Chapter 10: Soft Tissue injury, repair and management

Define strain?

Overstretching, overexertion, or overuse of soft tissue: tends to be less severe than sprain, occurs from slight trauma or unaccustomed repeated trauma of a minor degree. Disruption of musculotendinous unit.. Muscle issue.

What is overstretching, overexertion, or overuse of soft tissue: occurs from slight trauma or unaccustomed repeated trauma of a minor degree. Disruption of musculotendinous unit.. Muscle issue.

Strain

Define sprain

Severe, stress, stretch, or tear of soft tissue, such as joint capsule, ligament, tendon or muscle. This term is frequently used to refer specifically to injury of a ligament.

What is severe, stress, stretch, or tear of soft tissue, such as joint capsule, ligament, tendon or muscle. This term is frequently used to refer specifically to injury of a ligament.

Sprain

Define dislocation

Displacement of a part, usually the bony partners in a joint, resulting in loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain and muscle spasm.

What is displacement of a part, usually the bony partners in a joint, resulting in loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain and muscle spasm.

dislocation

Define subluxation

An incomplete or partial dislocation of the bony partners in a joint

What is an incomplete or partial dislocation of the bony partners in a joint

subluxation

Is pain experienced in the region of the breach when the muscle is stretched with a partial tear?

Yes

T/F: If a rupture or tear is complete, the muscle does not pull against the injury, so stretching or contraction of the muscle would cause pain

False: there would be no pain

Define tendinopathy

is the general term that refers to tendon injury affected by mechanical loading

What is the general term that refers to tendon injury affected by mechanical loading ?

tendinopathy

Define tenosynovitis?

Inflammation of the synovial membrane covering a tendon

What is inflammation of a synovial membrane covering a tendon ?

tenosynovitis

Define Tendinitis

Inflammation of a tendon

What is inflammation of a tendon?

Tendinitis

Define Tenovaginitis

inflammation with thickening of a tendon sheath

What is inflammation with thickening of a tendon sheath?

tenovaginitis

Define Tendinosis

is degeneration of the tendon due to repetitive microtrauma.

What is degeneration of the tendon due to repetitive micro trauma ?

tendinosis

Define synovitis?

Inflammation of a synovial membrane; an excess of normal synovial fluid in a joint or tendon sheath caused by trauma or disease.

What is inflammation of a synovial membrane; an excess of normal synovial fluid in a joint or tendon sheath caused b trauma or disease?

synovitis

Define hemarthrosis ?

Bleeding into a joint usually due to severe trauma

What is bleeding into a joint usually due to severe trauma ?

hemarthrosis

Define ganglion ?

Ballooning of the wall of a joint capsule or tendon sheath. Ganglia may arise after trauma, and they sometimes occur with rheumatoid arthritis.

What is ballooning of the wall of a joint capsule or tendon sheath. This may arise from trauma and they sometimes occur with rheumatoid arthritis?

ganglion

Defne bursitis?

Inflammation of the bursa

Define contusion?

Bruising from a direct blow , resulting in capillary rupture, bleeding, edema and an inflammatory response

What is an intrinsic muscle spams?

Prolonged contraction of a muscle in response to the local circulatory and metabolic changes that occur when a muscle is in a continued state of contraction.

What is prolonged contraction of a muscle in response to the local circulatory and metabolic changes that occur when a muscle is in a continued state of contraction?

intrinsic muscle spasm.

What type of degree of tissue injury involves mild pain at the time of injury or within the first 24 hrs?

grade 1 (first degree)

What is grade 1 (first degree) tissue injury?

Mild pain at the time of injury or within the first 24 hours. Mild swelling, local tenderness, and pain occur when the tissue is stressed.

What type of degree of tissue injury requires that the activity is stopped and when palpated the pain is greatly increased?

grade 2 (second degree)

What is grade 2 (second degree) tissue injury?

Moderate pain that requires stopping the activity. Stress and palpation of the tissue greatly increase the pain. When the injury is to ligaments, some of the fibers are torn, resulting in some increased joint mobility.

What degree of tissue injury is a near complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain?

Grade 3 (third degree)

What grade 3 (third degree) tissue injury?

Near-complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain. Stress to the torn tissue is usually painless; palpation may reveal the defect. A torn ligament results in instability of the joint.?

Inflammation happens in what stage of tissue healing?

a) Acute stage

b) subacute stage

c) Chronic Stage

a) acute stage

Proliferation, Repair, and Healing happens in what stage of tissue healing?

a) Acute stage

b) subacute stage

c) Chronic Stage

b) subacute stage

Maturation and remodeling happens in what stage of tissue healing?

a) Acute stage

b) subacute stage

c) Chronic Stage

c) Chronic Stage

In what stage of tissue healing does clot formation occur?

acute stage

In what stage of tissue healing is there growth of capillary beds into area?

subacute stage

In what stage of tissue healing is there very fragile, easily injured tissue?

subacute stage

In what stage of tissue healing is there an absence of inflammation?

chronic stage

What is A state of prolonged inflammation that may occur if injured tissue is continually stressed beyond its ability to repair?

chronic inflammation

What is a state that persists longer than 6 months. It includes pain that cannot be linked to a source of irritation or inflammation?

chronic pain syndrome

What is an adaptive shortening of the skin, fascia, muscle, or a joint capsule that prevents normal mobility or flexibility of a structure?

contracture

In which stage of tissue healing does pain occur only when the newly developing tissue is stressed beyond its tolerance or when tight muscle is stressed?

subacute stage

How long does the subacute stage usually last?

10 - 17 days

In which stage of tissue healing is there no signs of inflammation?

chronic stage

During the first 48 hrs. after insult to soft tissue, what type of changes primarily take place?

a) cellular

b) vascular

c) chemical

d) all the above

b) vascular

T/F: Complete or continuous immobilization is good during management of the acute stage.

False: Complete or continuous immobilization should be avoided whenever possible as it can lead to adherence of the developing fibrils to surrounding tissue, weakening of connective tissue, and changes in articular cartilage

What is abnormal adherence of collagen fibers to surrounding structures during immobilization, after trauma, or as a complication of surgery, which restricts normal elasticity and gliding of the structures involved?

adhesion

T/F: Passive and active movements are good during the acute stage of healing ?

False: only passive movements are

T/F: you should not stretch in the acute stage of healing ?

true

What are gentle isometric contractions that can help assist the circulation and fluid dynamics?

muscle setting

What serves the purpose of moving fluid and if it is applied cautiously and gently to injured tissue, it may assist in preventing adhesions?

massage

When treating muscle lesions, the muscle is usually kept in its ______________ position.

shortened

Fibroblastic activity, collagen formation, and granulation tissue development increase during which stage of tissue healing?

subacute stage

In which stage of tissue healing is there deposition and synthesis of collagen?

subacute stage

In which stage of tissue healing can active movement begin?

subacute stage

Is there joint effusion in the subacute stage of healing ?

Yes - it is decreasing but may still be present if joints are involved

In which stage of tissue healing is there soft tissue, muscle and/or joint contractures, which would be developing in immobilized areas?

subacute stage

In which stage of tissue healing is the therapist supposed to progress multiple-angle isometric exercises within patient's tolerance?

subacute stage