Card Set Information
Principals Guidelines Musculoskeletal Rehabilitation
Early Inflammation: INTERVENTION
: limt/curtail inflammatory response, treat pain, effusion, immobilization.
1. control pain and swelling
2. Injury protection
3. modalities and meds
4. gentle soft tissue mobz, to reduce pain, guarding, edema
5. Gentle passive movements
6. CMP w/in pain fre raing; no stretching
7. posssible Grade 1 oscillatory techniques
8. muscle setting
9. no pain or inflammation
Intermediat stage of Inflammation: Characteristics
: 4-14 days Repair & Healing
1. removal of noxious stimuli
2. growth of capillary beds into area
3. collagen proliferation
4. muscle strenght is decreased 2nd to immobilization, inhibited by pain & joint effusion leading to atrophy.
Intermediate stage of Inflammation: Clinical Signs
1. Decrease inflammation
2. Pain- intermittent, felt during movement, synchornous w/ motion barrier, porximal -> distal w/ repeated movements.
3. Motion Barrier
: Muscular (fast-slow garding)
Intermediate stage of Inflammation: Intervention
1. Pain contorl
: meds as needed
2. gentle movement (low grade mobz 1-2)
3. AROM/PROM in pain free range
Intermediate stages of Inflammation: Inert Tissues
no stretching of joint capsule if effusion is present.
can begin gnetle capsular stretching and joint mobz.
Intermediate stages of Inflammation: Contractile Tissue
1. begin isometric resistance exercises
2. begin gentle stretching techniques
3. gentle transverse friction massage
4. Muscle Tears
: develope mobile scar and parallel alignment of CT
5. Tendon Lesions
: promote parallel alignment of collagen fibers.
Intermediate stages of Inflammation: Precautions
some discomfot will occur w/ exercise during this stage, but it should not alst longer than couple hours
Intermediate stages of Inflammation: Signs and Symptoms of Excessive Activivty
1. prolonged pain
2. pain with rest
3. increse in swelling, heat, stiffness, or weakness
4. muscle guarding
*Activitiy levle must be decreased if these signs occur.
Late stages of Inflammation: Characteristics
: 14-21 days until there is pain free functional use; Maturation and Remodeling.
1. maturation of CT
2. contracture of scar tissue
3. appropriate stressin of collagen = parallel fibe alingment and improved proliferation of elastin.
Late stages of Inflammation: Clinical Signs
1. absense of inflammatory signs & symptoms
Late stages of Inflammation: Pain
1. not severe
2. proximal location
3. only felt w/ forceful movements
4. felt after motoin barrier (overpressure)
Late stages of Inflammation: Motion Barrier
Late stages of Inflammation: Intervention
1. vigorous soft tissue, joint mobz (grades 3-4), stretcheing
2. decreased ROM
: isometirc exercises at various ranges to maintain/imporve strength
3. adequate ROM
: progressive strengthening, endurance, and functional exercises
Late stages of Inflammation: Inert Tissue
vigorous capsular stretching and joint mobz if joint play is restricted and no effusion
Late stages of Inflammation: Contractile Tissues
Dynamic Resistance exercisese (eccentric): Parallel scar tissue increase tensile strength, and increases PSCA which results in decreased stress on injury site.
Maitland describes the irritability of a disorder as:
1. its susceptibility to becom painful
2. how painful it becomes
3. the lenght of time this pain takes to recover
PROM: High Irritability/Reactivity
1. Pain b4 motin barrier.
2. empty or muscular end feel (fast guarding)
PROM: Moderate Irritability / Reactivity
1. pain synchronous with motion barrier
2. muscualr end feel ( fast-slow guarding)
PROM: Low Irritability/Reactivity
1. pain felt after motion barrier (overpressure)
2. capsular (firm) end feel