Tendon and Ligament Injuries Flashcards
Tendon and ligament injuries,
- Sometimes referred to as soft-tissue injuries, can occur throughout the life span.
- Some types are more common in adults and geriatric populations.
- More common for us to work with adults with tendon and ligament injuries than other age groups.
Tendons
Collagen rich to elicit strong tensile strength to the bone.
Tendonitis
An inflammatory condition of the tendon.
Tendinosis
A degenerative condition of the tendon.
Tendonitis and Tendinosis Symptoms
- Pain with AROM of the involved tendon
- Pain with resistance to the involved tendon
- Pain when the involved tendon is placed on stretch
Lateral epicondylitis
- A tendonitis of the common extensor tendon
- Pain is often experienced at the lateral epicondyle
- Education focused on ergonomics and proper body mechanics
- Avoid lifting with elbow in full extension and pronation
- Screening of the entire upper extremity: Scapular Stabilization
DeQuervain’s Tenosynovitis
Tendonitis of the tendons in the first dorsal compartment
- Abductor pollicis longus (APL)
- Extensor pollicis brevis (EPB)
DeQuervain’s Tenosynovitis is commonly seen in…
- New mothers, golfers, knitters, and racquet sports players
- Avoid sustained thumb radial abduction
- Avoid pinching with wrist deviation
Ligament Injuries
A ligament connects bone to bone to provide stability to the joint.
Grade 1 Ligament Tears
Ligament is intact, but individual collagen fibers are disrupted or stretched
Grade 2 Ligament Tears
Ligament has been partially torn
Grade 3 Ligament Tears
Complete tear of the ligament
Skier’s Thumb
- A disruption of the ulnar collateral ligament (UCL) of the thumb MCP joint.
- Often seen with individuals who fall while skiing or with ball injuries.
- Surgery will be required if there is a complete tear to the UCL of the thumb
Tendon Lacerations
- If more than half of a tendon is lacerated, surgery will be required.
- An orthotic will be used after the surgery to protect the repair (often worn for 5-6 weeks)
- Clients can begin to engage in light functional tasks without resistance around 5-6 weeks post injury (Forceful AROM should be avoided prior to that time because when the muscle contracts it will pull on the repaired tendon)
Flexor Tendons
- More round and contained within a synovial sheath (filled with synovial fluid that helps provide lubrication to the tendons_
- Flexor retinaculum and transverse carpal ligament
- Cruciate and annual ligaments (help to keep the flecor tendons in place. at the fingers to prevent bowstringing of the tendons during functional movement)
Bowstringing
When the tendons are pulled away from the bone during a muscle contraction rather than staying close to the bone to elicit a smooth gliding movement
Extensor Tendons
- More flat
- Extensor retinaculum (prevents bowstringing. and divides the extensor tendons into 6 compartments)
- Extensor mechanism
Extensor Mechanism
A balanced combination of tendon fibers and ligamentous support that helps to extend the PIP and DIP joints
Flexor and Extensor Tendons
- Both flexor and extensor tendons are divided into zones
- These zones indicate different protocols following repair of the tendon
Extensor Zones Common Injuries
Zone 1 Injury: Located at the DIP joints
-Zone 3 Injury: Located at. the PIP joint
Flexor Zones Common Injuries
- Zone 1 Injury: “Jersey Finger”
- Zone 2 Injury: Can be more difficult to repair due to the limited blood supply and the necessary glide between the flexor digitorum superficialis and flexor digitorum profundus tendons; Area is often referred to as “no mans land”
Rotator Cuff Tendonitis
- Rotator Cuff is comprised of the supraspinatus, infraspinatus, subscapularis, and teres minor.
- The tendon of the supraspinatus is the most commonly impinged rotator cuff tendon.
- Can partially or fully tear, resulting in significant impairments in occupational tasks such as toileting, hair care, or hooking a bra.
Rotator Cuff Tendonitis Chief Complaint
Common Causes of Rotator Cuff Tendonitis
Repetitive overhead use, curved or hooked acromion, weakness of shoulder or scapula musculature, and capsular tightness
