Mechanisms and Characteristics of Musculoskeletal and Nerve Trauma Flashcards
Trauma
Some sort of force could be internal or external
Mechanical Injury
Change to state of rest (over stretching)
Tissue Properties
- Load
- Stiffness
- Stress
- Strain
Load
External force causes a reaction in tissues
Stiffness
- The ability of the of the tissue to resist a load.
- The greater the stiffness the greater the ability to resist
Stress
Internal resistance to load
Strain
- Muscle/tendon
- internal change in tissue
- over stretching
Creep
Deformation in shape caused by a constant load or force
Body Tissue
are viscoelastic and contain both viscous (thick) and elastic properties
Yield Point
- point at which elasticity is almost exceeded is the yield point
- if deformation persists, following release of load permanent or plastic changes result
when yield point is far exceeded mechanical failure occurs resulting in damage
Tissue Loading
- Tension
- Compression
- Shearing
Tension
Pulling
Compression
Pushing, squishing
Shearing
across the tissue, blistering, abrasion
Bending
- Two force pairs act at opposite ends of the structure
- (4 points)
Torsion
- Twisting
- loads caused by twisting in opposite directions from opposite ends
Traumatic Injuries
- Onset
- Acute
- Short Duration
- a direct blow
Overuse Injuries
repetitive dynamic use over time
Acute vs Chronic injuries
- When injury is acute- something has initiated the injury process
- Injury becomes chronic when it doesn’t properly heal
Musculotendinous Unit Injuries
- High incidence in athletics Anatomical Characteristics: - composed or contractile cells that produce movement Possess following characteristics: - irritability - contractility (response to stimulus inability) - conductivity - elasticity
Three types of muscle
- Cardiac
- Smooth
- Striated (skeletal)
Muscle Strains
- Stretch, tear or tip to muscle or adjacent tissue
Cause of Muscle Strains
- failure to reciprocal coordination of agonist and antagonist
- electrolyte imbalance due to profuse sweating
- strength imbalance
Grades of Muscles Strains
Grade 1- some fibers have been stretched, maybe minor tearing, pain in ROM
Grade 2- number of fibers have been torn and active contraction is painful, usually a depression or divot is palpable, some swelling
Grade 3- Complete rupture of muscle or musculotendious junction, a lot of pain that diminishes due to nerve damage
Muscle Strain pathology
- similar is very similar to contusion or sprain with capillary or blood vessel hemorrhage
- could be 6-8 week recovery or more
- return to play too soon could result in re-injur
Muscle Cramps
- painful involuntary skeletal muscle contractions
- Occurs in well- developed individuals when the muscle is in a shortened position
- can be experienced at night or in a resting state
- could be electrolyte, hydration, stretch them
Muscle Guarding
- happens after injury
- muscles within the effected area contract to splint the injured area to minimize pain through limited ROM
- involuntary muscle contraction
- not a spasm though, that could indicate increased tone due to upper motor neuron lesion in the brain
Muscle Spasm
- a relax reaction caused by trauma
Two types - clonic: alternating involuntary muscular contractions and relaxations in quick succession
- tonic: rigid contraction that lasts a period of time
- could lead to muscle or tendon injuries
Muscle soreness
Two types
- Acute onset muscle soreness: fatigue and muscle pain immediately following exercise
- DOMS: pain that occurs 24-48 hours of muscle soreness following exercise that goes away about 3-4 days later
Prevention of muscle soreness
gradually increase intensity of physical activity
what are tendons?
- wavy parallel collagenous fibers organized in bundles- upon loading
- can produce and maintain 8700-18000 lbs/sq inch
- collagen straightens during loading but will return to shape after loading
Breaking point of tendons
6-8% of increased length
where do tears generally occur
in the muscle and not so much in tendon
what happens to tendons after repetitive stress
- microtrauma and elongation, causing fibroblasts influx and collagen production
- this could lead to chronic muscle strain due to re-absorbtion of collagen fibers
- this weakens tendons
- most susceptible is the achilles
when does collagen re-absporption occur?
in early period of sports conditioning and immobilization making tissue susceptibility to injury
Tendinitis
caused by repeated micro trauma and degenerative changes (overuse and repetitive)
Signs and symptoms of tendinitis
swelling
pain
crepitus
tx of tendinitis
rest and ice but mostly rest
tendinosis
without proper healing of tendinitis may begin to degenerate and result in tendinosis
signs and symptoms of tendinosis
swollen stiffness restricted movement sometimes a tender lump with appear most common in middle and older age people
tx of tendinosis
stretching ad strengthening
tendinopathy
doesn’t apply to a specific pathology
but ofter refers to tendonitis or tendinosis
tenosynovitis
inflammation of the synovial sheath
signs and symptoms of tenosynovitis
acute cases- rapid onset, crepitus and diffuse swelling
chronic cases- thickening of tendon with pain and crepitus
mostly occurs in long flexor tendon and biceps tendon
tx for tenosynovitis
NSAIDS
Myofascial trigger points
discrete, hypersensitive nodule within tight band of muscle or fascia
development of myofascial trigger points
mechanical stress
- acute trauma or micro trauma
two types of myofascial trigger point
latent and active
latent trigger point
doesn’t cause spontaneous pain
may restrict movement or cause muscle weakness
become aware of presence when pressure is applied
active trigger point
causes pain at rest
applying pressure=pain=jump sign
tender to palpation with referred pain
found most commonly with muscles involved with postural support
Contusions
caused by sudden blow to the body
can be both deep and superficial
hematoma results form blood and lymph flow into surrounding tissue
rate of healing for contusions
could take a year to mature
can’t do surgery until it is mature
Myositis ossificans
chronically inflamed and contused tissue may result in generation of calcium deposits
atrophy
wasting away of muscle due to immobilization, inactivity, or loss of nerve functioning
contracture
an abnormal shortening or muscle
lots of resistance to passive stretch
caused by accumulation of scar tissue
synovial joints injuries
hyaline and/ or articular cartilage fibrous connective tissue capsule ligaments capsule with synodal membrane joint cavity with synovial fluid blood and nerve supply muscles menisci (fibrocartilage)
Hyaline/ articular cartilage
smooth
doesn’t go back
between articulating surfaces
