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33 Cards in this Set
- Front
- Back
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12 Soft Tissue Lesions
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strain
sprain sublux dislocation muscle/tendon tear tendon lesion synovitis hemarthrosis ganglion bursitis contusion overuse syndrome |
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Grade I Tissue Injury
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mild pain
swelling tenderness pain with stress |
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Grade II Tissue Injury
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moderate pain
activity stops stress/palpation increases pain torn fibers increased jt. mobility |
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Grade III Tissue Injury
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Near/Complete Avulsion
no pain with stress marked jt. instability |
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High Tissue Reactivity
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pain before tissue resistance
RX: rest, I & II oscillations, ice, TENS, motion within pain free range |
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Moderate Tissue Reactivity
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pain with resistance
RX: gentle capsular stretching, progressive oscillations, heat |
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Low Tissue Reactivity
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no pain at restriction
RX: static stretch, III & IV oscillations |
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High Subject Reactivity
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Pt can't carry out functional activity because of pain
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Moderate Subject Reactivity
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Pt can carry out activity but c/o pain during, likely experience post-activity pain
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Low Subject Reactivity
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Pt can carry out activity without pain during, may/may not c/o pain post-activity
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5 Stages of Healing
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Immediate
Acute SubAcute Settled Chronic |
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Acute Stage Characteristics
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vascular changes
exudate, clot formation, new capillaries pain 4-6 days |
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Acute Stage Signs/Impairments
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inflammation/edema,pain with ROM,muscle spasm
impaired movement jt. effusion decrease use of associated areas |
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Acute Stage Goals
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*directed at signs/impairments
control pain and edema maintain mobility/jt. integrity reduce effusion maintain function of associated areas educate pt |
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Acute Stage Intervention
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control pain/edema/muscle spasm with cryo, non-thermal US, massage, I & II oscillations
PROM submaximal isometrics AROM of associated areas |
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Indication of Adverse Reaction to Intervention during Acute Stage: 1 symptom, 1 sign
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symptom: increased pain
sign: increased inflammation |
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Acute Stage Contraindications
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AROM to specific impairments
stretching resistance exercise |
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Subacute Stage Characteristics
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decreasing inflammation, clot resolution
repair begins: increased fibroblast activity, new fragile collagen may begin 14-21 days post insult may last 10-17 days -> 6 wks "pt indicates improvement of condition" |
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Subacute Stage Signs
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decreasing edema
pain at end range decreasing effusion poss. contracture 2* disuse developing weakness decrease functional use of part/other areas |
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Subacute Stage Goals
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promote healing
restore mobility progressively strengthen maintain function of associated areas pt education |
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Subacute Stage Intervention
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Jt. mobs: II & III's
stretching: agonish contract 1st strength: isometric->MRE->AAROM->AROM, protected CKC exercises Transverse Friction Massage **Monitor pt response closely! |
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Indication of Adverse Reaction to Intervention during Subacute Stage
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resting pain
fatigue increased weakness muscle spasm |
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Chronic Stage of Healing:
Description 1 |
late stage tissue repair, low inflammation, lack full function
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Chronic Stage of Healing:
Description 2 |
longstanding condition, recurring episodes of pain 2* inflammation or dysfunction from healing process
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Chronic Stage Characteristics
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collagen maturation
CT responds well to remodeling no/low inflammation pain past end range with overpressure may have decreased strength, ROM and function |
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Chronic Stage Signs
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pain after tissue resistance
muscle weakness decreased functional use/unable to achieve PLOF limited jt. play/ROM due to adhesions/contracture |
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Chronic Stage Goals
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decrease pain related to contracture/adhesions
increase mobility develop strength, balance and muscular endurance functional independence return to PLOF educate pt |
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Chronic Stage Intervention
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aggressive soft tissue/scar mobility
mobilize adhesions progress therex to functional levels increasing demands on balance, endurance and strength |
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Indication of Adverse Reaction to Intervention during Chronic Stage
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soreness remains after 4 hrs post activity
pain increased over previous session increase in stiffness inflammation increase weakness over successive visits decreased function |
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Chronic Inflammation Characteristics
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low level persistent inflammation
fibroblast proliferation motion may be limited |
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Chronic Inflammation Mechanisms
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overuse, cumulative trauma
trauma old scar reinjury contracture/poor mobility |
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Chronic Inflammation:
Contributing Factors |
length/strength imbalance
excessive eccentric demand muscle weakness malalignment intensity/demand changes premature return to activity awkward postures aging factors environmental factors combination of any above |
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Chronic Inflammation Problems
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pain
limited ROM and jt play poor endurance and weakness length/strength imbalance decreased functional use faulty movement pattern |
