Fibrocartilage Tear Flashcards
What is a type of cartilage found in the body that is characterized by its dense fibrous structure?
Fibrocartilage
What is the damage of the fibrocartilaginous structure within a joint?
Fibrocartilage Tear
Where are the common tears?
- Knee
- Shoulder
- Hip Labrum
- Wrist
Knee : Medial meniscus MOI
- More vulnerable due to intimate attachment to medial collateral ligament
- Twisting, landing
- Frequently seen in conjunction with ACL and MCL tears
What structures are presented in Terrible Triad Injury?
ACL, MCL and Medial Meniscus
Knee : Lateral Meniscus MOI
- Moveable and therefore less prone to tear except when the ACL is injured
- Twisting while the foot is weight bearing and anchored to the ground
Shoulder : SLAP Lesion MOI
- Shoulder labrum tear in upper part of labrum due to traumatic or degenerative causes
- Trauma
- FOOSH, traction or combined
- Attritional : “Peel back” of long heads of biceps
- Degenerative : Overhead laboueres, overhead sports, or secondary to normal “wear and tear”
Shoulder : Bankart Lesion MOI
- Shoulder labrum tear from anterior dislocation or repeated subluxation in lower part of labrum
- Common in overhead activities
Hip Labrum Tear
Can result for degeneration, trauma, capsular laxity or dysplasia or femoroacetabular impingement
TFCC Injury
Wrist tear due to degeneration or traumatic ulnar deviation
What is triangular fibrocartilaginous complex?
Injury to joint between ulna and carpal bones distal to it
MOI :
- Degeneration
- Traumatic : compressive load during marked ulnar deviation
What are the signs & symptoms of acute?
- Inflammation
- Loss of function d/t swelling, protective spasm + pain, possible hemarthrosis, heat, redness
- Bruising is red, black and blue
- Crutches, sling
- MM, blood vessel, nerve damage possible in grade 2 & 3
- Joint may give way
What are the signs & symptoms in early subacute?
- Inflammation decreases
- Swelling decreases, protective spasm are still present
- Bruising is black and blue
- Crutches / sling
- ROM is limited
- Adhesions are starting to form
- TPs, local & compensatory
- Reduced proprioception
What are the signs & symptoms in late subacute?
- Inflammation further decreased
2 Edema decreased & gel like - Protective spasms, replaced by ADH & FR
- Bruising is yellow, green, brown
- Crutches, sling
- ROM increases
- Adhesions are maturing
- TPs, local & compensatory
- Reduced proprioception
What are the signs & symptoms in chronic?
- Inflammation is gone, tissue may be cool d/t adhesions & FRs
- Edema barely noticeable
- Bruising gone
- Point tenderness is local to injury site
- ROM is mild limitation in direction of injury, strength reduced, crepitus
- Adhesions are matured & local to ligament
- TPs local & compensatory
- Reduced proprioception at joint
What are CI’s & precautions?
- No special tests in acute
- Do not force extension or flexion of a locked knee
- In acute with effusion, no massage
- No frictions with anti inflammatories or blood tinners
What are assessment findings in acute?
- Antalgic gait if injury is in a weight bearing joint & more severe injury causes inability to bear weight
- Antalgic posture
- Possible pained facial expression
- AROM limited due to pain & effusion - especially flexion & extension with knee meniscus tear
- PROM springy block end feel
- RROM strong & pain free
What are assessment findings in subacute / post acute & chronic?
- Habituated antalgic gait & posture may be observed
- AROM may be limited due to pain, less so than in acute
- Extension with meniscus tear - PROM limited where joint locking is present, springy block end feel
- RROM reduced strength if disuse atrophy is present
- Positive meniscus, labrum or TFCC test
- Potential impact on ADLs
What are massage goals?
Acute :
1. Reduce inflammation
2. Prevent excess adhesion formation
3. Maintain function & mobility
4. Gradual return to movement with pain tolerance to avoid excess scar tissue
Subacute :
1. Reduce risk of reinjury via proprioceptive / balance training
2. Restore stability via strengthening of muscles that cross the joint
Chronic :
1. Normalize joint integrity & mobilty
2. Normalize muscle tone
3. Reduce TPs & adhesions
What are massage techniques?
- Edema reduce via elevation, cold application, lymphatic drainage
- Kneading, stripping
- O+I, GTO
- MET/PNF
- Px Free ROM / Frictions
What are homecare exercises?
Acute :
- RICE or PRICES
- Px free ROM
- Breathing exercises
Chronic :
- Stretching
- Strengthening
- Self massage
- Proprioceptive exercises
