Overuse Injuries Flashcards Preview

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Flashcards in Overuse Injuries Deck (24)
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1
Q

Preventing overuse injuries?

A
  • stretch prior to activity, shouldn’t hurt
  • warm up prior to activity, break a sweat
  • make sure you’re good enough in shape to participate
  • ease back into activity
  • don’t play through the pain
2
Q

Diff shoulder injuries?

A
  • overuse: fatigued tendons and muscles
  • subacute: fatigued tendons and muscles that now slowly begin to tear/wear out: pain is increasing
  • acute: fell, threw too hard, swung too hard, now your shoulder hurts
3
Q

Diff overuse shoulder injuries? Presentation?

A
  • tendonitis: irritation/inflammation of a tendon - pain down side of shoulder w/ overhead and behind back activity, nighttime pain
  • tendonopathy: sick tendon, similar pain complaints, pain may have been evident for a longer period of time
4
Q

Tx of overuse shoulder injuries?

A
  • make sure that is all it is: xrays and MRI
  • NSAIDs
  • ice
  • PT
  • corticosteroid injection
5
Q

What is a subacute shoulder injury? Dx, tx?

A
  • progression of an overuse injury
  • had occasional pain b/f, now it hurts worse and more frequently
  • xrays for bones
  • MRI for soft tissues
  • if unremarkable:
    NSAIDs
    ice
    PT
    +/- corticosteroid injection
6
Q

Dx and tx for acute shoulder injury?

A
  • XR and MRI

- tx depends on findings

7
Q

Workup for shoulder injuries? MRI indications?

A
  • in general w/u for overuse, subacute, acute shoulder pain is all the same
  • XRs are a must
  • MRI indications: drop arm sign, external rotation lag sign, dislocation
8
Q

Concerning shoulder injuries - + findings?

A
  • pain doesn’t improve w/ conservative management
    • findings on xrays: fx, arthritis
    • findigns on MRI: found something wrong- rotator cuff tear, labral tear, biceps tendon tear
9
Q

Tx of severe shoulder injury?

A
  • shoulder arthroscopy

- clean up shoulder and repair torn tendons

10
Q

Recovery time for shoulder surgery?

A

worst case scenario is a cuff repair:

  • 6 wks: healing phase- typically start therapy at 3 wks, full time sling 3 wks/part time 3 wks
  • 6 wks: rehab and strengthening
  • typically at 3-4 months: start resuming previous activities slowly
11
Q

3 sep compartments of the knee?

A
  • patellofemoral
  • medial
  • lateral
12
Q

2 main types of cartilage in the knee?

A
  • articular cartilage: thin lining of resilient CT that serves as padding and an ultra low friction surface
  • meniscal cartilage: serve to deepen the contact of the femur on the tibia, provide stability, and distribute force
  • jt reaction force in the knee is about 3x body wt when walking, this is absorbed by menisci and articular cartilage
13
Q

Problems w/ the knee?

A
  • tendonitis
  • meniscal tears
  • ligament injuries
  • cartilage injuries
  • arthritis
14
Q

What is tendonitis?

A
  • irritation/inflammation of tendon

- typically responds well to rest, ice, anti-inflammatories, and focused PT

15
Q

What is a meniscal tear? MOI?

A
  • disruption of continuity of meniscus of the knee

- MOI: twisting, turning, deep knee bends, pivoting

16
Q

Sxs of a meniscal tear?

A
  • focal pain, typically intermittent
  • swelling
  • nighttime pain
  • pain w/ activity
  • catching/locking
17
Q

Tx options for meniscal tear?

A
  • PT, injections

- arthroscopic surgery: remove/fix the tear, 80-90% better by 6-8 wks

18
Q

Tx of ligament tears?

A
  • ACL: fix in active, physical individual, no real age restriction, CI if significant arthritis
  • PCL: fix when sx, CI if sig arthritis
  • MCL: brace for 6 wks, wt bearing as tolerated
  • LCL: brace, fix if part of complex of lateral injuries
19
Q

What is cartilage injury of the knee? Dx? Tx?

A
  • damage to articular cartilage
  • typically unclear of severity until time of arthroplasty
  • variety of txs dependent on severity:
    smooth down
    microfracture
  • cartilage transplant: tx for smaller, focal cartilage defects, an attempt to prevent the progression to osteoarthritis (not useful in degenerative arthritis)
20
Q

Tx of meniscus tear w/ mild/mod arthritis?

A
  • rather common
  • meniscus tear is the mechanical problem
  • tx based on 6 wks of observation
  • if sxs are improving, monitor
  • if not or worsening, then consider viscosupplementation
21
Q

What is viscosupplementation?

A
  • soln of hyaluronan
  • lubricant and shock absorber in jts
  • OA reduces body’s ability to produce hyaluronan
  • w/o it pt experiences pain of OA as jt wears out
  • longevity: varies from pt to pt, depending on number of factors: age, wt, stage of disease
  • max benefits: can be seen up to 12 wks from last injection
  • in general: beneficial effects last from 6 months to a year
  • no CI to a repeat injection series
22
Q

Tx of medial and lateral epicondylitis?

A
- NICER:
anti-inflammatories
ice
compression
elevation
rest 
  • for recalcitrant cases:
    consider steroid injection, platelet rich plasma injection
  • most of the time these go away but some reqr surgery
23
Q

What is platelet rich plasma?

A
  • high concentration of fxnly viable platelets and their assoc growth factors
  • extracted from small amt of pt’s blood: 9-18 cc
  • spun through a simple centrifugation process to for a dense suturable fibrin matrix scaffold
  • delivered arthroscopically/open and placed directly into tear site to stimulate a reparative healing response for soft tissue and bone repair
24
Q

Applications for PDGF?

A
  • direct liquid form injections of concentrated platelets for various tendonitis problems
  • clot form applications w/ extended growth factor release for cuff repairs