Knee repetitive tissue and stress strains Flashcards
(28 cards)
what causes pes anserine bursitis?
repetiive motion or overuse
typically that causes resisted KF
what is pes anserine bursitis?
inflammation of bursa between pes anserine group and MCL/medial tibia
what are some symptoms of pes anserine bursitis?
- AROM and PROM knee extension may be painful
- resistive hamstring, sartorius or gracilis may be painful
- tightness of hamstrings and/or adductors
what is the rehab for pes answering bursitis?
- control pain and inflammation
- STM
- gentle stretching
- avoid repetivei motion that is causing pain…
- can start strengthening once pain and swelling subside
- correct biomechanical factors such as muscle imbalances, excessive foot pronation, bike fit, shoes etc
what are the clinical pearls for cyclists with pes answering bursitis?
- bike fit
- knee position on upstroke
- substantial change in trainng
what are the clinical pearls for runners with pes answering bursitis?
- hip weakness
- hip ROM/joint mob
- shoes: type, age, orthotics
- runnign surface/change in trainign
where/what is a bakers cycst?
posteromedial knee
- semimembranosus bursa
- communicates w knee joint
- not uncommon post srugery
if they have a bakers cyst and are not post op- check for intra articular pathology
what is tendinitis?
- involve acute injures accompanied by inflammation:
- DO NOT utilize eccentric exercise
- pain during acitivty but resolves quickly afterwards
what is tendinosis/opathy?
- chronic degeneration without inflammation
- accumulation of microscopic injuries that dont heal properly
- inflammation involved in initial stages of injury
- inability of tendon to heal perpetuates the pain and disability
what is patellar tendinopathy?
- inflammation of patellar tendon
- commonly seen in athletes who jump to decelerate frqeuntly
- jumpers knee
what are the 3 phases of patellar tendinopathy?
i: pain after activity (itis)
ii: pain during and after activity (becoming on osis)
iii: pain leading to functional disability/constant
what can patellar tendinosis lead to?
tearing or rupture
what is the rehab for -osis?
-heavy slow resistance program w goal of histological impact on tendon tissue
-progress to plyos and activity specific exercise
-cross friction massager once beyond inflamm phase
4-5x/week, 2-3 sets, 10-15 reps
what is the rehab of itis?
-pain and inflammation control
-activity modification
-cho-pat straps or knee sleeves could help
-gentle stretching
-anti inflamm measures
2-4 weeks
what is osgood-schlatters disease?
- traction of patellar tendon on immature bony anatomy
- develop pain and inflammation at tendon bone surface
- skeletally immaure (12-16 y/o)
- inflammation of tubercule w some fragmentation of growth plate
- do NOT do heavy slow resistnace
what is the management of osgood-schlatters?
- rest/activity modification
- gentle stretching or extensor mechanism/quads
- correction of muscle imbalance and alignment issues
- modalities for pain/inflammation as indicated
what causes IT band syndrome?
- friction of distal area across lateral femoral condyle
- COMPRESSIVE syndrome..tissue doesn’t move back and forth but the compressive force creates symptoms
why does IT band syndrome occur?
compression created by combo of alignment and quad/TFL contraction timing during KF to extension
- overdeveloped lateral thigh muscles= increased forces and tension ITB and end up with compressive forces at the fat pad
- TFL tightness can be a cause
- many complain of popping or crepitus
- frequently seen in runners
- sharp, stabbing pain
fat pad compressed by: TFL, glute max, VL and lateral hams
what is the rehab for ITB syndrom?
- correct muscle imbalances and foot mechanics
- stretching: TFL and VL
- patellar mobs (medial glide and tilt); prox tibiofibular manipulation
- STM
- iontophoresis
- NSAIDs/corticosteroid injection
- chronic cases may require surgery
what is the most common thigh muslce strain?
hamstring for both primary injury and recurrence
which strain is most common with high-speed sport/movement?
biceps femoris
which strain is most common with extreme lengthening like gymnastics or dance?
semimembranosus
what can be a complicating factor secondary to swelling and eventaul scar tissue near sciatic nerve?
neural tension
which muscle of the quads is most commonly injured?
rectus fem
