day nine: tendinopathies Flashcards
dequervain’s tenosynovitis
inflammation of tendonosis of the sheath of the tendons in the first extensor compartment
dequervain’s s/s
pain on the radial side of the thumb when pinching or grasping objects
what do you rule out first for the dequervains
CMC arthritis of the 1st MCP jt
how many extensor compartments
SIX
list the amount of tendons in each compartment:
2 2 1 2 1 1
dequervain’s frequently results form
repetitive motion
first dorsal extensor compartment is
abductor pollicus longus
extensor pollicus brevis
how do you diagnosis dequervain’s tenosynovitis
positive finkelstein’s test
what are four things to look for dequervain’s
positive finkelsteins’ test
pain along first dorsal compartment
decreased pinch and grip
a nodule or thickening of the extensor retinaculum
dequervain’s treatments include:
1 -4
conservative
splint
modalities
surgical
dequervain’s conservative
cryotherapy verses heat
thumb spica splint
pt education on activity modification
medical management
NSAIDS
Corticosteroid injection
surgical intervention
when should you initiate therapy post surgical theory dequervain’s tenosynovitis?
10 days post op
how many weeks after post surgery can you start strengthening exercises as well as fx use of the hand: DT
3-4 weeks
once suture removed you should start
scar mobilization initiated
intersection syndrome def:
tenosynovitis of second dorsa compartment where the first compartment crosses it in the radial dorsal 4 arm
APL EPB cross the
ECRL and ECRB
three tx for intersection syndrome:
thumb splint
pt education
surgical
acute tx of intersection syndrome
RICE
ice massage cold packs ultra sound iontophoresis cross friction massage ASTYM
chronic tx of tenonosis
HEAT
- different from acute
impingement can come from:
forward shoulder scapular dyskinesia tight pectoralis minor weak serratus anterior sleeping posture
what happens with shoulder impingement:
long head of the biceps gets inflamed from repetitive reaching or being “pinched”
supraspinatus can also be impinged by
the reduced subacromal space
cross friction massage:
technique that promotes optimal collagen healing by increasing circulation and decreaseing collage cross-linking, thus decreasing the formation of adhesions and scar tissue
cross friction massage produces
traumatic hyperemia and a histamine response to help flush the area of substance P
IASTM means
instrument assisted soft tissue mobilization
