Sprains and Strains Flashcards
Acute vs. overuse
Acute- sudden trauma
Overuse - with repetiive activity
Sprains…what is it, where does it occur, sx
Sretch and or terar of a ligament (stabilizes joints)
Most commonly in the ankle
AFL most, CFL, PTFL
Sx - pain, edema, ecchymosis, pop
Strain
Stretch and or tear of muslce or tendon
Most in hamstrings/low back
Pain, muscle spasm, muscle weakness, edema, ecchymosis
Mild
Mod
Severe
1 - stretching and soem damage to fibers
mod - partial tearing of the ligamen…abnormal laxity in certain ways
Severe - complete tear of the ligament or tendon…sig instability and jint nonfunction
Non pharm Tx
RICE
Rest - take a break from activity that cuase…relative rest - need to strengthen to improve
Ice - 15 mnutes at a time
Compression - to reduce swelling
Elevation - above heart to reduce swelling
Pharm tx
NSAIDs…Inhibit COX 1 and 2 so decreased prostaglandin formaiton
Take consistently…meloxicam or diclofenac are most common
Hx of ankle sprain
Most common is ankle inversion
MOA needs to be in pt’s own words…demonstrate on uninjured side
Ottawa ankle rules
Need Ankle X ray if pain in malleolar zone AND
Bone tenderness at posterior edge or tip of lat or medial malleolus
OR inability to bear weigth
Foot X ray if pain in midfoot and beone tenderness at vnavicular or base of 5th metatarsal…OR inability ot bear weight
Ankle sprain PE
Edema and eccchyymosis…no erythema or warmth
Tenderness over ATFL and CFL
No tenderness over medial or lateral malleolus
Ankle sprain mild and severe tx
RICE
Strenghtening
1-2 weeks
Severe - immobilize (don’t want to use crutches), elevate, ice…4 weeks to recover…PT
Both of these include proprioception
MCL or LCL vs. ACL/PCL
WIth MCL or LCL, there will be no swelling inside the knee joint
ACL and PCL function
ACL - prevent forward movement of the tibia…needed for pivots…think layup
PCL - prevents femur from sliding forward off the tibial plateua…think knee vs. dashboard***
Medial and lateral menisci function
Protect articular surface from damage
MCL and LCL function
MCL - prevents valgus opening of tibiofemoral joint
LCL - prevents varus
Lachman test
Tests ACL
Stabilie fumer with outside hand
Move tibia anteriorly
Posterior drawer
Knee at 90 felxion..apply posteriorly directed force to proximal tibia
for PCL
Valgus stress
MCL
At 0 and 30 degrees of knee flexion
Same for varus test
McMurray
Flex knee and place fingers on joint line
Ext rotate the leg and bring knee into extension
Plapbale pop or click
Causes of effusions
THink about things INSIDE the joint
What to do if suspicion for ACL tear
Brace and MRI…tylenol and ibubrofen for pain
Crutches
Ortho for surgery
ICE the knee
ACL surgery
Bone patellar tendon autograft is preferred
6-9 months to return to sport
Need pre-hab
MCL mech of injury
Valgus stress on a partially flexed knee
If severe laxity, then associated ACL tear
LCL injury
Usually with PCL and always need surgery
PCL MOI and tx
Direct blow with knee in flexed positon OR hyperexntension injury
Knee brace, rehab for 4 weeks (quad and hip)
Hamstring strain typical
Sprinting and felt a pull then a pop in pro posteriro leg
Edema, ecchynosis, tenderness mid-belly of medial hamstring
Hamstring strain MOI and tx
Forcefulll contraction as a result of hip flexion and knee extension
Ice, compresion, stretching, rehab
Semimembranosus, tendinosis, biceps femoris
AC sprain
Separated shoulder
Probably landed directly on
Tenderness over AC joint with “step-off” contour
AC sprain MOI and tx
Driect blow to lateral
ICe, sling, rest, 4-6 weeks full motion
Wrist sprain and most common ligament
FOOSH
Mild edema of dorsal aspect
Pain with extension and flexion of wrist
Scapholunate ligament
