Overuse injuries LL Flashcards
What is the MOI of overuse injuries
- gradual onset of symptoms
- changes to environment, load etc
Parts of physical exam - overuse
- observation related to nominated activities
- testing hypotheses
- assessing impairments
How to determine if you should make someone do an activity in an exam
- contraindications
- irritability
- severity
- level of current function
What to look for when observing nominated activities
- mechanics
- shock absorption
- possible impairments
- outcome measure
- correct any concerns and try again
Things associated with PFP
Reduced strength/control > Abd, ER, E
Reduced compliance > Add, IR, ITB
Motor patterning
Decreased pronation
Overstriding
What are some possible outcome measures for physical exam
- time to onset of pain
- distance to pain
- reps to pain
- pt rating pain throughout
What is a treatment direction test
Observe pt during nominated activity
Obtain outcome measure
Correct any biomechanic error
Observe and note outcome measure
Note improvement/same/worsening in performance
How to confirm/negate hypotheses
- reproduce symptoms
- load/test diff structures
- clear adjacent jts
- check neurodynamics
Common overuse injuries
- tendinopathy
- long standing groin pain
- labral tears
- PFP
- stress fracture/reaction
- OA
How to diagnose tendinopathy
- increased pain with increased loading
- palpate for tenderness around
- may have nodules
- may have swelling or crepitus
What are the types of groin pain
- adductor related
- iliopsoas related
- inguinal related
- pubic related
- hip related
Indications adductor groin pain
Pain: kicking, twisting, turning, side to side
Most at insertion of AddL
Pain on resisted add
Indications iliopsoas groin pain
Pain: straight line running, ant prox thigh
Resisted hip F and on hip F stretch reproduced pain
Indications inguinal groin pain
Pain: sit ups, coughing, palpation inguinal canal, resisted abs
Indications pubic groin pain
Tenderness at pubic symphysis
What increases risk of labral tears and the type
FAI - abnormal growth on femur
Cam, Pincer and Mixed types
What tests negative indicated not labral tear
- FABER
- FADIR
-Thomas
What increases PFP
level walking
stair climbing
squatting
Considerations for stress injury/reaction
- tests for bony continuity
- palpation
- REDs
- mechanics/load
Clinical tests to identify hip OA
Pain during
- squatting
- active hip F
- active hip E
- passive hip IR
- during scour test
Impairments associated with hip OA
- pain on loading
- decreased PROM
- decreased LL strength
- decreased balance
- increased risk of falls
Impairments with knee OA
- pain on loading
- decreased LL strength
- may have decreased knee ROM
- decreased balance
- risk of falls
