This course examines musculoskeletal injury from a tissue-level perspective using current evidence in biomechanics, mechanobiology, and sports medicine. Traditional clinical indicators--including pain, inflammation, imaging findings, and time-loss definitions--are contrasted with contemporary concepts emphasizing tissue load, mechanical stress, strain, and dynamic tissue capacity. Participants will explore how acute overload and fatigue failure develop, why tissue injury exists on a continuum, and how recovery influences adaptation and injury risk. Clinical case examples illustrate how these principles can improve rehabilitation progression, return-to-activity decisions, and patient education across orthopedic practice.

Course Goals and Learning Objectives

Following this course, participants will be able to:

• Define tissue injury using a contemporary load-capacity framework rather than relying solely on pain or imaging findings.
• Differentiate the concepts of external load, internal tissue stress, tissue strain, and tissue capacity.
• Explain the mechanisms underlying acute overload injuries and fatigue failure.
• Describe how tissue adaptation, recovery, and cumulative loading influence injury risk.
• Discuss the limitations of pain, inflammation, and diagnostic imaging as indicators of tissue integrity and readiness for loading.
• Apply load-capacity principles to clinical reasoning when progressing rehabilitation and making return-to-activity decisions.

About the Speaker:

Tedd Girouard, LAT, ATC, is the Program Director of the Master of Science in Athletic Training program at the University of Nevada, Las Vegas. He has been a certified athletic trainer for 31 years, including 15 years of clinical practice, and has taught at UNLV for the past 20 years. Mr. Girouard previously served as Chair of the Nevada State Board of Athletic Trainers and has extensive experience in athletic training education, rehabilitation, therapeutic modalities, and evidence-based clinical practice. In addition to his academic and clinical work, Mr. Girouard is an accomplished endurance athlete and coach. He has completed more than 100 triathlons, qualified for and finished 11 Triathlon World Championships, and was the 2019 USA Triathlon Long Course National Champion. He is a business owner and endurance coach of Silver Maple AT LLC, faculty advisor and coach for the UNLV Triathlon Club, and hosts The Evidence Base Triathlete podcast, where he translates current sports medicine research into practical guidance for endurance athletes and clinicians.