Phty200 - Definitions And Soft Tissue Injuries

The physiology of altered health

The study of factors that affect the health of populations

The cause of disease. Can be biological, physical, chemical, genetic or nutritional excesses/deficits

Defects present at birth

Sequence of pathological events that take place from the time of initial contact with aetiological agent (cause) until the ultimate expression of disease

Acute are short-term, chronic are long term and subacute is in-betweem.

Acute DOES NOT necessarily mean that it is more severe.

The possible outcome and recovery prospects from an ailment

- age

- race

- dietary habits

- lifestyle

- geographic location

Incidence is the number of NEW cases arising in a population.

Prevalence is the number of TOTAL cases at a given point.

Morbidity describes the effect of an illness on a persons life.

Mortality provides statistical information about trends in population health. (Life expectancy is a measure of mortality)

Health adjusted life expectancy - estimation of number of years spent free of disease

- Behavioral (smoking, sedentary lifestyle, etc)

- Biomedical (Obesity, High blood pressure, etc)

- Environmental

- Genetic (haemophilia, down syndrome, diabetes)

- Demographic (age, sex, population groups)

- Prostate

- Bowel

- Breast

- Melanoma

- Lung

- Contusions / Hematoma

- Strains/tears

- Focal thickening / fibrosis

- Compartment Syndrome

- DOMS

- Cramps

A sudden, heavy compressive force

(e.g. a direct physical blow to the muscle)

Large area of local bleeding (hemorrhage)

Excess blood exerting pressure on nerve endings.

Made worse by movement or direct pressure to the area

Myositis Ossificans

A complication causing haematoma calcification.

This occurs as a result of osteoblasts replacing fibroplasts during the healing process, hence the calcified tissue.

- increase in morning pain + pain with activity

- night pain

- palpable lump

- haematoma healing ceases and subsequently deteriorates

- Increased severity of haematoma (more likely with more severe haematoma)

- Rebleed (e.g. receiving another physical blow to the site during the healing process)

- Inappropriate treatment (heat/massage)

- Presence of knee effusion (excess fluid/swelling around the knee joint)

- Prone knee flexion less than 45 degs

A muscle is strained or torn when some or all the fibres fail to cope with the demands placed upon them.

- Excessive tensile forces (overstretch)

However, can also occur during strong contraction

Superficial 2 joint muscles. (e.g. hamstrings/RF)

Deceleration

Intramuscular is when the haeamatoma is completely contained within intact muscle fascia.

Intermuscular occurs when the surrounding muscle fascia is torn and the haemorrhage spreads to interstitial spaces.

- few tear of fibres

- minor swelling

- minor discomfort

- minimal or no loss of strength

- minimal or no restriction of movement

- significant number of fibres torn

- significant swelling

- significant discomfort

- pain on contraction

- loss of strength

- restriction to movement

- complete tear of muscle (all fibres torn)

- complete loss of muscle function

Muscle is a repair process in contrast to bone which is a regeneration process.

This means that muscle heals with a scar which replaces the original tissue

1. Inflammation / Destruction phase

(damaged tissue is destroyed and removed)

2. Proliferation / Repair phase

(scar begins to form)

3. Maturation / Remodelling phase

(scar tissue retracts andgradually replaced by mature myofibres)

Focal thickening / Fibrosis

A muscle overuse disorder when local swelling causes pressure within the muscle compartment.

Testing is done through 'compartment pressure tests' which are not conducted by physiotherapists.

Signs of CS is pain commencing during activity and ceasing at rest. Physio can only refer for further testing.

24-48 hours after

The aetiology is not clear, but there are theories that the following may cause DOMS:

- lactic acid

- muscle spasm

- torn tissue

- connective tissue

- enzyme efflux

- tissue fluid

Eccentric activity

A painful, involuntary muscle contraction

- Neural excitability

- Dehydration

- Low potassium/sodium

- inadequate carb intake

- excessively tight muscles

A generic term used to describe several pathologies of the tendon

A disorder of the tendon resulting in collagen degeneration (disorder & separation)

- pain sometime after exercise (e.g. next day)

- pain at rest, which decreases with use then worsens in cool down

- local tenderness or thickening

- swelling

- crepitus (creaking or crackling noise / feel)

Inflammation of the tendon.

However this has rarely been proven to occur at a histological level and therefore Tendinosis is a more correct term to use

Inflammation of the paratenon (outer layer of tendon

At the point of least blood supply

- Sudden onset of pain (e.g. felt like they were shot)

- localised tenderness

1. Inflammation

2. Proliferation

3. Maturation

1. Inflammation

2. Proliferation

3. Maturation

No - other structures can compensate for the missing function.