General Flashcards
(57 cards)
1
Q
Your client has been diagnosed with
Rotator Cuff Strain / Tendinitis.
Describe the region involved and position the client for work in this area.
A
- Shoulder
- Supine - Prone - Side-lying
2
Q
- Describe: Rotator Cuff Strain / Tendinitis
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition.
A
- It’s a pull or tear of a rotator cuff muscle (supra, infra, teres minor, subscap) resulting from foreceful contraction or stretch, or chronic overuse
- Limited shoulder range of motion
- Painful with stretch of injured muscle and the contraction
GOALS:
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
Muscles:
- Pec Major
- Coracobrachialis
- Trapezius
- Infraspinatus
3
Q
- Name 4 musculoskeletal structures involved in Rotator Cuff Strain / Tendinitis
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
-
Pectoralis Major (M 1/2 of clavicle, sternum, and cartilage fo R1-R6 –> Crest of greater tubercle)
-Effleurage, Muscle Squeeze, Stretch -
Coracobrachialis ( (coracoid process –> M mid-humerus)
-Effleurage, Petrissage, Gliding friction, Stretch -
Trapezius (Ext occipital protuberance, ligamentum nuchae and SP C7-T12 –> L 1/3 clavicle, acromion, and spine of scapula)
-Effleurage, Petrissage, Muscle Squeeze, Laminar Groove circular FX -
Infraspinatus (Infraspinous fossa –> G tubercle) [L-R and ADD]
-Effleurage, Petrissage, XXF on strain, Eccentric contraction stretch
Endagerment Sites:
- Posterior Triangle of Neck (SCM, Traps, Clavicle border)
- Suboccipital Region
4
Q
Your client has been diagnosed with
Thoracic Outlet Syndrome
Describe the region involved and position the client for work in this area.
A
- Neck, Shoulder Girdle, Arm
- Supine - Side-lying
5
Q
- Describe: Thoracic Outlet Syndrome
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- Entrapment of the brachial plexus and subclavian vessels
- Often caused by tight Pec minor (pulls clavicle down), and/or tight Scalenes (pulls ribs up)
- C/o numbness, tingling, weakness, pain and fullness of the arm
- Sx mimicked by cervical subluation, disk herniation, rib misalignment
- Commonly occurs secondary to cervical injuries - whiplash from car accident
- Sometimes misdiagnosed as Carpal Tunnel Syndrome
GOALS:
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
- Pec Major
- Pec Minor
- Subclavius
- Scalenes
6
Q
- Name 4 musculoskeletal structures involved in Thoracic Outlet Syndrome
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
-
Pectoralis Major (M 1/2 of clavicle, sternum, and cartilage fo R1-R6 –> Crest of greater tubercle)
-Effleurage, Muscle Squeeze, Stretch, Compress -
Pectoralis Minor (R3-R5 –> M coracoid process) [DP, ABD, DR scapula, ELV thorax w/inhalation]
-Have pt pull breast tissue away
-Effleurage, Gliding linear FX -
Subclavius (R1 and cartilage –> Inferior mid 1/3 clavicle) [DP, Stabilize clavicle, ELV R1 w/ inhale]
-Stretch by L-FLX opp side, hook onto 1st rib, and exhale as pull arm and rib off clavicle down. Then can glide linear FX
-Circular FX, Lift and stretch clavicle with exhale -
Scalenes (A: TP C3-C6 –> R1, M: TP C2-C7 –> R1)
-Effeurage, Petrissage, circ FX
—————–
ENDANGERMENT SITE:
- Anterior and Posterior triangle of neck
- SCM, Mandible and Trachea as borders: trachea, carotid artery, vagus nerve, internal jugular vein, lymph nodes
-Traps, Clavicle, SCM borders: vertebral artery,
subclavian vein, subclavian artery, external
jugular vein, brachial plexus, lymph nodes
- Axilla
- Brachial plexus, median nerve…
7
Q
Your client has been diagnosed with
Carpal Tunnel Syndrome
Describe the region involved and position the client for work in this area.
A
- Forearm, wrist, and hand
- Supine
8
Q
- Describe: Carpal Tunnel Syndrome
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- Compression of the carpal tunnel space with entrapment of the median nerve
- Inflammation of the flexor tendons and sheaths
- Tenosynovitis = inflammation of tendon sheath lining
- Tendonitis = inflammation of the tendon
- Also caused by displacement of carpal bone (capitate)
- Sx numbness, tingling, weakness, and pain in 1st-3rd digits
- Aggravated by extreme flex/ext
- Tx attempts increasing space by reducing inflammation and realigning carpal bones and lengthening flexor retinaculum (transverse carpal ligament) which increases space
- Mimicked by cervical strain/sprain or disc herniation; rotator cuff injures and TOS
GOALS:
- *Increasing carpal space by lengthening the transverse carpal ligament, reducing inflammation and realigning carpal bones (capitate)*
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
(Strong wrist FLX and PRON and overdevelopment can lead to CTS; work these first)
- Bicipital Aponeurosis
- Transverse Carpal Ligament (Flexor Retinaculum)
- Wrist and Finger Flexors
- Wrist and Finger Extensors
9
Q
- Name 4 musculoskeletal structures involved in Carpal Tunnel Syndrome
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
- Bicipital Aponeurosis
-
Transverse Carpal Ligament (Flexor Retinaculum)
-Arm supine on table and 90 stop sign flat, you standing caudad. Do the stretch by alien hand position with thumbs ontop, and stretch laterally with thumbs -
Wrist and Finger Flexors
-Arm supine, Gliding FX and knead -
Wrist and Finger Extensors
-Arm Pronate,vTraction wrist with FLX (making space) and feel back of wrist, Gliding FX on back of hand towards wrist,
—————
ENDANGERMENT SITE:
- Anterior Wrist
- Ulnar Notch
10
Q
Your client has been diagnosed with
Tennis Elbow - Lateral Epicondylitis
Describe the region involved and position the client for work in this area.
A
- Forearm, elbow
- Supine
11
Q
Your client has been diagnosed with
Tennis Elbow - Extensor Tendonitis
Describe the region involved and position the client for work in this area.
A
- Forearm, elbow
- Supine
12
Q
- Describe: Tennis Elbow - Lateral Epicondylitis and Extensor Tendonitis
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- Extensor Tenodinitis is inflammation or strain 1-2” distal to epicondyle at the musculotendinous junction of the extensors. Feel it when EXT wrist
- Lateral Epicondylitis is inflammation or pain at the L epicondyle with tenoperiosteal tearing (FX towards, never away)
- Tight wrist and finger extensor bellies transmit traumatic forces to origin of muscle
- Perpetuated by chronic extensor tension, repetitive stress, or traumatic reinjury
- Aggravated by forceful supination or wrist extension, especailly with pronation
- Mimicked by radiocapitellar joint injury
- Golfer’s elbow (medial epicondylitis) is a similar affliction of the medial elbow
GOALS:
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
(Work pronators and FLX first before weak EXT)
- Biceps Brachii
- Brachioradialis
- Pronator Teres
- Wrist extensors / Common extensor tendon
13
Q
- Name 4 musculoskeletal structures involved in Tennis Elbow - Lateral Epicondylitis and External Tendonitis
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
-
Biceps Brachii (SH: Coracoid process, LH: Supraglenoid tubercle –> Tuberosity of radius and aponeurosis of biceps brachii)
-Arm is supinated by side, compression down bicep, petrissage -
Brachioradialis (Distal L 2/3 humerus –>styloid process radius)
-Muscle squeeze, petrissage -
Pronator Teres (common FLX tendon M epicondyle + coronoid process ulna –> middle of L radius)
-Sit behind client next to head, arm = 90 stop sign ABD from body. Squeeze PT at RC joint as they active pronate/supinate. Pin it, then stretch my extending and supinate forearm ABD from body - Wrist extensors / Common extensor tendon (1-2” distal from L epicondyle)
- -Compression while EXT of wrist
————-
ENDANGERMENT SITES:
- Antecubital Region
- Ulnar Notch
14
Q
Your client has been diagnosed with
Dupuytren’s Contracture
Describe the region involved and position the client for work in this area.
A
- Hand, forearm
- Supine
15
Q
- Describe: Dupuytren’s Contracture
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- “Palmar Fascitis”
- Inflammation and fibrosis, resulting in thickening and shrinkage of the palm of the hand
- 4th and 5th digits held in flexion at MCP joint
- Callusing and ischemia in hypothenar (ulnar) aspect of palm is severe cases
- Cause is unknown, but repeated micro trauma is suspect
- Predominantly affects middle-aged white men, common in right hand when unilateral
- Higher incidence in invalids, alcoholics, epileptics, and with TB, DB, and liver disease
- Massage can slow or prevent, but not reverse the condition
GOALS:
*Issue is a base of 5th MCP that’s shrinking and holding flexion, want to relax and lengthen (4th, 5th, thenar)
*Do not Overtreat - especially Palmar Aponeurosis - Can accelerate contracture
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
- Biceps Brachii
- Flexor Digit Minimi
- Lumbricals
- Palmar aponeurosis
16
Q
- Name 4 musculoskeletal structures involved in Dupuytren’s Contracture
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
- Biceps Brachii
- Flexor Digit Minimi
- Lumbricals
- Palmar aponeurosis
———–
ENDANGERMENT SITE:
- Anterior Wrist
- Hoku / Reflex Point
- Ulnar Notch
17
Q
Your client has been diagnosed with
Tension Headache
Describe the region involved and position the client for work in this area.
A
- Head, neck, and shoulders
- Supine
18
Q
- Describe: Tension Headache
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- Pain originating with N, H, and/or jaw muscle tension and TMJ issues
- Usually related to stress, injuries, subluxations or postural problems
- HT reduces circ and results in local ischemic pain
- Once HA is relieved, underlying cause can be addressed appropriately
- Tension can mimic: Sinus, Vascular and Migraine HA
- SINUS - inflammation of sinus tissues, contra if acute, Hydrotherapy is effective for -VASCULAR - toxic hangover type, M may help with detox, but may intensify discomfort, contra if acute
- MIGRAINE - biphasic (ischemic/hyperemic), light-headedness followed by unilateral throbbing/pounding, pain may be preceded by visual and auditory phenomena (aura), M in ischemic phase may reduce intensity of hyperemic reaction, contra if acute
GOALS:
*Locate offending muscle and break ischemia/spasm/pain cycle
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
- Trapezius
- SCM
- Suboccipitals
- Occipitofrontalis
19
Q
- Name 4 musculoskeletal structures involved in Tension Headache
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
- Trapezius
- SCM
- Suboccipitals
- Occipitofrontalis
—————–
ENDANGERMENT SITE:
- Suboccipital Region
- Posterior Triangle of Neck
20
Q
Your client has been diagnosed with
Torticollis
Describe the region involved and position the client for work in this area.
A
- Neck
- Supine
21
Q
- Describe: Torticollis
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- “Twisted Neck”
- Unilateral spasm of cervical musculature: L-FLX to affected side, L-R to opp side
-Opp side is getting a BIG workout - Muscles typically responsible are those innervated by spinal accessory nerve (SCM, Trapezius)
- Caused by -
-Postural streses or emotional disturbances (wryneck, torsion dystonia)
-Injured or impinged spinal accessory nerve (spasmodic torticollis, myogenic torticollis)
-Visual disparity (ocular torticollis)
GOALS:
*Reduce pain and balance tensions in the neck to restore more normal posture
*Work opposite site first (uninvolved) - Flush and rejuvenate, but leave it toned and ready to work (overstretched, weak = increase circ and tone it, short strokes)
- *Work affected side x 2, reduce spasm and pain, leave it long and soft (tight = long and slow, deep, stretch)*
1) >circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) >ROM
MUSCLES:
- Pectoralis Major and Minor
- Erector Spinae Group
- SCM
- Longus Capitits and Colli
22
Q
- Name 4 musculoskeletal structures involved in Torticollis
- Outline and highlight fiber alignment
- Demonstrate treatment for each strucure
- Name 2 potential endangerment sites at risk
A
- Suboccipitals
- Suprahyoids
- Trapezius
- SCM
————
ENDANGERMENT SITE:
- Suboccipital Region
- Posterior Triangle of Neck
23
Q
Your client has been diagnosed with
Whiplash
Describe the region involved and position the client for work in this area.
A
- Head, neck, and shoulders
- Supine
24
Q
- Describe: Whiplash
- Explain your treatment goals for the condition.
- Name 4 musculoskeletal structures involved in the condition
A
- “Hyperextention/flexion sprain/strain myofascial dysfunction syndrome”
- Caused by sudden transverse loading or positional change in the neck, as with falls and MVA’s
- Damage may be intensified by the stretch reflex causing magnification of acceleration
- Hyperextension injures anterior cervical muscles and lig
- Hyperflexion injures posterior cervical muscles and lig
- Lateral felxion injures intertransverse ligaments, transverse processes, nerve roots, vertebral artery
- Watch for elevated hyoid
- May lead to:
- Fibromyalgia
- TMJ syndrome
- TOS
- Torticollis
- Reflex Sympathetic Dystrophy
- Interview thoroughly
- ALWAYS have imaging first before proceeding with treatment
- Physician’s guidance is recommended
GOALS:
25
* Name 4 musculoskeletal structures involved in **_Whiplash_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Pectoralis Major and Minor**
* **Erector Spinae Group**
* **SCM**
* **Longus Capitits and Colli**
_============_
ENDANGERMENT SITES:
* Anterior Triangle of Neck
* Posterior Triangle of Neck
26
Your client has been diagnosed with
**_TMJ Syndrome / Dysfunction_**
Describe the region involved and position the client for work in this area.
* Head, neck
* Supine
27
* Describe: **_TMJ Syndrome**_ and _**TMJ Dysfunction_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* **_TMJ syndrome_** is a complex of SX resulting from pain and dysfunction of TMJ
* SX: Jaw pain
* Popping, clicking or locking
* tooth grinding
* headaches
* tinnitus
* toothaches
* neck and shoulder pain
* generalized pain in severe cases
* **_TMJ dysfunction_** can result from muscle tension, trauma or cranial assymetry
* Dental extractions may contribute to articular misalignment
* Hip adductor tension may contribute reflexively to jaw muscle tension
---------------
GOAL:
*\*Decompress joint and reduce tension to reduce symptoms and prevent further damage*
1) \>circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) \>ROM
----------
MUSCLES:
* Hip Adductors
* Orofacial muscles
* Temporalis
* Masseter
28
* Name 4 musculoskeletal structures involved in **_TMJ Syndrome/Dysfunction_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Hip Adductors**
* **Orofacial muscles**
* **Temporalis**
* **Masseter**
_---------------_
ENDANGERMENT SITES:
* Notch posterior to Ramus of mandible
* Styloid process
* Facial nerve
* Trigeminal nerve branches
- Opthalmic nerve
- Maxillary nerve
- Mandibular nerve
* Femoral Triangle
* Inguinal Lig, Sartorius (L), Add. Longus (M):
* Femoral Nerve
* Femoral Artery
* Femoral Vein / Branches to Gr. Saphenous Vein
* (Empty space) underneath
* Lymph Nodes
29
Your client has been diagnosed with
**_Sciatica_**
Describe the region involved and position the client for work in this area.
* Lower torso, hip and leg
* Supine, side-lying
30
Your client has been diagnosed with
**_Sciatica - Piriformis Syndrome_**
Describe the region involved and position the client for work in this area.
* Lower torso, hip and leg
* Supine, Side-lying
31
* Describe: **_Sciatica_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Sharp shooting pain, numbness or tingling down the buttock and leg
* True sciaticas are those related to sciatic nerve impingement or inflammation
* Nerve root impingement:
- due to disc herniations and compression of the intervertebral foramen
- Test with Lesegue's sign (straight leg hip flexion with ankle dorsiflexion)
- Decompression of the lumbar spine slows spinal degeneration and reduces stress on nerves
* Truck driver's sciatica:
* Compression of the sciatic nerve by an external element, as with sitting on a wallet
* May actually be TP aggravation - see false sciatica
* False sciatica are conditions that produce similar pain
* Trigger points in the gluteul and hamstring muscles
* Pelvic torsion / sacroiliac sprain
* Tight iliotibial band and vastus lateralis
* Poor posture is often an aggravating factor in all forms of sciatica, both true and false
* Common problem posture: Lordosis with L-R of the hips and anterior tilt of pelvis
* shortens psoas and piriformis muscle
* shifts abdominal load bearing to the lumbar paraspinals
* ambulation favors hip flexion with ADDs and EXT with the ABDs
* tension patterns load the pelvic joints / ligaments
* Correction of the posture helps decompress the lumbar spine, lengthens the piriformis, reduces tension in the iliotibial bands and minimizes rotational forces in the pelvic structure
-------------------
GOALS:
\**Muscle balance, want to lengthen Rectus femoris to allow pelvis to roll back etc. Stretch tight flexors and activate weak inhibited muscles*
1) \>circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) \>ROM
----------
MUSCLES:
* Rectus Femoris
* Iliopsoas
* Quadratus lumborum
* Piriformis
32
* Describe: **_Piriformis Syndrome_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* The sciatic nervce comes through the sciatic notch and is compressed behind or within the piriformis muscle
* Release of the piriformis spasm alleviates the impingement, allowing the nerve to heal
--------------
GOALS:
\**Increase circulation and spasm/pain cycle of the piriformis*
1) \>circ, decrease HT/spasm, decrease pain
2) breakdown and decrease ADH, fascial thickening, contracture, and excess scar tissue
- Increase tissue organization and integrity (facilitating functional tissue alignment with XXF and eccentric contraction)
3) \>ROM
----------
MUSCLES:
* Rectus Femoris
* Iliopsoas
* Quadratus lumborum
* Piriformis
33
* Name 4 musculoskeletal structures involved in **_Sciatica**_ and _**Piriformis Syndrome_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Rectus Femoris** (ASIS --\> tibial tuberosity at patellar lig)
_-Petrissage_
* **Iliopsoas** (Bodies and TP L1-L5 --\> L. Trochanter)
_-Supine, have knees super bent to relax muscle, find space 4 fingers from belly button (after warmup) and between ASIS and belly button, take time to go in, have them lift leg to be sure_
* **Quadratus lumborum** (Posterior Iliac crest --\> TP L1-L4 and R12)
_-Side-lying, 4 fingers width from spine, static FX from lateral sides_
* **Piriformis** (Anterior surface of sacrum --\> Superior Gr. Trochanter)
-Side-lying, muscle direction across
_---------------------_
ENDANGERMENT SITES:
* **Femoral Triangle**
* Inguinal Lig, Sartorius (L), Add. Longus (M):
* Femoral Nerve
* Femoral Artery
* Femoral Vein / Branches to Gr. Saphenous Vein
* (Empty space) underneath
* Lymph Nodes
* Abdominal Region
* spermatic cord
* ovaries
* abdominal aorta
* kidneys
* spleen
* gall bladder
* liver
* xyphoid process
34
Your client has been diagnosed with
**_Tibialis Anterior Shin Splints_**
Describe the region involved and position the client for work in this area.
* Lower leg
* Supine, Prone
35
Your client has been diagnosed with
**_Tibialis Posterior Shin Splints_**
Describe the region involved and position the client for work in this area.
* Lower leg
* Supine, Prone
36
Your client has been diagnosed with
**_Anterior Compartment Syndrome_**
Describe the region involved and position the client for work in this area.
* Lower leg
* Supine, Prone
37
* Describe: **_Tibialis Anterior Shin Splints_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* *Pain in anterior lower leg, usually associated with overuse, commonly afflicting athletes, can get it by being on feet all day*
* Commonly affects hard heel droppers
* Impact energy is transferred through the hypertonic muscle to the tibial periosteum
* periosteum is injured, leading to bone spurs on the tibialis anterior to prevent further injury
* First proximal 1" - concerned about not tearing rest of periosteum off
* FX should be done carefully to avoid enlargement of lesion
----------------
GOAL:
*\*Restore length and extensibility in the tibialis anterior to prevent further injury*
[The common 6]
--------
MUSCLES:
* Gastrocnemius
* Soleus
* Plantaris
* Tibialis Anterior
38
* Describe: **_Tibialis Posterior Shin Splints_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Muscle strain of tibialis posterior
* Pain is aggravated with resisted plantar flexion and inversion
* Pain is aggravated with stretch dorsiflexion and eversion
* More severe than tibialis anterior, sometimes confused with tibial stress fractures
GOAL:
Reduce stress on the injured tissue and facilitate an intergrated mend
[common 6]
MUSCLES:
* **FLX Hallucis Longus** (mid 1/2 of posterior fib --\> distal 1st toe) and **FLX Digitorum Longus** (mid posterior tib --\> distal 2-5 toes)
* **Gastrocnemius**
* **Soleus**
* **Tibialis Posterior** (mid posterior tib/fib --\> goes M malleolus and base of 1-5 toes)
39
* Describe: **_Anterior Compartment Syndrome_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Pain usually manifests shortly after onset of increased physical activity, feels better when stop, starts again when resuming activity
* Swelling associated with increased muscle activity is contained by restrictive fascia
* Pressure builds in the space between the tibia and fibula, anterior to the interosseous membrane
* Tissue damage often results from "working through it"
* Asymptomatic with normal activty levels
* Often a result of tight gastroc and soleus which puts a strain on anterior compartment
GOAL:
*\*emphasizes the superficial layers (fascia) to reduce the restriction*
[common 6]
MUSCLES:
* **Superficial fascia of shin**
* **EXT hallucis longus**
* **EXT digitorum longus**
* **Tibialis Anterior**
40
* Name 4 musculoskeletal structures involved in **_Tibialis Anterior Shin Splints_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **EXT Hallucis Longus** (M anterior fibula --\>1st toe) **and EXT Digitorum Longus** (L condyle --\> 2-5 digits)
_-Petrissage_
* **Gastrocnemius**
_-Petrissage_
* **Soleus** (under gastroc)
_-Gliding FX to Soleus on lateral edge_
* **Tibialis Anterior** (L condyle --\>inner foot 1st MT)
_-Petrissage_
_----------------------_
ENDANGERMENT SITES:
* Medial Tibia
* Tibial nerve (posteiror to tib)
* Greater Saphenous Vein (anterior to tib)
* Popliteal Fossa
* Popliteal artery
* Popliteal Vein
* Tibial Nerve
* Peroneal/Common Fibular nerve
41
* Name 4 musculoskeletal structures involved in **_Tibialis Posterior Shin Splints_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **FLX Hallucis Longus** (mid 1/2 of posterior fib --\> distal 1st toe) and **FLX Digitorum Longus** (mid posterior tib --\> distal 2-5 toes)
_-Petrissage_
* **Gastrocnemius**
* **Soleus**
* **Tibialis Posterior** (mid posterior tib/fib --\> goes M malleolus and base of 1-5 toes)
ENDANGERMENT:
* **Medial Tibia**
* Tibial nerve (posteiror to tib)
* Greater Saphenous Vein (anterior to tib)
* **Popliteal Fossa**
* Popliteal artery
* Popliteal Vein
* Tibial Nerve
* Peroneal/Common Fibular nerve
42
* Name 4 musculoskeletal structures involved in **_Anterior Compartment Syndrome_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Superficial fascia of shin**
_-Skin Roll_
* **EXT hallucis longus**
* **EXT digitorum longus**
* **Tibialis Anterior**
_-Knead drain_
ENDANGERMENT:
* **Medial Tibia**
Tibial nerve (posteiror to tib)
Greater Saphenous Vein (anterior to tib)
* **Popliteal Fossa**
Popliteal artery
Popliteal Vein
Tibial Nerve
Peroneal/Common Fibular nerve
43
Your client has been diagnosed with
**_Hyperlordosis_**
Describe the region involved and position the client for work in this area.
* Lower torso, hip, leg
* Supine, Side-lying
44
* Describe: **_Hyperlordosis_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Excessive curvature of lumbar spine
* Causes and results from tension patterns that load the spin, pelvis, and hips (want to treat cave, pull bow, shortened Psoas)
* shorten **L rotators of hips, iliopsoas and piriformis muscles**
* During ambulation, favors hip flexion with ADD, extension with ABD
* Reintergrating abdominal muscle function reduces the load on the lumbar paraspinals
* Appropriate Abdominal muscle function supports pelvic posture by lifting the pubis
* Gait training is appropriate to defeat aggravating use patterns
GOALS:
[common 6]
* \*Release hip flexion tension --\> return to poster tilt, straigtening lumbar spine*
* \*Decrease L rotation to encourage posterior R of pelvis*
MUSCLES:
* **Rectus Femoris** (ASIS --\> Tibial Tub via patella)
* **Iliopsoas** (TP --\> L troch)
* **Piriformis** (ASIS --\> G troch)
* **Quadratus Femoris** (ishium --\>between intertroc crest)
45
* Name 4 musculoskeletal structures involved in **_Hyperlordosis_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Rectus Femori**s (ASIS --\> Tibial Tub via patella)
* **Iliopsoas** (TP --\> L troch)
* **Piriformis** (ASIS --\> G troch)
* **Quadratus Femoris** (ishium --\>between intertroc crest)
ENDANGERMENT SITES:
* **Femoral Triangle**
Inguinal Lig, Sartorius (L), Add. Longus (M):
Femoral Nerve
Femoral Artery
Femoral Vein / Branches to Gr. Saphenous Vein
(Empty space) underneath
Lymph Nodes
* **Popliteal Fossa**
Popliteal artery
Popliteal Vein
Tibial Nerve
Peroneal/Common Fibular
46
Your client has been diagnosed with
**_Hyperkyphosis_**
Describe the region involved and position the client for work in this area.
* Chest, neck, shoulders
* Supine, Side-lying
47
* Describe: **_Hyperkyphosis_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Excessive curvature of the thoracic spine
* Causes:
* Adaptation to physical activity
* respiratory problems
* emotional distress/depression
* postural compensation for lordosis
* spinal osteoarthritis (sponylosis)
* ankylosing spondylitis
* vertebral compression fractures
* embarrassment regarding breasts
* Breath and emotional release work are often helpful
GOAL:
[common 6]
* \*lengthen the anterior line of the torso, and broaden the shoulders*
* \*emphasize muscles and fascia of the pectoral girdle, chest, and abdomen*
MUSCLES:
* **Rectus Femoris**
* **Pectoralis Major**
* **Pectoralis Minor**
* **SCM**
48
* Name 4 musculoskeletal structures involved in **_Hyperkyphosis_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Rectus Femoris**
* **Pectoralis Major**
* **Pectoralis Minor**
* **SCM**
ENDANGERMENT SITE:
* Anterior Triangle of Neck
* Posterior Triangle of Neck
49
Your client has been diagnosed with
**_Scoliosis_**
Describe the region involved and position the client for work in this area.
* Chest, neck, shoulders, back, hip, leg
* Supine, Side-lying
50
* Describe: **_Scoliosis_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Excessive lateral curvature of spine
* Treat the concave, lengthen tight muscles, activate weak ones
* Could be caused by repetitive activity imbalance or MVC
* If long term condition, discs may be herniated or wedged
GOALS:
\*treat the concave, lengthen tight side and activate weak ones to create muscle balance
[common 6]
MUSCLES:
* Traps
* Latissimus Dorsi
* Paraspinals (Deep EXT: semispinalis, multifidous and rotators)
* Erector Spinae Group (Spinalis, Longissimus, Iliocostalis)
51
* Name 4 musculoskeletal structures involved in **_Scoliosis_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Traps**
* **Latissimus Dorsi**
* **Paraspinals** (Deep EXT: semispinalis, multifidous and rotators)
* **Erector Spinae Group** (Spinalis, Longissimus, Iliocostalis)
ENDANGERMENT SITES:
* **Posterior Triangle**
* **Lumbar Region**
* Kidneys
* Lumbar plexus
52
Your client has been diagnosed with
**_Herniated Disc_**
Describe the region involved and position the client for work in this area.
* Back, chest, shoulders, neck, ribs, hips, low leg
* Supine, Side-lying
53
* Describe: **_Herniated Disc_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Bulging disc due to trauma or uneven loading of the spine
* Scoliosis, hyperlordosis or kyphosis
GOALS:
[common 6]
\*lengthen tight muscles, activate weak inhibitied muslces
MUSCLES:
* **Traps**
* **Lats**
* **Erector spinae**
* **Quadratus Lomborum**
54
* Name 4 musculoskeletal structures involved in **_Herniated Disc_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Traps**
* **Lats**
* **Erector spinae**
* **Quadratus Lomborum**
ENDANGERMENT SITES:
* Lumbar Region
* kidneys
* lumbar plexus
* Posterior Triangle
55
Your client has been diagnosed with
**_Plantar Fascitis_**
Describe the region involved and position the client for work in this area.
* Foot, low leg
* Prone, Supine
56
* Describe: **_Plantar Fasciitis_**
* Explain your treatment goals for the condition.
* Name 4 musculoskeletal structures involved in the condition
* Primary role of the plantar fascia is to absorb shock from the weight of the body by maintaining the longitudinal arch of the foot
* Pain is most commonly felt in the heel (at the attachment of the plantar fascia to the calcanues) due to being on the ball of toes too much
* Tight gastroc
* Hyper pronation and sup
* \*Pain is usually worse after rest, especially when getting out of bed in the morning
* Sometimes confused with "heel spur"
* Overuse condition of the foot causing disorganizatino and irritation of the plantar fascia
* Fallen arches or excessive high-arch can contribute
* Most common cause is tight gastrocnemius and soleus muscles
* can create excessive plantar flexion, placing the client on his/her toes which stresses the longitudinal muscles of the foot
* Tight posterior Tibialis causes the client to walk or run on the outside of the foot, which stresses the plantar fascia in a diagonal direction
* Can occur from participating in sports, wearing high heels, trauma, weight gain and pregnancy
GOALS:
\*lengthen tight muscles, activate weak inhibited
\*Release from heels to toes
[common 6]
MUSCLES:
* **Gastrocnemius**
* **Posterior Tibialis**
* **Intrinsic Foot Muscles**
* **Plantar Fascia**
57
* Name 4 musculoskeletal structures involved in **_Plantar Fasciitis_**
* Outline and highlight fiber alignment
* Demonstrate treatment for each strucure
* Name 2 potential endangerment sites at risk
* **Gastrocnemius**
* **Posterior Tibialis**
* **Intrinsic Foot Muscles**
* **Plantar Fascia**
ENDANGERMENT SITE:
* **Popliteal Fossa**
* popliteal artery
* popliteal vein
* tibial nerve
* common fibular nerve / peroneal
* **Medial Tibia**
* Tibial Nerve
* Greater Saphenous Vein
