Chronic MSK injuries Flashcards
(47 cards)
what are the three challenges with chronic MSK injuries?
1) diagnosis
- requires comprehensive history of onset, nature, and pain
- as well as an assessment of risk factors such as training and technique
2) understand exactly how the injury occurred (etiology)
- can be quite evident or very subtle
- causes can normally be divided into extrinsic or intrinsic factors
3) treatment
- address the cause
- as well as activity modification, specific exercises to promote tissue repair, and manual therapy
7 extrinsic predisposing factors for chronic MSK injuries
1) training errors
- excessive volume or intensity
- rapid increase
- sudden change in type
- excessive fatigue
- inadequate recovery
- faulty technique
2) surfaces
- hard/soft
3) inappropriate/worn out shoes
4) inappropriate equipment
5) environmental conditions
6) psychological factors
7) inadequate nutrition
6 intrinsic predisposing factors to MSK injuries
1) malalignment
- pes planus/cavus, rearfoot varus
- genu valgum/varum
- patella alta
- femoral neck anteversion
- tibial torsion
2) leg length discrepancy
3) muscle imbalance/weakness
- can lead to pelvic rotation/ quad/hamstring balance
4) lack of flexibility
- general muscle tightness
- focal areas of muscle thickening
- restricted joint ROM
5) sex, size, and body composition
6) other:
- genetic factors
- endocrine factors
- metabolic conditions
muscle cramp - def./etiology
def: painful involuntary muscular contractions that occur suddenly and are temporarily debilitating
- most common in muscle that are overloaded and fatigued during high demand activities (calf, hamstrings, quadriceps, or abdomen)
Due to altered NM control rather than fluid/electrolyte imbalance:
- increased muscle spindle activity, and decreased GTO activity (mechanoreceptors) - over fatigued muscles
- causes continued muscle contraction
muscle cramps: treatment
- regular stretching
- correct muscle imbalances and posture
- good fitness levels (S and C program)
- incorporate plyometric exercises into training
- CHO diet
- massage or trigger pointing therapy
muscle guarding - def.
muscle surrounding an injury site contract to splint and protect the area
-minimize pain my limiting movement
-common in whiplash and low back pain
muscle soreness - def
result of unaccustomed or repetitive activity participation
-older athletes are more susceptible
what are the two types of muscle soreness?
1) acute onset: accompanies fatigue; immediate and transient
2) delayed onset (DOMS): most intense 24-48 hours after activity
- appears 12 hours after activity, can last for 3-4 days
- S&S: pain leading to increased muscle tension, swelling, and stiffness/resistance to stretching
what are the causes of DOMS?
- very small tears in the muscle tissue, due to eccentric isometric contractions
- disruption of the connective tissue surrounding muscle.tendon fibers
how can we prevent DOMS?
- properly planned training program (periodization)
- proper warm up/cool down
how can we treat DOMS?
-massage, cryotherapy, stretching and active recovery
tendinopathy - def.
any pathology in a tendon
tendinitis - def
inflammation of a tendon
tendinosis - def
tendon degeneration without inflammation
tenosynovitis - def
inflammation of the synovial sheath of a tendon
what are the three stages of tendon pathology
1) reactive tendinopathy
- non inflammatory response to tendon cells and matrix proteins; proliferation of tendon cells to get short term thickening to reduce stress
2) tendon dys-repair
- matrix breakdown; tendon cells that are present in larger numbers and changed appearance; protein production increases (collagen and matrix); collagen separates and matrix become disorganized
3) degenerative tendinopathy
- tendon cells and matrix continue to change (cell death); matrix becomes more disorganized; collagen is weak (type 3) and decreased
tendinitis - etiology and S and S
etiology: with repeated movements, a tendon becomes irritated or inflamed from sliding over other structures
S&S: pain on movement, swelling, warmth, and crepitus
what are the common injury sites of tendinitis?
achilles tendon in runners, shoulder in swimmers, and elbow in racquet sports
how can we treat tendinitis?
REST
- allow the normal healing process (inflammatory phase) to occur
- perform cross-training activities
-swimming takes stress off tendons, don’t need to be completely sedentary
tendinosis - etiology and S&S
etiology: when repetitive overuse movement continues and the inflamed tendon fails to heal
S&S:
- pain after exercise, or more frequently, the following morning
- pain-free at rest and becomes more painful with activity
- pain disappears when warm up, but returns after cool down
- in early stages, can still full train (although it interferes with healing)
- local tenderness and or thickening on examination
- swelling and possibly crepitus (crepitus more typical of tendinitis)
tendinosis: treatment
1) strengthening
- progressive loading
- isometric - eccentric - plyometric
2) stretching
- static, dynamic of PNF (proprioceptive neuromuscular facilitation) depending on the individual and activity participation
tenosynovitis: etiology and treatment
etiology: tendons that have a tight space through which they move are surrounded by a synovial sheath
- hand and wrists, feet and ankles, proximal biceps tendon
- repetitive movements cause inflammation when tendon rubs over the bony prominence
treatment: similar to tendinitis (rest)
- anti-inflammatory drugs
osteoarthritis - def
degeneration of the articular (hyaline) cartilage
-most common in weight bearing joints (knees, hips, and lumbar spine)
what are the causes of osteoarthritis?
wear and tear from normal ADLs (common in older individuals)
-mechanical changes to the joint due to acute or chronic trauma
