Tenndonitis

Question 1

Impingement Syndrome Stages (3)

Answer 1

Neer’s Stages of impingement syndrome.

1) Edema and hemorrhage
2) Fibroses and tendinitis
3) Bone Spurs

Can stop the stages if they are treated correctly.

Question 2

Shoulder Tendonitis

Answer 2

Degeneration caused by nutrition deprivation (ischemia) and mechanical stress.
Causes debris containing calcium breakdown of fibrils collagen.
Microtears of fibrils leads to debris and inflammation.

Question 3

Shoulder Tendonitis Pain

Answer 3

Pain is felt at the superhumeral space
Affects the RC muscles
Leads to poor posture.

Question 4

Calfcific Tendonitis

Answer 4

Build up of calcium increases at the bone insertion (can be seen on xray)
Calcium builds up when tendonitis occurs
May cause increased pain and further impairment
Tends to come on quicker and is less responsive to tx.

Question 5

Bursitis

Answer 5

Inflammation of the subdetoid bursa.
Overuse of injury at the joint at work or play can increase a persons risks of bursitis; incorrect posture at work or home and poor stretching or conditioning before ex. can also lead to bursitis.
Point tender in a larger area of the RC

Question 6

Clinical symptoms of sh. tendonitis

Answer 6

Pts. w/ sh. tendonitis have pain between 60-120 degrees in elevation (flexion & ABD) for both P/AROM.
Pt. has a vague hx. of pain., edema, diffused weakness, spasms in close muscles (scapula).
Pt. ususally gets tendonitis due to over activity of the affected UE and they typically injury occurs from repetitive use of the offending activity.

Question 7

Key to tendonitis intervention in both the acute and subacute phase

Answer 7

Regain function w/o irritation through pt. education, activity and enviormental adaptation to prevent re injury.

Question 8

Acute interventions

Answer 8

Conservative therapy: Active rest.
Rest and support arm but not at the side.
Work on positioning, and what feels best.
Codmins and pendgulum ex.
Fx. activities: use LUR more, hemi dressing techniques, sleep positioning (body pillow UE ABD to 30) cleaning/cooking

Question 9

Subacute interventions

Answer 9

Warm up w/ MHP.
Use AAROM w/ cane or wall climbing.
If AAROM is tolerated then use isometric (ER/IR/FLEX/EXT).
Massage (x5 min on trigger points)
Stretching-door stretch, cervical spine
Gradually increase to isotonics if AAROM is 75% and w/o pain.
Grade fx. activities from acute phase: no lifting over 1lb w/ cues.
HEP program

Question 10

Location for Busitis pain

Answer 10

subacromial bursa

Question 11

Location for calcific tnedinitis

Answer 11

Distal attachment of the RC muscles