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KNES 372 > lec 7 - muscle and tendon injury > Flashcards

lec 7 - muscle and tendon injury Flashcards

1
Q

what is a tendon

A

collagen tissue that connects muscle to bone
- transfer force from muscles into skeletal system

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2
Q

what is the enthesis

A

junction between a tendon and bone
- consists of fibrocartilage

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3
Q

what is an umbrella term for injuries affecting the enthesis

A

enthesopathy

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4
Q

what is the myotendinous junction

A

connection between tendon and muscle (where most muscle injuries occur)

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5
Q

where is the weakest part of the muscle-tendon complex

A

myotendinous junction

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6
Q

what does an event leading to 4% change in tendon lead to

A

plastic changes in the tendon leading to eventual injury/rupture

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7
Q

what is the tendon’s adaptation to training

A

increase in CSA

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8
Q

what is the ideal loading for tendons and what occurs in the tendon

A

loading every 2-3 days - protein synthesis stays elevated during this time
adapt to lower loads than muscle - higher collagen production with less load

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9
Q

what causes acute tendon injuries

A

direct trauma
rupture - force through tendon is exceeding what it can handle

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10
Q

are acute tendon injuries more likley to be caused by concentric or eccentric forces

A

eccentric - muscle forces can be higher in this phase of mvmt

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11
Q

what is the umbrella term for tendon problems

A

tendinopathy

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12
Q

what are 4 ways to manage tendinopathy

A

education
load monitoring
pain monitoring
exercise based progressive rehab program

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13
Q

how does pain monitoring work for tendinopathy

A

used to identify load volume adn load types that trigger the pain
- expect to have pain during rehab but look for progress
- need to load to retain healthy tissue

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14
Q

how is pain used in exercise based progressive rehab program

A

used as a marker to move up stages
- increased pain = too much at that stage

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15
Q

what are the 4 stages of exercise based progressive rehab program

A
  1. isometric exercises
  2. isotonic and heavy slow resistance exercises
  3. increases in speed and energy storage exercises
  4. energy storage and release and sport specific exercises
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16
Q

what are isometric exercises and what are the benefits

A

contraction without mvmt
- analgesic for tendinopathies
- good part of NMT warmup

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17
Q

what are the benefits of isotonic and heavy slow resistance exercises

A

improve muscle strength and tendon stiffness

18
Q

what are the benefits of speed and energy storage exercises

A

improve eccentric mvmt and deceleration phase

19
Q

what are possible mechanisms for tendinopathies

A
  • repetitive tensile or compressive loading = repetitive microtraumas
  • inadequate recovery between loadings
    high loads are NOT the problem
  • progression and periodisation are the most important
20
Q

what is the progression of tendinopathy symptoms

A
  1. pain after exercise
  2. pain at the start of an activity (don’t feel as much pain after warmup)
  3. pain both during and aftrer exercise
21
Q

what are the 3 stages in the cook purdam model for tendon pathology

A
  1. reactive tendinopathy
  2. tendon disrepair
  3. degenerative tendinopathy
22
Q

what is stage 1 - reactive tendinopathy

A

non inflammatory, structural changes, and thickening of stressed tendon area

23
Q

what is stage 2 - tendon disrepair

A

worsening tendon pathology
tendon structure becomes disorganised (more structural changes than stage 1)

24
Q

what is stage 3 - degenerative tendinopathy

A

chronic end stage of tendon injury
very hard / impossibel to be normal tissue again

25
Q

is acute rupture of a normal and healthy tendon common or rare

A

rare - only really occurs in athletes adn rec exercisers aged 30-50

26
Q

where does tendon rupture occur

A

most common = mid tendon area
also at the bone tendon junction

27
Q

what is the mechanism for achilles tendon rupture

A

strong contracture of the lower leg musculature with simultaneous extension
- eccentric loading of the tendon (deceleration)

28
Q

what is unique in the diagnosis for achilles tendon repair

A

reduced power in plantar flexion, gap in the tendon tissue

29
Q

why is an achilles repair casted with a heel lift

A

to let the tendon heal in the shortest position to maintain elasticity

30
Q

what are the main prevention strategies for tendon rupture

A

NMT
appropriate loading (S&C) and load management

31
Q

what is the function of muscle

A

generate power

32
Q

what does muscle force do in concentric action

A

max muscle force decreases as speed of contraction increases

33
Q

what does muscle force do in eccentric contraction

A

muscle force increases with increased speed of contraction
- higher risk of muscle injuries

34
Q

what are the 2 factors in muscles rapid adaptation to training

A

neural factors (1st) - increase the ability to recruit several muscle fibres at the same time
muscular factors (2nd) - muscle fibres increase their CSA (hypertrophy)

35
Q

where do muscle strains usually occur

A

close to MTJ (proximal or distal)
- hamstrings, quads, gastroc

36
Q

what are the symptoms of muscle strain

A
  • pain on active contraction and passive stretch
  • reduced contraction strength
  • decreaed ROM and loss of function
37
Q

what is the grading system for muscle strains

A

grade 1 (mild) - few fibre injury, minimal loss of strength and function
grade 2 (mod) - tissue damage, decreased ability to contract and decreased ROM
grade 3 (severe) - complete tear and loss of muscle function

38
Q

what are the two types of hamstring rupture

A

type 1 - sprinting related (biceps femoris)
type 2 - stretching related (semimembranosus)

39
Q

what are the stages of muscle injury healing and how do they relate to general injury healing phases

A
  1. destructive phase (hemostasis and inflammation)
  2. repair phase (proliferation)
  3. maturation phase (remodelling)
40
Q

how to prevent hamstring strains

A

eccentric training is way more beneficial than concentric
- loading is so important
- no evidence that stretching helps (doesn’t decrease risk)

KNES 372 (24 decks)

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