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Chapter 9 Joints > Details of a Sprain > Flashcards

Details of a Sprain Flashcards

1
Q

What is a sprain of a Joint?

A

It is a over stretched ligament.

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2
Q

What is a Ligament?

A

It is a flexible connective tissue that is non-contractile.
It surrounds a joint and blends into the periosteum.
Holds bones together and limits ROM.

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3
Q

What can cause a Sprain?

A

Trauma - like wrenching or twisting the joint beyond the normal ROM.

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4
Q

What are factors that can making Spraining your joints easier?

A

Weakened muscles, Hyper-mobility of the joints and Altered biomechanics.
Also having a sprain previously can make it easier.

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5
Q

What are the Classifications of Sprains?

A

There is grades 1-2-3

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6
Q

What does Grade 1 Sprain mean?

A

Mild primary, minor stretch or tear, No stability on PR (passive relaxed)

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7
Q

What does Grade 2 Sprain mean?

A

Moderate secondary, Moderate stretch or tears of the fibres.
Snapping noise/ Joint gives way.
Hypermobile but stable on PR.
Decreased ALD (Active daily life).

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8
Q

What does Grade 3 Sprain mean?

A

Sever, Complete Tear, Snapping noise and gives way, Instability with no end point on PR.
No ADL due to the pain and instability.

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9
Q

How long can it take for the full stability to return to the joint after a Sprain?

A

ligaments have little blood supply so this can take up to 6 months.

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10
Q

What are common sites for sprains?

A

Ankle, Wrist, knee, elbow and Shoulder.

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11
Q

What are symptoms of an Acute grade 1 Sprain?

A

Mild Prish, Joint is Stable, Slight to no Bruising.

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12
Q

What are symptoms of an Acute Grade 2 Sprain?

A

Tearing of Fibres, Joint gives way/ Snapping, Moderate Prish (Worsened with activities that stress the ligaments), Hypermobile but stable, Bruising.

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13
Q

What are the symptoms of a Acute Grade 3 Sprain?

A

Complete Rupture of the Ligament, Snapping/Joint gives way, Sever Prish, Instability and client has to stop ADL.

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14
Q

What is true for all grade 2-3 Sprains?

A

Protective muscle spasming, Decreased ROM (AF), Possible vascular or nerve complications with Grade 2-3.

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15
Q

What usually gets torn at the ankle when you get a sprain?

A

1st Anterior Tibiofibular Ligament and Second Calcaneo Fibular ligament.
(These both only occur during Inversion)

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16
Q

What are symptoms of Sub acute Sprains?

A

o Bruising

o PRISH decreasing Grade 1: Stable

Grade 2: Stable but hypermobile Grade 3: Unstable and hypermobile

o Adhesions (in grade 2 and 3 especially)

o Trigger points and hypertension

o Decreased AF ROM

o Splints/casts/taping

o Loss of proprioception

17
Q

What are symptoms of a Chronic Sprain?

A

o Local pain if stretched

o Bruising minimal or gone

o Adhesions, scar tissue, trigger points and hypertension

o Decreased AF ROM

o Possible chronic edema

o Coolness due to ischemia

o Loss of proprioception

o If surgery, up to 10 weeks after the joint may be immobilized

o Unstable (grade 3)

o Weakness/atrophy

o Taping/splints/crutches

18
Q

What usually gets torn at the Elbow when you get a sprain?

A

These occur with a fracture.

19
Q

What usually gets torn at the Shoulder when you get a sprain?

A

Acromial Clavicular ligament (occurs with Separation).

A/C joint Ligament.

20
Q

What usually gets torn at the Shoulder when you get a sprain?

A

Acromial Clavicular ligament (occurs with Separation).

A/C joint Ligament.

21
Q

During an Assessment What can you observe in an Acute Sprain?

A

Redness

● Swelling

● Bruising

● Antalgic gait/posture

● Facial expression of pain

● Taping/splints SUBACUTE

● Bruise-yellow/green/brown

● Antalgic gait

● Supports

● Residual edema

● Scars is surgery CHRONIC

● Habituated gait/posture

● Taping/splints/crutches

● Residual edema

● Minimal bruising

● Scars

22
Q

During an Assessment What can you observe in an Acute Sprain?

A

Redness

● Swelling

● Bruising

● Antalgic gait/posture

● Facial expression of pain

● Taping/splints SUBACUTE

● Bruise-yellow/green/brown

● Antalgic gait

● Supports

● Residual edema

● Scars is surgery CHRONIC

● Habituated gait/posture

● Taping/splints/crutches

● Residual edema

● Minimal bruising

● Scars

23
Q

When Palpating an Acute Sprain what can you feel?

A

Heat

● Swelling (firm)

● Protective muscle spasming

● Pain on palpation

24
Q

When Palpating a Sub acute sprain what can you find?

A

Warmth

● Pain on palpation

● Boggy swelling

● Adhesions/trigger points CHRONIC

● Coolness

● Pain on palpation

● Residual edema

● Adhesions/ trigger points/hypertension

● Disuse atrophy

25
Q

When doing test on a client with An Acute Sprain what must you do?

A

You must work proximally to the injury.
The affected joint will have decreased ROM.
(the higher the grade of the Sprain the lower the ROM of the joint)

26
Q

How would you perform a special test on a client with an acute sprain?

A

They are all CI’d besides (Joint effusion of the knee).

27
Q

What is testing a client’s ROM like in the Sub acute stage?

A

● Proximally/affected/distally

● AF is decreased by pain but less than in the acute stage

PR

● Proximally/affected/distally

● ROM that stresses joint is tested last. May see empty end feel

AR

● If strictly ligamentous-no pain

● If muscle injury as well-pain and weakness

28
Q

What are Special test you could do on the Knee after a sprain?

A

● Valgus/varus stress

● Apley’s distraction

● Ballottable patella

● Brush test

● Anterior and poster drawer test

● Lachman’s

● McMurray’s

● Bragards Sign

● Apley’s compression

29
Q

What are some test you could on the A/C joint after a Sprain?

A

A/C Shear test.

30
Q

What are some test you could do on the SI joint after a sprain?

A

SI joint gapping

● SI joint squish test

● Galenslen’s

31
Q

What are some test you could do on the wrist after a Sprain?

A

Radial stress/ulnar stress

● PR wrist extension/flexion

32
Q

What does treatment to a client with an Acute sprain involve?

A

Rice

● MLD

● Comp. structure – GSM

● Mid range PR ROM proximally (not it muscle crosses affected joint)

33
Q

What are CI’s for treating a client with an Acute Sprain?

A

Testing other than AF

● Removal of muscle spasm

● Distal work past injury site

● Heat SUBACUTE and CHRONIC

● Heat if casted

● Overstretching hypermobile or repaired lig

● Joint play if unstable

● Frictions if on anti-inflammatories

***Screws/pins/plates: no hydro or deep work/frictioning

34
Q

What would treatment to a client with A sub acute sprain involve?

A

Contrast hydro

● Cool if edema

● Comp. structures – GSM

● GTO’s , O and I’s

● Onsite – start with vibrations/shaving/gentle petrissage 🡪 increases as client can

tolerate pain/pleasure

● Mid range PR ROM

● Distally muscle squeezing and stroking 🡪 increase pressure and techniques

● Gentle frictioning 🡪 use joint play to stretch ligament

● Strengthening

35
Q

What would treatment to a client with a chronic Sprain involve?

A

DMH (deep moist heat)

● Deep techniques

● Frictioning (careful surgeries and pins)

● Tx Compensatory structures

● TP’s

● JT play

● PR ROM

● Strengthening

36
Q

What is homecare you can give a client that has an Acute sprain?

A

RICE

37
Q

What is some homecare you can give to a client with A Sub acute Sprain?

A

Contrast hydro

● Strengthening CHRONIC

● DMH

● Strengthening

Chapter 9 Joints (20 decks)

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