Selective Tissue Tensioning Flashcards
what are the 5 principles of diagnosis for soft tissue injuries?
- look for “inherent likelihoods”
- look for objective physical signs
- Palpation
- selective tensionoing: non-contractile vs contractile tissue
- The “pain” is the pain for which the pt. is seeking treatment
T/F: palpation is helpful but can be unreliable
TRUE
some things are just naturally tender to palpate which can often be misinterpreted
list different types of contractile tissues
- tendons
- muscles
- musculotendinous junction
- bone adjacent to attachment of tendon
a contractile tissue will have stress with what 3 tests/things?
- isometric contraction
- stretching
- palpation
List different non-contractile tissues
- joint capsules
- ligaments
- bursae
- aponeuroses
- nerves
a non-contractile tissue will have stress with what?
- stretch
- palpation
*no increase in discomfort/stress with isometric contraction
when testing active and passive movements, what things should you observe/look for?
- pain
- ROM
- quality of movement
- willingness to move
- compare AROM, PROM, resistance testing and palation between involved and uninvolved side
T/F: you do not need to manually test a muscle through it’s full ROM
It depends
only to rule out/rule in a suspicous area
when palpating a stationary joint what things are you looking for?
- temperature
- swelling
- gaps
- tenderness
- pulsation
when palpating a moving joint what things are you looking for?
- crepitus
- clicks
- end-feel
- hypermobility
- hypomobility
- willingness to move
- pain
what can you use to help you make a decision/diagnosis when the pt is in severe or slight pain?
- pt. history
- functional testing - try to recreate their pain in a motion
- ask them to return when symptom returns
what AROM results should you expect for a muscle/tendon strain, tendonitis or possible small tear?
likely limited due to pain and/or weakness
may be able to move through full ROM but with pain
what PROM results should you expect from a muscle/tendon strain, tendonitis or possible small tear?
if truly passive: should have full pain free motion in all directions
EXCEPT
direction which stretches involved area may be limited due to pain (empty end feel)
what isometric/MMT results should you expect from a muscle/tendon strain, tendonitis or possible small tear?
likely weak and painful when testing involved area
what palpation results should you expect when testing a muscle/tendon strain, tendonitis or possible small tear?
involved area painful to palpation
what AROM results should you expect from a muscle or tendon complete tear?
very limited due to weakness
likely not as much pain as seen w/partial tear, but much more weakness
what PROM results should you expect from a muscle or tendon complete tear?
if truly passive: full pain free motion in all directions
EXCEPT
direction that stretches involved area, may be limited due to pain (empty end feel) if a muscle is guarding in the area
what isometric/MMT results should you expect from a muscle or tendon complete tear?
extremely weak
what palpation results should you expect from a muscle or tendon complete tear?
involved area painful to palpation
what AROM results should you expect to see from a joint capsule injury?
limited
possibly painful at end ranges
what PROM results should you expect to see from a joint capsule injury?
limited in same direction as AROM with firm end feel
possibly painful at end ranges
what Isometrics/MMT results should you expect to see in a joint capsule injury?
if done at mid range - shouldn’t produce sig pain and should be strong
may have pain due to compensation or guarding of surrounding muscles
what Palpation results should you expect to see in joint capsule injury
depends on depth of joint capsule
most of the time, cannot palpate deep enough to feel joint capsule
surrounding structures may be inflammed and cause discomfort with palpation
T/F: if the AROM or PROM loss doesn’t match the capsular pattern for that joint it is prob not an issue with the joint capsule
FALSE
can still be the joint capsule even if it doesn’f follow the capsular pattern.
what AROM results should you expect to see in a ligament injury?
full but pain at end ranges that stretch the ligament
what PROM results should you expect to see in a ligament injury?
full but pain at end range that stretches the ligament
what Isometric/MMT results should you expect from a ligament injury?
strong and no pain when tested in mid range
UNLESS there is guarding in area
What Palpation results should you expect to see in a ligament injury?
involved ligaments are painful to palpation
