Musculoskeletal System: Lec.21B - Rehabilitation Medicine - Tendon And Lig Dysfunction

Front 1

Musculoskeletal System:

Lec.21B - Rehabilitation Medicine - Tendon and Lig Dysfunction

Back 1

Musculoskeletal System:

Lec.21B - Rehabilitation Medicine - Tendon and Lig Dysfunction

Front 2

Q21B:

Musculoskeletal ultra sound, is it any good?

Back 2

yes, it can often give you information that even an MRI can not give you

Front 3

Q21B:

what is a strain?
tendinitis?
Tendinosis?
Tendinopathy?

Back 3

- Injury to tendon
- inflammation of tendon
- chronic degeneration, DISTINCT LACK OF INFLAMMATORY CELLS(more accute term for chronic injury)
- any disorder of the tendon

Front 4

Q21B:

What is enthesis?

Back 4

insertion site of tendon, ligament, fascia, or articular capsule into bone

Front 5

Q21B:

What is an enthesopathy?

Back 5

- any disorder of the enthesis

Front 6

Q21B:

Enthesitis?

Back 6

inflammation of enthesis (common in rheumatic disorders)

Front 7

Q21B:

Name the ligaments indicated by the thick Grey lines

Back 7

- iliolumbar lig
-sacrotuberous lig
- sacrospinous ligaments

Front 8

Q21B:

What are the common enthesopathies of the spine / SI region?

Back 8

-Iliolumbar ligament
-Posterior sacroiliac ligaments
-Sacrotuberous ligament
-Gluteal tendons
-Hip adductor tendons

Front 9

Q21B:

What are the most common enthesopathies?

Back 9

Rotator cuff
-Lateral epicondyle of humerus
-Lower pole of patella
-Achilles tendon insertion
-Plantar fascia of the heel

Front 10

Q21B:

how common are tendon or ligament injuries?

Back 10

100 million musculoskeletal injuries occur annually worldwide, 30-50% involve tendon or ligament injury

Front 11

Q21B:

what sorts of pertinent history is there for tendon and or ligament dysfunction?

Back 11

- trauma
- joint subluxation / dislocation
- polyarthralgia
- pain upon awakening and after physical activity
- pseudoradicular symptoms with negative imaging, EMG and / or poorly responsive to spinal injections
- OMT does not hold or makes a problem worse
- joint hypermobity
- Local tenderness usually at entheses (with or without referred pain along the pseudoradicular distribution)
- Exacerbation of pain with active resistance and or passive stressing of the muscle tendon unit
- myfacial dysfunctoin (with trigger points in muscles supporting a relatively lax joint)
- joint hypermobility (often masked by muscle spasm) as determined by the beighton hypermobility score

Front 12

Q21B:

What is pain referral pattern for the iliolumbar ligament>

Back 12

- into the groin and latteral hip

Front 13

Q21B:

What is the pain referral pattern for the posterior sacroiliac ligament/

Back 13

- posterior and anterior thigh

Front 14

Q21B:

What is joint hypermobility syndrome?

Back 14

- 4-13% of general population
- women > men

Front 15

Q21B:

What is the brighton hypermobility score?

Back 15

- 9 points max (>4 = major criterion <4 = minor criterion)
- lumbar flexion = 1pt
-elbow flexion =1pt
knee hyperflexion = 1pt
wrist flexion = 1pt
5th finger hyperflexion= 1pt

Front 16

Q21B:

What are two common pain disorders around the hip

Back 16

- Sacroilitis
- Trochanteric bursitis

Front 17

Q21B:

SI joint problem vs SI ligament problem?

Back 17

Usually a ligament problem, not a joint problem

Front 18

Q21B:

what are two important components of inflamation>

Back 18

- pain (so that you will stop reinjuring it)
- inflamation = healing process
(if we interupt inflammation then we interupt the healing process)

Front 19

Q21B:

if you use NSAIDs soon after a Fx, what will happen?

Back 19

-it will decrease the healing of the Fx

Front 20

Q21B:

Where have steroids been shown to notabally aid in the reduction of chronnic inflammation of tendon lesions?

Back 20

- Trigger finger

Front 21

Q21B:

what will ECCENTRIC strengthening help with?

Back 21

-reduction of pain and reduction of swelling in lower extremity tendenopathy.

Front 22

Q21B:

Prolotherapy?

Back 22

-"proliferative therapy"
- “Method of injection treatment designed to stimulate healing. Various irritant solutions are injected into the ligaments, tendons, and joints to encourage repair of damaged tissue”
- hyperosmolar dextrose (one of the best injections

Front 23

Q21B:

Platelet-Rich Plasma (PRP) injection therapy

Back 23

- injections of autologous plasma rich in platelets and growth factors into dysfunctional tissue (about 3x more powerful than prolotherapy, only been in use for about 5 years)