Test 2: Tendonapathies

Question 1

Tendinitis

Answer 1

Inflammation process- inflammatory cells found in tissue

Question 2

Tendonalgia

Answer 2

Pain neurogenic in nature; free nerve endings are irritated and signal pain to the brain
-tells brain there is damage that needs addressed

Question 3

Tenosynovitis

Answer 3

The synovial sheath the tendon runs through is inflamed

Question 4

Finkelstein’s test

Answer 4

Tests for DeQuervain’s Tenosynovitis:

• Pt ulnarly deviates wrist, OR practitioner passively deviates wrist on pt (acute)
• Passive flexion of thumb down to palm in ulnar flexion position (chronic)
• ->positive if there is pain at styloid process

Question 5

Acute treatment of tendonapathies

Answer 5

RICE: Rest, Ice, Compression, and Elevation 
-Ice massage
-Ultrasound
-Cold pack
-Cross friction massage
ASTYM

Question 6

Chronic treatment for tendonapathies

Answer 6

• Heat
• Massage and soft tissue mobilization
• Stretch (non-composite to composite)
• Joint mobilization
• IASTM (Instrument Assisted Soft Tissue Mobilization)
• Eccentric exercise (non-composite or composite with no load)
• Splint/orthopedic

Question 7

Different definitions of tendon pain

Answer 7

• “itis”- inflammation
• “osis”- scar tissue
• “algia”- nerve irritation

Question 8

Lateral epicondylitis

Answer 8

“Tennis Elbow”- inflammation of the tendon fibers that attach the forearm extensor muscles to the lateral epicondyle

Question 9

Stages of lateral epicondylitis

Answer 9

• Stage 1: Peritendious inflammation
• Stage 2: Angioblastic degeneration- pain not due to inflammation
• Stage 3: further degeneration/ rupture
• Stage 4: Fibrosis and calcification

Question 10

Activity modification for tendon injuries

Answer 10

• Avoid repetitive wrist movements
• Avoid excessive finger extension
• Avoid lifting and pilling items with a lot of resistance
• Lift with the flexors with the forearm supinated and close to body

Question 11

Medial Epicondylitis

Answer 11

“Golfer’s elbow” - results from repetitive wrist and finger flexion

• involves common origin of the wrist and finger flexors
• Ulnar N can get inflamed
• AVOID lifting with forearm supinated and elbow extended

Question 12

Trigger finger

Answer 12

A1 pulley Tenosynovitis

-finger gets stuck or clicks when trying to straighten

Question 13

Green Classification of Staging (trigger finger)

Answer 13

• Grade 1: pain and tenderness at A1 pulley
• Grade 2: Catching if digit
• Grade 3: locking of digit which is passively correctable
• Grade 4: fixed locked digit which will develop contracture

Question 14

Trigger finger treatment

Answer 14

• Surgical: release A1 pulley leaving A2 pulley intact
• Corticosteroid injection
• Splinting to block MP flexion