L5 - Ortho OMM Evaluation And Tx Flashcards
Anything that damages the intra-articular structure probably damaged what?
The things that hold it together
Forces that cause injury usually induce what?
Somatic dysfunction
What is a dislocation?
Complete lack of contact between 2 articular surfaces
What is subluxation?
Residual contact between 2 articular surfaces
What is a sprain?
Damage to ligament
What is a strain?
Damage to tendon or muscle
What treatment should be provided during days 1-7 for a swollen joint?
Reduce pain and tissue congestion Ice packs 15 min, q2h, qid Provide ROM exercises Effleurage/petrissage OMT (reduce joint dysfunction without causing further injury)
How long is the inflammatory healing process?
8 weeks long
What treatment should be provided during the fiber deposition stage (weeks 1-4) of the inflammatory healing process?
Maintain joint alignment (low force techniques to prevent further injury or strain on new and still weak fibers)
Tension is the enemy of healing (reduce muscle and fascial tension through effleurage/petrissage, OMT)
Prevent atrophy through isometric strengthening
Neuro retraining (static proprioception)
What should be done during weeks 4-8 of the inflammatory healing process (contraction and alignment of fibers)?
Maintain soft tissue balance
Maintain joint alignment and positioning as ligaments and fascia tighten (HVLA may be safe by week 3)
Active strengthening
Advance the neuro retraining (dynamic proprioception)
What should be done post 8 weeks for re-evaluation of sufficient healing?
Test for palpable tissue deficits
Test for persistent laxity
Consider causes for slowed healing such as improper activity, re-injury, smoking, poor nutrition
Consider re-activation of the healing process: prolotherapy
Informed consent includes a discussion of what?
Risk (adequate to mention top 3-4 depending on their prevalence)
Benefit
Side effects
Alternatives (other traditional and manual techniques)
-no Tx, conservative Tx, interventions such as chiropractor, PT, massage therapy, acupuncture, surgery
Which conditions call for an ortho surgery consult?
Unstable fracture
Fx with significant decision or with likelihood of poor healing
Fx crossing the joint surface
Injuries with significant soft tissue damage
Comminuted fracture (bits and pieces)
What is the procedure for significant fractures and dislocations?
Splint and send to ortho within the next 0-2 days
Call immediately if there is any sign of vascular or neurologic compromise
What types of fractures or injuries should be put in a cast, splint, tape (that we can do ourselves)?
Fx that are likely to heal well, that do not require casting
Fx with minimal deviation that are not likely to worsen
Soft tissue injures that result in mild to moderate regional laxity such as grade II sprain
Stress fracture
Always consider post injury PT
