soft tissue disorders Flashcards
strains
stretching or tearing of the musculotendinous unit
tendinosis/tendinopathy
chronic condition of the tendon with minimal or no inflammation histologically
what does the tissue of a tendon with tendinopathy look like (2 main things)
- expanded local cells
- thinner collagen fibrils
muscle contusion
- bruising with intact skin
- incites an inflammatory response
- sometimes causes hematoma formation
Myofascial Compartment Syndromes
Increased interstitial pressure within a closed
myofascial compartment
(compromises nerves, muscles, and vessels)
where do myofascial compartment syndromes typically occur (4)
within “envelopes” of lower leg, forearm, thigh, and foot
which soft tissue injury can cause ischemia and irreversible muscle loss
myofascial compartment syndromes
osteochondritis dissecans and osgood schlatter disease both cause damage to what soft issue structure
growth cartilage
4 joints most at risk for subluxation
glenohumeral
acromioclavicular
sacroiliac
atlantoaxial
dislocation
complete loss of joint integrity coupled with significant ligamentous damage
where does the most common joint dislocation occur
glenohumeral joint
what is the most common CONGENITAL dislocation location
hips
what type of training should occur first when dealing with a soft tissue injury
ISOMETRICS!!
it aligns the fibers and is the least forceful contraction to begin with
what type of exercise is advocated for chronic tendinopathies
eccentric contractions
after the pt can do isometric + isotonic exercises without pain… what type of training is next?
isokinetic with minimal load
heterotopic ossification (OH)
bone formation in nonosseous tissues like muscles and other soft tissues
myositis ossifications form in….
bruised, damaged, or inflamed muscles
hallmark sign of heterotopic ossification (OH)
pain + progressive loss of ROM at a time when posttraumatic inflammation should be resolving
5 sites most common for heterotopic ossification (OH)
hip
elbow
knee
shoulder
TMJ
2 types of connective tissue diseases
mixed connective tissue disease (MCTD)
overlap connective tissue disease (OCTD)
connective tissue diseases have features of many ___________ disorders
autoimmune
___________ combines features of SLE, scleroderma, polymyositis, and polyarthralgias
OCTD
what autoimmune disease is present in 75% of OCTD cases
RA
polymyalgia rheumatica (PMR)
diffuse pain and stiffness in multiple muscle groups
what muscle groups are typically involved in PMR
shoulder muscles
pelvic girdle muscles
painful stiffness lasting longer than ______ in the morning indicates PMR
1 hour
PMR: unilateral or bilateral?
bilateral and symmetric
rhabdomyolysis
the rapid breakdown of skeletal muscle tissue resulting in release of creatine phosphokinase enzymes, myoglobin, and other TOXIC BY PRODUCTS
accumulation of muscle breakdown by-products is dangerous to which body system?
RENAL SYSTEM
military recruits + marathon runners who have been exercising in hot and humid weather are more susceptible to _________
rhabdomyolysis
physical rhabdomyolysis causes
prolonged high fever
hyperthermia
excessive physical exertion
mechanical rhabdomyolysis causes
crush injuries
burns
compression
compartment syndrome
chemical rhabdomyolysis causes
medications
excessive alcohol
electrolyte abnormalities
infections
tea colored or cola soft drink colored urine indicates….
severe rhabdo + need to go to emergency room
what ion is released by injured muscles that can cause fatal disruptions in heart rhythm?
POTASSIUM –> hyperkalemia
critical illness myopathy (ICM) is associated with….
prolonged stays in ICUs
trigger points (TrPs)
hyperirritable sports in a taut and of skeletal muscle
painful on compression, stretch, contraction, etc.
active vs latent trigger points
active: spontaneous local + referred pain
latent: causes pain only on stimulation
allodynia
normally non-painful stimuli (light touch, pressure, or temp) trigger intense pain
what 4 micronutrients could be involved in myofascial pain like TrPs
iron
magnesium
B12
D
what layer of the pelvic floor are the levator ani muscles in?
3rd layer (deepest)
symptoms of underactive pelvic floor
urinary/fecal incontinence
pelvic organ prolapse
absent/weak pelvic floor contraction
symptoms of overactive pelvic floor
obstructive voiding/defecation
dyspareunia
pelvic pain
nonrelaxing pelvic floor muscles
what is the most common cause of an underactive pelvic floor
birth-related trauma
what should the treatments of overactive pelvic floor be targeted toward
hypersensitive nervous system
coccygodynia
pain related to the coccyx and the muscles attached to it
sacral chordoma
rare, slow-growing tumor that presents with neurologic symptoms as well as pain similar to coccygodynia
