MS: Soft Tissue Dysfunction Flashcards
What are the fibrous components in extracelluar matrix?
collagen and elastin
What are the ground structures for connective tissue?
glycoproteins and proteglycans, water
for joint lubrication
What are the regions for stretching?
toe, elastic, plastic, failure
What is creep in regards to viscoelasticity?
the ability to deform over time when a constant load is applied
in LBP pts making sure they get up every 30 mins to counteract creep
What is stress relaxation in regards to viscoelasticity?
reduction in stress within a material over time as the material is subject to constant deformation
What effects viscoelasticity?
- immobilization- weakness of soft tissue
- overuse- can’t adapt and build starts breaking down
- hormones- low estrogen in females causes laxity in women
- disease- lung and heart issues cause lack of O2 to tissue
What is a strain?
acute injury to muscle or tendon
What is a sprain?
injury to ligament of jt capsule
ex. dislocation, subluxation, instability
What is the basic function of a tendon?
to be able to elongate (stretch) and sustain force (strength)
what is a microstrain of tendon?
why is this tendon breaking down, possible over use?
What is a macrostrain of tendon?
the tendon is torn
What are healing factors of a tendon?
age
vascularity- for example supraspinatus and achilles have poor blood supply
comorbidities, auto immune meds
What is tendinopathy?
a big subcategory, a general descriptors to include all pathologies that arise in and around tendons
What is tendonosis?
the breakdown within the tendon likely due to ageing, microtrauma and vascular compromises
often palpable with no swelling but it is tender
Would you use anti- inflammatory with pt with tendonosis?
No, b/c these will decrease blood flow to the area
goal of PT is to rebuild tendon, therefore you need swelling
What is tendinitis?
overuse, or symptomatic degeneration of the tendon with vascular disruption and inflammatory repair
Do you want to use anti- inflammatory meds with tendinitis patients?
Yes, to decrease blood flow to promote reduced swelling
use PRICE
What is paratenonitis?
inflammation of the outer layer of the tendon, external architecture is affecting the tendon
ex. the sheath of tendon
What is De Quervains disease?
AB Pl and Ext PL tendon sheaths
create a sandpaper effect during motion
Treatment for tendonosis?
a lot of eccentric training to generate length and force
create microswelling
load and stretch tendon
Treatment for tendonitis?
PRICE
concentric—–> eccentric
Treatment for paratenonitis?
whats not efficient around the tendon and fix it
What are primary stabilizers of a joint?
ligaments and capsule- 1st
muscles- 2nd
What is a muscle strain?
results usually from a sudden stretch on a muscle that is actively contracting
What is a 1st degree strain?
some stretching of the muscle fibers
pain increases as muscle contracts
slight swelling, pain at site of injury
What is a 2nd degree strain?
actual tearing of some muscle fibers (5%-95%)
same as 1st but Sx last longer
bruising distal or at site of injury
What is a 3rd degree strain?
complete rupture of muscle
total loss of function, palpable defect in muscle
less pain due to nerve endings death
What is a 1st degree sprain?
ligaments stretched with little or no tearing of fibers
less pain but jt feels unstable
slight swelling, mild tenderness with firm end feel
What is 2nd degree sprain?
partial tearing of ligament’s fibers (5-95%)
soft but definite end feel- loss of joint function (blood in joint)
symptoms lasts longer than 1st degree
What is a 3rd degree sprain?
complete rupture of ligament’s fibers
empty or absent end feel
joint laxity or instability, complete loss of jt function
severe swelling
What are two forms of bursitis?
- subcutaneous- can be large and not affect joint, not pain unless hit, swelling remains in sac (prepatellar, olecranon)
- Bursa seperating tendinous or ligamentous tissue like in Pes Anserine often cause high pain with motion (system no effecient)
Treatment- cortisone injection
What is a peripheral nerve injury?
entrapment of nerves where symptoms are always distal
sx: dull ache, weakness
Ex: median, radian nerve
What is a spinal nerve root injury?
pinching up root like C6 (radiculopathy)
pain in a larger area, numbness distal with increased pressure, motor weakness, absent of reflexes (hypo-)
what are spinal cord compression symptoms?
myelopathy- bilaterally
UMN signs and symtpons- numbness distally, spasticity, HYPERreflexia, clonus (uncontrolled mvmt)
balance and gait distubences, Babinski sign’s
sudden changes in bowel or bladder function
What are examples of fibrocaritlage?
menisci, IV discs, pubic symphysis
reduces friction
What is articular cartilage?
aka hyaline
any articular surface, strong tensile strength, flexible support
Fx- absorbs and spreads load across jt surface, decreases friction
doesn’t heal well- due to little or no blood supply
How does articular cartilage get nutrition?
provided by synovial fluid
this is impt in rehab to promote synovial fluid to joint affected (bike, MET)
What is Osteoarthritis (OA) or Degenerative Joint disorder (DJD)?
degeneration of articular cartilage and is most common musculoskeletal disorder
What is the cause of DJD/OA?
still unknown:
- genetic predisposition/ obesity causes articular cartilage defect/damage
- posttraumatic- trauma or intra-articular cartilage fx disrupts AC
- immobility or excessive loading can cause failure
Signs and symptoms of OA/DJD?
joint pain, reduced motion, crepitus with motion, deformity (Wolff’s law), muscle weakness
synovitis can occur due to breakdown of jt surface
severity depends on when pain occurs- after, during or before activity?
PT management of OA/DJD?
meds- to reduce swelling
PT- best response for joint conservation
Surgery- clean it out or replace it
