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Treatments I > Tendinopathy > Flashcards

Tendinopathy Flashcards

1
Q

What is tendinopathy?

A

Disease or disorder of a tendon

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2
Q

What is inflammation of a tendon?

A

Tendinitis

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3
Q

What is the non inflammatory degeneration of a tendon (over time)?

A

Tendinosis

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4
Q

What is the inflammation of a the outermost layer of the tendon?

A

Paratenonitis

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5
Q

What is the inflammation of the synovial sheath?

A

Tenosynovitis

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6
Q

What is the etiology?

A
  1. Chronic degeneration due to trauma, repetitive usage, age
  2. Rheumatoid arthritis, lupus, or chronic renal failure
  3. Poor biomechanics
  4. Muscle imbalances
  5. Insufficient rest after activity
  6. Degeneration is thought to be more common than inflammation
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7
Q

Where is it frequently seen?

A
  1. Common flexor tendon (golfer’s elbow / medial epicondylitis)
  2. Common extensor tendon (tennis elbow / lateral epicondylitis)
  3. Quadriceps (patellar)
  4. Achilles / Calcaneal / Triceps Surae
  5. Wrist & Ankles (tendon sheath)
  6. 2nd-5th digits (flexor tendons)
  7. 1st digit (abductor & extensor pollicis tendon sheath - De Quervain’s Tenosynovitis)
  8. Rotator Cuff
  9. Biceps Brachii (Long Head)
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8
Q

What are the general signs & symptoms?

A
  1. In all stages of tendinosis, stiffness & pain are present, especially with resisted movements and stretching - Stretching the damage tendon
  2. Often the client can clearly identify the location of tendinopathy
  3. Pain is frequently described as “severe” or “sharp” in early stages, “dull ache” after tendinopathy has been present for a longer period
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9
Q

Tenosynovitis has an added feature of?

A

Resistance & crepitus as the affected tendon moves through its sheath

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10
Q

Tendinitis presents with classic signs of ______ and & is categorized by ______

A
  1. Inflammation
  2. Grade
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11
Q

What is the sign & symptom of Grade 1 tendinitis?

A
  1. Pain after activity only
    - Playing tennis but hurts after playing
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12
Q

What is the sign & symptom of grade 2 tendinitis?

A
  1. Pain at beginning of activity, disappears during activity, then returns after the activity
    - Pain at beginning of playing tennis, disappears during, goes home & it hurts
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13
Q

What are the signs & symptoms of grade 3 tendinitis?

A

Pain at beginning, during and after activity : pain may restrict activity

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14
Q

What are the signs & symptoms of grade 4 tendinitis?

A

Pain with ADLs

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15
Q

What are contraindications & precautions?

A
  1. No frictions with anti inflammatory or blood thinners
  2. Avoid joint movements that produces pain or will overstretch that injured tissue
  3. If repeated cross fiber strokes produces inflammation, end with cool or cold local hydrotherapy
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16
Q

Assessment

A
  1. AROM usually painless (tendon damage, not muscle)
  2. PROM pain in the range that STRETCHES the affected tendon
  3. RROM pain in the range that TESTS THE AFFECTED MUSCLE, pain increases with the force of contraction, and possible weakness
  4. Strength testing possible weakness and pain, especially if testing the muscle in a lengthened position
  5. Length testing of the affected muscle is likely painful
  6. Potential impact on ADLs
  7. Positive tendinopathy tests (de Quarvain’s)
17
Q

What assessments to do in acute?

A
  1. Antalgic gait or posture
  2. Signs of inflammation may be visible
  3. Palpation reveals point tenderness of the affected tendon, as well as hypertonicity & TPs (local & antagonists)
18
Q

What assessment to do in chronic?

A
  1. Postural assessment to determine source of muscle imbalances
  2. Palpation reveals pain at or near the tendon, adhesions, stiffness, HT, TPs, and possibly crepitus
19
Q

What are goals in acute?

A
  1. Control inflammation (if present)
  2. Reduce pain via (strip, frictions)
  3. Prevent excess adhesion formation
  4. Maintain strength, function & mobility
  5. ASAP, gradual return to movement within pain tolerance to avoid excess scar tissue formation
  6. Encourage local circulation
20
Q

What are goals in chronic?

A
  1. Decrease muscle imbalance
  2. Restore mobility
  3. Normalize muscle tone
  4. Gradually restore muscular length & strength
  5. Reduce TPs & adhesions
21
Q

What are techniques?

A
  1. Compressions increase circulation
  2. Stripping, kneading reduce HT
  3. Pickups, open c’s
  4. Stretching reduce adh form
  5. AROM
22
Q

What are homecares?

A
  1. RICE
  2. Breathing
  3. Contrast / hot to increase local circulation
  4. Stretching (slow and pain free)
    - up to pain
    - AROM
  5. Strengthening (eccentric contractions)
    - low level : isometric / isotonic

Treatments I (12 decks)

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