Soft Tissue Injuries

Question 1

What might a patient present to you that would result in the diagnosis of a strain?

Answer 1

Visible deformity, able to ‘pin point’ the pain (at the musculotendinous junction), discolouration, overstretching, blood pooling distal to the site of the trauma, may also have a history of acute onset.

Question 2

Distinguish the 3 grades of a strain

Answer 2

Grade 1. -slight pulling
Grade 2 - partial tear or rupture
Grade 3 - complete tear or rupture

Question 3

What is tendonitis?

Answer 3

Inflammation within the tendon or the tendon sheath, most often occuring at the musculotendinous junction

Question 4

Tendons are ____x as strong as the muscle it serves

Answer 4

2

Question 5

What is tendinosis?

Answer 5

Gradual degeration of tendon tissue without inflammation, characterized by gradual weakening, flattening, micro tears, fat infiltration

Question 6

In terms of injuries, why is tendinosis problematic?

Answer 6

Increases the chances of future injury?

Question 7

What are the 4 main classes of tendon injury?

Answer 7

Tendonitis
Tendonsynovitis
Ethesitis
Tendinosis

Question 8

List in order, the continuum of tendinosis

Answer 8

Adaptive remodelling —— reactive tendinopathy — tendon disrepair — degenerative tendinopathy

Question 9

Explain each of the 4 phases of the continuum of tendinosis

Answer 9

Adaptive remodelling - normal adaptations due to exercise, sometimes pain gets more sore after workout
Reactive tendinopathy - if tendon does not improve, it is in a symptomatic state of disrepair, and gets better within 6 weeks, it is tendonitis. If it does not get better within 6 weeks, it is called degenerative retinopathy.

Question 10

Tendonitis shows up _____ on an MRI

Answer 10

White

Question 11

Tendinosis shows up _____ on an MRI

Answer 11

Black

Question 12

Tendonitis responds well to ________, while tendinosis responds well to ________

Answer 12

Ice, heat

Question 13

What are some of the signs and symptoms of tendinosis?

Answer 13

Gradual onset
Pain located throughout length of tendon upon palpation,
Pain with stretching and resistance
May be accompanied by ‘crepitus’ - cracking

Question 14

What might cause tendinosis?

Answer 14

Overuse, repetitive stretching,

Question 15

What are some of the common signs and symptoms of bursitis?

Answer 15

Major or minor localized swelling
History of sudden onset of pain
Localized pain and warmth on palpation

Question 16

What are some potential causes of bursitis?

Answer 16

Single traumatic compression or a series of repeated compression. Linked to a contusion