Approach to MSK Injuries Flashcards
Grade 1 muscle strain
Small number of fibers
Localized swelling/pain
Normal strength
Grade 2 muscle strain
Significant number of fibers
Severe swelling/pain
Reduced strength
Grade 3 muscle strain
Complete tear
Usually at the musculotendinous junction
Mild swelling/pain
Absent strength
Munich Muscle classification
Classified by mechanism
Direct (external trauma or force)
Indirect (internal forces - functional or structural)
British Athletics Muscle classification
Classified by anatomical site
Fasica, muscle tendon junction, tendon
Grades based off MRI findings
SEADS on physical exam
Swelling Erythema Atrophy Deformity Symmetry
Risk factors for muscle injury
Poor mechanics (big*) Cold muscles/poor warm up Excessive tightness Prior injury Diabetes mellitus 2 joint muscles
5 2 joint muscles
Hamstrings Gastrocnemius Rectus femoris Biceps brachii (long head) Triceps (long head)
Contusion (what is it, Tx, avoid)
Direct blow
Tx: minimize bleeding, then physio
Avoid heat, massage, EtOH
Myositis ossificans
Rare complication of contusion Ossifies, forming a palpable mass X-ray Rest SLOW rehab
Fibrosis
Firm bands Tender Thickening Increased risk of tendon injury Treat with physio
Delayed Onset Muscle Soreness
24-48 hours
Eccentric (lengthening a muscle) is worse
Proposed to be from shearing and shredding of the myofibrils
Rhabdomyolysis
Severe injury to muscle caused by exertion or compression
Muscle breakdown
Can be life threatening
Compartment syndrome
Acute usually from trauma (bleeding into a fixed compartment) - need to do a fasciotomy
Chronic is usually exertional (from an increased blood supply) - work on mechanics, massage, fasciotomy
Dermatomyositis
Inflammatory CT disorder Proximal weakness No pain CK, EMG, biopsy Rheumatology referral
