Strains (mms or tendons))

Question 1

what is a strain

Answer 1

Trauma to a mm and/or its tendon from overstretching or violent contraction

Question 2

2 types of mm contractions

Answer 2

concentric (shortening)

eccentric (lengthening)

Question 3

___ contractions produce a greater force on mm and are therefore usually the cause of a strain

Answer 3

eccentric

Question 4

where is the most common area of a mm to get a strain

Answer 4

musculotendinous junction (weakest point)

Question 5

causes of strains (3)

Answer 5

-a sudden overstretching
-an over contraction (strong explosive force, either eccentric or concentric)
-overuse/abuse: Inadequate warm-up/cool down, limited flexibility, fatigue, repetitive overuse, strength imbalances, previous injuries (strains), and improper biomechanics are all contributing factors

Question 6

mms that cross ___ ___ are more likely strained than ones that’re not

Answer 6

2 joints

Question 7

severity of strains in divided into ___ categories

Answer 7

3

Question 8

tearing of musculotendinous fibers, varying from several fibers to majority of fibers (11%-99% fibres torn)

Answer 8

grade 2 (moderate)

Question 9

minor stretch and tear (<10%fibres damaged) to musculotendinous unit
and minimal strength loss

Answer 9

grade 1 (mild)

Question 10

complete rupture (100% fibres torn=full thickness tear) of musculotendinous unit or avulsion fracture

Answer 10

grade 3 (rupture)

Question 11

if a pt can’t walk or has a serious limp from a strain (grade 2 or 3) the therapist should do what

Answer 11

refer to doctor

Question 12

which grade do these acute symptoms suggest:
-edema and heat minimal/not present, no bruising
-local tenderness and DOMS post activity
-little/no loss of strength/function
-pt can continue activity
-Usually self limiting unless there is repeat trauma to an area which can progress into grade 2&3
-Functional healing time: 2-7 days (structural healing: 4-14 days)

Answer 12

grade 1

Question 13

if pt can continue activity the strain is likely a grade ___

Answer 13

1

Question 14

when inquiring about a pts strains it’s important to ask if they experienced a ___ sound or sensation and if they were able to ___ ___. And about meds (painkillers, etc…), and mechanism of injury and if it has happened before

Answer 14

snapping or popping,
continue activity

Question 15

which grade do these acute symptoms suggest:
-may be a snapping noise/sensation
-mod. Local edema/heat, hematoma and bruising blue/black/red
-may be a palpable gap
-mod. Tenderness at lesion site
-mod. Pain w/activities that contract/stretch musculotendinous unit (protective mm spasm)
-mod. Loss of strength/function
-Functional healing time: 1-10 weeks (structural healing: 3-12+ weeks)

Answer 15

grade 2

Question 16

which grade do these acute symptoms suggest:
-snapping noise/sensation
-severe pain at time of injury and then minimal pain afterward
-marked local edema, heat and red/blue/black bruising and hematoma
-gap palpates in the tissue
-immediate loss of mm strength and function
-pt cannot continue the activity
-Functional healing time: 10 weeks- 6 months(structural healing: 12+ months)

Answer 16

grade 3

Question 17

4 symptoms to expect with subacute (proliferation)

Answer 17

-bruising changed to yellow, green, brown
-edema and inflammation decreased from acute stage
-Protective mm spasm decreases, TP in affected and compensatory mms
-adhesions develop

Question 18

with Rmmt mms will present as ___ and ___

Answer 18

weak and painful

Question 19

remodeling, recovery and fibrosis is also known as what stage of strain

Answer 19

chronic

Question 20

symptoms experienced in the chronic stage of strain (6)

Answer 20

-bruising gone, ↑tone or tension/TP’s in affected and/or compensatory mm
-adhesions have matured (fibrosis) tissue possibly cool due to ischemia
-Pain on ROM, possible instability of joints
-Gr. 2/3 ROM of joint crossed by mm may be ↓, chronic low grade mm spasm
-Gr. 3 -if surgery/casting see atrophy notes. If no surgical repair there is ↓strength since only the synergists of affected mm can fx
-↓ strength of musculotendinous unit, possible disuse atrophy

Question 21

another word for a limp

Answer 21

antalgic gait

Question 22

T or F: tissue may feel both cold or hot after a strain

Answer 22

T
hot- inflammation
cold-ischemia

Question 23

5 things you may feel upon palpation of a strained mm

Answer 23

-Heat (inflammation) or cold (ischemia)
-Local tenderness
-Palpable gap
-Increase MM tone/TP’s
-Adhesions/fibrosis in affected/surrounding soft tissue

Question 24

3 STTTs you’ll perform with a strain

Answer 24

-PROM/AROM
-Rmmt
-special tests

Question 25

tx goals for acute strains (3)

Answer 25

-Educate patient -Decrease inflammation/edema -Position for drainage/comfort -Decrease pain -Treat compensations -Reduce but do not remove protective mm spasm -Do not disturb hematoma

Question 26

tx goals for subacute strains (2)

Answer 26

-Decrease inflammation/pain/edema/spasm/T-P’s/adhesions -Do not remove protective mm spasm by over treating synergists and antagonists -Maintain or increase ROM/function

Question 27

tx goals for chronic strains (2)

Answer 27

-Treat compensations -Decrease edema/STT/TP’s/adhesions -Increase ROM/strength/function

Question 28

tx