Topic 8: RSI's

Question 1

_________ _________ occurs if tissue has sustained microtrauma and is continuously stressed, it won’t have the opportunity to heal and the inflammatory state can last much longer than the normal acute 4-6 day span.

Answer 1

Chronic Inflammation

Question 2

Tissues exposed to chronic inflammation possess an upregulation of fibroblasts, as well as increased macrophages and lymphocytes. This results in increased collagen production with simultaneous destruction of mature tissue. This yields a predominance of new, _________ ________ – weakening the tissue overall.

Answer 2

Immature Collagen

Question 3

T/F: RSI’s have a slow, insidious onset. Pain, inflammation and/or weakness come on slowly, and often people don’t seek treatment right away.

Answer 3

True

Question 4

_______s are vulnerable to repetitive strain: When muscles are unable to bear a given load – whether they lack adequate strength or endurance, the load is then passed on.

Answer 4

Tendons

Question 5

T/F: Tendons are not as vascularized as muscle and therefore have reduced perfusion and increased healing time.

Answer 5

True

Question 6

Individuals with chronic tendon pain tend to have an abundance of type _ and _ collagen

Answer 6

Type 3 and 5 collagen

Question 7

General term referring to tendon pathology.

Answer 7

Tendonopathy

Question 8

Acute or chronic inflammation of a tendon.

Answer 8

Tendonitis

Question 9

Chronic degradation of a tendon without inflammation. Characterized by disrupted collagen fibres within the tendon, increased cellularity, neovascularization (not associated with increased healing).

Answer 9

Tendonosis

Question 10

Inflammation of a tendon sheath (some tendons have sheaths surrounding them, (e.g. biceps long head tendon) that can become irritated and inflamed.

Answer 10

Tenosynovitis

Question 11

The following describes treatment of tendonopathy in the _______ stage:
Ø Control the inflammation : cold hydro, elevation, lymph drainage
Ø Decrease UMRT
Ø NB : GTO is CI’d at lesion site, but safe for the non affected tendon
Ø Don’t challenge tissue or irritate injury site
Ø Patient education -> REST
Ø Can maintain integrity and mobility of tissue with nonstressful passive movement (pain free)

Answer 11

Acute stage

Question 12

The following describes treatment of tendonopathy in the ______ stage:
Ø Can start to challenge tissue
Ø Decrease UMRT, myofascial restrictions/ adhesions and TRP’s
Ø Develop strong/ mobile scar – (skin roll/myofascial/direct fascial/ friction)
Ø Castor oil and wax with heat
Ø Work on contributing factors – ie postural dysfunction
Ø Self care program – normalize length/strength imbalances, endurance

Answer 12

Sub-acute and Chronic stage

Question 13

_________ _______ has been shown to be one of, if not the most effective intervention for tendonopathies

Answer 13

Eccentric loading

Question 14

________ _______ describes calcium deposits in a damaged tendon.

Answer 14

Calcific tendonitis

Question 15

A ________ is a cystic tumors developing in a tendon sheath.

Answer 15

Ganglion

Question 16

Inability of a finger to flex or extend as a result of a nodule, or thickening of tendon preventing the tendon from smoothly sliding in a tendon sheath

Answer 16

Stenosing Tenosynovitis (Trigger Finger)

Question 17

A bursa is a sac like structure filled with synovial fluid.They form in areas of the body that are prone to _______ i.e. tendonous attachments.

Answer 17

Friction

Question 18

Bursitis is very painful and will be accompanied by inflammation. Pain will be on ________, or when the bursa is _________ by movement of the structures crossing it.

Answer 18

Pain will be on palpation, or when the bursa is stressed by movement of the structures crossing it.

Question 19

During the acute stage of bursitis, there will be pain with movement only.

Answer 19

False: There may also be pain at rest in the acute stage.

Question 20

_________ bursae may be red, hot, and visibly swollen. ________ bursae may not present with heat or redness, but will be quite tender on palpation.

Answer 20

Superficial bursae may be red, hot, and visibly swollen. Deeper bursae may not present with heat or redness, but will be quite tender on palpation.

Question 21

Bursitis typically is accompanied by characteristic ‘________ _____’. A tight structure overlaying the bursa will compress and deform it, causing a sharp spike of pain as the contraction is released.

Answer 21

‘Rebound pain’

Question 22

Bursitis pain may be exacerbated by both ___ and ___ testing due to the inflammation. Stretching or tensing the overlying tissue can irritate the inflamed bursa. With ___, often the pain will be greatest after releasing.

Answer 22

PR and AR

With AR, often the pain will be greatest after releasing.