Lecture 3: Ligaments and Muscle

Question 1

Ligaments are

Answer 1

fibrous bands of dense connective tissue

Question 2

Ligaments resist what type of load

Answer 2

ideal arrangement to resist tensile load

Question 3

Ligament function

Answer 3

checks motion

proprioception

Question 4

Grade 1 ligament sprain
Definition
ROM
Pain on stretch
Weakness

Answer 4

Few fibers torn, but integrity intact / stable joint

Dec

Yes

Minor

Question 5

Grade 2 ligament sprain
Definition
ROM
Pain on stretch
Weakness

Answer 5

Half of fibers torn (partially), laxity evident

Dec

Yes

Minor to Moderate weakness

Question 6

Grade 3 ligament sprain
Definition
ROM
Pain on stretch
Weakness

Answer 6

Complete tear

Depends on edema

No

Minor to Moderate weakness

Question 7

Do ligament tears have pain with isometric contraction? if so which grade/s

Answer 7

No

Question 8

What are the 4 phases of ligament and tendon healing

Answer 8

Hemorrhagic
Inflammatory
Proliferation
Remodeling/Maturation

Question 9

How long does it take for some tensile strength come back to the ligament after injury

Answer 9

5th week

Question 10

How long does it take for 50% of normal tensile strength come back to the ligament after injury

Answer 10

6 months

Question 11

How long does it take for 80% of normal tensile strength come back to the ligament after injury

Answer 11

1 year

Question 12

How long does it take for 100% of normal tensile strength come back to the ligament after injury

Answer 12

1 to 3 years

Question 13

*Should you apply force to a healing ligament and why?

Answer 13

Forces applied to the ligament during its recovery help it to develop strength in the direction that the force is applied

Question 14

3 phases of muscle injury

Answer 14

• Destruction phase
• repair phase
• remodeling phase

Question 15

Muscle Strain grade 1

Definition

Answer 15

• Mild
• No gross disruption of muscle/tendon unit
• Localized swelling and tenderness

Question 16

Muscle Strain grade 1
# fibers
ROM
Pain on stretch 
Weakness
Pain w/ isometrics

Answer 16

Few 
Dec.
Yes
Minor
Minor

Question 17

Muscle Strain grade 2

Definition

Answer 17

• Moderate
• some disruption of the muscle /tendon unit
• limitation in ROM in adjacent joints

Question 18

Muscle Strain grade 2
# of fibers
ROM
Pain on stretch 
Weakness
Pain w/ isometrics

Answer 18

Half of ms fibers
Dec.
Yes
Minor to major
Mod to major

Question 19

Muscle Strain grade 3

Definition

Answer 19

• severe
• one or more components of muscle - tendon unit are completely disrupted
• Other joint ROM severely restricted
• site of disruption is commonly visable

Question 20

Muscle Strain grade 3
# of fibers
ROM
Pain on stretch 
Weakness
Pain w/ isometrics

Answer 20

All ms fibers are torn 
Depends on Edema
No
Mod to major weakness
No to minor

Question 21

Muscle strain pain regarding MMT and PROM

Answer 21

Pain in MMT in one direction and painful PROM in opposite motion

Question 22

What is the difference between tendinitis and tendinosis

Answer 22

Tendinitis is a tear/inflammation of the tendinous portion of the muscle

Tendinosis is more chronic. A degenerative process at the tendon bone interface. These tears can add up to an eventual complete disruption

Question 23

What happens in the destruction phase of muscle injury

Answer 23

the muscle fibers and their connective tissue sheaths are totally disrupted

Gaps appear b/w the end of ruptured muscle fibers when muscle fibers retract

Necrosis of muscle tissue

Hematoma and edema form at the site of injury

Question 24

What happens in the repair phase of muscle injury

Answer 24

Matrix formation- Blood

Collagen formation- production of type 1 collagen by fibroblasts

Question 25

What happens in the remodeling phase of muscle injury

Answer 25

Regenerated muscle matures and contracts with reorganization of the scar tissue

Atrophy