E3 - Shoulder Complex 3 -5 Flashcards
how do you treat tendinitis and tendinosis
pt education - load management
POLICED
how can NSAIDS affect healing of tendinitis and tendinosis
shout term pain relief if acute
delays healing if injury at insertion
poor response and no support in persistent presentation
why do NSAIDS not aid in healing during a persistent condition
tendon is structurally changing
the issue is not inflammation
how does bracing/taping/straps aid in treatment of tendinitis and tendinosis
decreases resistance arm
decreases stress on tendon
what is the soreness rule with ADLs and exercise
activities as long as the quality of movement is good and no symptoms during/after 24 hours
keep with the activity to give tendon load to maintain tendon response
what are the primary purposes of MET with tendinosis
tendon proliferation
what are the primary parameters of MET with tendinosis
implement after any acuity settles
heavy loads
slower eccentrics/3 sec muscle actions
what is the general rx of MET for tendinosis
2-3 sets of 10-15 reps to fatigue
2-3 exercises with involved tendon
8-12 weeks
what is the expected activity response of MET with tendinosis
mild-moderate increase in pain (5/10)
pain should ease to baseline levels before repeating exercises (24-48 hours)
my soreness rule
what are some complications that could delay healing in tendinosis
predisposition/prevalence of “failed healing response”
obesity
diabites
low grade inflammation
how does obesity affect tendinosis healing
excessive fat absorbes inflammaoryt cells away from tendon
how does diabetes affect tendinosis healing
excessive glucose impairs collagen production/remodeling
how does low grade inflammation affect healing with tendinosis
associated with systemic disease/poor diet
persistent inflammation limits proliferation/remodeling
what are MD rx’s for patients with tendinopathy
what is the rare intervention
cortisone injections for short-term benefits
glycerin trinitrate patches to increase circulation
surgical debridement
sclerosing injections - stiffens tendon for pain relief
t/f
MET is just/more beneficial than surgical debridement
true
what is surgical debridement and how is it intended to aid in tendon healing
surgeon scrapes tendon which increases blood flow leading to inflammatory response
how does scapular taping aid in impingement syndrome
improved short term pain
may provide an earlier “window” for MET and limit ADL provocation
no difference at 6 weeks
are modalities beneficial for patients with impingment syndrome
mostly not beneficial
are JM recommended for impingment syndrome
strong recommendation
GH joint
aids in regional interdependence
how does joint mobilities aid in the thoracic spine
accelerated recovery and reduced pain and disability immediately when compared to usual care
t/f
JMs added to exercise are more effective than exercise alone
true
is high-dose MET more beneficial than conventional low-dose exercise
what is low-dose exercise
yes
4-5 exercises for 3x10 reps
what time frame is MET beneficial for tendinosis
> 6 months of symptoms
what muscles in the shoulder are targeted with MET with tendinosis
cuff (SITS)
scapular exercises (MT/LT/Rhom/SA)