Management Approaches to Muscle health and injury Flashcards
What are the subjective and objective assessments associated with diagnostics.
The subjective assessments are:
- Mechanism,
- Symptoms,
- PMH-risk factors
The objective assessments are:
- Clinical assessment and findings,
- Investigations such as Diagnostic imaging e.g. MRI etc
What are 2 common types of muscle injuries
- Myofascial muscle injuries,
- Musculotendinous muscle injuries.
What are the classifications and severity of impairment (injury)
- Grade 0= Focal area of muscle pain/generalised muscle pain (DOMS)
- Grade 1=Small myofascial/muscle tear,
- Grade 2=Moderate myofascial/muscle tendon junction tear,
- Grade 3=Extensive myofascial/muscle tendon junction tear
- Grade 4= Full thickness tear muscle or tendon
What are the important things to consider about management with a patient who has a muscle injury?
- To consider the stage of muscle (soft tissue) healing,
- To understand the patients individual hopes, fears and support,
- What approach to take e.g.
- A medical approach,
- A surgical approach
- A conservative approach,
- A Complimentary approach.
Key things about medical management
-Pain-Analgesia, how do we go about relieving it? Paracetamol is standard medication but if pain is more severe- higher up on the ‘Analgesic ladder’ more stronger medication.
- How to treat swelling/inflammation and pain?
- Usually by Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and Naproxen
What are the most common surgical techniques used to treat muscle injuries?
- Surgical management depends on the extent of the injury and the tissues involved.
- Rotator Cuff Repair and TA repair are two common surgical procedures.
What are the conservative management principles of dealing with a patient who has a muscle injury? (older/outdated principles)
PRICER:
- Protection,
- Rest,
- Ice,
- Compression,
- Elevation,
- Rehabilitation.
What are the Better management principles of dealing with a patient who has a muscle injury (used early 2010s)
POLICE,
- Pressure,
- Optimal,
- Loading,
- Ice,
- Compression,
- Elevation
What are the even better management principles of dealing with a patient who has a muscle injury (used today) ?
PEACE + LOVE,
- Protection,
- Elevation,
- Avoid Anti-inflammatories,
- Compression,
- Education,
- Load,
- Optimism,
- Vascularisation,
- Exercise.
What does Peace and Love stand for?
- Protection,
- Elevation,
- Avoid Anti-Inflammatories,
- Compression,
- Education,
- Load,
- Optimism,
- Vascularisation,
- Exercise
What are the main roles and goals of a Physiotherapist who is treating somebody who has a muscle injury?
- To promote optimal management and tissue healing,
- To promote function and independence,
- Exercise=Appropriate load which is manageable for the patient,
- Education= Encourage patient to understand the underlying physiology and self manage, planning ongoing treatment,
- Manual therapy= To promote appropriate functional movement of joints, muscles and nerves as required.
- Electrotherapy
What is the Biopsychosocial model of health?
- It connects biological issues with psychological and social ones.
- Biological=What’s wrong with the tissues/medical management,
- Psychological=Education, understand their beliefs and values to maintain a good working relationship.
- Social=Participation what things are limited in, limiting ability to work or play sports for example
How should we deal with a patients hopes and fears?
- Take time to understand their goals,
- Short term goals and long term goals,
- How to get their and make it happen,
- Its vital you don’t downplay their goals as they need motivation and goals to improve
What is meant by Complementary or Alternative?
- The two terms are conceptually distinct and should not be used interchangeably,
- ‘Alternative’ implies the process of excluding one thing to favour another,
- ‘Complementary’ implies coexistence or enhancement, and the two things complementing each others deficiencies
What do we do with Patient choice?
- Its important to understand the patients beliefs and value system,
- Don’t dismiss these options but work with the patient.
e. g. Acupuncture, Alexander technique, cupping, massage, meditation, Yoga
