Identify Pain Patterns Flashcards
1
Q
Muscle strain
A
- active shortening: Generally painful if load is sufficient. May not be painful if there is not enough load on the muscle tendon unit.
- Active lengthening: usually most painful at the end range of muscle lengthening. May be painful throughout active lengthening if eccentric load on the muscle is sufficient.
- passive shortening: Rarely produces pain because load is removed from affected tissues.
- passive lengthening: Pain likely at or near the end range where the muscle is being stretched and there is tensile load on the strain site
- manual resistance: Very likely to reproduce pain from load applied to the strained fibers.
2
Q
Muscle Hypertonicity/ Trigger Points
A
- Active Shortening: Frequently not painful, but may be depending on which muscle and the amount of load. The greater the load, the greater chance of pain.
- active lengthening: Frequently not painful, but may be depending on which muscle and the amount of load. The greater the load, the greater chance of pain. Pain is more likley near the end range.
- passive shortening: Rarely produces pain because load is removed from affected tissues.
- passive lengthening: Pain likely during lengthening and especially approaching end range where the muscle is being stretched.
- manual resistance: May be painful if hypertonicity or trigger points are significant. Certain small postural muscles like cervial muscles are more prone to pain during manual resistance.
3
Q
Contusion
A
- Active shortening: May be painful if load is sufficient. Not unusual for pain to be absent with active shortening if the muscle isn’t under sufficient load.
- active lengthening: May be painful if load is sufficient. If painful, pain likely to increase near end range.
- passive shortening: Rarely produces pain because load is removed from affected tissues.
- passive lengthening: Pain likely during lengthening and especially approaching end range where the muscle is being stretched.
- manual resistante: Pain likely during manual resistance. Localized exaggeration of pain at site of contusion.
4
Q
Tendinosis
A
- Active Shortening: Generally painful if load is sufficient. May not be painful if there is not enough load on the muscle tendon unit.
- Active Lengthening: Usually most painful at the end range of muscle/tendon elongation. May be painful throughout active lengthening if eccentric load on the muscle/tendon is sufficient.
- Passive Shortening: Rarely produces pain because load is removed from affected tissues.
- Passive Lengthening: Pain likely at or near the end range where the tendon is being stretched and tendon is under sufficient tensile load.
- Manual Resistance: Very likely to reproduce pain from load applied to the impaired tendon.
5
Q
Tenosynovitis
A
- Active Shortening: Generally painful if load is sufficient. May not be painful if there is not enough load on the muscle tendon unit. In some cases friction during movement may cause pain even with small load.
- Active Lengthening: Usually most painful at the end range of muscle lengthening. May be painful throughout active
lengthening if eccentric load on the muscle/tendon is sufficient or condition is more severe. - Passive Shortening: Rarely produces pain because load is removed from affected tissues. In more advanced cases compression or friction during movement may reproduce pain at some joint positions.
- Passive lengthening: Pain likely at or near the end range where the tendon is being stretched and sufficient tensile load is placed on the tendon. If severe, pain may be felt earlier in movement.
- Manual Resistance: Very likely to reproduce pain from load applied to the impaired tendon
6
Q
Nerve Compression/ Tension
A
- Active Shortening: Will likely reduce pain or neurological symptoms when nerve is slackened unless position or shortening motion increases compression or tension somewhere along nerve’s path.
- Active Lengthening: Pain or neurological symptoms likely to increase as nerve is pulled taut.
- Passive Shortening: Will likely reduce pain or neurological symptoms when nerve is slackened unless position or shortening motion increases compression or tension somewhere along nerve’s path.
- Passive Lengthening: Pain or neurological symptoms likely to increase as nerve is pulled taut.
- Manual Resistance: No change in symptoms likely during manual resistive test unless some muscle entrapping the nerve increases compression or tension on nerve during resistance.
7
Q
Capsular Tear or Capsular Adhesion
A
- Active Shortening: Unlikely to be painful when the capsular tissue is slackened.
- Active Lengthening: Pain likely to increase with any movement that lengthens capsular fibers.
- Passive Shortening: Unlikely to be painful when the capsular tissue is slackened.
- Passive lengthening: Pain likely to increase with any movement that lengthens capsular fibers.
- Manual Resistance: Pain unlikely during manual resistive test as long as there is no pain at the starting position of the test.
8
Q
Ligament Sprain
A
- Active movements: May produce pain if the active movement causes the injured portion of the ligament to move across any bony prominence or protrusion. Pain may also be felt during any active movement that puts tensile stress on the ligament
- Passive movement: May produce pain if the passive movement causes the injured portion of the ligament to move across any bony prominence or protrusion. Pain may also be felt during any passive movement that puts tensile stress on the ligament
- Manual resistante: Rarely produces pain because no motion is
occurring at the joint and the ligament is an inert tissue that is not stressed when there is no motion occurring.
9
Q
Joint Cartilage - osteoarthritis:
A
- Active Movements: May produce pain if there is a significant amount of cartilage degeneration.
Pain is more likely in any movements performed while there is also compression on the joint.
Cartilage degenration may occur in the absense of pain as well, so this finding is not definitive. - Passive Movements: May produce pain if there is a significant amount of cartilage degeneration. Pain is more likely in any movements performed while there is also compression on the joint. Cartilage degenration may occur in the absense of pain as well, so this finding is not definitive.
- Manual Resistance: Pain is unlikely during manual resistive tests there is no motion at the joint and no additional stres on the joint cartilage.
10
Q
Bursitis
A
- Active Movements: May produce pain if the joint movement produces additional compression or the bursa either directly or by some other tissue being pulled taut over the top of the bursa.
- Passive Movements: May produce pain if the joint movement produces additional compression on the bursa either directly or by some other tissue being pulled taut over the top of the bursa.
- Manual Resistance: Pain is unlikely during manual resistive tests as there is no motion at the joint and no additional stress on the bursa.
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