Lecture 2 Flashcards
Strain
muscle and tendon
Sprain
ligament
Dislocation
complete loss of connection between 2 bones
Subluxation
partial dislocation. some continuity/connection
Tendinopathy
all problems related to tendons
Synovitis
inflammation of synovial fluid
Hemarthrosis
bleeding into tissues or joints
Bursitis
inflammation to bursa
Contusion
bruise/impact injury
Overuse syndrome
more than 1 event leading to injury
Grade 1
mild, no significant loss of continuity or stability
Grade 2
moderate pain, unable to continue activity, pain w/palpation & stress to tissue. significant number of fibers are torn.
ligament = increased joint mobility
Grade 3
severe pain, near complete or complete tear of tissue, stress to tissue is usually painless, may palpate defect
ligament = unstable
Stages of inflammation and repair
acute stage = inflammatory
subacute = repair/healing
chronic = maturation/remodeling
continued if not healed –> chronic inflammation & pain
Phase 1 Interventions
avoid excessive stretching
single-limb balance
grapevine
plank, 5x10s
side plank, 5x10s
bent knee bridge, 10x5s
low speed jogging
Phase 1 Hamstring lengthening
the diver, 3x6 reps every other day
the extender, 3x12, 2xday
Phase 2 Interventions
lateral shuffle
grapevine jog
rotating body bridge 5s on each side, 2x10 reps
supine bent knee bridge w/walk outs, 3x10
bridge on bench, single leg. 2x10
single limb balance windmills 4x8 reps
Phase 2 lengthening
the glider, 3 sets, 4 reps, 3x week
progression is increased by increasing distance
Phase 3 Interventions
skipping
rotating body bridge
sport-specific drills
forward-backward accelerations
Tissue Response Stage
Inflammation
Most apparent in 1st 48 hours
Lasting 4 to 6 days on average
cellular, vascular, chemical
Patient Response Acute Stage
Palpable pain/tenderness, swelling, heat, redness, pain at rest, loss of function
limitations in joint or muscle ROM = guarding
pain is before end range or even before actual movement
nerve endings are irritated due to altered chemical states
Goal of acute stage
protection
Goal of subacute stage
controlled motion
Goal of chronic stage
return to function
Acute stage plan of care
patient education
protection of the injured tissue
prevention of adverse effects due to immobility
decrease pain
Acute stage interventions
PROM (to remote muscles)
grade 1 joint mob
muscle setting
massage for edema
Precautions for Acute
signs of increasing inflammation after activity or intervention
Contraindications for Acute
stretching and resistance exercises should not be performed at the site of the inflamed or swollen tissue
Subacute stage, physiological response
14 to 21 days after onset of injury, can last 6-8 weeks
creation of new collagen, very easy to break
new capillary beds
pain = tissue resistance
Plan of care for sub acute
muscle relaxation
joint mob
stretching
using new range
sub max isometric
active range
endurance
Signs of excessive stress
soreness that doesn’t decrase after 4 hours, isn’t resolved in 24
pain that comes on earlier/increased
decreased ROM
swelling/red/warmth
weakness
decreased use
Chronic stage Tissue reponse
maturation and remodeling
21-60 days fibroblasts being remodeled
reduction of wound size
quality of collagen increases
remodeling of tissue
Plan of care chronic stage
education, stop hands on
progression
return to high demand
Non-modifiable risks of hamstrings
prior history
greater than 23
ACL, calf strains, other knee/ankle injuries
Modifiable risks for hamstrings injuries
hamstrings weakness
fatigue
strength and coordination deficits
What contributes to high rate of reinjury?
persistent weakness in injured muscle
reduced extensibility of musculotendon
adaptive changes in biomechanics or motor patterns
strength/control of lumbopelvic muscles
Nordic hamstrings
help to prevent hamstring tears. does not reduce the severity of the injury
1x per week, 2 sets 6 reps
Planes of movement
Early active mobilization in the frontal and transverse planes
progress to movements in sagittal plane
