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KCP > Week 9- Soft Tissue Injuries > Flashcards

Week 9- Soft Tissue Injuries Flashcards

1
Q

What are some examples of soft tissue injuries?

A

Bruises
Muscle strains and tears
Tendonitis, tendinopathy, tendon rupture
Ligament rupture or tear
Capsulitis
Bursitis
Sprains

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2
Q

What are some examples of tendon injuries?

A

Tennis elbow, golfer’s elbow, Achilles tendinopathy

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3
Q

Give an example of a muscle/musculotendinous tear

A

Shoulder rotator cuff tear

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4
Q

Give an example of a ligament injury

A

Ankle sprain

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5
Q

Give an example of bursitis

A

Subacromial bursitis

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6
Q

What are the common mechanisms of injury?

A

Trauma
Sports
Overuse
Abnormal use/repetitive use
Lack of conditioning, lifestyle

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7
Q

What factors make someone more likely to get tennis elbow (lateral epicondylitis)

A

Affects 1-3% adults annually
Most common in age range 35-50
Usually in dominant arm
Tennis players
Repetitive manual work

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8
Q

What things are done in the examination for tennis elbow?

A

Look, feel, move
Palpation of the lateral epicondyle- for tenderness and swelling
Examination of wrist extension- pain with resisted wrist extension with elbow in full extension
Mill’s test- reproducing tenderness over extensor compartment
Resisted supination- reproducing tenderness over extensor compartment

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9
Q

How is tennis elbow treated?

A

Change activity
Exercise the tendon as close to its limit as possible
Strengthening exercises
Analgesia- paracetamol or NSAIDs acutely
Ice after activity

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10
Q

What is the rotator cuff and what does it do?

A

Rotator cuff comprises four muscles designed to stabilise glenohumeral joint and assist in initiation of movement

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11
Q

What are the two groups rotator cuff tears can broadly be divided into?

A

Chronic degenerative tears
Acute traumatic tears

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12
Q

What things would you look for when suspecting rotator cuff tear?

A

Trauma– significant injury implying acute tear
Age
Comorbidities– diabetes
History of subacromial impingement
Cardinal feature is weakness
Secondarily pain
Exclude fracture and neurological cause (cervical spine, plexus)

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13
Q

What is done during a clinical examination for a rotator cuff tear?

A

Supraspinatus– resisted abuction with thumbs down to defunction deltoid
Infraspinatus and teres minor– resisted external rotation
Subscapularis– resisted internal rotation

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14
Q

What investigations are done for a rotator cuff injury?

A

X-ray– shoulder trauma series to exclude fracture or dislocation
Ultrasound scan/MRI– confirms cuff tear and dimensions

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15
Q

What is done to manage acute tears of rotator cuff (identified within 6 weeks)?

A

Surgical repair for younger patients (<50)
Older patients- ice, NSAIDs, exercises, possible corticosteroid injection

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16
Q

What is done to manage chronic tears of the rotator cuff?

A

Ice, NSAIDs, exercises, corticosteroid injection

17
Q

Describe the Achilles tendon and what it does?

A

Strongest tendon in the human body
Connects plantaris, gastrocnemius and soleus to the calcaneum
Comprised of type I collagen
Tendon covered by connective tissue rich in elastin

18
Q

What are some common movements that cause rupture of the Achilles tendon?

A

Sudden unexpected dorsiflexion
Strong push off (plantar-flexion) with simultaneous knee extension and calf contraction

19
Q

How does pain with rupture of Achilles tendon present?

A

Sudden pain often with an audible “pop”

20
Q

What are the risk factors for Achilles tendon rupture?

A

Male, middle age
Sports activity
Chronic inflammatory disease- rheumatoid arthritis
Chronic renal failure
Certain drugs- corticosteroids, fluoroquinolone antibiotics

21
Q

What is used to diagnose rupture of Achilles tendon?

A

Pain and bruising around heel
Thompson test
Ultrasound used to confirm

22
Q

What is used in the management of an Achilles tendon rupture?

A

Rest/immobilisation
Use crutches
Air-cast/moonboot slight plantar flexion
Ice
Analgesia
Refer to orthopaedic surgery

23
Q

What is an ankle sprain?

A

‘Lateral ligament complex’
Deltoid ligament
Syndesmosis ligaments
Injury such as stretch or tear of these ligaments is an ‘ankle sprain’

24
Q

How is an ankle sprain diagnosed?

A

Ankle X-ray
Pain in malleolar area AND any of the following-
Unable to weight bear
Bony tenderness at posterior edge or tip of lateral malleous
Bony tenderness at posterior edge or tip of medial malleous

25
Q

What is used in the management of an ankle sprain?

A

Analgesia
Rest including a controlled ankle motion walking boot
Ice
Compression
Elevation

26
Q

What exercises are done in the management of an ankle sprain?

A

Early ankle motion in a controlled brace after 48 hours, against resistance within 4-5 days- therabands
Ankle strengthening
Improve proprioception- wobble board, BOSU ball

27
Q

What is a key aspect of treating soft tissue injuries?

A

Physiotherapist

KCP (9 decks)

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