Adhesive Capsulitis and Achilles Tendon Rupture

Flashcards on Adhesive Capsulitis and Achilles Tendon Rupture

Adhesive capsulitis

An enigmatic shoulder disorder characterized by inflammation and fibrotic thickening the anterior joint capsule of the shoulder.

Secondary adhesive capsulitis

Inflammation within the joint capsule causes fibrous adhesions to form and the capsule to thicken, leading to a decrease of synovial fluid and further irritation to the glenohumeral joint.

Arthrogram

Can assist with the diagnosis of adhesive capsulitis by detecting a decreased volume of fluid within the joint capsule

Diagnosis of adhesive capsulitis

Confirmed from clinical evaluation and past medical history. The patient may present with the greatest restriction of glenohumeral motion in abduction and lateral rotation, but all planes of motion are usually affected.

Prevalence of Adhesive Capsulitis

adhesive capsulitis occurs in 2% of the population within the United States and in 11% of individuals that are diagnosed with diabetes mellitus

Adhesive Capsulitis history

includes past medical and surgical history medications, family history, current symptoms, current health status, social history and habits, occupation, leisure activities, and social support system.

Anthropometric characteristics for Adhesive Capsulitis

circumferential measurements of bilateral upper extremities.

Physical therapy intervention during the acute phase of adhesive capsulitis

Icing or superficial heat, gentle joint mobilization, progressive strengthening, pendulum exercises, and isometric strengthening.

Physical therapy intervention during the chronic phase of adhesive capsulitis

Ultrasound, grade III and IV mobilization, increasing the extensibility of the joint capsule, and techniques such as PNF to restore painless functional range of motion.

Achilles Tendon Rupture

Rupture normally occurs within one to two inches above its tendinous insertion on the calcaneus.

Achilles tendon

The largest and strongest tendon in the human body and is formed from the tendinous portions of the gastrocnemius and soleus muscles coalescing above the insertion on the calcaneal tuberosity.

Laboratory or imaging studies to confirm Achilles Tendon Rupture

X-ray to rule out an avulsion fracture or bony injury. MRI can be used to locate the presence and severity of the tear or rupture.

Diagnosis of an Achilles tendon rupture

Relies on patient history of the event and a positive Thompson's test.

Symptoms of an Achilles tendon rupture

Present with swelling over the distal tendon, a palpable defect in the tendon above the calcaneal tuberosity, and pain and weakness with plantar flexion.

Achilles Tendon Rupture history

Mechanism of present injury, past medical history, medications, current health status, social history and habits, occupation, living environment, and social support system.

Assistive and adaptive devices for Achilles Tendon Rupture

potential utilization of crutches

Non-surgical treatment for Achilles Tendon Rupture

Serial casting for approximately ten weeks followed by the use of a heel lift to ensure maximal healing without stress on the tendon for three to six months.

Physical therapy intervention for Achilles Tendon Rupture

Includes range of motion, stretching, icing, assistive device training, endurance programming, gait training, strengthening, plyometrics, and skill specific training.

Treatment for acute Achilles tendonitis

rest for 2-3 weeks and use a heel lift