Soft tissue

Question 1

how does tendinopathy occur

Answer 1

overload- one off or recurrent, overload detected by cells, cells activate (reactive stage), aggrecan gets produced= hydrophilic, apoptosis increases (cells die faster), matrix loose structure, providing opportunity for vascular penetration

Question 2

managing risk factors

Answer 2

modifiable- tendon load, muscle power, obesity, cholesterol, recent injury
non-modifiable risk factor- DM, genetic factors, early menopause, rheumatological disease, recent sciatica

Question 3

exercise must be specefic

Answer 3

strength, length, ROM, power (force and speed), endurance, shock absorption (mainly LL), graded exposure (reduces fear avoidance and analgesic), proprioception/balance/ control of limb

Question 4

mechanotherapy

Answer 4

loading tissue, stimulates cellular response, tissue adapts, tissue improves structure, tissue able to maintain homeostasis= less pain

Question 5

effective treatment

Answer 5

load management, increase muscle strength/co-ordination, progressive rehab, graded exposure for central and peripheral change, treat the person, continue maintenance regime

Question 6

proprioceptive rehab

Answer 6

positional sense, reduced with injury/pain, primary treatment target for some conditions

Question 7

proprioceptive rehab

Answer 7

positional sense, reduced with injury/pain, primary treatment target for some conditions

Question 8

tissue- tendons and joints/OA and liagments

Answer 8

tendons- modify load/ strengthen., progress/ RTP
joint/OA- modify load/ROM//strength/progress function
lig- modify load/ROM/balance/strength/neuromuscular control

Question 9

tissue- fractures and joint replacements

Answer 9

ROM, strengthen, rehab function

Question 10

Ax soft tissue-

Answer 10

lengthen, strength, isometric, palp for tenderness, endurance, power, proprioception and balance, motor control/patterning

Question 11

soft tissue treatment

Answer 11

SSTM, DTF, muscle lengthening, trigger point/myofascial release, EXERCISE, if you rest muscle for too long after injury= atrophy= substantially weaker post injury

Question 12

Adapted cook and Purdum’s model- unloaded/ excessive

Answer 12

stress shield- normal tissue- excessive load and individual factors= tissue dysrepair= degenerative tissue
normal or excessive load +/- individual factors

Question 13

Adapted cook and Purdum’s model- optimum

Answer 13

optimised load- optimised load= adaptation- strengthen- appropriate modified load= degenerative tissue

Question 14

ACL rehab

Answer 14

diagnosis and assessment, mobility/ control and optimal strength, power and reactive strength, linear running, multi-directional running, reproducibility under fatigue

Question 15

activity modification

Answer 15

Silbernagel pain monitoring model- 0-3= continue exercises, 4-5= reduce exercise, stop 6-10= stop exercise and allow to settle, then restart

Question 16

activity modification- reduce external loading

Answer 16

volume, intensity, frequency, duration, heel raises, activities throughout the day

Question 17

psychosocial factors in tendinopathy

Answer 17

fear avoidance, catastrophizing, pain behaviours

Question 18

fundamentals of rehab and marginal gains- education

Answer 18

lack of protein, alcohol, lack of sleep, psychosocial factors, stress

Question 19

fundamentals of rehab and marginal gains- pyramid (bottom to top)

Answer 19

education= understanding of the disorder, modify loading and pain monitoring model, isomated MTU= quantify/ isotonic, reduce physiological tremor, high load isometric/eccentric, SSC (strength shortening cycle- plyometrics), SSE (sports specific exercise)

Question 20

management

Answer 20

load management- for most conditions (POLICE), increase muscle strength/co-ordination, restore ROM, progressive rehab, graded exposure for central and peripheral sensitization (pain), treat the person not the tissue, continue maintenance regime (overuse conditions)

Question 21

benefits of exercise

Answer 21

decrease stress, increase balance and co-ordination, decrease body fat, decrease CAD, decrease osteoporosis, relaxation, increase muscle tone/flexibility/posture, increase CR and resp function, increase well being and confidence

Question 22

how does a stress fracture and tendinopathy occur- wear

Answer 22

training load, previous injury, muscle weakness, LL biomechanics, footwear, training surface

Question 23

how does a stress fracture occur- repair

Answer 23

bone structure, insufficient calories, diabetes, medication- steroids, increase age, gender, genetic predisposition, sedentary behaviour, sleep, stress, rheumatological disorders

Question 24

why do we use eccentric exercise

Answer 24

sarcomeregenisis- process of adding sarcomeres, allow MTU to contract ore effectively and grow stronger

Question 25

what is mechanotransduction

Answer 25

the process by which the body converts mechanical loading into cellular responses 3 stages- mechanocoupling (mechanical trigger), cell-cell communication (communication throughout a tissue to distribute the loading message), the effector response (the response at the cellular level to effect the response)

Question 26

mechanotransduction- stage 1

Answer 26

mechanocoupling- the physical load causing a physical perturbation to cells that make up the tissue. tendons can also experience compressive forces, which elicit a deformation of the cell that can trigger a wide array of responses depending on the type, magnitude and duration of loading.

Question 27

mechanotransduction- stage 2

Answer 27

cell to cell communication- the signalling proteins for this step includes calcium and insoitol triphosphate. the key point is the stimulation of one cell leads to a distant cell registering a new signal even though it is not stimulated.

Question 28

mechanotransduction- stage 3

Answer 28

effector cell response, focuses on boundary between extracellular matrix and a single cell. this process can be harnessed by mechanotherapy to promote tissue repair and remodelling.

Question 29

how do plyrometric work

Answer 29

generate rapid stretch in the muscles, and over time the body adapts by increasing the efficient of the movement, by redirecting the forces generated to produce more force in return