Shoulder Complex- Tendon Rx through Regional Interdependence

Question 1

With Tendon Rx, what are the treatment options?

Answer 1

Pt. education about load management

POLICED

NSAIDS

Bracing/taping

Question 2

With Tendon Rx, NSAIDS are a ____-_____ relief in _______ presentation

Answer 2

short-term

acute

Question 3

Which tendon Rx has a poor response and no support in persistent presentation?

Answer 3

NSAIDS

Question 4

With NSAIDS, it _______ healing if injury is at the insertion

Answer 4

delays

Question 5

With Tendon Rx, modalities such as : iontophoresis, ultrasound, phonophresis, and low-level laser treatment, it _______ sufficient evidence

A. gains
B. lacks
C. acquires

Answer 5

B.

Question 6

With tendinosis, what is the soreness rule?

Answer 6

Soreness begins after 8-12 hours of exercise and can last up to 24-48 hours

Question 7

With tendinosis, ________ therapy can restore accessory motion as needed

Answer 7

manual

Question 8

What should be the primary goal for tendinosis with MET?

Answer 8

proliferating the tendon and possible spinal stabilization (if regional interdependence)

Question 9

With tendinosis, you should implement MET after any ________ settles and for ALL _______ changes in the tendon (including tears)

Answer 9

acuity; structural

Question 10

Which of the following are the ideal and ultimate sets, repetitions, and loads to improve a tendinosis condition?

A. 2-3 sets of 10-15 repetitions with heavy loads

B. 2-3 sets of 20-25 repetitions with heavy loadS

C. 2-3 sets of 10-15 repetitions with moderate loads

D. 1-2 sets of 10-15 repetitions with moderate loads

Answer 10

A.

Question 11

For tendinosis, ________ eccentrics are encouraged

Answer 11

slower

Question 12

Isometric loading without compression from lengthening, the isometrics are in a ___________ position

Answer 12

shortened

Question 13

Isotonic loading without compression from lengthening, the isotonics from __________ into shortened position

Answer 13

neutral

Question 14

Isotonic loading with compression from lengthening, isotonics loading from a __________ position

Answer 14

lengthened

Question 15

What are examples of isometric loading in weight bearing?

Answer 15

UE weight shifting, planks, push ups

Question 16

What are examples of plyometric loading?

Answer 16

ball bounces, tosses, and throwing

Question 17

With tendinosis, activity response can have a ______ to _______ increase in P! (possibly 5/10)

Answer 17

mild; moderate

Question 18

What is the time frame for MET with tendinosis?

Answer 18

8-12 week program

Question 19

What are some precautions with heavy loads for MET and tendinosis?

Answer 19

deconditioned population

young people (growth plates)

Question 20

What could complicate the healing response for tendinosis?

Answer 20

obesity- excessive fat absorbs inflammatory cells way from the tendon

diabetes- excessive glucose impairs collagen production and remodeling

low grade and persistent inflammation- associated with SAD diet and systemic disease/ limits proliferation and remodeling

Question 21

MD Rx: Cortisone injections are a _____-_____ benefit

Answer 21

short-term

Question 22

MD Rx: Glycerin trinitrate patches effective by increasing ___________

Answer 22

circulation

Question 23

MD Rx: Sclerosing injections help to ________ tendon for P! relief

Answer 23

stiffen

Question 24

What is the last option for MD Rx with Tendon conditions?

Answer 24

surgery

Question 25

What are the PT Rx for impingement syndrome?

Answer 25

POLICED, modalities, and scapular taping

Question 26

US, LASER, Extra-corporeal shockwave _________ evidence with impingement syndrome

Answer 26

lack

Question 27

Scapular taping improved _____ ______ P!

Answer 27

short term

Question 28

What is the strongest manual PT Rx recommendation at GH joint?

Answer 28

JM

Question 29

With JM in the thoracic spine, it had an _________ recovery and ________ P! and disability immediately vs usual care

Answer 29

accelerated; reduced

Question 30

JM added with exercise are _______ effective than exercise alone

Answer 30

more

Question 31

What is the primary treatment option for impingement syndrome?

Answer 31

MET

Question 32

With MET and tendinosis, it has to be > than ____ months of symtoms

Answer 32

6

Question 33

With MET and tendinosis, it should include ______ and _______ exercises

Answer 33

RC and scapular exercises (MT/LT/Rhom/SA)

Question 34

With MET and tendinosis, your patient should have an ______ with supporting PT visits

Answer 34

HEP

Question 35

At 3 months, there should be ____% improved P! function with MET

Answer 35

70

Question 36

What is the prognosis typically for impingement syndrome?

Answer 36

earlier improvements, if no tendinosis or tears

Question 37

MD Rx: With subacromial decompression, there is partial ______ acromioplasty due to hooking

Answer 37

anterior

Question 38

With subacromial decompression, there is distal ________ resection and ________ ligament

Answer 38

clavicle; coracocclavicular

Question 39

Subacromial depression should NOT be performed if _______ and present > ___ months

Answer 39

atraumatic; 3

Question 40

____________ is when differing body regions are biomechanically and neurophysiologically interdependent and impairment in one region can contribute to impairment in another, particularly if persistent

Answer 40

regional interdependence

Question 41

A pt. will have significant lower strength in what 3 areas when persistent with neck pain?

Answer 41

neck, shd, and scapula

Question 42

Lower ____ and Lower ______ strength are persistent with neck P!

Answer 42

hip; back

Question 43

Remember that co-existing ______ is a risk factor for neck P!

Answer 43

LBP

Question 44

With regional interdependence, recruit what you need for __________ ________

Answer 44

overhead reaching

Question 45

Where is the most common segment for dysfunction with regional interdependence?

Answer 45

C5-C6

Question 46

Imbalanced overhead reaching: Excessively recruited ____'s share innervation from _____ with C5/6 segment and inhibition of _____'s

Answer 46

IR C6 ER

Question 47

With imbalanced overhead reaching, the humeral head is pulled anterior and into _____

Answer 47

IR

Question 47

With imbalanced overhead reaching, it creates excess ______ and _______ underneath the _______ head of the biceps tendon

Answer 47

tension compression long

Question 48

Imbalance with overhead reaching: Excessively recruited scapular elevators that share innervation from _____ with C2,3 segment

Answer 48

C3

Question 49

Imbalance with overhead reaching at C2,3 creates excess tension and compression underneath the _______ tendon

Answer 49

supraspinatus

Question 50

With inhibition of the depressors, there will be impingement at how many degrees?

Answer 50

150

Question 51

C2,3 jt. dysfunction: The supraspinatus and long head of Biceps tendons will impinge which can lead to __________ A. tendinosis B. tendinopathy C. tendinitis

Answer 51

B.

Question 52

With the C2,3 jt. dysfunction, which two shoulder joints can lead to hypermobility/instability?

Answer 52

GH and AC

Question 53

Inhibited mm. develop protective _______ at rest

Answer 53

hypertonicity aka "tightness"

Question 54

With regional interdependence, address _______ and involved _______

Answer 54

mechanics; tissues