Fibrosis Of Repair

Front 1

hypertrophic fibrosis

Back 1

fibrosis of repair
reflex contraction of muscles reduces the blood flow through the muscular tissue and in anoxic regions of low pH fibroblasts proliferate and increased fibrous tissue is formed

thickening of the fascia and subdermal connective tissue will also occur

Front 2

end feel

Back 2

felt in joint play; move joint in PROM

Front 3

soft end feel

Back 3

This is due to soft tissue approximation, usually when motion is stopped by the compression of muscle tissue. (elbow and knee flexion)
normal

Front 4

firm end feel

Back 4

This is the most common normal end feel and results from the stretching of soft tissues around the joint including ligaments and the joint capsule. This is described as leathery. (shoulder)
normal

Front 5

hard end feel

Back 5

This is due to two bone surfaces contacting each other (elbow and knee extension). Usually soft tissues limit motion before the bones contact each other.
normal

Front 6

firm end feel

Back 6

This may be due to muscle spasm, which limits movement so it feels abrupt. It may also be due to scar tissue as with the fibrosis of repair. Pain is associated with this end feel.
abnormal

Front 7

empty end feel

Back 7

This end feel is one in which no apparent mechanical or obstruction exists to movement but the patient cannot due it due to pain. Bursitis may cause this.
abnormal

Front 8

springy block end feel

Back 8

This us usually caused by a loose body or fragment in the joint space (joint mouse). The loose body alters the end-feel of the joint. However, it may not alter it in the same way each time. When movement is attempted the limb can spring back a little due to the loose body or fragment of cartilage being pinched in the joint.
abnormal

Front 9

impairment

Back 9

A physical limitation

Front 10

disability

Back 10

A social (work) limitation

Front 11

trigger points are bands of fibrous tissue

Back 11

that surrounds muscle fibers and that is infiltrated with lymphocytes

Front 12

diagnostic criteria of trigger points

Back 12

exquisite tenderness in a muscle: jump sign
circumscribed, painful, thickened area in a muscle: rope sign
pressure causes a characteristic referred pain pattern to a distal muscle site