1, 2 Intro to T3 MSK and Lower Leg, Ankle, Foot Flashcards
What are the treatment priorities of MSK?
- Decrease pain
- Normalize ROM
- Improve function (strength/endurance)
What are causes of pain?
- Mechanical
- Inflammation
- Referral (TrP, Neurological)
- Visceral
- Psychosomatic
How is Mechanical Pain assessed?
- postural assessment
- AF
- PR
- mm length testing
- palpation
What are treatment options for mechanical pain?
- massage
- heat
- stretch
How is Referral pain assessed?
TrP:
- referral patterns
- palpation
- mm length/strength tests
Neurological:
- dermatomes
- nerve tension tests
- tinnel’s
- TOS tests
- palpation
What are some treatment options for referral pain?
TrP:
- petrissage
- heat
- stretch
- PIR
- acupuncture
Neurological:
- massage
- MF techs (nerve mobilization)
- acupuncture
- spine joint mobes if nerve root implicated
How is visceral pain assessed and how is it treated?
Assessment:
- special tests
- palpation
- case history
Treatment:
- refer out or osteopathy
What are causes of hypomobility?
- increased MRT (tone/TrP)
- decreased myofascial (muscular) extensibility
- adhesions/scarring
- periarticular adhesions/contracture
- swelling
- pain
- weakness/inhibition
What’s the definition of muscle integrity?
The extent to which a muscle conforms to the expected anatomical and biological norms.
What’s the definition of muscle tone?
The resting tension and responsiveness of muscle to passive elongation or stretch.
What are normal degrees of ROM in the Talocrural and Talocalcaneal (subtalar) joints?
Talocrural:
- 0-20° dorsiflexion (at least 10° needed for normal gait)
- 0-50° plantarflexion
Talocalcaneal (subtalar): 5° inversion/eversion
What bones is the Hindfoot composed of?
talus and calcaneus
What bones is the Midfoot composed of?
navicular, cuboid, cuneiforms
What bones is the Forefoot composed of?
metatarsals and phalanges
What’s normal ROM for 1st MTP joint? How much range is needed for normal gait?
- normal: 70-90° of extension
- 65° needed for normal gait
What are the “dynamic arch supporters” of the foot? What can happen if any of these are weak?
- Tibialis anterior, Tibialis posterior, Peroneus longus
- with weakness or inhibition of these mm, overpronation (of arches during gait) can occur
In which direction does the lower extremity rotate during contact with ground during ambulation/heel strike?
rotates inward
At what point during stance does the tibia start to rotate externally?
from mid-stance to terminal stance
What’s the aka for Bunions?
Hallux valgus
What’s Morton’s Neuroma and what’s its aka?
- Irritation of a branch of the plantar nerve between the 3rd and 4th toes leading to scar tissue formation around the nerve
- aka Intermetatarsalgia
What’s Shin Splints? What normally causes this pain/dysfuntion?
- a non-specific term used to describe pain in the anteromedial or posteromedial tibia
- pain/dysfunction is usually one of the following:
- periostitis
- tibial stress fracture
- exertional compartment syndrome
What is Periostitis and where is it normally felt?
- inflammation of the periosteum
- commonly felt at the attachment of soleus, tibialis posterior, flexor digitorum mm
What are predisposing factors of Periostitis?
poor biomechanics – excessive pronation is likely present
What’s Exertional Compartment Syndrome?
(not the same as acute compartment syndrome) (generally ant. or [deep] post. comp syndrome)
- Results from an increase in the intracompartmental pressure in the compartment of the lower leg. Ant or deep post compartment are most commonly affected
- Repetitive (excessive) mm contraction leads to increased demand for blood to the tissues.
- Increased pressure leads to ischemia and pain.
