lecture 2: treatment goals and managements of soft tissue lesions Flashcards
what type of scar is raised , but within bound of injured region
Hypertrophic scar
what type of scar extends beyond the boundary of the injured site
keloid scar
what is collagen syntheses dependent on
O2
what can chronic inflammation occur due to
repeated stress and immune response
in the chronic inflammation there is increased production of what type of immature collagen
3
soft tissue techniques minimize what
edema, pian and ROm restriction
what is considered the best modality
exercise
what should the pateint education be for the acute stage
the expected duration of symptoms (4-6 days) and precautions or contraindications
what modalities is used to limit bleeding , reduce swelling and pain , it produces vasoconstriction and blocks pain and is combined with compression in the first 24- 48 hours
cryotherapy
what modalities reduce swelling and pain and blocks pain and alters cellular permeability
electrical stimulation
what is the purpose of massage in the acute stage
to move fluid and prevent adhesions
what do Grade I or II distraction and glide techniques do in the acute stage
improve fluid dynamics in the joint to maintain cartilage health
what direction and technique should you do joint mobs in
passive gliding or traction movements applied at the joint surface and oscillation technique
what exercise interventions are contraindicated in the acute stage
active movement and stretching
how should the mm be during exercise for the acute stage
low intensity , isometric mm contraction within limit of pain , place mm in th shortened position
what phase is the control motion phase
the subacute phase
what is the clinical signs for the subacute phase
decreasing inflammation and pain synchronous with tissue resistance
what are the 3 pt goals and interventions for teh subacute phase
promote tissue healing
develop mobile scar
promote function
what is the progression of ROM in the subacute phase to restore soft tissue , muscle and joint mobility healing
progress from PROM > AAROM> AROM within limit of pain
in what stage do you progress from multiple angle isometric exercise to isotonics within patient’s tolerance
subacute stage
how does th modalities change in the subacute stage
changes from cold to heat to increase circulation , promote healing , reduce pain and increase tissue extensibility
what is used as a precautionary indicator for changing from cold to heat in teh subacute phase
increased swelling
what massage technique do u use int he subacute stage
trigger point , friction and myofascial release
what massage type do u use to mobilize ligaments, incision sites, and muscle scar tissue or tendon adhesions
cross friction
what joint mob grade do you use in subacute
grade 3 sustained or 3 and 4 oscillation
what type of exercises can u do in the subacute stage
multiple angle , sub max isometric exercises in shortened or relaxed position
what kind fo ROM can you do in the subacute phase
active movement (AROM) in pain free range to develop control of th emotion
what kind of muscle endurance exercise do u use in the subacute phase
low intensity , high repetition AROM exercise
what is the initiation and progression of stretching in subacute stage
warm the tissue
mm relaxation technique
stretching technique
use of new range
exercise or activity soreness that does not decreased after ___ hours and is not resolved after __ hours is a sign of excessive stress
4
24
which stage is the return to function phase and is aimed to promote remodeling
return to function phase
what are the clinical signs for retunr to function phase
absence of inflammation
pain after tissue resistance
what are the PT goals and intervention during the chronic stage
increase tensile quality of scare
develop functional independence
what are the 7 basic movements patterns
squat
lunge
push
pull
bend
twist
gait
in which stage do you provide ways to avoid re injury and safe body mechanics to the pateint
chronic stage
what type of resistance are u dong in the chronic stage
submax to maximal
what are the 2 modalities to control symptoms in the chronic stage
deep head and electrical stimulation
what type of massage are u doing in the chronic stage
myofascial massage
what grade of joint mobz are u doing in the chronic stage
Grade III sustained or III and IV oscillation
what are most modalities we use for
to impact the inflammatory response
what is the purpose of heat modality
• Increase metabolic rate
• Increase circulation
• Modulate pain
• Reduce muscle spasm
what is the purpose of cold modality
• Decrease metabolic rate
• Decrease edema production
• Modulate pain
• Reduce muscle spasm
what is the purpose of electrical stimulation modalitiy
• Modulate pain
• Increase muscle
contractions
• Muscle re-education
• Improve tissue environment
• Increase metabolism
• Increase circulation
• Increase cell wall permeability
• Soften collagen
• Selectively heat tissues
what modality does these things
ultrasound
• Increase muscle activation
• Decrease circulation
• Increase muscle
hypertrophy
• Increase muscle cross section area
what modality does this
blood flow restriction
SOFT TISSUE TECHNIQUES HELP TO TREAT MOTION RESTRICTIONS BY…
• Increasing soft tissue extensibility and compliance
• Minimizing adhesions
• Between tissue layers
• Increasing circulation
• Modulating pain
• Reducing edema
• Facilitating inhibited muscles
• Increasing soft tissue extensibility and compliance
• Controlling Inflammation
• Minimizing adhesions
• Modulating pain
• Reduced muscle guarding
• Facilitating motion of involved
tissue
• Reducing tone
• Facilitating inhibited muscles
• Reducing edema
these things are done by what to help treat motion restrictions
physcial agents
• Increasing soft tissue extensibility
• Joint capsule
• Muscle-tendon units
• Controlling inflammation
• Reducing edema/effusion
• Reducing adhesions
• Modulating pain
• Facilitating motion
• Increasing strength
• Reducing pathologic increased
muscle tone
• Raising pathologically low muscle tone
what helps to treat motion restrictions by doing these things
therapeutic exercise
