Msk Pathologies (upper Limb) Flashcards
Which muscles are in the rotator cuff all work in rotation and abduction
Supraspinatus, infraspinatus, teres minor,
Which muscles work in flexion
Posterior muscles
What may cause tendonopathy of the rotator cuff
Tendon compression, tendon overuse/underuse which is more likely to irritate superior aspect of cuff, most damage found inferiorly, compression. Between tuberosity of humerus and glenoid, age, nutrition, diabetes
Clinical pain of rotator cuff tendonopathy
Pain and impairment of shoulder movement, usually during flexion and extension, increased superior glide of huméral head in glenoid, painful arc
Physio management of rotator cuff injury
Exercise to improve scapula rhythm, strengthening education, modify load
What’s lateral epicondylitis
Overuse syndrome in elbow, tendonopathy involving extensor muscles, ECRL, ECRB most commonly affected, repetitive, excessive overuse can cause it, affects thumb extension, abduction and radial deviation, pain on palpation,
What’s a strain (contractile tissue)
Involves over contracting or lengthening a muscle causing rearing of collagen
Different grades from 1-3
2 joint muscles, eccentric contractions
Management of a strain
POLICE, PRICE, mobilisations, stress through muscle, strength/ loading , endurance training, proprioception balance training
What’s a sprain (innert tissue)
Stretch or tear of a ligament usually caused by a joint being forced out of its usual ROM,in elastic fibres stretched too far, ligaments play an important role in stability and proprioception a common sprain is the ankle primarily affecting the anterior talofibular ligament
Management of a sprain
POLICE, PRICE, early mobilisation, early weight bearing exercises, education, return to sport if it can cope, physios aim to prevent scar tissue formation, stiffness and muscle weakness, restore proprioceptive deficits, pain relief through joint mobs, soft tissue massage and TENS, Strengthening of affected area by exercises and techniques, improving performance
EXAMPLE: How would you assess if someone had an ankle sprain
Mechanism of injury, observation of the patients gait pattern, standing posture, wear and tear on patients shoes, any atrophy of muscles, oedema should be noticed, palpation of structures that may have been involved in the injury followed by active and passive rom
What special tests might be used to assess someone with an ankle sprain
Anterior draw test- ATFL, talar tilt CFL, posterior tilt PTFL
Management/ treatment of ankle sprains
Active movements to improve local circulation, AP movement results in greater improvement in ROM, exercises to improve muscle strength, active stability, foot/ankle motion, motion, walking, running, education provide information about preventative measures, advice wearing appropriate shoes, practice balance, muscle strength, foot motion/mobility, gradually increase load from static dynamic to fully loaded exercise
Why do we want to improve rom (stretches)
To decrease pain
What’s adhesive capulitis (frozen shoulder)
Formation of excess scar tissue or adhesion across Glenohumeral joint leading to stiffness pain and dysfunction, glenohumeral ligaments and joint capsule which are affected, primary occur spontaneously, secondary occurs after trauma
