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Musculoskeletal injuries 1 practcial Flashcards

1
Q

Signs and Symptoms
• Pain localized over the tibial tubercle
• Swelling over the patellar tendon
• Pain increases with activity and decreases with rest
• Usually present bilaterally
• More common in males between the ages of 11-15
• x-rays show regularity of the tibial tuberosity

A

Osgood schlatter’s disease

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2
Q

treatment for Osgood schlatter’s

A

Treatment
• Rest from painful activities
• Restore strength and flexibility to lower extremity muscles

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3
Q

igns and Symptoms • Localized pain on the calcaneal apophysis
• Pain increases on palpation and with activity and decreased with rest
• More common in males
• Most common between the ages of 11-15 years
• x-rays reveal sclerosis and irregularity of the apophysis

A

calcaneal apophysitis / sever’s disease

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4
Q

what is the treatment for calcaneal apophysitis

A

Treatment
• Heel lifts
• Ice and rest
• Casting (only way to make the child rest)
• Orthotics
• Proper athletic shoes
• Stretching of gastrocnemius and soleus muscles
• Strengthening of lower extremity muscles

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5
Q

Signs and Symptoms
• Pain over the distal pole of the patella
• Palpable prominence evident
• Pain increases with activity and decreases with rest
• Higher location than Osgood Schlatter’s disease
• Common in females between the ages of 8-13
• Common in males between the ages of 10-15
• Bilateral involvement usually
• x-rays reveal irregularity or fragmentation of the inferior pole of the patella

A

sinding Larsen Johansson Disease

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6
Q

what is the treatment for sinding Larsen Johansson disease

A

Treatment
• Same as for
○ Strengthening and stretching lower extremity

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7
Q

Signs and Symptoms
• Pain in the groin, anterior thigh and knee
• Antalgic gait pattern
• Decreased hip abduction, extension and external rotation
• More common in males between the ages of 3-8 years

A

Legg Calve Perthes Disease

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8
Q

what is the treatment for legg calve perthes disease

A

Treatment
• Immobilization in an abducted position in non weight bearing. Immobilization may last 1-2 years.
• Surgery to prevent further deformity of the femoral head

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9
Q 
Signs and symptoms 
Grade 1
	• Normal gait pattern and posture 
	• Slight pain on palpation 
	• Little or no swelling 
	• Full ROM of the lumbar spine and hip

Grade 2
• Antalgic gait pattern with shorten swing phase
• Patient stands in flexed and side flexed position towards the side of the injury
• Pain on palpation
• Visible swelling and bruising
• Active lumbar spine and hip flexion ROM decreased and painful
• Pain and weakness with resistance testing
• Positive Thomas test

Grade 3
• Pain with coughing sneezing or laughing
• Severe pain, swelling and bruising (must rule out a fracture or a eruption of muscle or ligament)
• All other findings as per grade 2

A

hip pointer

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10
Q

what is the treatment for hip pointer

A

Treatment
• Rest, ice, compress and elevate the area (RICE) PRICE p=protect
• Crutches for walking
• Non steroidal anti-inflammatory medications (NSAIDS)
• Electrical modalities such as TENS, interferential current and ultrasound
• Protective pad over the area
• Stretch and strengthen the appropriate muscles

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11
Q

Signs and Symptoms
• Burning or arching pain over or posterior to the greater trochanter
• May report a snapping sensation in the hip region with movement
• Pain on palpation of the greater trochanter of the hip
• Pain with active flexion, abduction and internal rotation of the hip (tensor fascia latae muscles) and extension and external rotation of the hip (involved)
• Pain with resistance testing of the hip for the associated muscle involved

A

trochanteric bursitis

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12
Q

what is the treatment for trochanteric bursitis

A

Treatment
• Ice
• Protected rest
• NSAIDS
• Electrical modalities such as ultrasound and interferential current
• No compression because that is the whole cause of the bursitis
• Stretching of the tight muscle
• Determine the potential cause of this problem an modify
• Aspiration of the bursa
• Surgical removal of bursa

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13
Q

Signs and symptoms
• Snapping of the hip with certain active and passive movement
• May also have associated pain with these movements
• Positive Ober’s test -ITB when it gets tight can cause the noise

A

snapping hip syndrome

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14
Q

what are the treatments for snapping hip syndrome

A

Treatment
• NSAIDS
• Stretching of the tight structures and strengthening of the weak muscles involved
• Alter the biomechanics and technique of the activity

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15
Q

Signs and symptoms
• history of poor posture, inflexibility and muscle imbalance
• Antalgic gait pattern with the inability to fully extend the knee at heel strike
• Sharp pain in the posterior thigh and buttocks. May also have bruising and palpate a defect within the muscle.
• Increased pain with active hip extension and knee flexion
• Increased pain with passive hip flexion and knee extension
• Pain and weakness with resisted hip extension and knee flexion (with the knee internally and externally rotated)

A

hamstring muscle strain

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16
Q

what is the treatment for hamstring muscle strain

A

Treatment
Phase 1:
• Protected rest, ice, compression and elevation
• NSAIDS
• Use of crutches if an antalgic gait pattern is evident

Phase 2:
• Electrical modalities such as ultrasound and EMS
• Introduce slow, pain free and gradual stretching program
• Begin gentle isometric strengthening exercises

Phase 3:
• Progressive stretching and strengthening exercises
• Sport specific exercises that involve rapid stops, starts and directional changes
• Focus on the prevention of future injuries

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17
Q

Signs and symptoms
• Bruising and swelling over the anterior thigh
• Antalgic gait pattern
• Pain with active hip flexion and knee extension
• Pain with passive hip extension and knee flexion
• Weakness with resisted knee extension and hip flexion
• Palpable tenderness in anterior thigh region

A

quadriceps muscle contusion

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18
Q

what is the treatment for quadriceps muscle contusion

A

Treatment
• Rest, ice, compress and elevate the area with the knee in maximal flexion
• Crutches may be used initially for the first few days keeps the extremity in a non weight bearing position
• NSAIDS
• Gentle stretching and strengthening program initially
• Electrical modalities such as ultrasound and EMS
• Progress exercises to include sport specific exercises, jumping, stopping and starting, changing directions and changing speed
• May also want the athlete to wear a protective pad upon returning to their sport

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19
Q

Signs and Symptoms
• Develops as a complication of a muscle contusion
• Warm, firm and swollen on palpation
• Have longer pain and dysfunction and does not respond to initial treatments
• Self limiting progression with maturation at 6-12 months
• x-rays are required for diagnosis of this injury. Bone mass in muscle evident on radiograph 3-4 weeks after injury

A

myositis ossificans

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20
Q

what is the treatment for myositis ossificans

A

Treatment
• Protected rest, ice, compression and elevation is required
• NSAIDS
• May take 6-12 months to resolve and if conservation treatment is not effective then surgical excision may be required

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21
Q

Signs and Symptoms
• Tightness and pain reported in the anterior thigh region
• Antalgic gait pattern
• Pain with active knee extension and hip flexion
• Pain with passive knee flexion and hip extension
• Pain and weakness with resisted knee extension and hip flexion
• Palpable pain and defect in the quadriceps muscle

A

quadriceps muscle strain

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22
Q

what is the treatment for quad muscle strain

A

Treatment
• Rest, ice, compress and elevate the area with the knee in maximal flexion
• Crutches may be used initially for the first few days keeps the extremity in a non weight bearing position
• NSAIDS
• Gentle stretching and strengthening program initially
• Electrical modalities such as ultrasound and EMS
• Progress exercises to include sport specific exercises, jumping, stopping and starting, changing directions and changing speed
• May also want the athlete to wear a protective pad upon returning to their sport

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23
Q

adductor muscle strain

A

Signs and Symptoms
• Antalgic gait pattern
• No pain with running straight ahead of backwards but pain with side to side movements
• Palpable tenderness over pubis ramus or lesser trochanter
• Palpable defect in muscle belly
• pain with active hip adduction
• Pain with passive hip extension, abduction and external rotation
• pain with resisted hip adduction

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24
Q

what is the treatment for adductor muscle strain

A

Treatment
• Rest, ice, compress and elevate the area with the knee in maximal flexion
• Crutches may be used initially for the first few days keeps the extremity in a non weight bearing position
• NSAIDS
• Gentle stretching and strengthening program initially
• Electrical modalities such as ultrasound and EMS
• Progress exercises to include sport specific exercises, jumping, stopping and starting, changing directions and changing speed
• May also want the athlete to wear a protective pad upon returning to their sport

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25
Q

Signs and Symptoms
• Minimal swelling is evident
• Antalgic gait pattern in which the individual may be unable to fully extend his knee on heel strike
• Decreased extension at the end of active and passive ROM
• Pain on the medial joint line of the knee on palpation
• Pain and possibly gapping with the valgus stress test

A

medial collateral ligament sprain

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26
Q

what is the treatment for medial collateral ligament sprain

A

Treatment
• Protection rest, ice, compression and elevation
• May use crutches for ambulating in the early stages
• Modalities such as ultrasound and interferential current
• Gentle active ROM exercises as soon as the acute symptoms subside
• Gentle strengthening exercise progression from isometric to concentric to eccentric and to close kinetic chain exercise
• No surgery is required in the case of a grade 1 injury but it may take 4-6 weeks to heal
• In the case of a grade 2 and 3 non operative treatment is usually the treatment of choice
• Complete tears of the ligament may require a cast brace to immobilize the knee joint or a surgical repair
• Figure-8 test to see if the patient can return to play, running cutting and planting on the affected leg is stressed with this test
• May require a MCL stabilizing brace upon return

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27
Q

Signs and Symptoms
• Minimal swelling is evident
• Antalgic gait pattern in which the individual may be unable to fully extend his knee on heel strike
• Decreased extension at the end of active and passive ROM
• Pain on the medial joint line of the knee on palpation
• Pain and possibly gapping with the varus stress test

A

lateral collateral lig sprain

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28
Q

what is the treatment for LCL

A

Treatment
• Protection rest, ice, compression and elevation
• May use crutches for ambulating in the early stages
• Modalities such as ultrasound and interferential current
• Gentle active ROM exercises as soon as the acute symptoms subside
• Gentle strengthening exercise progression from isometric to concentric to eccentric and to close kinetic chain exercise
• No surgery is required in the case of a grade 1 injury but it may take 4-6 weeks to heal
• In the case of a grade 2 and 3 non operative treatment is usually the treatment of choice
• Complete tears of the ligament may require a cast brace to immobilize the knee joint or a surgical repair
• Figure-8 test to see if the patient can return to play, running cutting and planting on the affected leg is stressed with this test
• May require a MCL stabilizing brace upon return

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29
Q

Signs and symptoms
• Patient usually hears a pop with injury
• Patient describes a rapid onset of swelling, nausea and pain deep inside the knee joint (disrupt artery)
○ Hemarthrosis -need to drain blood, because the blood will destroy the bone.
• The knee feels like it gives way and feel unstable
• Antalgic gait pattern evident with the knee bent at heel strike
• Decreased active and passive ROM of the nee for all movements
• Decreased strength will resistance testing for all movements
• +ve anterior drawer and lachman test

A

Anterior cruciate lig sprain

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30
Q

what is the treatment for ACL sprain

A

Treatment
• Similar to the treatment protocol for a MCL sprain in the acute stages
• Surgery is often indicated in the case f a grade 3 ACL sprain
• Refer to the protocol that the orthopaedic surgeon uses for the treatment of these injuries post operatively

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31
Q

Signs and Symptoms
• Patient usually hears a pop with the injury
• Patient describes a rapid onset of swelling nausea and pain deep inside the knee joint
• The knee feels like it gives way and feels unstable
• Decreased active and passive ROM of the knee for all movements
• Decreased strength with resistance testing for all movements
• +ve posterior drawer and posterior sag test

A

posterior cruciate lig sprain

32
Q

what is the treatment for PCL

A

Treatment
• Similar to the treatment protocol for a MCL sprain in the acute stages
• Surgery is often indicated in the case f a grade 3 ACL sprain
• Refer to the protocol that the orthopaedic surgeon uses for the treatment of these injuries post operatively

33
Q

Signs and Symptoms
• Patient may have heard a pop with the injury
• Experience locking of the knee with the inability to bend or straighten the knee
• Patient may describe a clicking grinding or popping sensation in the knee
• Pain localized over the medial or lateral joint lines
• Decreased and painful ROM at the extremes of rotation and flexion
• Slight swelling around the nee. Delayed swelling
• +ve McMurray’s and Apley’s compression tests

A

meniscal injuries

34
Q

what is the treatment for meniscal injuries

A

Treatment
• Similar to the treatment protocol for a MCL sprain in the acute stages
• Surgery is often indicated in the case f a grade 3 ACL sprain
• Refer to the protocol that the orthopaedic surgeon uses for the treatment of these injuries post operatively

35
Q

Signs and Symptoms
• Initially pain is present only after running or late in a run. Later this becomes sore earlier in the run and may progress to where it is sore all of the time
• Pain with climbing stairs and running up or down hills
• Pain and crepitus may be evident with active flexion and extension of the knee
• Palpable tenderness on the lateral aspect of the knee that may progress to soreness throughout the ITB
• +ve Obers test
○ Used for the hip as well, executed the same way but whether is it positive on the knee or hip is determined by the location of pain

A

iliotibial band friction syndrome

36
Q

what is the treatment for iliotibial band friction syndrome

A

Treatment
• Rest, ice, compression and elevation
• NSAIDS
• Massage
• Bracing
• Treat the mechanical cause of the problem
• May have to examine footwear and require orthotics
• May have to alter the training schedule regime and training surface
• Stretch the ITB and associated muscle such as the hip abductor flexor and lateral thigh muscle

37
Q

Signs and Symptoms
• Pain with squatting, jumping and stair climbing
• Initially have pain after the activity progresses to where pain is present at the start of the activity but subsides after the warm up and reappears after the activity; later stages complain of constant pain including night pain
○ Think fracture with night pain
• Pain with passive knee flexion at the end of range (beyond 120 degrees)
• Pain with resisted knee extension
• Pain on palpation of the patellar tendon
• Enthesitis

A

patella tendonitis

38
Q

what is the treatment for patellar tendonitis

A

Treatment
• Rest
• Modalities such as ice, heat, ultrasound and neuromuscular electrical stimulation may be used
• Bracing
• Deep transverse friction or massage
• Modify the cause of the problem and training regime
• Stretching and strengthening of associated lower extremity muscle

39
Q

Signs and symptoms
• Deep dull and achy pain over the anterior aspect of the knee
• Pain with descending stairs, prolonged sitting and squatted
• Crepitus, clunking and pain reported with squatting kneeling and bending and straightening knee
• Palpable tenderness over the lateral facet of the patella
• Pain on compression of the patellafemoral joint

A

patellafemoral pain syndrome (movie going)

40
Q

what is the treatment for patellafemoral pain syndrome

A

Treatment
• Modalities such as ice, ultrasound and neuromuscular stimulation
• Stretching and strengthening program for the associated lower extremity structures
• Surgical release of the tight lateral structures
• Taping or bracing to correct misaligned patella and tracking

41
Q

Signs and Symptoms
• Audible pop followed by collapse of knee
• Sudden onset of swelling
• Tenderness along the medial and lateral border of the patella
• Positive patellar apprehension test

A

patellar dislocation

42
Q

what is the treatment for patellar dislocation

A

Treatment
• Reduction of the dislocation and aspiration of the hemarthrosis if necessary
• Immobilization in a split
• Isometric contractions of the quadriceps and straight leg raising while in the splint
• Stretch the Iliotibial band and hamstrings
• Strengthening the vastus medialis muscle
• Bracing of the patellafemoral joint
• Surgery

43
Q

Signs and Symptoms
• Table of degrees in textbook (grade 1, 2 and 3)
• Grade 3: Blood pooling; swelling, limp, blood pooling/ bruising
• Grade 1: nothing just tender
• Peroneals muscle strain

A

lateral ankle sprain

44
Q

what is the treatment for lateral ankle sprain

A

Treatment
Phase 1:
• rest, ice, compression and elevation
• Put a horse shoe around the malleolus for compression and wrap a tensor bandage around the ankle
• Preventative taping
• Use crutches for walking
Phase 2:
• Modalities (ultrasound, IFC- increase blood flow, TENS -painful)
• Deep friction massage over the ligaments
• Stretching and strengthening exercises
• Proprioception exercise using wobbles board and balance exercises
• May require taping or bracing
Phase 3:
• Progression of stretching strengthening and sport specific exercises
• Remodeling phase can last up to one year

45
Q

Signs and symptoms
• Pain and swelling on the medial aspect of the ankle not as much swelling as lateral
• Point tenderness over the DL
• Pain with passive dorsiflexion of the ankle

Pain and laxity with talar tilt (this is a test) positive if gapping and or pain

A

medial ankle sprain

46
Q

medial ankle sprain treatment

A

Treatment
• Same as for lateral ankle sprain:
Phase 1:
• rest, ice, compression and elevation
• Put a horse shoe around the malleolus for compression and wrap a tensor bandage around the ankle
• Preventative taping
• Use crutches for walking
Phase 2:
• Modalities (ultrasound, IFC- increase blood flow, TENS -painful)
• Deep friction massage over the ligaments
• Stretching and strengthening exercises
• Proprioception exercise using wobbles board and balance exercises
• May require taping or bracing
Phase 3:
• Progression of stretching strengthening and sport specific exercises
• Remodeling phase can last up to one year

47
Q

Signs and Symptoms
• Pain with activity in the early stages and progresses to the point of pain with activity and at rest in the later stages
• Palpable tenderness on the posteromedial side of the tibia
• Percussion is negative (to rule out, tapping on the area and if it hurts it is a stress fracture if it does not it’s a medial tibial stress syndrome)
• Pain with active and passive of motion and with resistance testing depending upon the muscle involved
• Soleus- plantar flexion
• Tibialis posterior - plantar flexion and inversion
• Tibialis anterior dorsiflexion and inversion

A

medial tibial stress syndrome (shin splints)

48
Q

what is the treatment for medial tibial stress syndrome

A

Treatment
• Rest, ice, compression and elevation
• NSAIDS
• Non weight bearing activities
• Strengthening exercises using theraband or rubber tubing (only strengthen weakened muscles)
• Stretching excises for the soleus, tibialis posterior and tibialis anterior muscles
• Reassess the equipment used training technique, surface, shoes and schedule and any other anatomical factors that may be the cause of the problem

49
Q

Signs and Symptoms
• History of trauma to the anterior aspect of the lower leg, excessive exercise, vascular injury or prolonged externally applied pressure
• Dull ache and sense of fullness is compartment; often bilateral
• As the person continues to use the foot the pain may become more severe and disabling; pain is predictable
• Weakness with resisted testing of dorsiflexion and eversion of the ankle and extension of the first tow
• The patient may walk with a drop foot
• Numbness between the 1st and 2nd web space of the toes or over the entire dorsum of the foot
• What every compartment is affected will be apparent in the lower extremities
• Palpable tenderness and mass over the area the skin in the region feels very tight and increased skin temperature
• Decreased dorsalis pedis pulse (should be strong on both sides)

A

compartment syndrome

50
Q

what is the treatment for compartment syndrome

A

Treatment
How would you treat a compartment syndrome?
• Rest, ice, crutches,
• Total rest and ice
• Do not apply compression (already under too much pressure) and elevation ( it is hard enough for the heart t supply the distal components and elevation will increase the demands on the heart)
• Referral to a physical for consultation and monitoring is absolutely necessary
• Fasciotomy (open wound can be in the hospital for 1 or 2 months)

51
Q

Signs and symptoms
• Initially presents with a pin during activity in the early stages and the with pain both during activity and at rest in the later stages
• Pain with active (using the muscle) plantar flexion and passive (stretching the muscle) dorsiflexion of ankle
• Pain and weakness with resisted plantar flexion
• Palpable tenderness or nodule over the achilles tendon

Pain during the push off phase of walking and running

A

Achilles tendonitis or tendinosis

52
Q

what is the treatment for tendonitis or tendinosis

A

Treatment
• Rest, ice, compression and elevate
• NSAIDS
• Heel lift
• alter the training regime and the potential biomechanical causes of the problem
• Stretching exercises
• Introduce non weight bearing exercises

Eccentric heel drop strengthening (180 reps per day)

53
Q

Signs and Symptoms
• Feels like they were kicked in the heel
• Hears and feel a characteristic “pop”
• Visible swelling, bruising or a defect in the tendon
• Excessive passive dorsiflexion
• Weakness with resisted plantar flexion and inability to stand on toes
• May have palpable gap and tenderness in the region
• May be painless if completely ruptured
• +ve Thompson Test (not Thomas ) this is basically squeezing the calf normally functioning achilles will plantar flex )

A

Achilles tendon rupture

54
Q

what is the treatment for Achilles tendon rupture

A

Treatment
• Surgical repair
• Immobilization in a cast
• The course of action is dependent on the supervising physician

55
Q

Signs and Symptoms
• Pain first thing in the morning with the first few steps and after resting for a while. This pain diminishes after a few minutes of walking
• Tightness in the achilles tendon is evident with passive dorsiflexion
• Palpable tenderness over the anteromedial calcaneal tubercle of the heel
• Pain with passive extension of the toes and dorsiflexion of the ankle
• Normal resistant test and other tests all come out as normal

A

plantar fasciitis

56
Q

what is the treatment for plantar fasciitis

A

Treatment
• Rest, ice, compression and elevation
• Modalities
• Stretching of the achilles tendon
• Low dye taping
• Extracorporeal shockwave therapy (cant use it in children, diabetes, people who use aspirin)
• Heel pad or corrective orthotics
• Strengthening of the intrinsic foot muscles
• Address the biomechanical cause of the problem
• Cortisone injection into region
• Surgery

57
Q

Grade 1
• No visible deformity
• Slight swelling evident
• Minimal palpable pain
• No restriction in movement but may report pain
Grade 2
• Visible prominence on the medial end of the clavicle
• Moderate swelling evident
• Moderate palpable tenderness
• Restriction in abduction and horizontal adduction and pain reported with all movements
• Pain and weakness with all movements
Grade 3
• Gross prominence of the medial end of the clavicle
• Severe swelling evident
• Severe palpable tenderness
• As per grade 2 for mobility and strength testing but the pain may be more severe

A

sternoclavicular (SC) joint sprain

58
Q

what is the treatment for sternoclavicular joint sprain?

A

Treatment
• Rest and ice to the region
• NSAIDS
• Immobilization of the shoulder in a sling, figure 8 strap or a clavicular strap. For grade 3 injuries, reduction mat be required and the immobilization is maintained for 3-5 weeks
• Stretching and strengthening program. This is not initiated for 3-4 weeks in grade 2 or 3 injuries
• Surgical excision of the medial part of the clavicle

59
Q

Grade 1
• No visible deformity
• Slight swelling evident
• Palpable pain over the joint line
• No restriction on movement but may report pain with abduction greater than 90 degrees
Grade 2
• Visible elevation of the lateral end of the clavicle
• Moderate swelling evident
• Moderate palpable tenderness
• Restriction and pain with abduction and horizontal adduction
• Pain and weakness with all movements
Grade 3
• Gross prominence of the lateral end of the clavicle
• Severe swelling evident
• Severe palpable tenderness, depression and step down deformity
• As per grade 2 for mobility and strength testing but the pain may be more severe

A

acromioclavicular joint sprain

60
Q

what is the treatment for acromioclavicular joint sprain

A

Treatment
• Rest and ice the region
• NSAIDS
• Immobilization of the shoulder in grade 1 injuries is only used when pain is present. For grade 2 and 3 injuries immobilization is maintained for 2-4 weeks (ex. Sling)
• Modalities (common ultrasound and IFC)
• Stretching and strengthening program
• Surgical management for grade 2 and 3 injuries is sometimes considered

61
Q

Signs and Symptoms
• The client may report intense shoulder pan initially and then less painful
• Tingling and numbness in the arm and shoulder
• +ve x-ray findings
• The patient holds the arm in a slightly abducted and externally rotated position when anteriorly dislocated
• The patient may hold the arm adducted and internally rotated across the chest when posteriorly dislocated
• Marked pain and restriction in the active shoulder ROM
• Marked pain and weakness in the shoulder
• Palpation of the axilla reveals the presence of the humeral head with an anterior dislocation
○ When everything hurts it is something serious like a fracture or dislocation
• Palpable bulge in the posterior aspect of the shoulder with a posterior dislocation
• Marked pain and restriction in the active shoulder ROM
• +ve apprehension and Sulcus test

A

shoulder dislocation

62
Q

what is the shoulder dislocation treatment

A

Treatment
• Treat as a fracture, immobilize the arm in the position it is found in and seek medical attention as a physician to reduce the dislocation
• Apply ice to the region to control pain, muscle spasm and hemorrhage
• After the shoulder is reduced, the shoulder is immobilized in a sling for 3-6 weeks
• Gentle stretching and strengthening exercises may begin after the period of immobilization

63
Q

Signs and Symptoms
• Deep anterior shoulder pain reported
• Unable to sleep on the affected side
• Painful arc with abduction or downward flexion between 70-90 degrees
○ Elbow flexion weakness biceps
• Pain and muscle weakness may be evident with the associated muscle
• +ve impingemnet test
• The patient may present with a +ve empty can test or speed’s test depending upon which muscle in the shoulder

A

rotator cuff impingement syndrome

64
Q

what is the treatment for rotator cuff impingement syndrome

A

Treatment
• Restriction movements below shoulder height
• Rest and ice
• NSAIDS
• Modalities (TENS-pain, ice- 15 minutes, ultrasound- increase blood flow)
• Modifications of the aggravating activity or technique
• Stretching and strengthening exercises

Surgical repair of the rotator cuff and labrum

65
Q

Sings and Symptoms
• Snapping or cracking sensation
• Severe pain and rapid swelling
• Total loss of function
• Arm held in flexion , with forearm appearing shortened
• Obvious deformity with the olecranon and redial head visible and palpable posteriorly
• Slight indentation in triceps visible just proximal to olecranon
• Nerve palsy (cant move hands or wrist, nerve may be damaged, in tension or torn)

A

elbow dislocation

66
Q

what is the treatment for an elbow dislocation

A

Treatment
• Apply ice and immobilize the elbow and seek medial attention to have the elbow reduced
• The immobilization period is 3-6 weeks
○ More time than fracture because you have damage to all the soft tissue in the area, and it is required
• Stretching and strengthening exercises

67
Q

Signs and Symptoms
• Palpable tenderness is evident over the MCL of the elbow
• +ve valgus stress test
• Diagnosis is based upon the clinical presentation, subjective and objective assessment findings

A

medial collateral ligament sprain

68
Q

what is the treatment for MCL of the elbow

A

Treatment
• Rest, ice and compress the area
• NSAIDS
• May require immobilization n a sling for approx.. 10 days
• Protected ROM exercises
○ Not to the end of range, or within pain free limits

Strengthening exercises

69
Q

Signs and Symptoms
• Pain over the lateral epicondyle of the elbow and the extensor muscle belly
• Pain and muscle weakness may be evident with activities requiring gripping and wrist extension
• Pain with active wrist extension and passive wrist flexion
• Pain with weakness with resisted wrist extension with the elbow in full extension (ECRL) and flexed to 90 degrees (ECRB)
• Pain with resisted extension of D3 of the hand (EDC)
• +ve Tennis elbow test

A

Lateral epicondylitis (tennis elbow) or medial epicondylitis (golfers elbow)

70
Q

what is the treatment for lateral epicondylitis and medical epicondylitis

A 
Treatment 
	• Rest, ice and compress the area 
	• NSAIDS
	• Night splint 
	• Tennis elbow strap 
	• Modalities 
	• Stretching and strengthening program 
	• Modify the cause of the problem examining the activity, technique, equipment used or the training regime 
	• Cortisone injection
71
Q

Signs and Symptoms
• Visible swelling in the posterior aspect of the elbow
• If ruptures, goose egg visible
• Tenderness on palpation of the posterior aspect of the elbow
• Motion limited at extreme of flexion- tension increases over bursa

A

olecranon bursitis

72
Q

what is the treatment for olecranon bursitis

A 
Treatment 
	• Rest, ice and compression 
	• NSAIDS 
	• Modalities 
	• Protective padding over the area 
	• Aspiration of the area
73
Q

Signs and Symptoms
• The patient complains of numbness or shocking pain in the posterior and medial aspect of the elbow or in D4 and D5 of the hand
• +ve tinel test of the elbow

A

ulnar nerve entrapment

74
Q

what is the treatment for ulnar nerve entrapment

A

Treatment
• Rest
• NSAIDS
• Surgical release

75
Q

Signs and Symptoms
• Sudden snap in the elbow region during an eccentric and sudden loading of the elbow
• Swelling, bruising and visible indentation on inspection
• Pain on palpation over the radial tuberosity and anterior aspect of the elbow
• Pain and weakness with resisted elbow flexion and forearm supination

A

biceps muscle strain

76
Q

what is the treatment for biceps muscle strain

A

Treatment
• Modalities
• Stretching and strengthening exercises
• Surgical repair on young active person

77
Q

signs and symptoms:

the lunate may also sublux or dislocate in a dorsal direction

A

dorsal dislocation

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