Sports Medicine Part 2 Flashcards
muscle tears often occur during an ___ contraction.
during an eccentric contraction (muscle contraction while lengthening)
- hamstrings, quads, gastrocnemius
Grade 1, 2 or 3 muscle injuries
what is a contusion. What is the best imaging modality to visualize it
crush injury of muscle tissue with bleeding and hematoma formation (crush injury resulting in hematoma).
U’S helps with diagnosing contusion. don’t usually need imaging to diagnose a contusion though. Pec and bicep tears are helped to diagnose by MRI
Diagnostic ultrasound (US) is used extensively for non-invasive real-time imaging of muscle, tendon, fascia, blood vessels and other soft tissues and is suitable for use in a medical office setting.
management of a muscle tear . How shouldd you immobilize?
quadriceps contusion
- immobilize in flexion to prevent stiffness
- aspiration of hematoma.
- bandage quadriceps in full flexion after you aspirate it.
a person with a muscle tear continues to complain of pain even though it’s been a long period of recovery. what’s going on?
myositis ossificians. complication. post-traumatic heterotrophic calcification seconday to intra-muscular bleeding.
tendinitis vs teninosis
tendinitis: acute tendon inflammation
tondinosis: intra-tindinous degenerative change. more chronic. 70s and sore shoulder. If its not a tear it’s probably tendinosis problem.
tenosynovitis; inflammation of tendon sheath
tenosynovitis
inflammation within a tendon sheath. will feel crepitus and creaking.
enthesopathy
tendon disease at tnedon-bone insertion/interfce. enthesitis.
grading of tendon strains and tears
- partial
- complete. complete tendon rupture will result in complete loss of function.
in addition to pain, a person with a tendon injury would experience ____. what type of motion would be hard with someone with a muscle/tenon tear? what kind of motion would they have?
weakness secondary to pain. Not crepitus because this is not a bone or joint issue. will have weakness and pain of active range of motion. They would have a normal joint ROM because it’s not a joint issue/blockage.
which tendon is torn?
The torn Achilles is just causing the foot to fall flat. There is no definition. The toe points up/dosriflexed. It has lost its plantar flex natural position.
this is a complete Achille’s tendon rupture
diagnostic imaging for tendon injuries
US and MRI.
operative and non operative management of tendon injury`
non-operative
- NSAID/analgesic
- symptomativ management with rest, ice, compression, activity modificatino.
- bracing
- physiotherapy
- stretching and eccentric strengthening exercises
- extra-corporeal shock wave therapy.
- nitroglycerin patching.
- surgical debridement.
Surgical
- reattachment.
T/F if it’s a partial muscle/tendon tear you should surgically repair it
false. brace, NSAIDS, physio, PRP. ONly surgical reattachment if it’s a complete tear.
ligaments connect bone to ___
bone to bone. static stabilizer of joints. neurosensory.
static vs dynamic stabilizer
Dynamic stabilizers consist of the local musculature (the rotator cuff and periscapular muscles), whereas static stabilizers include the glenoid labrum and associated capsuloligamentous components.
grade 1, 2, 3 for ligament injuries/tear
Note; if you have enough force to tear a ligament, you should look for other ligaments too. Do an X Ray to make sure were not missing a bone or cartilage injury.
Ex/ If you tear ligaments in the knee (like the medialCL) then you should look for meniscal injuries.
what ligaments are the arrows pointing to and what kind of injury tears this area?
the ATFL and CFL. this is on the lateral side of the foot. Caused by inversion and plantar flexion.
what type of injury would damage the interosseous membrane/
external rotation and dorsiflexion.
the interosseous membrane and the anterior inferior tib fib ligament.
what kind of injury?
“high” ankle ligament sprain. The tibia and fibula aren’t connected. There is more space here. Probably a ligament tear. Needs to get a WEIGHT BEARING X-RAY or else it might not loo separated.
plantar fasciitis is a fascial injury in which the thick connective tissue which supports the longitudinal arch of the foot gets inflammed.
the person will feel inflammation at the ___ ___ and medial calcaenal tuberosity to the metatarsal heads.
the person will feel inflammation at the CALCANEAL TUBEROSITY and medial calcaenal tuberosity to the metatarsal heads. Inflammation at calcaneal insertion. Pain in prolonged sitting or when first getting up in the morning. Can’t walk well on the heels because of the pain. May or may not see a heel spur on the X-ray.
this person has pain walking on heels and some tenderness at the medial calcaneal tubercle.
CR: presence of calcaneal spur is not causative but this is most likely a plantar fasciitis.
the ultrasound may show tear.
management of plantar fasciitis.
T/F the ITBS fascial injury presnts with lateral knee pain which is brought on by running and jumping. It prsents with swelling.
FAlse. no swelling. the knee exam will be normal but there will be weak hip External rotation and Abduction.
muscle, nerve, and blood supply of the deep posterior compartment
muscle: psoterior tibialis, FHL (flexor hallicus longus), FDL (flexor digitorus longus).
nerve: tibial nerve
artery: posterior tibial artery and vein.
magenetment of busitis.
what kind of ROM would you expect in someone with adhesive capsulitis
functional restrictino of both active and passive shoulder motion. you would also see normal xrays except for osteopenia or calcific tendonitis.
what might this have?
frozen glenohumeral joint.
rule out osteopenia and rule out OA. rule out RC tear.
management of a stiff shoulder
meds; NSAIDS, neuropathic, oral analgesics
- corticosteroid injection
- suprascapular nerve block
- PT PT PT PT PT!!!!
- Continue ROM and isometric strengthening exercises PT for more aggressive ROM exercises
- Could consider surgical capsular release referral if still very stiff after 12 to 18 months
