Roll your eyes in a clockwise circle Now notice the sensations of
tension. Pause Roll them now in an anticlockwise direction.
Place your palm downwards on a surface (table, chair arm or thigh);
press your fingertips into the surface, drawing them towards your
palm so that your hand gradually takes on the shape of a spider
Hold the position, feel the tension in the hand and then let the tension
go and relax the muscles.
Keeping your toes firmly in contact with the floor, raise your heels
up in the air Now feel the tension in your calf muscles Relax
drop your heels to the ground and notice the relief, the comfort, the
warm tingling sensation in your calves.
9. Create your own relaxation techniques; write down five

examples of such exercises and then read them to your deskmates.
10. Translate into English, using the new words:

1. Plasai-v ambele mini pe umeri. Rotii-v trunchiul alternativ la
stnga apoi la dreapta.
2. Stai n poziie deprtat, cu minile pe lng corp. Ridicai mna
dreapt i ndoii corpul spre stnga. Revenii n poziia iniial. Apoi

16 ADINA RDULESCU
ridicai mna stng i ndoii corpul spre dreapta. Repetai micarea

de cinci ori.
3. ndoii-v uor trunchiul n fa. Atingei-v genunchii, apoi
gambele, apoi gleznele i dac putei chiar i degetele de la picioare.
4.Stnd pe un scaun, plasai-v ambele coate pe coapse, ntindei-v
antebraele i micai-v degetele.
5. nchidei ochii, ridicai minile deasupra capului i arcuii-v uor
trunchiul pe spate. Stai n poziie 10 secunde i apoi revenii n poziia
iniial.
6. Plasai-v ambele mini pe olduri. ndoii-v uor genunchii i apoi
rotii-v corpul la stnga i la dreapta. Observai ce simii la
articulaiile oldului.
7. ntindei-v braele lateral. Apoi ndoii-le din coate spre n fa, la
nivelul umrului. Repetai micarea de cte ori dorii.
8. Stai ghemuii pe vrfurile picioarelor, cu capul aplecat i cu
minile atrnnd pe genunchi. Simii cum vi se relaxeaz muchii
gtului. Meninei poziia ct dorii.
9. Stai cu picioarele deprtate i cu minile pe old. nclinai-v spre
dreapta, ridicnd piciorul stng. Meninei poziia pentru 5 secunde.
Apoi repetai n direcia opus.
10. Stai cu picioarele deprtate i cu minile ntinse lateral i cu
pumnii strni. Rotii-v simultan braele, trasnd un cerc mic n aer.
ncercai rotirea braelor n ambele direcii. Observai ce se ntmpl
cu muchii braelor i pieptului.

UNIT 2
THE SKELETAL SYSTEM

Interrogative pronouns and adverbs used before the verb to be
Asking questions
1. Read the following texts and write down the new words:
The function of the bones is to form a hard skeleton for the softer
materials of the body, to enclose and protect some of the most
important vital organs. Bone development takes place at a very early
period. In embryonic life, the parts destined to become bones consist
of a congeries of cells which constitutes the simplest form of cartilage.
This temporary cartilage is an exact miniature of the bone which in
due course is to take its place. The process of ossification is slow and
not completed until adult life. The next step is the ossification of the
intercellular substance and of the cells composing the cartilage. The
period of ossification varies much in different bones. It commences
first in the clavicle, in which the primitive point appears during the
fifth week; next in the lower jaw. The ribs also, and the long bones of
the limbs, appear soon after. For a long period after birth, a thin layer
of unossified cartilage remains between the diaphysis and epiphyses,
until their growth is finally completed.
(Henry Gray Grays Anatomy. Descriptive and Surgical)
*
Almost all the elements of the joints of adults are also present in the
joints of the newborn. The most active factor determining the
formation of a joint after birth are the muscles which exert an action
on the given joint, i.e. the work of a joint.
The development of bone articulations is directly dependent on the
formation of the bony and connective-tissue structures and muscular

18 ADINA RDULESCU
tissue. All the elements encountered in the joints of the newborn

continue their formation and acquire the geometrical shapes of the
articular surfaces characteristic of each joint of an adult.
(R.D. Sinelnikov Atlas of Human Anatomy)
VOCABULARY PRACTICE
2. Pronounce and learn the names of the main parts of the skeletal
system. Add more terms to the list:
The skeletal system:

- skull = craniu
- spine/spinal column/backbone = coloana vertebral
- vertebra, -ae/bony ring = vertebr
- spinal cord/marrow = mduva spinrii
- the cervical, dorsal, lumbar, sacral and coccygeal sections of the
spine = seciunile cervicale, dorsale, lombare i coccigiene ale
coloanei vertebrale
- rib = coast
- cartilage = cartilaj
- sternum/breastbone = stern
- clavicle/collarbone = clavicul
- thoracic cage = cuc toracic
- shoulder girdle = centur scapular
- scapula/shoulder blade = omoplat, scapul
- pelvis = pelvis
- pubis = pubis
- sacrum = os sacral
- coccyx = coccis
- articulation/joint = articulaie
- fibrous joint = articulaie fibroas
- synovial joint = articulaie sinovial
- ossification = osificare
- ligament = ligament
- hip joint = articulaia oldului

- knee joint = articulaia genunchiului

- ankle joint = articulaia gleznei
3. Complete the following sentences using the nouns in the box.

The first one has been done for you as an example:
sternum coccyx carpus calcaneus

scapula phalanges cranium joint
tibia metacarpus femur vertebrae
1. The spine is a flexuous column, formed of a series of bones called

vertebrae.
2. The ____________ is composed of eight bones: the occipital, two
parietal, frontal, two temporal, sphenoid and ethmoid.
3. The ____________ is a long, flat vertical bone, situated in front of
the thorax to which are attached the collarbone and the first seven
parts of ribs.
4. The ____________ is the longest, thickest and heaviest bone in the
skeleton, articulating with the pelvis above and the knee below.
5. The ____________ is the inner and thicker of the two bones of the
human leg, between the knee and ankle.
6. The ____________ is a small triangular bone at the end of the
spinal column, articulating by its base with the apex of the sacrum.
7. The ____________ is a large, flat bone, triangular in shape which
forms the back part of each shoulder.
8. The hand is subdivided into three segments: the __________ or
wrist, the ____________ or palm and the ____________ or fingers.
9. The ______________ or heel bone is the largest tarsal bone,
irregularly cuboidal in form and situated at the lower back part of the
foot.
10. The structures which enter the formation of a ___________ are:
bone, cartilage, fibro-cartilage, ligament and synovial membrane.

20 ADINA RDULESCU

1. breastbone a. Rings placed one above the other which
form a single column, the spinal column
2. ligament b. Triangular bone that forms the back of
the pelvis
3. skull c. Twelve pairs of curved bones extending
from the backbone round the chest
4. vertebrae d. Narrow, bony and curved column as a
cable for the spinal cord
5. clavicle e. Basin-shaped framework of bones at the
lower end of the body
6. spine f. Tough white flexible tissue attached to
bones and joints
7. pelvis g. Tough, flexible tissue that connects bones
and holds organs in position
8. sacrum h. Thin, flat, vertical bone in the chest,
between the ribs
9. cartilage i. Bone joining the breastbone and the
shoulder blade
10. ribs j. Bony framework of the head under the
skin
GRAMMAR
Interrogative pronouns and adverbs used before the verb to be
When forming interrogative sentences with the verb TO BE the rule

to be remembered is to place the words in the following order:
WHAT
WHICH
WHERE + is (sg.) / are (pl.) present + object
WHY + was (sg.) / were (pl.) past + object
HOW
HOW MANY

WHAT is used to ask somebody to specify one or more things,

places, people, etc from an indefinite number:
What are the main causes of muscular weakness?
What is the shape of the spinal column?
WHICH is used to ask somebody to specify one or more things,
people, etc from a limited number:
Which is the best treatment in this situation?
Which is the shortest and the most curved of all the ribs?
WHY means for what reason or purpose:
Why is physical therapy better than surgery in my case?
WHERE means in or to what place or position:
Where is the sternum situated?
HOW means in what way or manner:
How is the sternum described in terms of shape, position,
structure and development?
HOW MANY is used to inquire about the number of things:
How many phalanges are for each finger, except the thumb?
5. Ask questions for the underlined phrases using the

interrogative words what, which, where, why, how, how many and
the verb to be. The first two have been done for you as examples:
1. There are twelve ribs on each side of the thoracic part of the spinal
column.
How many ribs are on each side of the thoracic part of the spinal
column?
2. The foot consists of three divisions: the tarsus, metatarsus and
phalanges.
Which are the three divisions of the foot?
3. The leg consists of three bones: the patella (knee cap), placed in
front of the knee, the tibia and fibula.
_______________________________________________________?

22 ADINA RDULESCU
4. The patella is a small, flat, triangular bone situated at the anterior

part of the knee joint.
_______________________________________________________?
5. The scapula is situated between the first and seventh ribs.
_______________________________________________________?
6. The sternum has the shape of an ancient sword, consisting of three

parts.
_______________________________________________________?
7. That form of cartilage which enters into the formation of the joints
is called articular cartilage.
_______________________________________________________?
8. The ligament is pliant and flexible, so as to allow perfect

freedom of movement but strong, tough and inextensible, so as not
to yield under a severely applied force. (ask three questions)
_______________________________________________________?
9. There are 206 distinct bones in the entire skeleton of an adult.
_______________________________________________________?
10. The superior extremity is the largest part of the humerus.
_______________________________________________________?

6. Read the following extracts and translate them into Romanian:

Most bones of a human adult consist of a bony and cartilaginous
framework, as a result of which a bony part and a cartilaginous part
are distinguished in the skeletal system. The bony part makes up most
of the bone. The articular cartilages, the epiphyseal cartilages and the
costal cartilages form the cartilaginous part of the skeletal system.
The long bones (humerus, clavicle, femur, phalanges, etc.) have a

middle part, the diaphysis, and two end parts, the epiphyses. The
epiphysis located closer to the axial skeleton is called the proximal
epiphysis, while the epiphysis of the same bone but situated further
from the axial skeleton is called the distal epiphysis. The wider parts
of long bones between the diaphysis and the epiphysis are known as
metaphysis. Their boundaries are visible only in the bones of children
and adolescents when a cartilaginous layer, the epiphyseal cartilage
still remains between the diaphysis and epiphyses.
The red marrow possesses high functional activity and is capable of

forming blood cells of the myeloid series. With the development and
growth of the organism, the red marrow is gradually replaced by the
yellow marrow. The yellow marrow is less active and plays a reserve
role, but under certain conditions it may be activated.
(R.D. Sinelnikov Atlas of Human Anatomy)
7. Translate the following questions into English, using the new

vocabulary. Providing an answer to these questions will also test
your anatomy knowledge:
1. Care este tiina care se ocup cu studiul oaselor?
2. Care sunt principalele tipuri de oase?
3. Care sunt prile constituente ale unei articulaii?
4. Care sunt cauzele care determin traumatismele i fracturile
coloanei vertebrale?
5. Din cte oase este format craniul i care sunt acestea?
6. Care articulaie este cel mai frecvent afectat n fracturi?

24 ADINA RDULESCU
7. Cte vertebre are coloana lombar? Dar coloana toracal?

8. Unde este plasat acromionul?
9. Cum este descris sternul n atlasul de anatomie?
10. De ce este intervenia chirurgical mai potrivit n acest caz dect
fiziokinetoterapia sau balneoterapia?
Pair work
8. Question-answer exercise: Using your anatomy courses notes, ask
your deskmate questions about the skeletal system.

UNIT 3
THE MUSCULAR SYSTEM
Adjectives basic knowledge
Describing a certain muscle
1. Read the following texts about the muscular system and write
down the new words:
There are more than 600 skeletal muscles in the human body and
their total mass accounts for up to 28-35 per cent of the body mass in
females, up to 40-45 per cent in males, and up to 45-55 per cent in
athlets. Up to 50 per cent of the total weight of the skeletal muscles
fall to the share of the muscles of the lower limbs, up to 30 per cent to
those of the upper limbs, and up to 20 per cent to the share of the
muscles of the head and trunk.
Each muscle has a developed network of blood vessels. The
contraction of a muscle promotes rapid flow of blood, i.e. the muscle
is a peculiar pump which forces the blood forward. Under conditions
of reduced motor activity (hypokinesia) in an active mode of life or
when prolongued bed-rest is necessary, this function of the skeletal
muscles is excluded as a result of which the blood flows slower,
metabolic processes are reduced and stasis occurs. In contrast, under
conditions of motor activity the reserve capillaries open, new
capillaries form, and nutrition of the skeletal muscles improves.
(R. D. Sinelnikov Atlas of Human Anatomy)
All elements of the musculoskeletal system are in dynamic

equilibrum, continually changing shape, structure and function, in
response to loading and mechanical demands. The system is
vulnerable to trauma, peculiarly susceptible to local and systemic
inflamatory disorders.
Acute inflammation or tissue damage often becomes chronic, perhaps
because of continuous movement and mechanical stresses.

26 ADINA RDULESCU
Musculoskeletal disorders are major worldwide causes of chronic pain

and severe physical handicap, particularly as population becomes
older, generally fitter, and more health conscious.
(The Merk Manual of Diagnosis and Therapy)
Muscles vary considerably in their form. In the limbs, they are of

considerable length, especially the more superficial ones, the deep
ones being generally broad; they surround the bones and form an
important protection to the various joints. In the trunk, they are broad,
flattened and expanded, forming the parietes of the cavities which they
enclose.
(Henry Gray Grays Anatomy. Descriptive and Surgical)
VOCABULARY PRACTICE
2. Pronounce and learn the main terms and collocations related to

the muscular system. Add more terms to the list:
- muscle = muchi
- skeletal muscle = muchi scheletic
- tendon = tendon
- muscular tissue = esut muscular
- blood vessels = vase sanguine
- nerves = nervi
- fibers = fibre
- fascia = fascie
- diaphragm = diafragm
- musculature = musculatur
- muscle bulk = mas muscular
- muscular contraction/cramp = contracie muscular
- muscular endurance = rezisten muscular
- muscle fatigue = oboseal/extenuare muscular
- muscular hypertrophy = hipertrofie muscular
- muscle tone = tonus muscular
- hypotonic muscles = muchi hipotonici
- hypertonic muscles = muchi hipertonici

- muscle rigidity = rigiditate muscular

- muscle spasm = spasm muscular
- spasticity = spasticitate
- muscle sprain = luxaie
- muscle strain = ntindere muscular
- muscle strength = for muscular
- muscular tension = tensiune muscular
- muscular weakness = slbire muscular
3. Match the half-sentences in column A with their corresponding

half-sentences in column B to form correct and complete
sentences:
A B
1. Muscle bulk. a. a progressive loss of
muscle strength in a variety of
muscle groups.
2. Muscle-setting exercise. b. very firm, may be spastic or
rigid and resists sideways
movements.
3. Muscular dystrophy is a c. a muscle sprain or strain,
degenerative muscle disorder arthritis, a tumor or a ruptured
characterized by . cartilage disk between vertebrae.
4. Electromyography (EMG) is a d. very soft, weak and flabby
techique and is easily moved laterally.
5. A hypertonic muscle feels e. gives an indication of the
state of the musculature.
6. If you have observed muscle f. an evaluation of the
weakness, condition and functioning of the
muscles, joints and bones of the
body.
7. Involuntary movements and g. is a method of contracting
tremors and relaxing a skeletal muscle
without moving that part of the
body.

28 ADINA RDULESCU
8. Low back pain at the base of h. that records changes in the

the spine can be caused by electrical potential during
muscle contractions.
9. Musculoskeletal system i. are signs of some
assessment is neurological disorders.
10. A hypotonic muscle feels j. then a detailed test will be
necessary for each muscle.
1. tendon a. Fibre or bundle of fibres carrying

impulses of sensation or of movement
between the brain and all parts of the body
2. fasciae b. Large muscle at the front of the upper
arm, which bends the elbow
3. blood vessels c.Wall of muscle, between the chest and
the abdomen, that helps to control
breathing
4. fibres d. Very narrow blood vessels connecting
arteries and veins in the body
5. nerve e. Fibrous membranes which form linings
for body cavities and cover muscles and
organs
6. capillaries f. Strong band or cord of tissue that joins
muscle to bone
7. muscular dystrophy g. Slender threads of which many human,
animal or plant tissues are formed
8. diaphragm h. Tubes (arteries, veins or capillaries)
through which blood flows in the body

9. biceps i. Broad, thick, triangular muscle, situated

at the upper and anterior part of the chest
that draws the arm towards the body
10. pectoral muscle j. Long-lasting illness in which the
muscles become gradually weaker
GRAMMAR
Adjectives basic knowledge
Participial and qualificative adjectives
Degrees of comparison
Constructions with comparisons
Considering the frequency of certain types of adjectives in medical

language we shall deal only with participial and qualificative
adjectives.
Participial adjectives are participial forms used as adjectives:
- Present Participle forms: short infinitive + -ING: increasing,
relaxing, growing
- Past Participle forms: short infinitive + -ED (for regular verbs):
reduced, flattened, expanded or the third form of irregular verbs: cut,
hidden, frozen.
Example:
This relaxing atmosphere and these stimulating exercises will have a
pronounced effect on your back muscles.
Qualificative adjectives include all types of adjectives denoting

quality, size, shape, colour, origin, age and general descriptions of
objects (parts of the body, diseases, symptoms etc) and people:

30 ADINA RDULESCU
Example:
The first piece of the sternum has a triangular form, broad and thick
above and narrowed below.
Both participial and qualificative adjectives can either precede the
noun, having the same form for all genders, both singular and plural
(attributive position) or follow the noun, having the function of
predicatives for copulative verbs such as: be, become, look, seem, turn
etc:
Example:
Moderate exercises have a therapeutic effect on muscles.(attributive
position)
The muscles become resistant to fatigue and the patients no longer
look exhausted at the end of the session.(predicative position)
Degrees of comparison
According to the way they form their degrees of comparison
adjectives fall into three categories:
1) monosyllabic (or short) adjectives and bisyllabic adjectives
ending in -er, -y and ly which form their corresponding degrees of
comparison by adding er and est (synthetic comparison):
thick thicker the thickest
thin thinner the thinnest
2) long adjectives bisyllabic (ending in -ful and -re),
trisyllabic or plurisyllabic which form their degrees of comparison
by periphrastic means: more and (the) most (analytic comparison):
extensive more extensive the most extensive
3) adjectives with irregular degrees of comparison:
good better the best
bad worse the worst
little less the least
many/much more the most
old older the oldest (of people and objects)
old elder the eldest (of people)
far farther the farthest (of space)
far further the furtest (of time)

Constructions with comparisons:

The use of adjectives at different degrees of comparison requires the
use of certain patterns. For instance, adjectives at superlative will be
associated with perfect tenses:
This is the most distressing pain I have ever had.
The comparative requires the specification of the second term of
comparison, which can be either a word or a sentence:
I am not as useless as my blind brother /as you think I am.
The injury was more severe than we thought.
Gradual increase or decrease is expressed by two comparatives joined
by and:
As your breathing becomes slower and slower you are feeling
more and more relaxed.
Sometimes the comparatives are placed at the beginning of the
sentences:
The sooner you practise the exercise, the better you will feel.
The larger the muscle, the greater its strength.
5. Reread the texts about the muscular system and extract all the
adjectives. Group them according to their attributive or
predicative position. For derivational adjectives indicate the noun
that they derive from and their suffix or prefix as in the following
examples:
systemic = system (noun) + -ic (suffix)

skeletal = skelet (noun) + -al (suffix)
6. Form derivational adjectives from the following nouns and

verbs, choosing the appropriate suffixes in the box. Sometimes
more than one suffix can be attached to part of the words:

32 ADINA RDULESCU
-al -ic -ous -less

-ish -ive -ful -able
-ible -ed -ing -y
Example:
Stern + -al = sternal
thorax comfort
sphere to identify
muscle to contract
abdomen access
stomach memory
anomaly to connect
fibre to digest
fever health
cure infection
help pain
7. Translate the following sentences into English, using the new

vocabulary and grammar notes of this unit:
1. Ce cauzeaz hipertrofia muscular?
2. Cu ct rezistena muscular este mai mare cu att va fi mai mare
numrul de contracii musculare.
3. Tensiunea muscular prelungit poate produce durere, care poate
duce la spasm muscular i prin urmare la mai mult durere.
4. Tensiunea muscular are strns legtur cu modul nostru de a
gndi; astfel, cu ct suntem mai stresai, cu att mai mare va fi i
tensiunea noastr muscular.
5. Activitatea fizic prelungit cum ar fi mersul sau pasul alergtor
poate duce la oboseal muscular.
6. Care sunt cauzele principale ale extenurii musculare?
7. Muchiul gastrocnemian este cel mai superficial muchi situat n
partea din spate a piciorului, care formeaz cea mai mare parte a
gambei.

8. Tendonul lui Ahile este cel mai gros i mai puternic tendon din
corpul uman.
9. Muchiul deltoid este un muchi lat, gros, triunghiular, situat pe
partea lateral i posterioar a umrului.
10. Muchiul abductor al policelui este un muchi subire, plat,
ngust, plasat imediat dedesubtul tegumentului (integument).
Pair work:
8. Using your anatomy courses notes, choose a certain muscle and
ask your deskmate to describe it.
9. Guessing game: Think of a certain muscle. Your deskmate will

ask you as many questions as necessary to guess the muscle. Here
are some examples of possible questions:
Is it a muscle of the trunk/head/upper limb/lower limb? for

general location
(It is a muscle of the upper limb)
Is it a muscle of the shoulder girdle or of the free upper limb? for
specific location
(It is a muscle of the shoulder girdle)
Where is it situated?
(It arises from the clavicle and scapula.)
What is its function?
(It helps the upper arm move forward, backward and horizontally.)
Can you describe it?
(It is a thick, triangular muscle with the base facing upwards and the
apex downwards)
Is it the deltoid muscle?
(Yes, it is indeed.)
The following classification of muscles may prove useful for this

exercise:

34 ADINA RDULESCU
A. The muscles of the trunk:
the muscles of the back

the muscles of the neck
the muscles of the chest
the muscles of the abdomen
B. The muscles of the head:

the muscles of facial expression:
the muscles of the scalp
the muscles surrounding the eyes
the muscles surrounding the mouth
the muscles surrounding the nose
the muscles of mastication
C. The muscles of the upper limb:

the muscles of the shoulder girdle
the muscles of the free upper limb:
the muscles of the upper arm
the muscles of the forearm
the muscles of the hand
D. The muscles of the lower limb:

the muscles of the hip joint
the muscles of the free lower limb:
the muscles of the thigh
the muscles of the leg
the muscles of the foot
10. Complete the classifications above with all categories of

muscles you have studied so far.

UNIT 4
EXAMINING THE PACIENT
Polysemantic words
Therapist-patient discourse greetings, identification and
introductory dialogues
1. Read the following text and check the glossary below to

translate the unknown words. Write down other unknown words
and try to approximate their meaning:
Examination of a pacient is a continuous process that starts with

your first meeting and continues until treatment ceases prior to
discharge. The initial examination leads to an assessment of the
pacients` needs and a decision on the early treatment.
If the pacient has been previously examined by a diagnostician who
provides full notes, some useful and time-saving information may be
obtained by their careful perusal. To use such notes to the maximum,
divide your perusal into:
Obtaining basic information about the pacient as a social entity:
names, sex, marital status, age, current work, former job and/or
retirement status, cultural background and family circumstances.
Reading, in date order, the medical events that are former medical
history and the events that have marked the development of the
current illness/disability and its progress.
Noting, if available, the clinical examination findings and the results
of tests, including X-rays. Any abnormalities indicated by the medical
examination sheet need to be checked by the present examiner, as
different variables such as the subjective assessment of the previous
examiner or the change in patients condition from the last
examination may influence the course of the treatment.Knowledge of
normal parameters should be used to decide whether any of the test
records show a need for care in examination and treatment.

36 ADINA RDULESCU
Obtaining a record of immediate past and current treatment and

medication. It is important that current medications are noted for these
may have some effect on selection of or precautions in administrating
your treatments.
When examining the pacient some things need to be provided: a clean,
well ventilated, adequately warmed area, suitable coverings for the
pacient, the position of the examination couch or table in relation to
the lighting and, quite important, verbal confidentiality.There are
some small testing devices that the examiner needs: a tape measure, a
pin, a goniometer, a reflex hammer, some cotton wool, test tubes
containing hot and cold water.
Escorting the patient to the examination area can be an opportunity to
observe his/her ability to walk unaided, the type of gait abnormalities
if any, the general mien and posture.
Successful questioning produces maximum information with the
minimum of questions and is a skill that improves with practice.
Listening to the patient`s answers requires patience, instant awareness
and interpretation, and listening to the silences is equally
important.What the patient fails to say may have great relevance.
Palpation is a skill that is acquired by practice. It requires that your
hands should be relaxed, in firm comfortable contact, and aware of
what is under them.The following procedures are to be used when
palpating for specific anatomical features: place more of your hand
than you need in contact with the area to be examined, lift your palm a
little to reduce the contact, so that only the finger pads are touching
firmly enough.Your fingers should be straight so that your nails are
unlikely to be in contact. Remember that too hard a pressure will feel
like a drill digging in and too light a pressure will feel like a butterfly
coming to rest. In neither case will you feel or find anything.
Always allocate sufficient time for an initial examination of the
patient, and if the examination turns out to be more time-consuming
than your original estimate, complete only part of the tasks and
conclude the examination at a further session.
(Adapted from M.Hollis, P.Yung Patient examination and
assessment for therapists)

GLOSSARY
to cease = a nceta, a se opri
prior to = nainte de
discharge = externare
assessment = evaluare, estimare
previously = mai nainte, n prealabil
perusal = citire, lectur atent
former job = slujb anterioar
retirement = pensionare
cultural background = formaie cultural
medical history = anamnez
disability = incapacitate, invaliditate
clinical examination findings = constatrile examinrii clinice
medical examination sheet = foaie de observaie clinic
testing devices = instrumente de testare
tape measure = rulet, panglic de msurat
pin = ac cu gmlie
goniometer = goniometru
reflex hammer = ciocnel pentru testarea reflexelor
cotton wool = vat
test tube = eprubet
gait = umblet, mers
mien = inut, comportament
posture = postur corporal
instant awareness = nelegere rapid
palpation = palpare
finger pad = buricul degetului
drill = burghiu
to dig in = a nfige
2. Scan the text above so as to answer the following questions:

1. Why is the patients initial examination important?
2. What should basic information about the patient include?

38 ADINA RDULESCU
3. Why does the present examiner need to check the patient`s prior
medical examination sheet?
4. Why does the examiner need to note the patient`s current
medication?
5. What things need to be provided when examining the patient?
6. What testing devices does the examiner use?
7. What should the examiner observe while escorting the patient to
the examination area?
8. When can we say that questioning the patient has been
successful?
9. What procedures are to be used when palpating the patient?
10. What should be done if the first examination takes longer than
expected?
3. Create your own examiner patient dialogues, including

questions and answers regarding the patient`s basic information,
former medical history, clinical examination findings, past and
current medication, etc.
VOCABULARY PRACTICE
Polysemantic words
Many words that are pronounced and spelt in the same way can be
used in different contexts with different meanings. They are
polysemantic words. Polysemy is closely related to homonymy and it
is sometimes difficult to distinguish between words that are
homonyms and words that are polysemantic. There is still a criterion
that can help us distinguish one notion from the other: while with
homonymy the words that have the same form do not share any
semantic resemblance in their meanings, with polysemantic words we
can easily notice a semantic feature common to all the elements of a
class. Here are two examples for each notion:

Heart, as a polysemantic word, has a semantic feature associated

that of being the central part of a body, of ones life or of something
else that is carried over from one example to the next:
Even if his heart stopped beating for several seconds, he did not die.
I think you should get to the heart of the matter.
He is my heart, my reason of living.
Calf as a young of cattle (viel) or of certain other mammals such as
the buffalo, elephant, giraffe and whale and calf as the thick fleshy
part of the back of the leg between the ankle and the knee are two
homonyms that have nothing in common, semantically speaking.
Moreover, by looking words up in a dictionary, one can also
distinguish between polysemantic words and homonyms as the former
are listed with different numbers under the same lexical entry, while
the latter are listed and treated as separate words: calf1 and calf 2.
4. Choose from among the meanings of the following polysemantic

words the one that has been used in the text Examining the
pacient:
1. examination means:
a) written exercises, oral questions or practical tasks, set to test a
candidates knowledge and skill;
b) physical inspection of a patient or parts of his body, in order to
verify health or diagnose disease;
c) the formal interrogation of a person on oath (an accused or a
witness) by a lawyer in a lawcourt.
2. discharge means:
a) an official permission for (sb) to leave, after he has carried out a
duty (discharge a soldier, a patient, release a prisoner from custody);
b) unloading (cargo) from a ship;
c) firing (a gun), launching flying weapons (arrows).

40 ADINA RDULESCU
3. background means:
a) part of a view, scene or description that forms a setting for the
chief objects, people;
b) information that is needed to understand a problem;
c) a persons social class, education, training or experience;
d) a low level of sound, lighting whose purpose is to be an
unobtrusive or appropriate accompaniment to something else, such as
a social activity, conversation or the action of a film.
4. device means:
a) a machine or tool adapted for a special purpose (time-saving
device, safety device, an explosive device etc);
b) a particular pattern of words, figures of speech used in literature
to produce a certain effect on the reader;
c) a written, printed or painted design or figure, used as a heraldic
sign, emblem, trademark by a noble family;
d) a plan or plot, esp. a clever or evil one; a scheme, trick.
5. Write your own contexts in which the polysemantic words

above, except for the version of your choice, are used with other
meanings. You can use the following expressions:
examination paper
background music
entrance examination
working-class background
to take an examination
background on the companys financial
position
pass/fail an examination
time-saving device = aparat de uz casnic
medical examination
labour-saving device = dispozitiv mecanic

to be under examination
an explosive device = dispozitiv explozibil
to stay/keep in the background
stylistic device = figur de stil
6. Match each of the meanings below to one of the seven

polysemantic words in the box:
a. patient b. tongue c. head

d. foot e. bottom f. spine g. nerve
1. a movable organ in the mouth, used in tasting, licking,

swallowing and speaking;
2. foam on the top of a poured beer;
3. a person who is receiving medical care in hospital;
4. part of the body on which one sits, buttocks;
5. a measure of length equal to 12 inches;
6. row of bones along the back of humans and some animals,
backbone;
7. boldness, courage;
8. a person capable of accepting delay that can still remain calm;
9. part of the body, containing the eyes, nose, mouth and brain;
10. a language, dialect or idiom;
11. the lowest part of the leg, below the ankle, on which a person or
animal sits;
12. ground under the sea, lake or river;
13. any of the bundle of fibres carrying sensory or motor impulses
between the brain and all parts of the body;
14. any of the sharp needle-like parts on some plants (cactuses) and
animals (hedgehogs);
15. chief person of a group or organization;
16. a flap of leather on a shoe, under the laces or buckles to protect
the instep;

42 ADINA RDULESCU
17. the lowest, deepest or farthest removed part of a thing;

18. the back part of a book that is visible when it is in a row on a shelf;
19. rib or vein in a leaf or any of the veins of an insect`s wing;
20. mental ability or natural talent for something.
7. Write your own contexts for the different meanings of the

polysemantic words above. You can make use of the following
syntagms and expressions:
to be patient with sb. = a avea rbdare cu cineva

mother tongue = limb matern
to have lost/find one`s tongue = a-i pierde/redobndi graiul
the head of the family = capul familiei
head office = sediu central
to have a good head for business, figures = a avea cap de
afaceri, cifre
at the foot/bottom of the stairs/hill/ mountain/list/page = n
partea de jos a
a 7-foot high wall = un zid nalt de 7 picioare
to fall on one`s bottom = a cdea n fund
the bottom of the sea/lake/river = fundul mrii/lacului/rului
to go to the bottom = a se scufunda
to lose/regain one`s nerve = a-i pierde/redobndi curajul
to have the nerve to do smth.= a avea curajul/tupeul de a face
ceva
to strain every nerve = a-i ncorda toate puterile
THERAPIST-PATIENT DISCOURSE greetings,

identification and introductory dialogues
Here are some examples of initial greetings and introductory dialogues

used before the examination takes place:

The therapist:
Good morning, Mrs. Johnson. Let me introduce myself. I am
your therapist, Dr. Green.
Please come in and take a seat.
Make yourself comfortable. I will be with you in a second.
My name is Dr.Green. I think we talked on the phone, didn`t
we?
I remember you. You were my patient last year. How is your
back?
You are Dr. Thomson`s sister, aren`t you? He told me all
about you.
Inquiring about the patient`s problem:
Well, Mrs. Johnson, what can I do for you?
Tell me, Mr. Baum, what`s troubling you?
Well, Mrs. Redcliff, what`s brought you here?
Well, let`s see what seems to be the problem?
Your brother, Dr. Thomson tells me that you have been having
low back pains
I couldn`t help noticing your slight limp. Can you tell me
more about it?
I can`t tell you how sorry I am about your terrible accident.
How is your recovery going on?
I understand that you have seen several therapists before.
How can I help you?
Programming further sessions:
Considering your diagnosis, I will have to see you twice a
week, for six weeks.
For the first two weeks we shall meet every day till your pain
goes away.
Bring me the X-rays and then I will schedule a meeting for
you for next week.
I am sorry, but you should have seen an orthopaedist before
coming here.

44 ADINA RDULESCU
I will meet you for our sessions three times a week, for at least
three weeks.
We shall start on Monday and see how it is going.
I think we can have good results if you come to all your
sessions.
Pair work
8. Practise therapist-patient dialogues using the examples above.
You can as well come up with your own examples.
9. Translate into English, using the new vocabulary:

1. Recomandarea unui program de exerciii terapeutice nu se
poate face fr o examinare amnunit a pacientului.
2. Orice informaii cu privire la datele personale ale pacientului,
la un diagnostic anterior i medicamentaie se pot dovedi
extrem de importante n recomandarea terapiei ulterioare.
3. Pe toat durata examinrii pacientul trebuie s se simt
relaxat, protejat, fiind asigurat de confidenialitatea discuiilor
sale cu terapeutul.
4. Terapeutul poate sesiza n mod indirect anumite caracteristici
motrice ale pacientului, prin simpla observare a posturii sale
corporale, a inutei generale i a mersului acestuia.
5. Palparea pacientului i testarea gradului su de mobilitate sunt
indicii clare n stabilirea afeciunii prezente i indicarea
tipurilor de exerciii corespunztoare.

UNIT 5
TYPES OF INJURIES
Passive modal constructions
Present Tense Simple and Present Perfect
Therapist-patient discourse patient`s symptoms and
complaints
Formal and informal medical terms
1. Read the following extracts and check the glossary below for
new words. Then translate these texts into Romanian:
Patient rehabilitation after fractures

Patient rehabilitation should begin immediately, depending on the
type of fracture and soft tissue stability. Adjacent joints should be
mobilized as soon as possible; however, in open fractures motion of
musculotendinous units over fracture surfaces will irritate the soft
tissues and may decrease resistance to infection. Immobilization of
adjacent joints can be done by using splints, braces or foot
attachments to external fixation systems. Physical therapy should
include active exercises for joint mobilization, weight-bearing
exercises, as well as range of motion and strengthening exercises, all
practised under the close supervision of both the physician and the
kinetotherapist.
(Adapted from Thomas A. Russell General Principles of Fracture
Treatment)
Hip dislocation
Hip dislocation is an orthopaedic emergency and must be reduced
immediately. It occurs primarily in conjunction with severe multiple
trauma from high-speed motor vehicle accidents. The longer the hip
remains dislocated, the more likely is the possibility of complications,
including avascular necrosis of the femoral head and posttraumatic

46 ADINA RDULESCU
arthritis. Most dislocations of the hip can be reduced by close

manipulation and this treatment should take precedence over treatment
of all other skeletal injuries.
(Adapted from David G. LaVelle Acute Dislocations)
Sprains or ligamentous injuries

Most sprains or ligamentous injuries can be treated by
immobilization. Even though immobilization allows the stretching of
ligaments, quickly relieves pain and may be beneficial in reducing the
swelling, many specialists report that early mobilization for these
injuries produces superior results to immobilization.
(Adapted from S. Terry Canale Ankle Injuries)
Rupture of muscles and tendons

The most frequent cause of partial or complete rupture of a muscle
or tendon is eccentric overload of the muscle-tendon unit. Muscle
strains are initially treated with ice, rest and antiinflammatory
medication, followed by a gentle stretching and progressive
strengthening program as symptoms resolve. Failure to regain full
flexibility and normal strength of the muscle-tendon unit results in
increased risk of further recurrent injury.
(Adapted from Barry B. Phillips - Rupture of muscles and tendons)
Note : the texts above as well as many other specialised texts in this
handbook are written in American English; this accounts for many
spelling differences that you may encounter for one and the same
word, spelt differently as it appears either in a British English source
or in an American English one.
GLOSSARY
rehabilitation = recuperare, reabilitare
fracture = fractur
adjacent joint = articulaie adiacent
to decrease = a reduce, diminua
to increase = a mri, intensifica

splint = atel
brace = ortez
foot attachment = dispozitiv de fixare a piciorului
weight-bearing exercise = exerciiu de susinere a greutii corporale
range of motion = grad de mobilitate
strengthening exercises = exerciii de ntrire muscular
to occur = a se petrece, a avea loc
in conjunction with = n legtur cu
avascular necrosis = necroz avascular
femoral head = cap femural
arthritis = artrit
to take precedence over smth = a avea loc nainte, a avea prioritate
fa de
skeletal injury = leziune a sistemului scheletic
sprain = luxaie, scrntire
to relieve pain = a alina durerea
swelling = umfltur
rupture = ruptur, hernie
overload = ncrcare excesiv
muscle strain = ntindere muscular
failure = eec, insuficien
further = ulterior, adiional
2. Scan the texts above for modal constructions (can, may, should,
must etc) and write them down. Then, underline the passive ones
as in the examples below:
Example:
Should begin
Should be mobilized

48 ADINA RDULESCU
GRAMMAR
Passive modal constructions
All scientific languages make use of passive constructions to express

impersonal observations, avoid mentioning unknown or indefinite
subjects and focus on action and effect rather than on the agent that
caused them.
Even though the process of converting active constructions into
passive ones seems to be artificial, it may prove to be useful and
practical in situations when passives are preferred to active
constructions. Here are some examples of passives constructions
illustrated for modal verbs:
Excessive flexion and extension of the neck should be avoided in

spinal injuries.
Clinical instability may be caused by trauma, neoplastic or
infections disorders.
Spinal alignment can be obtained by skeletal traction.
The pathologic anatomy must be carefully defined before

treatment is determined.
These pills must be taken twice a day, on an empty stomach.
With modal verbs the transformation from active voice to passive

voice is made by keeping the modal unchanged and using a passive
infinitive:
Active Voice Passive Voice
Should avoid should be avoided (modal + BE + past participle

short inf.+ ED )

Must take must be taken (modal + BE + past participle the 3rd

form of irregular verbs)
3. Insert the following modal constructions in their corresponding

context, choosing the active or passive form that best completes
the sentence:
must be applied should wear must be used should

first direct should be confirmed may be selected
must be covered
should not be done should not be rubbed may be
1. Open hand wounds . immediately with a sterile

dressing to prevent further contamination.
2. If bleeding continues, manual or digital pressure
to the wound through the dressing.
3. At times it helpful to elevate the arm with the
patient lying supine.
4. Cleaning the wound .. in a hurry.
5. Both the examiner and the patient .. masks when the
wound is examined.
6. Sterile instruments and gloves ..
7. The examiner his attention to the circulation and
skin and then to bones, tendons and nerves.
8. The depth of the wound with a sponge
or a brush.
9. Suspected damage to tendons and nerves .
by direct vision.
10. A regional block or general anesthetic
depending on the patient`s age and the severity of the injury.

50 ADINA RDULESCU
4. Rewrite the following sentences in the passive voice, making the

words in italics the subject of the sentence and placing, when
necessary, the agent at the end of the sentence:
Example:
The surgeon should closely follow the progress of patient`s
regeneration.
The progress of patient`s regeneration should be closely followed by
the surgeon (agent).
1. The examiner should advise the patient as to the extent of his

injuries.
2. The surgeon must evaluate the extent of the skin loss from the
injury.
3. The surgeons may delay the repairs of nerve and tendons.
4. During surgical procedures the assistants should use a double
binocular microscope.
5. Surgeons can master microsurgical techniques only after
countless hours of practice.
6. The surgeon must avoid coffee just before surgery.
7. If suitable instruments are available and if the surgeon is rested
he may undertake repair of severed nerves on the day of injury.
8. During weeks after nerves repair operation the patient should pay
careful attention to avoid fixed contractures.
9. After the operation the patient should begin progressive
strengthening exercises.
10. The patients should also make monthly clinical evaluations.
5. Translate into English using passive modal constructions:

1. Pacientul suspectat de fractur a coloanei vertebrale nu trebuie
mutat pn la sosirea ajutorului calificat.
2. Dac este imperativ ca pacientul s fie mutat, capul, gtul i
toracele lui trebuie susinute n poziia lor iniial de ctre mai
multe persoane.

3. Aceast plag ar trebui curat imediat iar fractura deschis

ar trebui imobilizat.
4. Primul ajutor n caz de rnire trebuie s fie ntotdeauna rapid,
eficient i de preferin efectuat de ctre personal calificat.
5. Programul de recuperare motorie a pacientului ar trebui
nceput la cteva sptmni dup operaie.
THERAPIST-PATIENT DISCOURSE
Patient`s symptoms and complaints
Patients and therapists/doctors do not always use the same language,

even if they are speaking about the same things. There is a certain
difference between a formal medical language used between doctors
and medical care takers, the scientific language of all medical texts
and an informal medical language that non-specialists (patients) use
to describe their symptoms or disabilities. In therapist-patient
communications a common informal language should be used to
ensure proper communication. Here are some examples of the same
notions with different formal vs. informal medical terms:
Formal term Informal term Translation

contusion bruise contuzie, vntaie
tenosynovitis inflamed tendons tenosinovit
arteriosclerosis hardening of the arteroscleroz
arteries
sedative sleeping pill, dope sedativ
analgesic pain killer analgezic, calmant

52 ADINA RDULESCU
6. Match the formal term in column A with its corresponding

informal term in column B:
A B
1. thyroid cartilage a. dizziness
2. halitosis b. bamboo spine
3. maxilla c. lower jaw
4. alopecia d. palpitations
5. spine e. heart attack
6. tachycardia f. Adam`s apple
7. mandible g. low blood sugar
8. myocardial infarction h. bad breath
9.ankylosing spondylitis i. womb
10. subluxation j. backbone
11. thorax k. flu
12. influenza l. chest
13. hypoglycaemia m. dislocation
14. uterus n. upper jaw
15. vertigo o. baldness
Patients symptoms and complaints
Without assuming to cover at least part of the symptoms and problems

that patients may have when coming to see a kinetotherapist, some
examples of common complaints are presented below:
I have sprained my left ankle. (Mi-am rsucit/ luxat glezna

stng)
I have strained my deltoid muscle. (Am o ntindere muscular
la deltoid.)
I have pulled a hamstring muscle. (Mi-am ntins un tendon
muscular.)
I have torn a ligament in my right knee. (Am o ruptur
ligamentar la genunchiul drept.)

I have snapped a tendon in my left thigh. (Am o ruptur de

tendon la coapsa dreapt.)
I have got a cartilage problem in my left knee joint. (Am o
problem la nivelul cartilajului articulaiei genunchiului
stng.)
I have got chilblains in my toes. (Am suferit degerturi la
degetele de la picioare.)
I have pins and needles in my feet all the time. (Simt
furnicturi n picioare tot timpul.)
I feel a tingling sensation in my fingers. (Simt o senzaie de
furnicturi n degete.)
I have got a severe pain in my left heel. (Am o durere
puternic n clciul stng.)
I get cramp in my calves. (Am crampe la gambe.)
I have got swelling of my ankles. (Am gleznele umflate.)
I have got numb fingers/legs when I wake up. (Am
degetele/picioarele amorite cnd m trezesc.)
My fingers tremble a lot and even my hands have started
shaking.(mi tremur degetele i chiar i minile.)
GRAMMAR
Present Tense Simple and Present Perfect
Present Perfect and Present Tense Simple are the tenses normally
used to express complaints in the above sentences.
7. Identify each tense in the sentences above and say how they are
formed.
Example:
Have sprained = Present Perfect Simple; formation: the auxiliary verb
have + past participle of the regular verb sprain (short infinitive +
-ed)
Have torn = Present Perfect Simple; formation: the auxiliary verb
have + past participle of the irregular verb tear (tear, tore, torn)

54 ADINA RDULESCU
Present Perfect Simple is used in the above-mentioned complaints to

express previous causes/injuries that still have a certain effect in the
present, while Present Tense Simple makes these complaints a
general fact; the symptoms presented are something felt as usual.
8. Put the verbs in brackets into the Present Tense Simple or

Present Perfect:
1. _______ you ever ________ (sprain) your ankle? Its not so

bad but you have to stay in bed for a while.
2. _______ it _________ (hurt) if I touch your swollen ankle?
______ you _______ (feel) a burning sensation?
3. My aunts fingers always __________ (tremble) when she
________ (give) me my monthly allowance.
4. I am still in hospital. I ________________ (not recover) yet. I
always ______ (get) cramps in my calves in the morning.
5. I ________ already _________ (practise) this stretching
exercise three times. Yes, but you still ___________ (not do)
it right.
9. Translate into English using Present Perfect Simple and Present

Tense Simple as in the above-presented examples of patient`s
complaints; sometimes modal verbs are to be used as well:
1. Nu pot s-mi ndoi cotul drept. Cred c mi l-am luxat.

2. Mi-am fracturat oldul i am nevoie de exerciii de reabilitare.
3. Mi-am dislocat umrul stng. A dori s am un grad mai mare
de mobilitate.
4. Mi-am rupt trei coaste ntr-un accident de schi. Am fost n
spital ase sptmni.
5. Am adesea crampe durerose n ambele gambe dup
terminarea meciului de fotbal.
6. Cnd m scol dimineaa nu-mi simt picioarele de la genunchi
n jos.

7. Am dureri de spate acute. Am fost la muli doctori i m-am

hortt s ncerc i nite exerciii terapeutice.
8. Am o ntindere muscular suprtoare la nivelul gtului. Am
nevoie de cteva exerciii de ntindere pentru a-mi redobndi
flexibilitatea.
9. Am o ruptur de tendon n deltoid i nu-mi pot continua
programul de antrenament pentru Olimpiad.
10. Am contracii musculare n gamba stng iar fora mea
muscular nu mai este aceeai.
10. Place yourself in a patients situation and complain about

your symptoms, asking your colleagues future kinetotherapists
for help and advice.

56 ADINA RDULESCU
UNIT 6
THERAPEUTIC EXERCISES
Word formation - derivation
Therapist-patient discourse - recommending different
therapeutic exercises
1. Read the following text and write down the new words; then
translate it into Romanian, using the glossary below.
The goals of therapeutic exercises include the prevention of

dysfunction as well as the development, improvement, restoration or
maintenance of strength, endurance and cardiovascular fitness,
mobility and flexibility, stability, relaxation, coordination, balance and
functional skills.
Strength is the ability of a muscle or muscle group to produce tension
and a resulting force during a maximal effort, either dynamically or
statically, in the relation to the demands placed upon it. To increase
strength, a load that exceeds the metabolic capacity of the muscle
must be used during exercise. To produce greater muscular tension, a
high-intensity exercise (exercise performed against heavy loads) must
also be used, but for a relatively low number of repetitions.
Muscular endurance is the ability of a muscle to contract repeatedly
or generate tension, sustain that tension and resist fatigue over a
prolonged period of time. It is necessary for performing repeated
motor tasks in daily living, such as walking or climbing stairs. Active
exercises that challenge the oxygen transport system will increase
endurance - the major goal of cardiac rehabilitation programs.
Exercises are usually directed to large muscle groups, as in walking,
running, swimming and cycling and are to be prolonged and
performed for 15 to 45 minutes or more.
Mobility of soft tissues and joints is necessary for the performance of
normal functional movements.
Flexibility is the ability to move a single joint or series of joints
through an unrestricted, pain-free range of motion. It is dependent

upon the extensibility of muscles, which allows muscles that cross a

joint to relax, lengthen and yield to a stretch force.
Stability is usually required in more proximal structures, such as the
trunk, hips and shoulder girdle, for effective positioning and motion of
the arms and hands or legs and feet.Stabilization exercises are the
means by which a patient can learn to control proximal areas of the
body and, at the same time, maintain a stable, well-aligned position
while carrying out functional activities.
Relaxation refers to a conscious effort to relieve tension in
muscles.Exercises promoting relaxation are based on the therapeutic
use of reflexive and conscious processes. Thus, the patient should be
placed in a comfortable position, with all body parts well supported
and be taught to progressively contract and relax the musculature.This
process is often coupled with deep-breathing exercise to further
promote relaxation.
Coordination, balance and the acquisition of functional skills are all
interrelated and are complex aspects of motor control. Coordination
refers to the ability to use the right muscles at the right time with
appropriate intensity. It is the basis of smooth and efficient movement
that can occur on a voluntary or involuntary level. Balance refers to
the ability to maintain the center of gravity over the base of support,
usually while in an upright position. It is a dynamic phenomenon that
involves a combination of stability and mobility. Finally, functional
skills refer to the varied motor skills necessary to function
independently in all aspects of daily living. Learning functional motor
tasks involves constant repetition of simple to more complex motor
activities, use of sensory cues (tactile, visual) to enhance motor
performance and as the quality of movement improves, so should the
speed and timing of movements.
(Adapted from Carolyn Kisner&Lynn Allen Colby Therapeutic
Exercise. Foundations and Techniques)
GLOSSARY
dysfunction = disfuncie
restoration = refacere, restabilire

58 ADINA RDULESCU
maintenance = meninere
strength = for, vigoare
endurance = rezisten fizic
cardiovascular fitness = tonus cardiovascular
balance = echilibru
functional skills = abiliti funcionale
load = greutate
a high-intensity exercise = exerciiu cu intensitate crescut
fatigue = oboseal
motor tasks = sarcini motorii
to challenge = a solicita
to lengthen = a se lungi, ntinde
to yield to = a ceda, a nu rezista la
stretch force = for de ntindere
stable = stabil
well-aligned position = poziie corect adoptat
carry out = a ndeplini, a realiza
to relieve = a destinde, relaxa
deep-breathing exercise = exerciiu de respiraie profund
acquisition = dobndire, obinere
smooth movement = micare lin, fr ntreruperi
upright position = poziie vertical
sensory cues = indici senzoriali
to enhance = a mri, intensifica
motor performance = randament motoriu
timing = sincronizare
Pair-work
2. Question-answer exercise: Reread the text above on paragraphs.
One student will ask his/her colleague one or two questions for
each paragraph and he/she should answer it either by
reproducing fragments from the text or by freely expressing a
summary of that fragment. Here is an example for the first
paragraph:

Example:
What are the main goals of therapeutic exercises?
Well, if I remember corectly, the goals of therapeutic exercises
are.
How is strength defined in the text?

Well, let my see, strength is defined as ..
What should be done to produce greater muscular tension?
Well, it says here that a high-intensity exercise.
3. Question-answer exercise: Try to find out how much you really

know about your physical abilities. Ask your deskmate to make a
self-evaluation of his/her physical abilities (strength, muscular
endurance etc.); in your answers you can make use of the
following assessment patterns or come up with new ones:
Well, my strength is quite bad/ is not so bad/ is actually quite

good/ is excellent.
Muscular endurance is not my strong point, if you get my
meaning.
As for my mobility and flexibility, it goes without saying that
all I need is a little practice, to get back into shape.
Well, my stability depends a lot on my mental stability; a state
of nervousness will certainly be detrimental to my stability.
I have always had problems with balance; to me, it is
sometimes that does not improve with practice; you either
have it or not.
WORD FORMATION DERIVATION
Derivation with suffixes and prefixes is one of the means of word

formation. Generally, there are some typical noun/ adjective/ adverb/
verb forming suffixes and prefixes, but there are cases when the

60 ADINA RDULESCU
same prefix or suffix is used to form different categories. For instance

the suffix al is used to form both nouns like in arrival, refusal,
proposal and adjectives like in functional, educational. The suffix
ing is used to form the present participle that can be used as a verbal
category (She came walking across the field.), as a noun (Walking can
sometimes be very relaxing.) or as an adjective (He was reading a very
amusing novel.). The suffix ly is the most common adverb-forming
suffix (rapidly, daily, usually). Still, there are some adjectives that
contain the ly suffix: daily schedule, monthly payment. The
following exercises are meant as forms of practising the word
formation process.
4. Extract from the text above (Therapeutic exercises) all the

derivational nouns and include them into their corresponding
suffix category as shown in the example:
Example:
-ion: prevention
-ment: development
-ance: maintenance
-ness: fitness
-ity: mobility
-ing:walking
5. Find the corresponding base forms (verbs, adjectives) and the

corresponding suffixes for every derivational noun in the same
text:
Example:
prevention prevent (verb) + -ion (suffix)
mobility mobil (adjective) + -ity (suffix)

derivational adjectives and include them into their corresponding
suffix category:

Example:
-ic: therapeutic
-al: functional
-ing: resulting
-ed: prolongued
-ive: effective
-ly: daily
-(i)ous: conscious
-able: comfortable
-y: sensory
7. Find the corresponding base forms (nouns, verbs) and the

corresponding suffixes for every adjective in the text:
Example:
therapeutic therapeut (noun) + -ic (suffix)

derivational adverbs and include them into their corresponding
suffix category:
Example:
-ly: relatively
-ally: dynamically
9. Find the corresponding base forms (adjectives) and the

corresponding suffixes for every adverb:
Example:
relatively relative (adjective) + -ly (suffix)
There are many nouns in English that have an identical form with their
corresponding verbs:
Verbs Nouns
to pressure pressure
to question question
to estimate estimate
to exercise exercise

62 ADINA RDULESCU
Yet, sometimes there are some slight spelling differences between the
noun and its corresponding verb that can easily pass unnoticed:
Verbs Nouns
To practise practice
To respond response
10. Give other examples of nouns that have the same form as their
corresponding verbs and write contexts in which the same word
functions both as a noun and as verb.
11. Write in the second column the corresponding nouns for the
verbs listed in the first column. The first one has been done for
you as an example:
include inclusion_
1. examine ________
2. prescribe ________
3. operate ________
4. assess ________
5. decide ________
6. retire ________
7. interpret ________
8. confirm ________
9. immobilize ________
10. rehabilitate ________
11. swell ________
12. treat ________
13. dislocate ________
12. Rewrite the sentences below using the nouns in the second
column (exercise 11) instead of their corresponding verbs. Do not
change the meaning of the sentences:

Example:
It was more than vital to include Mr. Dean in our clinical study.
Mr. Dean`s inclusion in our clinical study was more than vital.
1. I will be able to tell you more after I examine the patient.

2. You should not take these pills if the doctor did not prescribe
them.
3. The surgeons operated on the injured man immediately.
4. After the therapist assesses the patients needs, he will also
decide a further treatment.
5. As Mrs. Strauss retires next month, she will have more time
for her therapy.
6. After the doctor interprets the results of your X-rays, he will
probably confirm your need for surgery.
7. To immobilize the patients fractured leg is one of the first aid
measures to be taken.
8. Our clinic is specialized in rehabilitating patients who
suffered severe injuries.
9. What can I do if my ankle swells over night?
10. I cannot treat patients without their full consent and
cooperation.
11. If the patient`s shoulder is dislocated, an emergency
intervention is needed.
Recommending different therapeutic exercises
Listening to the patientscomplains and symptoms will normally be

followed by the therapists recommandations regarding different
therapeutic techniques and exercises. Here are some examples of such
kinetotherapy exercises that therapists may recommend to their
patients:

64 ADINA RDULESCU
Kinetotherapists recommendations:
You should start with a very simple relaxation technique.

A deep-breathing exercise will help you relax.
Some massage sessions will be good for your local
circulation.
Passive stretching exercises will lengthen your shortened
tissues.
You can practise these self-stretching exercises as part of
your home exercise program.
As a gymnast, do not forget to practise your overstretching
exercises.
Considering your long-term immobilization, you need to
practise strengthening exercises every day.
The best solution for you to regain your balance is to practise
weight-bearing exercises.
I recommend you to continue with joint mobilization
techniques to treat your muscular stiffness.
In treating your spine injury, traction techniques are a good
option.
13. Translate the above sentences into Romanian and say whether
you are familiar with these exercises; give examples of such types
of exercises.
14. Consider yourself as a kinetotherapist; choose one type of the

exercises above and explain the basic procedure to a colleague-
patient of yours.
15. Consider yourself as a patient with a certain dysfunction (you

can choose one of the symptoms presented in Unit 5) and ask your
colleague-therapist what exercises he would recommend you.

16. Translate into English using the new vocabulary:

1. Este foarte important s-i alegi un program de exerciii care
s-i fie cu adevrat de ajutor.
2. Exerciiile de meninere a greutii corporale ar trebui s
nceap cu renvarea schimbrii greutii corporale.
3. Dac vrei s-i corectezi postura corporal defectuoas ar
trebui s ncepi cu exerciii de ntrire a musculaturii slbite.
4. Exerciiile de ntindere sunt recomandate persoanelor n
vrst, indivizilor sedentari i persoanelor care se refac dup
operaii sau o imobilizare prelungit.
5. Creterea rezistenei musculare va duce implicit la
mbuntirea tonusului cardiovascular.
6. Tehnicile de mobilizare a articulaiilor sunt folosite n tratarea
atrofiei cartilajului articular, a slbirii ligamentoase, a
hipomobilitii articulare .a.m.d.
7. Tehnicile de traciune sunt practicate pentru a se redobndi
flexibilitatea, fora, rezistena i stabilitatea coloanei
vertebrale.
8. Poi s-i menii echilibrul timp ndelungat pe o suprafa
ngust i fiind legat la ochi?
9. Rezistena muscular nu este ntotdeauna rezultatul
antrenamentelor susinute. Urcatul i cobortul scrilor ntr-un
bloc fr lift, alergatul dup autobuz sau mersul pe jos ne in
n form n fiecare zi.
10. Toate capacitile noastre fizice pot fi perturbate atunci cnd
suntem nevoii s fim imobilizai la pat pentru o perioad
prelungit de timp.

66 ADINA RDULESCU
UNIT 7
THERAPEUTIC PROCEDURES IN HANDLING THE
PATIENT
Passive verbal constructions
Therapist-patient discourse positioning and handling the patient
1. Read the following extracts and then solve the tasks that follow
them:
Movements at a joint are determined by the shape of the articular

surfaces. For instances, the following movements are possible at the
shoulder joint: flexion and extention about the transverse axis with
the movements occurring in the saggital plane; abduction and
adduction about the anteroposterior axis, in which case the movement
is made in the frontal plane; and finally, rotation about the vertical
axis including pronation (medial rotation) and supination (lateral
rotation), with the movement occurring in the horizontal plane.
(R. D. Sinelnikov Atlas of Human Anatomy)
Weight-bearing control and stability

Develop ability to shift the body weight. If the patient cannot bear
full weight, begin in the parallel bars with part of the weight borne on
the hands. The patient shifts anteriorly, side to side, and obliquely.
Manual resistance to the motion is added with pressure against the
patient`s pelvis.
To increase flexion of the hip with the knee extended
Hand placement:
With the patients knee fully extended, support the patients lower
leg with your arm or shoulder.
Stabilize the opposite extremity along the anterior aspect of the thigh
with your other hand or a belt or with the assistance of another person.
With the knee in maximum extension, flex the hip as far as possible.
Alternate position.

Kneel on the mat and place the patient`s heel against your shoulder.
Place both of your hands along the anterior aspect of the distal femur
to keep the knee extended.
The opposite extremity is stabilized in extension by a belt or towel and
held in place by the therapists knee.
To increase dorsiflexion of the ankle with the knee extended

Hand placement
Grasp the patients heel (calcaneus) with one hand.
Stabilize the anterior aspect of the tibia with your other hand.
Pull the calcaneus downward with your thumb and fingers and gently
push upward on the heads of the metatarsals.
To increase wrist extension

Hand placement
Pronate the forearm and grasp the patient at the palmar aspect of the
hand. Stabilize the forearm. To lengthen the wrist flexors, extend the
patient`s wrist, allowing the fingers to passively flex.
Alternate position:
Support the patients forearm on the table but allow the hand to drop
over the edge of the table. Then passively extend the wrist. This may
be more comfortable for the therapist or necessary if the patient has a
severe wrist flexion contracture.
(Carolyn Kisner&Lynn Allen Colby Therapeutic Exercise.
Foundations and Techniques)
TASKS
1. Enumerate the movements that are possible at the shoulder
joint.
2. Name the type of therapeutic exercise that deals with
controlling body weight.
3. What is hand placement?
4. Which parts needs to be stabilized in: hip flexion, ankle
dorsiflexion and wrist extension?
5. What should the therapist do to lengthen the wrist flexors?

68 ADINA RDULESCU
6. What is recommended if the patient has a severe wrist flexion

contracture?
7. What objects does the therapist use in handling the patient?
8. Pair work: Choose one of the last three therapeutic procedures
and illustrate them, respecting the indications offered in the
texts.
9. Pair work: Repeat the task at point 8, this time with the
therapist describing the procedure (in his /her own words)
while illustrating it in front of the class.
10. Invent one type of exercise for a certain purpose, first practise
it with your deskmate and then, describe it to your audience.
2. Complete the missing correspondent in the following verb-noun

pairs:
VERBS NOUNS
flexion
extension
abduction
adduction
rotation
to pronate
to supinate
resistance
pressure
to stabilize
to lengthen
to support

3. Complete the missing correspondent in the following adjective-

adverb pairs:
ADJECTIVE ADVERB
possible
manual
anteriorly
obliquely
comfortable
necessary
gently
passively
fully
horizontal
severe
GRAMMAR
Passive verbal constructions
In Unit 5 we have already introduced the issue of Passive Voice and
exemplified its use in dealing with passive modal constructions.
Learning how to use the passive forms of the most frequently used
verbal tenses is the objective of this unit.
As a general rule, the passive voice is formed by putting the verb to be
into the same tense as the verb in the active voice and adding the past
participle of the active verb. The direct object of the active verb
becomes the subject of the passive verb, while the subject of the active
verb becomes the agent of the passive verb.
Example:
Therapists sometimes hypnotize their patients.

subject direct object

70 ADINA RDULESCU
The patients are sometimes hypnotized by their therapists.

subject agent
Read the chart below to see how the active to passive

transformation works for the main verbal tenses:
TENSES ACTIVE PASSIVE VOICE

VOICE
Present treat am/is/are treated
Tense
Simple
Present is/are is/are being examined
Tense examining
Continuous
Past Tense injured was/were injured
Simple
Past Tense was/were was/were being
Continuous transporting transported
Present has/have has/have been found
Perfect found
Past Perfect had had been discharged
discharged
Future Tense will/shall will/shall be included
Simple include
Future will/shall will/shall have been
Perfect have healed healed
Conditional would would be recovered
recover
Perfect would have would have been saved
Conditional saved
Gerund practising being practised

4. Put the verbs in brackets into the passive voice of the tense
indicated:
Example:
The range of motion of the ankle is restored (restore Present Tense
Simple) by performing stretching exercises.
1. The ankle ___________________ (immobilize Present

Tense Simple) in a short cast for 3 to 4 weeks.
2. The patient`s lower leg ___________________ (elevate
Present Tense Continuous) now.
3. Successive weight-bearing stresses ________________
(impose Past Tense Simple) on the feet.
4. These faulty foot postures __________________ (cause
Present Perfect) by the excessive adduction of the forefoot.
5. The rehabilitation program ________________ (start Future
Tense Simple) as soon as possible.
6. Little effort _______________ (require Present Tense
Simple) to maintain this position for extended periods.
7. Ankle and foot motions ________ previously ____________
(perform Past Perfect) by the patient.
8. The same motion ____ now ____________ (repeat Present
Tense Continuous) with the patient in alternate position.
9. Many balance activities _________________ (practise Past
Tense Simple) but without any result.
10. Muscular endurance _________________ (increase Present
Perfect) by performing the same exercises for a repeated
number of times.
5. Change the following sentences from Active Voice into Passive

Voice; the underlined direct objects will become the subjects of
the passive sentences:

72 ADINA RDULESCU
Example:
The patient sometimes describes pain from muscle spasm as a
headache.
Pain from muscle spasm is sometimes described as a headache.
1. If the patient is experiencing acute inflammation, he should

be placed in a less irritating position.
2. If a disk lesion is the cause of the acute back pain, the
therapist will first take measures to alleviate the pain.
3. Injury or degeneration of the disk affects spinal mechanics in
general.
4. The patient with acute disk lesions has avoided sitting with
the hips and knees flexed or leaning forward.
5. The patient needs bed rest during the first 2 days when
symptoms are highly irritable.
6. The therapist will instruct the patient to avoid flexion
activities that increase intradiskal pressure.
7. In one of my patients with spondylosis, traction exercises
temporarily relieved the pressure.
8. Many patients have often expressed emotional stresses as
increased tension in their lumbar region.
9. The patient performs elongation exercises only within
tolerance during the early healing phase.
10. Imbalances in the shoulder girdle will perpetuate faulty
postures.
Positioning and handling the patient
Pair work

6. Read the following positioning indications to your colleague-

patient who will then illustrate them in front of the class:
The patient is supine, with arms in resting position.

The patient is side-lying, with the affected hip up.
The patient is hook-lying.
The patient is cross-sitting.
The patient is heel-sitting.
The patient is on hands and knees.
The patient is prone, with hands placed under the shoulders.
The patient is supine, with the foot pointing upright to keep
the hip neutral to rotation.
The patient is sitting, with the forearm supported on the
treatment table, wrist over the edge of the table.
The patient is standing, with the hands placed in the low-back
area.
Team work
7. Read the following hand placement and stabilization procedure
indications to a therapist-patient pair who will then illustrate
them in front of the class.
Grasp the patients wrist with your lower hand.
Place your thumb on the anterior surface of the proximal end
of the clavicle.
Place a belt around your shoulder and under the patients
thigh to help hold the weight of the lower extremity.
Support the patients leg with the fingers of the top hand
under the patients knee and the lower hand under the heel.
Stabilize the patients pelvis with the top hand or arm.
Stabilize the patients pelvis by flexing the opposite hip and
holding the thigh with the hands. The hip to be mobilized is in
resting position.
Sitting on a low stool, stabilize the leg between your knees
and place one hand on the anterior aspect of the tibia.

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Team work
8. Read the following therapeutic techniques to a therapist-patient
pair who will then illustrate them in front of the class:
Perform elbow flexion and extension with the forearm

pronated as well as supinated.
Flex the patients hip and knee to 90 degrees; support the
knee with the top hand.
Pull the foot away from the long axis of the leg in a distal
direction by leaning backward.
Flex the elbow to 90 degrees and abduct the shoulder to 90
degrees.
Rotate the humerus by moving the forearm like a spoke on a
wheel.
Flex the patient`s knee until discomfort is experienced in the
anterior thigh.
Instruct the patient to arch the back by pressing against the
floor with the back of the neck and the sacrum.
9. Translate into Romanian all the sentences from the exercises 6,

7 and 8 above.
Pair work
10. One student will be given a hand out containing indications for
a therapeutic exercise. He or she will read the text and then start
illustrating the stages of the exercise. The task for the other
student is to write down the content of the exercise while watching
it. The exercise will be repeated several times. At the end the
teacher or a third student will compare the two texts and
comment on their degree of similarity. Here is an example of a
hand out:

Example:
The patient is standing, with the hands placed on the shoulders. The
patient bends his body sideways with one hand over his head. The
movement is repeated three times for each side. Then the patient
returns to the initial position.
11. Create your own therapeutic exercises, using the examples

provided in this unit and read them to your colleagues.
12. Translate into English, using the new vocabulary of this unit:
1. Plasai pacientul n poziie de supinaie, cu minile ntinse

lateral.
2. Prindei ncheietura minii pacientului i rotii-i braul.
3. Indicai-i apoi pacientului s ncerce s fac aceeai micare
singur.
4. Poziie iniial: pacientul aflat n sprijin pe mini i genunchi.
5. Indicai-i pacientului s-i menin greutatea corporal pe
mini i genunchiul stng i s-i ntind uor genunchiul
drept n spate.
6. Greutatea corporal va fi apoi mutat pe mini i pe
genunchiul drept, iar piciorul stng va fi ntins.
7. Poziie iniial: pacientul este n poziia stnd pe clcie.
Indicai-i pacientului s se aplece n fa, cu capul ntre braele
ntinse, pn ce abdomenul se va odihni pe coapsele
anterioare.
8. Poziie iniial: pacientul este aezat pe-o parte, pe masa
terapeutului, cu capul plasat la marginea mesei.
9. Indicai-i pacientului s-i ntind mna de deasupra peste cap,
lsnd-o s atrne pe lng mas. Poziia trebuie meninut
pentru cteva minute.
10. Aceeai micare se va repeta pentru braul opus, cu pacientul
aezat n poziie simetric.

76 ADINA RDULESCU
UNIT 8
MUSCULOSKELETAL AND CONNECTIVE TISSUE
DISORDERS
Pronouncing tongue-twisters
Therapist-patient discourse describing symptoms and
recommending therapeutic exercises
1. Read the following definitions and match the names of the

disorders listed below with their corresponding definitions:
1. Osteoarthritis
2. Rheumatoid Arthritis
3. Ankylosing Spondylitis
4. Osteoporosis
5. Low Back Pain
6. Tendinitis and Tenosynovitis
7. Amyotrophic Lateral Sclerosis
A. A systemic inflammatory disorder affecting primarily the spinal

column and the large peripheral joints and eventually resulting in
hardening and deformity of the affected skeleton.
B. A generalized, progressive reduction of bone mass as bone

resorption outstrips bone formation, causing skeletal weakness and
fractures.
C. A chronic degenerative disease process occurring primarily in the

hips and knees and characterized by deterioration of the joint cartilage,
formation of new bone in subchondral areas and joint margins, and
joint hypertrophy.
D. May be caused by a muscle sprain or strain, arthritis, a tumor, or a

ruptured cartilage disk between vertebrae. Other causes are poor

posture, obesity, enlarged prostate gland, sagging abdominal muscles,

sitting for prolonged periods of time, or excessive physical effort
involving the back muscles.
E. A rapidly progressive, degenerative disease of the upper and lower

motor neurons characterized by atrophy of the hands, arms, legs, and,
eventually, the entire body. Seventy percent of individuals die within
5 years of diagnosis.
F. A chronic systemic degenerative disease characterized by

inflammation of the connective tissues and manifested primarily in
and around peripheral joints.
G. An inflammation of the tendon and lining of the tendon sheath

characterized by pain on movement of the associated joint.
2. Translate the definitions above into Romanian, using the words

in the glossary:
GLOSSARY
disorder = disfuncie, afeciune, boal
primarily = n primul rnd
to harden = a ntri
bone resorption = resorbie osoas
to outstrip = a depi, ntrece
subcondral areas = zone subcondrale
ruptured cartilage disk = disc cartilaginos rupt
poor posture = postur defectuoas
sagging muscles = muchi czui, lsai
lining = ngroare
tendon sheath = teac/nveli al tendonului

78 ADINA RDULESCU
PRONOUNCING TONGUE-TWISTERS
Mastering stress-emphasis is one of the keys to pronouncing multi-

syllable medical terms. English makes use of a primarily/strong
stress ( that has this graphic symbol: ') placed before the stressed
syllable and of a secondary/weaker stress (that has this graphic
symbol ) that usually precedes the primarily stress, especially in
multi-syllable words.
Example:
circulation [s: kju'lein ]
inflammation [infl'mein ]
Note for the following pronounciation exercises each student
should make use of an English dictionary that contains phonetic
transcription.
3. Place the following two-syllable words in their corresponding
stress-emphasis pattern:spinal, disease, column, weakness, fracture,
prostate, muscle, tumor, posture, rotate, treatment, ankle, discharge,
bandage, acute.
Example:
first syllable stress second syllable stress

spi - nal ro - tate
4. Place the following three-syllable words in their corresponding
stress-emphasis pattern: atrophy, progressive, reduction, skeleton,
excessive, cartilage, formation, disorder, arthritis, physical, systemic,
lateral, sclerosis, surgery, maximum, resistance, endurance, effective.
Example:

a - tro phy sys - te - mic

5. Place the following four-syllable words in their corresponding

stress-emphasis pattern: vaccinated, peripheral, saturated,
pulmonary, pneumonia, diagnosis, emergency, compatible, penicillin,
deformity, circulation, independent, hypertrophy, spondylitis,
tendinitis, ability, relaxation, alternative, combination, voluntary,
phenomenon, restoration.
Example:

vac-ci-na-ted pneu-mo-ni-a
third syllable stress

in-de-pen-dent
6. Find the corresponding stress-emphasis pattern for the

following multi-syllable words and draw their graphic
reprezentation: degenerative, deterioration, individual, osteoarthritis,
osteoporosis, tenosynovitis, amyotrophic, cardiovascular,
rehabilitation, musculoskeletal, extensibility, pathophysiologic.
Example:
De-ge-ne-ra-tive
Describing symptoms and recommending therapeutic exercises
Read about the main causes and symptoms of the musculoskeletal

and connective tissue disorders in the following chart:

80 ADINA RDULESCU
The disorder Causes Symptoms

1. Osteoarthritis The etiology is early symptoms:
unknown but is deep, aching joint pain
believed to be that is aggravated by
related in some way exercise and that
to aging and worsens as the day
genetics. Men and progresses; stiffness
women are equally following inactivity.
affected, but the midcourse symptoms:
onset in men occurs reduced joint motion,
earlier. In women, tenderness, crepitus,
the incidence grating sensation,
increases after flexion contractures,
menopause. joint enlargement
late symptoms:
tenderness on palpation,
pain with passive range
of motion, increase in
degree and duration of
pain, joint deformity
and subluxation.
2. Rheumatoid The etiology is early symptoms:
Arthritis unknown but the nonspecific symptoms
disease is often of fatigue, malaise, low-
characterized as an grade fever, anorexia,
autoimmune weight loss.
disorder, and a midcourse symptoms:
familial link is tenderness, pain, and
suspected; women stiffness in affected
are three times joints (most often the
more likely than fingers) that occurs in a
men to be affected. bilateral, symmetric
pattern and spreads to
the wrists, elbows,

knees, and ankles;

diminished joint
function; paresthesia;
joint contractures and
deformities.
3.Ankylosing the exact cause is early symptoms:
Spondylitis unknown. A higher recurrent pain in the
than expected level lower back or large
of HLA-B27 tissue peripheral joints;
antigen is seen in morning stiffness that is
90% of individuals relieved by activity;
with the disease. It stooped posture; limited
is three to four motion of lumbar spine
times more or limited range of
common in men motion in affected
than in women, and joints; fatigue; fever;
onset typically anorexia; weight loss;
occurs between 20 diminished chest
and 40 years of age. expansion; red, painful
eyes.
late symptoms:
kyphosis, fixed flexion
of hips, vertebral
fractures, impotence,
incontinence,
diminished bladder and
rectal sensation, angina,
pericarditis, pulmonary
fibrosis (rare).
4. Osteoporosis Inadequate calcium A dull, aching, constant
intake, early pain in the bones,
menopause, particularly the back
sedentary life-style, and chest; muscle
a familial hystory spasm; the spinal
of the disease, column mass

82 ADINA RDULESCU
endocrine diminishes, dorsal

disorders, kyphosis and cervical
prolongued lordosis increase,
immobility leading to multiple
compression fractures
of the spine and a
reduction in height.
5. Low Back Muscle sprain or The pain may be
Pain strain, arthritis, a accompanied by muscle
tumor, or a weakness or spasms. It
ruptured cartilage may radiate down the
disk between back of one or both
vertebrae; poor legs, as in sciatica. It
posture, obesity, may be started or
enlarged prostate increased by coughing,
gland, sagging sneezing, rising from a
abdominal muscles, seated position, lifting,
sitting for stretching, bending, or
prolonged periods turning.
of time, or
excessive physical
effort involving the
back muscles.
6. Tendinitis and Repetitive The involved tendons
Tenosynovitis movements, strain, usually show visible
or excessive, swelling; the joint may
unaccustomed be tender and hot to the
exercise; touch; motion of the
underlying joint causes pain.
systemic disease
(rheumatoid
arthritis, gout,
sclerosis); middle-
aged and older
adults and athletes

or individuals with
occupations
requiring repetitive
motion are at
greatest risk.
7. Amyotrophic The etiology of early symptoms:
Lateral Sclerosis amyotrophic lateral weakness, cramps in the
sclerosis (ALS) is hands and forearms.
unknown, but midcourse symptoms:
proposed fatigue; dyspnea;
explanations slurred speech;
include genetics, dysphagia; asymmetric
metabolic spread of muscle
disturbances, and weakness to the rest of
the body; spasticity;
external agents.
fasciculations;
hyperactive deep
tendon and extensor
plantar reflexes.
late symptoms:
paralysis of vocal cords;
paralysis of chest
muscles, necessitating
ventilatory support.
Pair work
7. Check if your deskmate has attentively read the chart by asking
him/her questions like these:
What are the main causes of low back pain?

What are the early symptoms in amyotrophic lateral
sclerosis?
What are the late symptoms in ankylosing spondylitis?
The symptom of which disease is the visible swelling of
tendons?

84 ADINA RDULESCU
Which parts of the body are affected by pain in ankylosing

spondylitis?
In which diseases does stiffness affect various parts of the
body?
Take turns in asking and answering various questions.
8. Extract or create sentences using the chart above and ask your
deskmate to say if they are true or false.
Example:
Athlets or individuals with occupations requiring repetitive
movements are very likely to suffer from tendinitis and tenosynovitis.
True
Men are three times more likely than women to be affected by

rheumatoid arthritis. False
9. Translate the content of the chart above using a medical

dictionary.
10. Match the disorders in the first column with their

corresponding therapeutic exercises in the second column. Check
the symptoms in the chart above so as to make the appropriate
choice of the therapeutic exercises:
The disorder Therapeutic exercises

1. Osteoarthritis a. Therapy and exercise to increase range
of motion, strength, and endurance; balance
of activity and rest; splints, canes, walkers
to aid mobility;
moist compresses, paraffin gloves to reduce
pain and edema.
2. Rheumatoid b. The patient should sleep on a firm
Arthritis mattress with the knees flexed and
supported. Pain killers, muscle relaxants,

and tranquilizers may help, as may applying

dry or moist heat. When the pain subsides,
the patient may increase activity if fatigue
is avoided. A corset or back brace may be
required. The patient should use a straight-
backed chair and not cross or extend the
legs.
3. Ankylosing c. Moist heat compresses to joint; rest of
Spondylitis joint with controlled progressive exercise
program.
4. Osteoporosis d. Physical therapy, exercise, postural
training; traction/back brace in special
cases.
5. Low Back Pain e. Physical therapy to maintain muscle
strength; occupational therapy for activity
of daily living support; speech therapy to
aid communication; splints for neutral joint
alignment; leg braces, canes, walkers to aid
ambulation.
6. Tendinitis and f. Exercise: isometric, isotonic, isokinetic,
Tenosynovitis strengthening, stretching, range of motion,
balance exercise; rest; massage, moist heat
for pain; elastic bandages for support;
canes, walkers to aid mobility. Avoid: soft
chairs, recliners, pillows under knees; use
firm bed and hard chairs; wear sturdy,
lowheeled shoes.
7. Amyotrophic g. Consistent exercise regimen, including
Lateral Sclerosis weight-bearing hyperextension and resis-
tance exercises to slow calcium loss and
strengthen musculature; heat and massage
for muscle spasm; orthopedic supports for
back and neck to prevent stress fractures.

86 ADINA RDULESCU
Pair work
11. Consider yourself as a kinetotherapist and choose the best way
to recommend the corresponding therapeutic exercises to your
colleague patient who may ask you many questions regarding
the duration, the difficulty and the expected results of such an
exercise programme. Use the charts with medical information,
symptoms and treatments above. Here are some examples to help
you:
Example:
Therapists recommandations:
Considering your aggravated joint pain and your stiffness
following inactivity, it is to your best interest that you should
start these therapeutic exercises.
I do not want to put any pressure on you, but I do believe that
you should consider starting your physical therapy as soon as
possible.
Your low back pain now radiates down the back of both your
legs. And as things are not getting better, you should really
take some urgent measures and start your therapy.
Patients questions:
In what way will my general condition be improved after
starting these therapeutic exercises?
How long will this therapy be and how many sessions a week
are necessary?
Will this therapy be painful? How difficult are the exercises?
Do I have to make any changes in my diet or in my daily
routine?
Will this short-term therapy prevent the disease from getting
worse?

UNIT 9
POSTURAL PROBLEMS
Conditional clauses
Therapist-patient discourse improving communication
1. Read the following text, consult the glossary below and

translate the text into Romanian:
Posture is a position or attitude of the body, the relative arrangement

of body parts for a specific activity, or a characteristic manner of
bearing ones body.
A postural fault is a posture that deviates from normal alignment but
has no structural limitations. The postural pain symdrome refers to
the pain that occurs from mechanical stress when a person maintains a
faulty posture for a prolongued period; the pain is usually relieved
with activity. There are no abnormalities in muscle strength or
flexibility, but if the faulty posture continues, strength and flexibility
imbalances will eventually develop.
Lordotic posture
This posture is characterized by an increase in the lumbosacral angle,
an increase in the lumbar lordosis, and an increase in the anterior
pelvic tilt and hip flexion. This is often seen with an increased thoracic
kyphosis and forward head and is called a kypholordotic posture.
Relaxed or slouched posture
This posture is also called swayback. The entire pelvic segment is
shifted anteriorly, resulting in hip extension and the thoracic segment
is shifted posteriorly, resulting in flexion of the thorax on the upper
lumbar spine. This results in an increased lordosis in the lower lumbar
region, an increased kyphosis in the lower thoracic region, and usually
a forward head. When standing for prolongued periods, the person
usually assumes an asymmetric stance in which most of the weight is
borne on one lower extremity, with periodic shifting of weight to the
opposite extremity.

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Flat low-back posture

This posture is characterized by a decreased lumbosacral angle, a
decreased lumbar lordosis, hip extension, and a posterior tilting of the
pelvis.
Flat upper back posture
This posture is characterized by a decrease in the thoracic curve,
depressed scapulae, depressed clavicle, and a flat-neck posture. It is
associated with an exaggerated military posture but is not a common
postural deviation.
It is not normal for a person to always maintain good posture.
Therefore, the patient should be instructed to use cues throughout the
day to check posture. For example, the patient can be instructed to
check the posture every time he or she walks past a mirror, waits at a
red light while driving a car, sits down for a meal, enters a room, or
begins talking with someone. If the patient becomes aware of his/her
daily routines, they can be used as reminders to practise maintaining a
good posture.
(Carolyn Kisner&Lynn Allen Colby Therapeutic Exercise.
Foundations and Techniques)
GLOSSARY
to bear ones body = a-i susine corpul
postural fault = defect postural
mechanical stress = solicitare mecanic
imbalance = dezechilibru
eventually = n cele din urm
pelvic tilt = nclinare/aplecare pelvian
forward head = cap mpins ctre anterior
to slouch = a se grbovi cocrja
swayback = nclinare spre spate
to shift = a deplasa, schimba
stance = poziie, postur
bear, bore, borne = a purta, a duce
flat low-back posture = postur aplatizat a zonei inferioare a spatelui

flat upper-back posture = postur aplatizat a zonei superioare a

spatelui
thoracic curve = curbur toracic
depressed scapulae = omoplai czui, lsai
flat-neck = gt ntins
cues = indicii
throughout the day = pe toat durata zilei
2. Check your reading comprehension by solving the following
tasks:
1. After reading about the four faulty postures, try demonstrating
each of them in front of the classroom.
2. Define in your own words what a postural fault is.
3. When does postural pain syndrome occur?
4. What happens if a patient continues to maintain a faulty
posture?
5. What are the visible signs of kypholordotic posture?
6. What postural habit does the slouched patient manifest while
standing?
7. What are the characteristics of flat upper-back posture?
8. What methods can a patient use to correct a faulty posture?
9. What are the causes of faulty postures, in your opinion?
10. How do you correct your faulty postures when you become
aware of them?
GRAMMAR
Conditional clauses
Conditional clauses consist of two parts: the subordinate clause or the
if-clause and the main clause. There are three main types of
conditional clauses and various mixed types. Each type is used to
express different real/unreal, present/past conditions, using certain
pairs of tenses. There are also many exceptions from each type but
students dealing with conditionals for the first time should simply
concentrate on the basic rules that will be presented in the following
chart:

90 ADINA RDULESCU
Types If-clause Main clause Meaning

Type I Present tense Future tense
simple simple
If the faulty strength Real
posture continues, imbalances will situation,
develop. present or
Present tense Modal verbs future
simple oriented
If the pain the patient
increases, must/should see
a doctor.
Present tense Imperative

simple
If you get tired, take a break and
then start again.
Type II Past tense would
simple/continuous could + short Unreal,
should hypothetic
infinitive situation,
might present or
If I were you, I would try the future
new procedure. oriented,
If he had more he could come to unlikely to
time, his sessions. happen
If she did what the

she might have a
doctor says, chance to avoid
surgery.
Type III Past perfect would Imaginary
simple/continuous could + have + situation,
should past past
might participle oriented

If I had known I could have (regrets,

anything about helped the unfulfilled
first help, injured cyclist. plans,
wishes to
If you had you would have change the
practised your felt better. past)
therapeutic
exercises,
3. Fill in the gaps with the verbal constructions in the box to

complete the following conditional clauses:
may simply disappear begins should get up

would not have felt knew cannot relax
had performed is check could control
1. If the patient . to feel discomfort, ask him to

corret the faulty posture.
2. If you were able to notice what posture causes your low back
pain, you it.
3. If you modify your sleeping posture, your morning pains
.
4. If he . his relaxation exercises, he would not
have got stiff-necked.
5. If you are experiencing any pain, . your posture.
6. If you have a sedentary job, you .. and walk every
hour.
7. If the mattress .. too soft, the patient sags and stresses
ligaments.
8. If the mattress is too firm, some patients .
9. If she had slept in a comfortable bed, she
.. so tired in the morning.
10. If I what my ideal sleeping posture is, I would not
hesitate to immediately adopt it.

92 ADINA RDULESCU
4. Put the verbs in brackets into the correct tense:
a) I met my wife in hospital ten years ago. I had fallen on ice and
broken my leg. She was a nurse in my orthopaedics ward. Just
imagine! If I (1).. (not fall) on ice and (2) .
(not brake) my leg, I (3) . (never meet) her. So I
could say that there is nothing so bad as not to be good for
something.
b) If this desk height (4) (be) adequate, I (5)

. (not have to) lean over my work. My back is
killing me! Not to mention the chair! If it (6) .. (not be) so
high, my feet (7) . (rest) comfortably on the floor. I
should complain about all these to our personnel manager. If more
employees (8) .. (express) their complaints, some
measures (9) . (passive take).
c) You know what they say, that it all happens for a reason Take
my example. If (10) .. (passive not be) injured in
that car accident last year, I (11) (accept) that job
offer in Paris. But here I am now working in this rehabilitation
clinic If people (12) (know) how to deal with their
disabilities, they (13) . (be able) to accept them more
easily.
5. Rewrite the following sentences, using an if construction:
Example:
a) The patient suffers from osteoporosis. Then, he will need
physical therapy, exercise and postural training.
If the patient suffers from osteoporosis, then he will need
physical therapy, exercise and postural training.

b) The patient did not sleep on a firm mattress. He had to take pain
killers and muscle relaxants for his poor back.
If the patient had slept on a firm mattres, he would not have had to
take pain killers and muscle relaxants for his poor back.
1. This injury is severe. That is why the patient may run the risk
of paralysis.
2. He got injured in a football match. He had his left leg broken.
3. I worked hard to finish my science project. I had mild low
back pain for a week after.
4. My mother has a low resistance. She catches diseases very
easily.
5. The old man got panic-striken. His heart started beating more
rapidly.
6. He has the surgery right now. The chances of success may
increase to about 20%.
7. The infection spread. That is why he needed that urgent
treatment.
8. The diagnosis is correct. The family will have to evaluate their
options.
9. You do not spend enough time relaxing. That is why you are
always complaining about being tired.
10. These therapeutic exercises are to be practised every day.
They prevent the patient`s condition from getting worse.
6. Translate the following conditional sentences into English:
1. Dac practici aceste exerciii regulat, vei dobndi flexibilitatea

i rezistena necesare pentru meninerea stabilitii spinale.
2. Dac vrei s-i uurezi acest durere acut, trebuie n primul
rnd s-i modifici obiceiurile posturale.
3. Nu poi obine stabilitate postural dac nu nvei s-i
controlezi greutatea corporal.
4. Dac a fi tiut c oboseala muscular mrete riscul de
accidentare, nu m-a mai fi antrenat att de mult.

94 ADINA RDULESCU
5. Dac eti obosit i te simi mult mai relaxat ntr-o poziie

grbovit, corecteaz-i imediat aceast tendin nesntoas.
6. Dac persistai n a v menine defectele posturale pentru mult
timp, aceasta va duce la slbire muscular i la rezisten
muscular redus.
7. Dac meseria v solicit s stai aplecai pentru perioade
ndelungate de timp, nu uitai s facei o pauz scurt din
or-n or i s v facei exerciiile de ntindere.
8. Dac pacienii ar fi mai contieni de programul lor de micri
sigure, nu le-ar mai fi team de o nou accidentare.
9. Dac un pacient cu handicap fizic vrea s fie independent, el
va trebui s nvee cum s-i modifice mediul nconjurtor:
patul, scaunele, scaunul din main, locul de munc etc.
10. Dac pacienii doresc ca programul lor de exerciii s fie
eficient, ar trebui s cunoasc mai nti foarte bine tehnicile
posturale i numai apoi s le i execute.
Improving communication
7. Insert the sentences below in their corresponding semantic

class:
A. THERAPISTS INSTRUCTIONS
B. CHECKING IF THE PATIENT GOT THE MESSAGE
C. OFFERING ASSISTANCE FOR THE PATIENT
D. ENCOURAGING THE PATIENT
E. BUILDING MUTUAL TRUST
F. GETTING A POST-PRACTISE FEED-BACK FROM
THE PATIENT

Example:
Do you see my point?B.(CHECKING IF THE PATIENT GOT THE
MESSAGE)
1. Lean backward and hold the stretch!
2. Did you get it right?
3. Is this too difficult for you?
4. Im right here if you need me!
5. Dont worry! Ill keep an eye on you!
6. You can do it! Give it another try!
7. Need I say this again?
8. You have to trust me on this!
9. Have the cramps gone away now?
10. Lean forward, resting your abdomen on the anterior thighs.
11. Does this make any sense to you?
12. Dont hesitate to ask for my help!
13. You had to deal with worse than this before!
14. Can you manage practising this exercise by yourself now?
15. You have to take my word for it!
16. Are you with me on this?
17. Dont give up! One more try!
18. Have you experienced any muscle spasms during this
exercise?
19. Bend your trunk laterally and hold the position.
20. Did you take my hint?
21. If you need a helping hand Im not going anywhere!
22. Do your best! Its worth trying!
23. Does it still hurt when you flex your knee?
24. You will have to learn to trust me.
25. Tuck in your chin and lift your head.
26. Did you get my message?
27. Do you still feel pins and needles in your feet?
28. I give you my word on this! Dont you doubt it!
29. Lift both arms simultaneously.
30. Are your fingers still numb now?

96 ADINA RDULESCU
8. Create your own therapist-patient dialogues using the semantic

classes above and the examples provided for each class. Follow the
logical order of asking questions (first the instructions, then the
checking part and so on so forth).
9. Read the following types of dialogues and match them with
their corresponding titles:
1. Fixing an appointment
2. Changing an apointment
3. Returning a call
4. Taking a family history
5. Taking a social history
6. Examining a patient
A.
Dr. Thomson: Well, are you married?
Mr. Stiff: Yes, of course, who isnt ?
Dr. Thomson: Do you have any children?
Mr.Stiff: Yes, but they are no longer living with us.
Dr. Thomson: What about your parents? Are they in good health?
Mr. Stiff: My mother died last year. Bone cancer. And my father
suffers from osteoarthritis.
Dr. Thomson: I`m sorry to hear that.
B.
Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you?
Mr. Jones: Yes, hello. I am calling to fix an appointment, to see
Dr. Wilkinson.
Secretary: Right. Let me check his schedule. Er how about 25th of
September?
Mr. Jones: Oh, Im afraid it is a bit late. I have an urgent matter, you
see
Secretary: Well, what about 21st of September, at 11 a.m.?
Mr. Jones: Oh, thats better, thank you.
Secretary: Call us, please, in case you cant make it.
Mr. Jones: Thank you, it would not be the case.

C.
Dr. Richards: Could you just take off your clothes so that I can
examine you?
Mr. Spike: Okay, I have done this many times
Dr. Richards: Would you, please, lie flat on the couch for a few
minutes? Can you now show me where it hurts?
Mr. Spike: Right here, in my left thigh.
Dr. Richards: Can you raise your left leg for me? And hold it for a
second? Does it hurt when you rotate it?
Mr. Spike: A little bit, when I return to the initial position.
D.
Mrs. Slender: Hello, Dr. Walsh?
Dr. Walsh: Speaking.
Mrs. Slender: Ah, Mrs. Slender here.
Dr. Walsh: Yes, hello, Mrs. Slender. It is good that you returned my
call.
Mrs. Slender: Is there anything wrong, doctor?
Dr. Walsh: No, nothing to worry about. I have just received your
X-rays and it looks that your ankle is not broken, but just sprained.
Mrs. Slender: Oh, what a relief!
Dr. Walsh: Please, come to see me tomorrow and well discuss more
about it.
E.
Secretary: Wilkinson Rehabilitation Centre. Hello, may I help you?
Mr. Jones: Yes, hello. Im Jones, I called you a couple of days ago
Secretary: Yes, Mr. Jones. What can I do for you?
Mr. Jones: It is about my appointment. I wont be able to make it. I
wonder if we could possibly move it to the 25th of September?
Secretary: First of all, Mr. Jones, you change your appointment at
short notice and then you want to fix the day for your future
appointment?

98 ADINA RDULESCU
Mr. Jones: Im very sorry if I have caused you any inconvenience.

Shall I call back another time?
Secretary: We have your phone number and if someone cancels an
appointment well let you know.
Mr. Jones: Thank you for your trouble.
F.
Dr. Thomson: Yes, you are still working, isnt it?
Mr. Stiff: Yes, two more years till my retirement.
Dr. Thomson: Have you pushed yourself too hard lately?
Mr. Stiff: You know how things are. I am no longer young and keeping
up with the newly hired
Dr. Thomson: What about your working hours? Have you considered
working part-time?
Mr. Stiff: Im afraid this is not an option in my field.
Dr. Thomson: Then, I hate to bring you the bad news, but you should
consider retiring. Otherwise..
Pair work
10. Create your own dialogues, starting from the following titles:
Introductory dialogues, The first examination, Programming the
first session, Recommending a better treatment, Proposing a new
experimental programme, Explaining how the devices work, How to
focus your effort, Dealing with home exercises programme, etc.

UNIT 10
REVISION EXERCISES
1. Complete the following sentences using the nouns in the box:
dislocation muscular dystrophy fracture

cartilage spinal column joints
balance cardiovascular disease
postural fault range of motion exercise
1. The .. is made up of 33 vertebrae that are

separated by spongy disks and protects the spinal cord that
runs inside of it among other things.
2. The connections between bones are called each
being classified according to structure and movability as
fibrous, cartilaginous, or synovial.
3. The .. is a tissue made of cells and fibers, that
connects and supports. It is found mostly in the joints, the
chest, and stiff tubes of all sorts, as the voicebox (larynx),
windpipe (trachea), nose, and ear.
4. In all forms of there is a slow loss of
strength with increasing disability and deformity.
5. is the displacement of any part of the body
from its normal position; this applies most often to a bone
moved from its normal position with a joint.
6. A is an injury to a bone in which the tissue of
the bone is broken.
7. A .. may cause problems with the
heart and blood vessels.

100 ADINA RDULESCU
8. .. refers to the ability to maintain the center of

gravity over the base of support, usually while in an upright
position.
9. .. any body action involving the
muscles, joints, and movements in natural directions of arms
and legs.
10. A is a posture that deviates from normal
alignment but has no structural limitations.
2. Choose the right version that best completes the sentence:
1. Being placed in a supine position means:

a) lying flat or face downwards;
b) lying or resting on the back, with the face, palm, etc
upwards;
c) sitting cross-legged;
d) side-lying, with one arm up.
2. To adduct the arm means:
a) to draw or pull the arm towards the median axis of the
body;
b) to flex and elongate the arm successively;
c) to pull away the arm from the median axis of the
body;
d) to turn the arm around its own axis.
3. .. is a generalized, progressive reduction of
bone mass as bone resorption outstrips bone formation,
causing skeletal weakness and fractures.
a) Osteomyelitis;
b) Osteoarthritis;
c) Rheumatoid Arthritis;
d) Osteoporosis.
4. Inadequate calcium intake, early menopause, sedentary life-
style, endocrine disorders, prolongued immobility are some of
the causes of ..

a) Osteoarthritis;
b) Ankylosing Spondylitis;
c) Osteoporosis;
d) Amyotrophic Lateral Sclerosis.
5. An abnormal, increased degree of forward curvature of any
part of the spine is the characteristic of .
a) kypholordotic posture;
b) lordotic posture;
c) slouched posture;
d) flat low-back posture.
6. . are necessary to treat joint
dysfunctions such as stiffness, reversible joint hypomobility,
or pain.
a) strenghtening exercises;
b) stretching exercises;
c) weight-bearing exercises;
d) joint mobilization exercises.
7. is the ability of a muscle to
contract repeatedly or generate tension, sustain that tension
and resist fatigue over a prolonged period of time.
a) muscle strength ;
b) muscular endurance ;
c) muscular contraction ;
d) muscular extensibility.
3. Find the root-verbs that the following nouns are derived from:
examination, treatment, assessment, decision, diagnostician,
information, retirement, development, selection, questioning,
interpretation, palpation
Example:
examination examine (the root-verb)

102 ADINA RDULESCU
4. Derive the corresponding nouns, adjectives and adverbs from

the following verbs:
affect, aggravate, compress, contract, diminish, disturb, explain,
expect, function, immobilize, include, increase, limit, paralyse,
propose, radiate, reduce, repeat, suspect, swell.
Example:
verb noun adjective adverb
repeat repetition, repeatable, repeatedly
repeater, repeated,
repeating,
repetitional
5. Find the corresponding stress-emphasis pattern for the

following two/three/four/multi-syllable words and pronounce
them accordingly: affected, aggravated, alignment, compression,
contracture, deformity, disease, duration, fasciculation,
hyperextension, inactivity, kypolordotic, lumbosacral, pericarditis,
recliner, strengthening, stiffness, subluxation, tranquilizer.
6. Complete each space with a word formed from the words in
capitals.
A. Warming up soft tissues prior to
stretching will increase the
(1) of the shortened tissue. EXTEND
Warm muscles relax and (2). LENGTH
more easily, making stretching more
(3) .. for the patient. As COMFORT
the temperature of muscle increases, the
amount of force required to elongate
noncontractile and contractile tissues and
the time the stretch force must be
(4) . decrease. Although APPLY
stretching is often thought of as a warm-

up activity and performed prior to

(5) exercise, the clinician VIGOUR
and patient must always remember that
an appropriate warm-up must also occur
in the (6) .. for PREPARE
stretching. It is (7) DEBATE
whether heating should occur prior to or
during the stretching procedure.
B. Some anger may serve a

(1) purpose; much anger USE
however, is purely (2).. DESTRUCT
The energy that goes into its arousal
could often be more (3) .. PROFIT
spent in solving the problem. Here are
some ways in which anger can be
controlled:
reinterpreting the stimulus in a more
positive light; many situations contain
ambiguities which allow
(4) .. to be made; REINTERPRET
being realistic in our (5). EXPECT
of other people;
giving oneself (6) to PERMIT
make a mistake, as it is part of being
human to make mistakes (7).. OCCASION
distancing oneself; if circumstances
seem to be overwhelming, one can try
stepping back mentally to get a more
(8) . view; OBJECT
introducing humour at (9).. SUIT
moments; when a person smiles and
laughs the (10) . response RELAX
takes over.

104 ADINA RDULESCU
7. Read the text below and choose the version that best completes
the empty spaces:
Pain is often the reason why the patient has come for attention in the
first place. Always remember that pain is a/an (1) .. to the
patient who may find that it is making his or her life (2) .
Pain is a/an (3).. experience and any measurement must
incorporate a degree of (4) . .
Reactions to pain vary widely (5) . different people and
depend (6) . many different physical and mental factors. Specific
diseases and injuries and the health, pain (7) ., fear and
anxiety, and ethnic background all affect reactions to pain.
Patients will describe pain (8) .. in terms of its sensory
qualities, for example shooting, sharp, burning or in terms of its
affective qualities, for example vicious, cruel, sickening, or in terms of
its evaluative qualities, for example intense, unbearable, annoying.
Severe pain causes pale skin, cold sweat, (9).. bumps, wide
pupils, and higher levels of pulse, breathing rate, blood (10) ..,
and muscle (11) . When brief, strong pain starts to go away,
the pulse may be slower and the blood pressure lower than before the
pain began. If pain occurs often or is long term, the pulse (12) .
and blood pressure may not go up much. If pain lasts for many days,
the (13) to fight infections may be lost. The patient's tone of
voice, speed of speech, cries, groans, or other sounds, face and body
movements, or attempts to withdraw are noted by the physician.
It is hard to (14) strong or long-term pain, but a patient can
learn to live almost (15) .. even with some pain.
1. a) illusion b) reality c) dream d) perception

2. a) intolerable b) impossible c) easier d) irritating
3. a) individual b) objective c) personal d) subjective
4. a) objectivity b) doubt c) subjectivity d) error
5. a) to b) among c) with d) from
6. a) on b) of c) in d) with

7. a) point b)limit c) degree d) level

8. a) or b)either c) neither d) nor
9. a) hen b)road c) goose d) heat
10. a) group b)relation c) test d) pressure
11. a) bulk b) tension c) spasm d) strain
12. a) rate b)rhythm c) beat d) tempo
13. a) talent b)volition c) ability d) capacity
14. a) relieve b)cure c) release d) solace
15. a) usually b) patiently c) regularly d) normally
8. Turn the following sentences from active voice into passive

voice. Begin the passive sentences with the underlined words:
1. Total body streching, such as toe touches, may maintain or

overstretch a mobile area.
2. Strengthening programs tend to overemphasize flexion
exercises.
3. When performing this kind of stretch, you must keep your
shoes on.
4. Patients should perform flexibility exercises prior to and after
a strengthening program.
5. An effective stretching or flexibility routine should not cause
pain or excessive stress to tissues.
6. Patients should slightly bend their knees when performing
forward-bending exercises.
7. You will warm up the tissues with gentle rhythmic activities.
8. Increase the pace of activity so that you can maintain the
target heart rate for 10 to 20 minutes.
9. To avoid injuries from stress, you should use appropriate
equipment, such as correct footware.
10. People often use inappropriately the phrase No pain, no
gain as the guideline for intensity of stretch.

106 ADINA RDULESCU
9. Identify the type of the following conditional sentences and fill

in the missing tenses or modal constructions to complete them:
1. If pain begins while exercising, you

(decrease) effort and rest between sessions.
2. You would have avoided overuse symdromes if you
(perform) proper warm-up.
3. If she really wanted to protect vulnerable joints, she
... (not stress) joints and ligaments at the end
of the range.
4. If he wanted to increase his muscular endurance, he
. (perform) the exercises with many
repetitions and minimal resistance to the point of muscle
fatigue.
5. If you .. (keep) your knee straight, the
gastrocnemius is stretched.
6. If you do not want to be injured during your aerobic program,
you (avoid) running, jogging or aerobic dancing
on hard surfaces such as asphalt and concrete.
7. If your sister had practised aerobic activity 3 to 5 times per
week, she . (feel) much better.
8. If you bend your knee, the soleus . (be) stretched.
9. Concentrate on stretching the tight muscles, if there (be)
decreased flexibility between antagonistic muscle groups.
10. If your patient were excessively mobile in a segment of his
body, it (be) safer to selectively stretch tight
structures than the total body.
10. Translate intoRomanian, without using a dictionary:
a) Inability to reverse the normal lumbar lordosis on flexion occurs in

degenerative arthritis. Limited lumbar flexion is characteristic of
ankylosing spondylitis. Localized bone pain suggests such disorders

such as osteomyelitis, leukemia, primary or metastatic cancer,

compression fracture or herniated disk.
b) Normally, when a patient had limited range of motion, the

therapeutic approach was to stretch the region with passive stretching
techniques. Over the past 30 years, therapists have identified and
learned techniques that deal more directly with stretching the source
of limitation, and thus they are managing dysfunctions better and with
less trauma. Muscle elongation or active inhibition techniques are
used to counteract the loss of flexibility in the contractile elements of
muscles; cross-fiber massage techniques are used to increase mobility
in selected ligaments and tendons; and joint mobilization and
manipulation techniques are used to safely stretch or snap structures to
restore normal joint mechanics with less trauma than passive
stretching.
c) It could be argued that smoking has more to do with relaxation than

smoking abstinence has, and many people become smokers because
they perceive cigarettes as being a source of mental calm. However,
many such people then wish to quit smoking. Quitting is associated
with stress, which means that the same people may be seeking
relaxation training. Health care professional increasingly find
themselves faced with groups of people who are struggling to give up
cigarettes and for whom relaxation training hes been prescribed.
d) The main symptoms of muscular distrophy are: delays in gross

motor development; difficulty walking, running, climbing stairs, and
riding a tricycle appears about 3 to 5 years of age; progressive
weakness with waddling gait, lordosis, difficulty rising from a sitting
or supine position; calf muscle hypertrophy; scoliosis; contractures
and joint deformities; inability to ambulate by about age 12; mild
mental retardation; respiratory and accessory muscles involved in end
stage with cardiomegaly.
The general treatment includes: long-term rehabilitation (occupational
and physical therapy) to maintain activities of daily living and help

108 ADINA RDULESCU
adapt to progressive loss of function, prevent disuse syndrome, and

promote bowel and bladder control; assistive devices (canes, walkers,
bracing, casting, wheelchairs); counseling and psychologic support of
individual and family; respite home care; ventilatory assistance and
communication devices in end-stage; family genetic counseling,
identification of carriers.
e) Inverted bicycle
This popular exercise is performed by the subject starting supine, then
rolling up onto the shoulders so that the feet are up in the air. The
weight of the inverted body is borne on the upper thoracic and cervical
spine. Once in this position, the person attempts to balance while
flexing and extending the lower extremities in a reciprocal manner.
Problems with this exercise include the position itself, which places
the head in a forward-head posture. The body weight becomes a
strong stretch force into flexion on the upper thoracic region, a region
that frequently tends to be flexed from a faulty posture. The flexed and
inverted position compresses the lungs and heart, decreasing their
potential effectiveness. It is questionable whether the benefits of this
exercise outweigh the combined negative effects on the neck and
upper back posture, circulation and respiration.
f) Scissors
This activity is performed with the person lying supine and legs held
extended several inches above the exercise mat. The person then
abducts and adducts the legs, mimicking a scissors motion. The
mechanics of the activity are similar to straight-leg raising in that it
requires a strong abdominal muscle contraction to stabilize the pelvis
against the pull of the hip flexor muscles, which, in this case, must
contract strongly to hold the legs off the ground. There is no resistance
to the abductor and adductor muscles, because the legs move parallel
to the ground. To stabilize the pelvis, the person is often instructed to
place the hands under the pelvis. This defeats the intent of
strengthening the abdominals, because they then do not have to work.

g) Many types of joint surgeries are available to treat chronic joint

disease of the hip and some fractures of the hip that compromise the
vascular supply to the head of the femur. The procedures include
osteotomy (which is actually an extra-articular procedure), arthrodesis,
and several variations of arthroplasty of the hip, such as resurfacing,
hemireplacement, and total joint replacement procedures. The goals of
joint surgery and postoperative management are to provide a patient
with: a pain-free hip, a stable joint for lower extremity weight bearing
and functional ambulation, and adequate range of motion and strength
of the lower extremity for functional activities.
It is important for the therapist to have a basic understanding of the
more common surgical procedures for management of joint disease
and deformity and a thorough knowledge of appropriate therapeutic
exercise procedures and their progression for an effective and safe
postoperative rehabilitation program.
11. Translate into English:
a) Stai ntini sau aezai ntr-o poziie pe care o simii comod.

nchidei ochii. Simii cum ncepei s v relaxai. Pe msur ce trupul
i mintea se calmeaz, permitei-i locului dumneavoastr special s ia
contur n imaginaia dumneavoastr. Observai privelitea, sunetele i
mirosurile acestui loc. Apoi, ncercai s simii cum muchii se
relaxeaz, eliminnd tensiunea de peste zi.
b) Stai aezai, cu tlpile unite ctre interior i cu genunchii ndreptai

lateral ctre exterior. Plasai-v minile n jurul gleznelor i odihnii-
v coatele pe coapse. Apsai uor cu coatele asupra coapselor. Apoi
odihnii-v. Apsai apoi din nou. Ar trebui s simii o ntindere
plcut n zona oldului.
c) Pentru a nva s conducei relaxai, n primul rnd identificai

grupele musculare de care avei nevoie pentru condus. Dac observai
c aceste grupe sunt tensionate, relaxai-le. Verificai dac i muchii
pe care nu-i solicitai cnd conducei, cum ar fi muchii feei, sunt

110 ADINA RDULESCU
relaxai. Nu uitai zona umerilor. Meninei-v relaxai i atunci cnd

virai sau schimbai viteza.
d) Exerciiile de ntindere sunt att de utile pentru c ajut la

meninerea elasticitii. Elasticitatea este una dintre proprietile
esutului muscular care nu numai c permite muchilor s funcioneze
mai bine, dar i i protejeaz fa de o posibli accidentare. De multe
ori, obinuim la modul incontient s ne ntindem, dup ce am stat
mult timp n aceeai poziie. Se pare c trupul nostru ne-o cere. Ne
ntindem dup ce dormim, dup ce stm cu orele la birou, dup ce
lucrm aplecai n grdin
e) Cum ne dm seama, fr a fi specialiti, de existena unei luxaii sau

fracturi? Diagnosticul prezumtiv este relativ simplu: n cazul
luxaiilor, articulaia respectiv are o form anormal, nu mai poate fi
micat din cauza durerilor, iar pacientul i nclin corpul sau i
modific poziia membrului n poziia cea mai comod pentru el. n
aceast poziie l vom imobiliza sau l vom susine pn la cel mai
apropiat punct medical. Fracturile se recunosc uor prin deformarea
segmentului pe membrul respectiv (se anguleaz n locuri unde nu
sunt articulaii), mobilitatea anormal i dureroas, n aceleai locuri i
crepitaiile (prituri) care se aud n locurile respective cnd
accidentatul ncearc s mite membrul.
f) Tratamentul recuperator n cazul fracturilor este deosebit de

important, asigurnd reluarea ct mai rapid a funciei membrului.
Kinetoterapia ncepe din primele momente dup imobilizarea fracturii
i const n contracii izometrice musculare sub gips i micare activ
precedat de masaje a segmentelor libere. Activitatea cu membrele
sntoase (mersul cu crje) sunt o gimnastic ideal, simetria
impulsurilor care se transmit la ambele membre avnd rol trofic foarte
important pentru membrul lezat.
g) Hidrokinetoterapia este o form special de kinetoterapie care se

practic n secii de recuperare bine dotate. Ea se practic n bazine de

forme i dimensiuni variate n care pacientul execut micri sau

programe complexe pasive i active, n imersiune total (doar capul
rmne afar) sau parial ( membrul superior sau segmentele sale).
Imersiunea are un dublu rol: elibereaz micrile de aciunea gravitii
i opune rezisten micrilor.
h) Ergoterapia reprezint etapa cea mai complex a kinetoterapiei. Ea

constituie o etap prelungit de tratament, care st la baza reeducrii
profesionale i reintegrrii deficientului n circuitul economico-social.
Ergoterapia orientativ are ca scop educarea profesional i
ndrumarea deficienilor ctre anumite profesiuni pentru care au
aptitudini. Ergoterapia retributiv poate fi utilizat pentru bolnavii
care recupereaz spontan o paralizie sau care au suferit un tratament
paliativ al sechelelor i i-au rectigat micrile principale.

112 ADINA RDULESCU

GLOSSARY
acute muscle soreness = durere muscular acut

admission (to hospital) = internare
aerobic exercise = exerciiu aerobic
aid = ajutor
ailment = indispoziie, durere uoar
amputation = amputare
amyotrophic lateral sclerosis = scleroz lateral amiotrofic
anaerobic exercise = exerciiu anaerobic
analgesic/pain killer = analgezic. calmant
anemia = anemie
anesthesia = anestezie
anesthetic = anestezic
angina = angin
ankle joint = articulaia gleznei
ankylosing spondylitis/bamboo spine = spondilit anchilozant
anorexia = anorexie
antiseptic dressing = pansament antiseptic
aortic aneurysm = anevrism aortic
apnea = apnee
arrythmia = aritmie
arterial insufficiency = insuficien arterial
arterial pressure = tensiune arterial
arteriosclerosis/hardening of the arteries = arterioscleroz

114 ADINA RDULESCU
arteritis = arterit
arthritis = artrit
arthrokinematic = artrocinematic
arthropathy = artropatie
arthroplasty = artroplastie
arthroscopy = artroscopie
articular cartilage = cartilaj articular
articulation/joint = articulaie
atrophy = atrofie
avascular necrosis = necroz avascular
axilla/armpit = axil, subsuoar
balance = echilibru
bandage = bandaj
bladder = vezic urinar
blood vessels = vase sanguine
bowels = intestine
brace = ortez
bradypnea = bradipnee
calcaneus/heel = clci
calcification = calcifiere
cardiovascular fitness = tonus cardiovascular
carpus/wrist = ncheietura minii
cartilage disk = disc cartilaginos
cerebrovascular accident/stroke = accident cerebrovascular
cervical lordosis = lordoz cervical
chilblain/frostbite = degertur
clavicle/collarbone = clavicul
coccyx = coccis
compression dressing = pansament compresiv

connective tissue = esut conjunctiv

contusion/bruise = contuzie, vntaie
convalescence = convalescen
coronary artery disease = boal coronarian
cotton wool = vat
cranium/skull = craniu
crepitus = crepitaii
crutch = crj
cyanosis = cianoz
dermatitis = dermatit
diaphysis = diafiz
dislocation = dislocare
dorsiflexion = dorsiflexie
double up with pain = a se ndoi, chirci de durere
dynamometer = dinamometru
dyspnea = dispnee
dyspnea = dispnee
edema = edem
edema/swelling = edem, umfltur
electromyography = electromiografie
encephalitis = encefalit
epidemiology = epidemiologie
epiphyseal cartilage = cartilaj epifizar
epiphysis = epifiz
ergometer = ergometru
etiology = etiologie
exercise bouts = numr optim de repetri ale unui exerciiu
expiratory flow rate = frecven respiratorie
fibrous joint = articulaie fibroas
flat low-back posture = postur aplatizat a zonei inferioare a

116 ADINA RDULESCU
spatelui
forward head posture = postur cu capul mpins ctre nainte
gait = umblet, mers
gall bladder = vezic biliar
gangrene = cangren
go on crutches = a merge n crje
goniometer = goniometru
halitosis/bad breath = halitoz
hemarthrosis = hemartroz
hemiparesis = hemiparez
hereditary = ereditar
herniated disk = disc herniat
herniation = herniere
high-protein diet = diet bogat n proteine
hip = old
hip joint = articulaia oldului
hydrotherapy = hidroterapie
hyperglycaemia/high blood sugar = hiperglicemie
hyperkinesia = hiperkinezie
hyperplastia = hiperplastie
hyperreflexia = hiperreflexie
hyperthermia = hipertermie
hypertonic muscles = muchi hipertonici
hyperventilation = hiperventilaie
hypokinesia = hipokinezie
hypotonic muscles = muchi hipotonici
hypoxia = hipoxie
idiopathic = idiopatic
immobility = imobilitate

impairment = afectare
in-patient = pacient spitalizat/internat
inspiratory capacity = capacitate inspiratorie
instep = scobitura gleznei
isokinetic exercise = exerciiu izokinetic
isometric (static) exercise = exerciiu izometric
isotonic (dynamic) exercise = exerciiu izotonic
joint hypertrophy = hipertrofie articular
joint mobilization = mobilizare articular
knee joint = articulaia genunchiului
knuckle = articulaia degetului
kypholordotic posture = postur cifolordotic
kyphoscoliosis = cifoscolioz
kyphosis = cifoz
kyphotic posture = postur cifotic
lethargy = letargie
limb = membru
lordosis = lordoz
lordotic posture = postur lordotic
low back pain = durere joas de spate
low-grade fever = febr uoar; subfebrilitate
lupus erythematosus = lupus eritematos
lymphedema = limfedem
malaise = indispoziie
medical examination sheet = foaie de observaie clinic
medical history = anamnez
meningitis = meningit
mien = inut, comportament
motility = motilitate

118 ADINA RDULESCU
multiple sclerosis = scleroz multipl

muscle bulk = mas muscular
muscle fatigue = oboseal/extenuare muscular
muscle rigidity = rigiditate muscular
muscle spasm = spasm muscular
muscle sprain = luxaie
muscle strain = ntindere muscular
muscle strength = for muscular
muscle tone = tonus muscular
muscular contraction /cramp = contracie muscular
muscular dystrophy = distrofie muscular
muscular endurance = rezisten muscular
muscular hypertrophy = hipertrofie muscular
muscular tension = tensiune muscular
muscular weakness = slbire muscular
myocardial infarction/heart attack = infarct miocardic
nape (of the neck) = ceaf
nausea = grea
necrosis = necroz
neurasthenic = neurastenic
neuromuscular tension = tensiune neuromuscular
nostril = nar
numbness = amoreal
obesity = obezitate
occupational therapy = terapie ocupaional
ointment = unguent
onset = debut (al afeciunii, bolii)
orthopedic support = suport ortopedic
orthopedics = ortopedie

orthopnea = ortopnee
osteoarthritis/degenerative joint disease (DJD) = osteoartrit
osteomyelitis = osteomielit
osteoporosis/bone atrophy = osteoporoz
osteotomy = osteotomie
out-patient = pacient extern
overstrain = suprancordare
overstretch = suprantindere
palliative = paliativ
paralysis = paralizie
paraplegia = paraplegie
parasthesia = parestezie
paresis = parez
paresthesia = parestezie
patella, -ae/knee cap = rotul
pathology = patologie
pelvic tilt = nclinare/aplecare pelvian
pericarditis = pericardit
pharmacology = farmacologie
phlebitis = flebit
physician = medic
physiology = fiziologie
physiotherapy = fizioterapie
plantarflexion = flexie plantar
plaster bandage = pansament gipsat
plaster cast = aparat gipsat
poliomyelitis/infantile paralysis = poliomielit
postoperative = postoperator
postural fault = defect postural

120 ADINA RDULESCU
prescription = prescripie, reet

progressive muscular atrophy = atrofie muscular progresiv
progressive muscular dystrophy = distrofie muscular progresiv
psoriasis = psoriazis
pull ones hamstring muscle = a-i ntinde un tendon muscular
quadriplegia = cvadriplegie
recreational therapy = terapie recreaional
reflex hammer = ciocnel pentru testarea reflexelor
rehabilitation = recuperare (a pacientului)
remedy = remediu
remission = remisie
rheumatism = reumatism
rheumatoid arthritis = artrit reumatoid
rib = coast
round-back posture = postur rotunjit a spatelui
rupture = ruptur, hernie
sacrum = os sacral
scapula/shoulder blade = omoplat, scapul
sciatica = sciatic
scoliosis = scolioz
sedative/sleeping pill/dope = sedativ
seizure = atac de apoplexie
sequela, -ae = sechel, -e
shin/cannon bone = tibia, fluierul piciorului
shoulder girdle = centur scapular
skeletal injury = leziune a sistemului scheletic
skin lesion = leziune a epidermei
snap a tendon = a suferi o ruptur de tendon

sole = talp
spasticity = spasticitate
speech theraphy = logopedie
spinal cord injury = leziune a coloanei vertebrale
spinal cord/marrow = mduva spinrii
spine/spinal column/backbone = coloana vertebral
splint = atel
spondylitis = spondilit
spondylosis = spondiloz
sprain ones ankle/wrist = a-i luxa glezna/ncheietura minii
stance = poziie, postur
stasis = staz
sterile dressing = pansament steril
sternum/breastbone = stern
sticking plaster = leucoplast
stiffness = rigiditate
stitches = copci
stooped posture = postur aplecat, nclinat
strain ones muscle = a suferi o ntindere muscular
strengthening exercises = exerciii de ntrire muscular
stretcher = targ
stupor/apathy = indiferen, apatie
sway back posture/relaxed (slouched) posture = postur aplecat,
grbovit
symptomatic = simptomatic
synovectomy = sinovectomie
synovial joint = articulaie sinovial
synovitis = sinovit
tachycardia/palpitations = tahicardie
tape measure = rulet, panglic de msurat

122 ADINA RDULESCU
tear/pull a ligament = a suferi o ruptur ligamentar

tenderness = consisten redus
tendinitis = tendinit
tendinosis = tendinoz
tenosynovitis/inflamed tendons = tenosinovit
test tube = eprubet
testing devices = instrumente de testare
thigh = coaps
thoracic cage = cuc toracic
thrombophlebitis = tromboflebit
thrombosis = tromboz
thyroid cartilage/Adams apple = cartilaj tiroidian
tissue = esut
tomography = tomografie
twitch = tic nervos
vertebra, -ae/bony ring = vertebr
ward = secie/salon de spital
weight loss = scdere n greutate
weight-bearing exercise = exerciiu de susinere
a greutii corporale
wheel stretcher = targ prevzut cu roi

BIBLIOGRAPHY
Buschbacher, R. M., Randall, L. B., Practical Guide to

Musculoskeletal Disorders. Diagnosis and Rehabilitation,
Butterworth Heinemann, 2002.
Cobuild, C. English Guides. Word Formation, Harper Collins
Publishers, 1991.
Donatelli, R. and Owens-Burkhart, H. Effects of Immobilization on
the Extensibility of Periarticular Connective Tissue. Journal
of Orthopaedic and Sports Physical Therapy, 1981.
Garrison, S. J., Handbook of Physical Medicine and Rehabilitation
Basics, J. B. Lippincott Company, 1995.
Gray, H., Anatomy. Descriptive and Surgical, London, the
Promotional Reprint Company Ltd.,1991.
Hollis, M. and Yung, P., Patient Examination and Assessment for
Therapists, Blackwell Scientific Publications, first published
1985.
Holme, R., ESP ideas. Recipes for Teaching Professional and
Academic English, Longman, first published 1996.
Howley, E. T. and Franks, B. D., Health/Fitness Instructors
Handbook. Human Kinetics, Champaign, I. L., 1986.
Hutchinson, T. and Waters, A., English for Specific Purposes,
Cambridge University Press, first published 1987.
Kisner, C. and Colby, L. A., Therapeutic Exercise. Foundations and
Techniques, Philadelphia, F. A. Davis Company, 1996.
Maher, J. C., International Medical Communication in English,
Edinburgh University Press, Edinburgh, 1990.
McCarthy, M., Vocabulary, Oxford University Press, first published
1990.

124 ADINA RDULESCU
Oxford Advanced Learners Encyclopedic Dictionary, Oxford:Oxford

University Press, first published 1989.
Prlog, H., English Phonetics and Phonology, Editura ALL,
Bucureti, 1997.
Payne, R. A., Relaxation Techniques. A Practical Handbook for the
Health Care Profesional, Churchill Livingstone, New York,
1995
Quirk, R., Greenbaum, S., Leech, G., Svartvik, J., A Comprehensive
Grammar of the English Language, Longman, 1985.
Randall, L. B., Physical Medicine and Rehabilitation, second edition,
W. B. Saunders Company, 2000.
Riley, D., Check Your Vocabulary for Medicine. A Workbook for
Users, Peter Collin Publishing.
Sinelnikov, R. D., Atlas of Human Anatomy, vol.1 The Science of
Bones, Joints, Ligaments and Muscles, MIR Publishers,
Moscow, first published 1988.
The Merk Manual of Diagnosis and Therapy, Sixteenth Edition, Merk
Research Laboratories, U.S.A., 1992.
The Oxford-Duden Pictorial English Dictionary. Science and
Medicine, Oxford University Press.
Thomson, A.J. and Martinet, A.V., A Practical English Grammar,
Oxford University Press, 1986.
Zaharia, C., Elemente de patologie a aparatului locomotor, Editura
Paideia, Bucureti, 1994.

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1

Universitatea SPIRU HARET

Descrierea CIP a Bibliotecii Naionale a Romniei

Editura Fundaiei Romnia de Mine, 2003

Redactor: Andreea DINU

Bun de tipar: 16.12.2004; Coli tipar: 7,75

Universitatea SPIRU HARET

UNIVERSITATEA SPIRU HARET

EDITURA FUNDAIEI ROMNIA DE MINE

Universitatea SPIRU HARET

Universitatea SPIRU HARET

Universitatea SPIRU HARET

Universitatea SPIRU HARET

Specificul studierii limbilor strine n cadru universitar este

Universitatea SPIRU HARET

unui certificat de competen lingvistic pe specialitatea englez

Universitatea SPIRU HARET

THE MAIN PARTS OF THE BODY

1. Read the following texts containing relaxation techniques and

Trainers introduction: This relaxation procedure is one that has

Universitatea SPIRU HARET

3. Using the vocabulary practice below write the Romanian

Universitatea SPIRU HARET

5. Choose the right word that best completes the sentence:

Universitatea SPIRU HARET

2. It is not polite to talk to somebody when you have your

6. Match up the following words with their definitions:

1. wrist a. the thick, fleshy part of the back of the

Universitatea SPIRU HARET

4. tongue d. a thin, horny, translucent plate covering

above = deasupra, de deasupra, mai sus de

Universitatea SPIRU HARET

between = ntre (dou obiecte)

Other words indicating movement and direction:

Place your hands around your ankles.

Universitatea SPIRU HARET

Clasp both hands behind your head.

8. Read the following sentences and translate them into

9. Create your own relaxation techniques; write down five

10. Translate into English, using the new words:

Universitatea SPIRU HARET

ridicai mna stng i ndoii corpul spre dreapta. Repetai micarea

Universitatea SPIRU HARET

THE SKELETAL SYSTEM

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tissue. All the elements encountered in the joints of the newborn

The skeletal system:

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- knee joint = articulaia genunchiului

3. Complete the following sentences using the nouns in the box.

sternum coccyx carpus calcaneus

1. The spine is a flexuous column, formed of a series of bones called

Universitatea SPIRU HARET

4. Match up the following words with their definitions:

When forming interrogative sentences with the verb TO BE the rule

Universitatea SPIRU HARET

WHAT is used to ask somebody to specify one or more things,

5. Ask questions for the underlined phrases using the

Universitatea SPIRU HARET

4. The patella is a small, flat, triangular bone situated at the anterior

5. The scapula is situated between the first and seventh ribs.

6. The sternum has the shape of an ancient sword, consisting of three

8. The ligament is pliant and flexible, so as to allow perfect