Week 3 - Soft-tissue injuries & patient history taking Flashcards
Soft tissue injury signs + symptoms
- Amount of soft tissue fibres damaged
- Severity of pain, swelling, or bruising
- Severity of loss of ROM / ligament laxity
- Amount of LOF
Inflammatory phase:
0-72 hours
Initiates the proliferation of new tissue cells, which eventually remodel to restore normal tissue function.
- Swelling occurs (oedema)
Proliferation phase:
48 hrs - 6weeks
Remodelling phase:
3 weeks - 12 months
Bleeding 0-10 hours post injury:
- Due to damage of small blood vessels +capillaries in the soft tissue
- Can track distally due to gravity
- More vascular will bleed more
Main clinical features of the inflammatory phase:
- Pain, swelling, redness
- +/- increased local temp.
- LOF
The proliferation phase (what is happening):
- Collagen-forming phase (prod. of type III collagen fibres- form scar tissue)
- Formation of new blood vessels
- by 2-3 weeks most scar tissue is laid down.
Oedema:
Fluid retention causing affected tissue to become swollen
The remodelling phase (what is happening):
Collagen in scar tissue:
- Matures & becomes denser
- Becomes more organised along the lines of stress.
Contractile tissue 24 hr behaviour:
Usually benefits from rest, usually better in the mornings + worsen w/ activity throughout the day
Inflammatory behaviour 24 hr behaviour:
(i. e. OA/RA)
- May be worse in the morning, improve during the day then get worse in the evening.
Degenerating tendinopathies 24 hour behaviour:
Usually stiff in the morning & warm up with movement
- Worse the morning after activity
Serious pathology 24 hour behaviour:
Pain that wakes you up and keeps you up
Contractile tissue:
- Usually aggravated w/ activity that results in contraction fo that muscle.
- Improves w/ rest
Non-contractile tissue:
- Usually aggravated w/ activity that loads the joint/ligament
- Stress tests may be needed
- May stiffen w/ rest
