Soft Tissue Injuries Flashcards
What do ligaments do?
stabilize joints
What do tendons do?
move joints. they connect bone to muscle.
What is the bursae/ menisci?
reducers friction between moving parts- helps smooth the movements
Acute soft tissue injuries include what?
Sprain (ligaments) Strain (tendons) (these are d/t acute trauma)
Chronic soft tissue injuries include what?
Tendonitis (better term is tendinopathy) Bursitis (these are d/t overuse)
What is tendinopathy?
Repetitive mechanical load without sufficient time for healing (chronic overuse) —> micro-tears—> improper healing (insufficient time for healing)—> degenerative changes (loss of collagen, disorganized collagen) —> tear
Soft tissue injuries presentation- of acute injuries
- Clearly defined cause/ onset - Localized pain w/activities and at rest - “Pop” sensation (if tear) - Edema, ecchymosis
Soft tissue injuries presentation- of chronic injuries
- Gradual onset/ no clearly defined cause - Localized pain w/ specific movements (late stages at rest) No edema
General approach to diagnosis of soft tissue injuries
Most syndromes are diagnosed CLINICALLY
Best initial test for soft tissue injuries?
X-ray (best initial test) is indicated in some acute injuries or in chronic injuries if there is no improvement for 6 weeks. X-ray done r/o fracture, tumor, arthritis.
Most accurate test for soft tissue injuries?
MRI is the most accurate diagnostic test for soft tissues injuries
What is the best test for peripheral mono- neuropathy?
Nerve conduction study is the most accurate diagnostic test for peripheral mono-neuropathy
Treatment of ACUTE soft tissue injuries ?
RICE for the first 2-3 days + short course NSAIDs: Rest (mobility devices) Ice (20 min at a time) Compression (elastic bandage) Elevation When acute pain and swelling subsides (s/p 1 week)—> recommend physical therapy to prevent chronic instability and recurrent injury
Treatment of CHRONIC soft tissue injuries ?
- Relative rest. Braces or orthotics if exacerbating activities cannot be fully avoided 2. Pain control (a trial of NSAIDs, short course) 3. Physical therapy (stretching and muscular strengthening) 4. Corticosteroid injections ( if no response to pain control and relative rest for 6 weeks) 5. Surgery (if no response to conservative therapy for 6 months): debridement of degenerative tissues. Surgery is a last resort
Rotator cuff tondonitis s/s?
Pain with overhead activities, (+) Neer’s test, (+) Hawkins; common in painters, swimmers, volley ball players since they are always doing overhead activity- joint will sustain degenerative changes
Rotator cuff tear s/s?
Pain and weakness on abduction, (+) open can, drop arm tests
Adhesive capsulitis of the shoulder s/s?
aka frozen shoulder. Pain and limitation of ROM (active and passive)
Osteoarthritis s/s?
Pain with activity relieved by rest, crepitus, limited active and passive ROM. Pain gets worse as day goes by- worse with use
Cervical radiculopathy s/s?
(+) pain neck, shoulder and forearm (poorly localized) (+) sensory (numbness/ parasthesia) (+) motor deficits very rare (+) reduced DTRs : C5-C6 biceps C7-C8 triceps