Spasms

Question 1

Spasm

Answer 1

Involuntary sustained contraction of a muscle

Question 2

Extrinsic (CRAMP) - Reflex muscle guarding/contraction

Answer 2

-involuntary mm protective mechanism aka. muscle splinting/guarding
- prolonged contraction is occurring in response to painful stimulus
- generally when insult is removed, spasm goes away

Question 3

Intrinsic muscle spasm (protective, guarding)

Answer 3

• prolonged contraction related to alteration in circulatory or metabolic functioning of mm itself
• resulting from direct or indirect trauma, emotional tension, post athletic event fatigue, cold, immobilization, inflammation or infection
• can be a perpetuating pain/spasm cycle where it stays even after insult is removed or after relex mm guarding is no longer acute

Question 4

Self Perpetuating Cycle of intrinsic muscle spasm

Answer 4

• Reflex muscle contraciton
• Resisted mvmt
• circulatory stasis
• Pain
• muscle spasm
• restricted mvmt

Question 5

Causes of mm spasm (6)

Answer 5

• pain
• circulatory stasis
• increased gamma neuron firing
• chilling of mm
• an impaired nutritional supply
• lack of vitamin d

Question 6

Palpation for spasm

Answer 6

• mm may be hot due to acute congestion or cool due to ischemia
• mm point tender due to ischemia
• acutely spasmodic = firm, dense & congested
• intrinsic spasm = hard/fibrous
• mm, antagonists & synergists = increased STT

Question 7

if DVT is present

Answer 7

positive Homan’s Sign

Question 9

Tx Goals for Spasm

Answer 9

• break pain/spasm cycle and decrease spasm
• do not completely decrease reflex mm guard
• decrease perceived pain
• increase local circulation
• decrease tone/STT
• Tx antagonists/synergists
• increase ROM once spasms decrease

Question 10

Tx Goals intrinsic vs extrinsic (cramp)

Answer 10

Intrinsic
- remove cause
- address metabolic fxn
- warm tisse
- remove mm balance

Extrinsic
- remove cause
- correct jt dysfunction
- decrease mm guarding
- restore mm balance

Question 11

Reciprocal inhibition for spasm

Answer 11

• Reciprocal inhibition
• GTO
• O+I
• Muscle approx
• Heat

Question 12

Hydrotherapy for spasm

Answer 12

Ice - reflex mm guarding in response to acute injury

Heat - intrinsic spasm in chronically tense/ischemic mm (deep moist) or contrast application

Question 13

Contraindications for Spasm

Answer 13

• do not completely decrease guarding
• do not force a stretch to acutely spasmodic mm
• no heat if acute injury
• local massage to DVT