Stress And Tendon Injuries (2) Flashcards
What does the medial tibial stress syndrome account for?
Inflammatory, traction event on the tibial aspect of the leg
What is medial tibial stress syndrome common in?
Runners
What are the symptoms of medial tibial stress syndrome?
Tightness/tenderness
Throbbing along tibial crest that comes on with activity and goes away with rest
What are the causes of medial tibial stress syndrome?
Inappropriate footwear
Muscle weakness
Poor running mechanics
Tight gastroc
Excessive supination
Excessive pronation
What would provoke Tibialis anterior tendonopathy?
MMT
What will Tibialis anterior tendonopathy look similar to?
Medial tibial stress syndrome (palpation used to differentiate)
What can cause Tibialis posterior tendonopathy?
Pes planus
Irritation at insertion on navicular or behind medial malleoli
Where does perineal tendonopathy occur?
In sulcus behind lateral malleoli or at cuboid
What can cause perineal tendonopathy?
Overuse or friction
Where can peroneal tendonopathy rupture?
At the retinaculum which leads to peroneal subluxation
What is peroneal tendonopathy common after?
Inversion sprain
What is tarsal tunnel syndrome?
Lesion to posterior tibial nerve in flexor retinaculum
What causes tarsal tunnel syndrome?
Running on hard surfaces or poor fitting shoes
Over pronation
What are signs of tarsal tunnel syndrome?
Swelling
Medial ankle and heel pain
Sensory loss to medial heal
Positive tinels sign
Where is chronic exertional compartment syndrome often located?
Anteriorly
How long is the history of chronic exertional compartment syndrome prior to diagnosis?
2 year history
Who is chronic exertional compartment syndrome common in?
Runners and soccer players
What symptoms come along with chronic exertional compartment syndrome?
Neurologic weakness and numbness
How can you treat chronic exertional compartment syndrome?
Transition to forefoot running
How is Achilles tendonitis caused?
Overuse (gradual onset)
What is Achilles tendonosis?
Hypovascular zone 2-6 cm from insertion
What are symptoms that come with Achilles tendonosis?
Lack of CKC DF
Thickening of Achilles tendon
Tight, painful gastroc
Painful resisted Plantarflexion
What is the treatment for Achilles tendonosis?
Stretching
Eccentric strengthening
(No NSAIDs)
What is an Achilles tendon rupture?
Forceful sudden contraction (audible pop)
What are risk factors for Achilles tendon rupture?
Cortisone injections
30-40 y/o male
What does Achilles tendon rupture cause?
Inability to push off
Positive Thompson test
How is an Achilles tendon rupture most treated?
Surgically
What is Hallux abductovalgus?
Medial deviation of 1st metatarsal head
What are the two types of Hallux abductovalgus?
Adolescent
Degenerative
What is adolescent Hallux abductovalgus?
Hyperpronation of rear foot (may require surgical intervention)
What is degenerative Hallux abductovalgus?
Degenerative joint disease of 1st MT head
What are some treatments for Hallux abductovalgus?
Strengthening
Manual therapy
Modify footwear
Custom orthotics
Splinting
What is Morton’s neuroma?
Pain and paresthesia in interdigital space (2-3 or 3-4) with fibrous entrapment of interdigital nerve
What is management of Morton’s neuroma?
Shoe modifications
MT pads
MT mobilizations
How do you manage Morton’s neuroma if symptoms do not improve?
Surgical excision
