Soft tissue assessment and management

Question 1

Adapted Cook and Pardum’s model

Answer 1

if you load normal tissue with appropriate stress you will get tissue adaptations that will lead to alterations of the tissue and will make it more robust. However, if you use to much exercise, the excessive stress starts to cause derogations to the tissue causing pain

Question 2

soft tissue aetiology- overuse and misuse

Answer 2

overuse is performing a task with a frequency that does not allow the tissues to recover and symptoms may be due to lack of muscle strength or endurance. Misuse- using improper form equipment which may put abnormal stress on tissue

Question 3

soft tissue aetiology- abuse and disue

Answer 3

abuse is having excessive force going through normal tissue. Disuse occurs after taking period of time without training resulting in decondition or altered neuromuscular control

Question 4

soft tissue aetiology- intrinsic and extrinsic

Answer 4

intrinsic- inside the body- age, genetic predisposition, coordination, previous rehab
extrinsic-outside the body- training levels, environmental factors (temp, altitude), equipment

Question 5

soft tissue symptoms for

Answer 5

muscle tear, ligament tear, tendon disorder, all have pain, sudden onset of pain during activity, swelling, inability to carry on with function, cardinal signs of inflammation
body chart- aggs- things that would stress muscle/ ligament that will cause it to elongate, ligament- could be ROM of exercises

Question 6

what happens if you overload a tendon

Answer 6

gradual onset (RC may be throwing), aggs- things that stress the tendon, eases- relaxes tendon

Question 7

what is the limitations of PRICE

Answer 7

tissue need stress to heal, early activity can lead to a better healing, early mobilization improves likelihood of better outcomes

Question 8

what does POLICE stand for

Answer 8

protection, optimal loading, ice, compression ,elevations

Question 9

Mechanotherapy- loading tissue

Answer 9

contracting muscle, stressing tendon, if joint/bone- would use weight bearing

Question 10

Mechanotherapy- stimulates cellular response

Answer 10

produce more tissue- make tissue more robust and resilient

Question 11

Mechanotherapy- tissue adapts, tissue improve structure, tissue able to maintain homeostasis-

Answer 11

adapts- if we keep loading the tissue- switch cell on repeatedly, structures- better able to do its function, homeostasis- less pain

Question 12

the healing process of soft tissue

Answer 12

remodelling phase- formation of intra and extra molecular cross linkages between collagen fibres. Aim of treatment is to restore viscoelastic properties by promoting hysteresis, creep and plastic deformation

Question 13

how can you Ax muscle and tendon tissue

Answer 13

AROM/PROM- differential diagnosis, length- normal length, strength- oxford scale- through full ROM, isometric- looking for pain provation, palp for tenderness- feel for lesion, power, motor control/ patterning- proprioception components

Question 14

how an you assess ligaments

Answer 14

length- end feel and pain response- Accessory test

Question 15

soft tissue treatment techniques

Answer 15

specific soft tissue mobilization- SSTM- lengthen and mobilize tissue, deep transverse friction- pushing down into muscles and push side to side- need to be careful you don’t rub the skim, muscle lengthening- stretching, trigger point (Trp) myofascial release, EXERCISE

Question 16

SSTM

Answer 16

mobilises the tissue, may do it at same time as you lengthen tissue, amy be moving to sideways or push into muscles- accessory, the aim is to reduce pain alloing pain free function, not as effective as exercises- less force and therefore less stimulus

Question 17

SSTM- alter regeneration and remodelling phase

Answer 17

pain relief, collagen remodelling and ground substance, affects visco-elastic properties, pain in theory- less pain

Question 18

SSTM- physiological SSTM

Answer 18

self stretch, therapist stretch, oscillate (stretch to end range) using maitlands grading or static hold

Question 19

SSTM- accessory SSTM

Answer 19

direct pressure, bowing- pushing it sideways or inwards, transverse mobilisation

Question 20

SSTM- combined SSTM

Answer 20

this technique is for later stage or less irritable (low SIN) and uses a physiological and accessory technique combined

Question 21

deep transverse friction

Answer 21

applies force perpendicular to fibres orientation, bering about numbing 5-8 mins and then deeper friction than 10 reps- stimulate small degree of damage

Question 22

how does deep transverse friction work

Answer 22

break down adhesions, increased blood supply- traumatic hyperemia, activates cells in this area, helps re-orientate fibres- repair tissue in more robust way

Question 23

contraindications and precautions to DTFM and SSTM

Answer 23

open wounds, clotting disorder, DVT, skin infections, active inflammation, growth plates, skin disorders, possible Ca, foreign body/implant, fragile skin condition, RhA, spondyloarthropathies, bursitis, neural tissue

Question 24

graded mobilisation

Answer 24

determined by SIN factor- high SIN low dose, low SIN- more dose, position in range, guide dose- early, middle, later

Question 25

graded mobilization- grades

Answer 25

grade 1- small amplitude, grade 2- larger amplitude but not into resistance, grade 3- large amplitude- but foes into resistance, grade 4- small amplitude but movement goes into resistance, grade 1 ad 2 limited by pain, when do they start to get uncomfortable- pain?

Question 26

what are the grades determined by

Answer 26

position in the range, relationship to resistance and pain, amplitude