KCP: Soft Tissue Injuries Flashcards
The following are common example of what?
2. Tennis elbow
2. Golfer’s elbow
3. Achilles tendinopathy
Tendon injuries
A shoulder rotator cuff tear is a common example of which group if injuries?
Musculotendinous tears
An ankle sprain is an example of which group of injuries?
Ligament injury
What is tennis elbow?
It is a tendon injury affecting the tendon which attaches the extensor carpi radialis brevis to the lateral epicondyle caused by overuse of this muscle.
Commonly asscociated with tennis and repetitive manual work
Three muscles other than the extensor carpi radialis brevis that can be affected by tennis elbow?
- Extensor carpi ulnaris
- Extensor digitorum
- Extensor carpi radialis longus
- Supernator
Tennis elbow is also known as what?
Lateral epicondylitis
This can be a good way to remember the muscle groups that attach to the
4 examination methods for tennis elbow
- Tenderness at the lateral epicondyle when pressed with the elbow flexed at 90°
- Pain when wrist extension is resisted with an extended elbow
- Pain when supination is resisted
- Pain during a passive wrist stretch, known as Mill’s test
Tennis elbow treatment
- Paracetamol or NSAIDs
- Ice
- Strengthening exercises
What are rotator cuff tears?
Generally consists injured tendons around the rotator cuff
Can be split into two types:
- Chronic degenerative tears
- Acute traumatic tears
Presentationof rotator cuff tear
- Primarily weakness of the shoulder
- Secondarily pain
Rotator cuff muscles?
- Subscapularis
- Infraspinatus
- Teres minor
- Supraspinatus
Examination for supraspinatus tear?
Resited shoulder abduction with thumbs down to defunct deltoid
Known as Jobe’s test
Examination for teres minor and subspinatus tear?
Resisted external rotation
Examination for subscapularis tear
Resisted internal rotation
Investigations for rotator cuff tear?
- X-ray - shoulder trauma series to exclude fracture or dislocation
- Ultrasound or MRI - confirms cuff tear and it’s dimensions
Management of acute shoulder cuff tear in younger people <50
Surgical repair
Managment of acute shoulder cuff tear in older patients >50
- Ice
- NSAIDs
- Exercises
Management of chronic shoulder cuff tear
- Ice
- Exercises
- NSAIDs
- Corticosteroid injection
Activity associations with an achilles tendon rupture?
- Sudden unexpected dorsi-flexion
- Strong plantar-flexion with simultaneous knee extension and calf contraction
- Sudden pain and a pop
Diagnosis of achilles tendon rupture?
- No/ reduced plantar-flexion (thompson test)
- Pain and bruising around heel
- Ultrasound can confirm
Management of ruptured achilees tendon
Short term:
* Ice
* Rest/Imobilization
* Moonboot / air cast with slight plantar-flexion
* Analgesia
Long term:
* Surgery
* Functional rehabilitation
Ligaments often affected by an ankle sprain
Lateral ligament complex
Signs of ankle sprain pain
- Unable to weight bare
- Tenderness on posterior malleolus
