PHYS/PATH (what else)
Spasms, Cramps: involuntary contraction of voluntary mm; can involve O2 supply, nutrition, ischemia, exercise, splinting?
Strain: injury to mm, tendon
can be trauma, overuse
myofibers are torn, fibroblasts lay down scar tissue (1st-3rd degrees severity)
moderate to severe pain, local, scar tissue leads to adhesion
mvmt makes worse
***healing Phase
1- acute in flammation
2- collagen deposition (proliferative phase) can start 48hrs post to 12 months (3 wks typical)
3- **(most important for MT)- reorganization of collagen, up to 12 months (remodeling phase) **8-10 wks post collagen formation becomes permanent
Tx- RICE, rehab
Avascular Osteonecrosis/Necrosis: blood supply to bone is impeded leading to loss/death of bone tissue
femur head and distal end of scaphoid main areas
clots and embolisms can occur
S&S: pain (occurs with tissue dying) joint collapse
diag: radiography
Fractures: broken bone; simple, incomplete, compound, etc.
Tx. immobilization, hydro opposite limb
Osteoporosis: porous, bones, calcium removed faster than replaced (bone loss)
woman higher risk due to frame, childbearing (adrenals), menopause,
calcium consumption influence bone density also vitamins, minerals, exercise, blood pH, meds, moods, diseases
Calcium absorb- vit D,K, acidic environment in stomach (true for all minerals), too much vit A impede calcium uptake
Calcium loss- caffeine, hyperthyroid, alcohol, smoking, inflammatory bowel disease
maintain
osteoblasts/clasts, ends of bones
femur head and vertebrae are common area affected
DEXA- bone density scan
prevent, get calcium from absorbable source
Paget Disease: bone broken down 50x faster; replaced with disorganized fibrous connective tissue
osteoclasts are 5x larger than normal
areas: skull, vertebrae, pelvis, legs
S&S: plapable heat
complication- fractures
local contra
Postural Diviations
-hyperkyphosis: humpback
-hyperlordosis: wayback
-scoliosis: s,c curve
Ankylosing Spondylitis: autoimmune disease, progressive inflammation, arthritis of spine with fusing
hip, SI joint, low back
**most common in 16-35yr old men
goes with Crohn disease (inflam of intestines), psoriasis, other autoimmune disease
Pain LB, refers to butt, legs
flare and remission
during flare, generral malais?, irits** (inflammation in eyes), possible fracture
complications: cauda equina syndrome (PNS pressure), inflammation of kidneys, eyes, etc.
Tx- PT, anti inflam, surgery
Dislocation: bone not where it should be
shoulders, fingers, hip
hip dysplasia, (Marfan, Ehlers Disease)
S&S: swelling, discoloration, loss function, pain
Complications: ligament laxity
Gout: chemistry based inflam. arthritis (big toes, spleen/liver meridian)
men 10:1
uric acid crystals- very painful
metabolic gout and
penal gout
trigger- drinking, diet, high-purine (meat), obesity, alcohol, hypertension,
sudden onset
complication: kidney stones, renal failure
pseudogout
Tx- drugs
Lyme Disease: infection with spirochete
Stages- bull's eye rash (50/50), high fever, fatigue, stiff neck
diag- difficult to be accurate
Tx- antibiotics
prevention: long sleeves, pants, check for ticks
Osteoarthritis: synovial jt (especially weight bearing), usually due to wear and tear*
bone on bone
degenerative joint disease
-most common type of arthritis
MT- take care of saddle joint (thumb)
causes risk: age, overweight, decrease h2o, history of trauma, surgery
with fingers: DIPs (Heberden nodes) over PIPs (Bouchard nodes)*
Tx- NSAID
exercise within pain tolerance, maintain ROM, strength mm, stamina/weight
Patellofemoral Syndrome: inflammation behind patella
precursor for osteoarthritis
main causes- overuse/overloading, alignment
S&S: pain anterior knee, stiff, crepitas (crunchy knees/jt), difficulty with walking(especially down stairs)
Rheumatoid Arthritis (whole body thing): autoimmune on synovial membrane
women>men
thick/welling in synovial, nodules
typically bilateral, may not be symmetrical
nodules on sclera, pleuritis, hepatitis, vasculitis (Raynaud)
Sjogren syndrome: dry up glands
diag: super stiff AM, hot showers help
Tx- anti-inflam, decrease pain, suppress immune system
Spondylosis: shrink between joint spaces (disk space), and edges of bones move out
not all cause pain, can put pressure on nerves
Sprains: injured/torn ligaments (1st-3rd degree severity)
repair = collagen fibers laid down
swelling is greater than strain
Tempromandibular Joint Disorder: issues with jaw
problems with spine leads to jaw/TMJ
common after MVA
common with fibromyalgia and others
bruxiam: grinding teeth
Ehlers-Danlos Syndrome: (producing bad collagen) weak connective tissue lead to jt dislocation
Rare
don't heal well after injury
delicate skin
detach retina
Marfan Syndrome: genetic, dysfunctional fibrillin
tend to be tall, with bulge or caved sternum, long fingers and toes
connective tissue is weak
eye disorders, heart aorta
Tx- manage symptoms
Massage- gentle
Muscular Dystrophy: degenerative wasting mm tissue
mm being replaced with fat
noticed by age 2- walking on toes
Duchene and Becker are X linked (more common in men)
other types not gender specific
blood test- creatine kinase super high
short life expectancy
Osteogenesis Imperfecta: bones formed with weak collagen; super easy to break (movie Unbreakable)
Baker Cyst: behind knee, cyst in synovial
common in kids, also adults with other trauma, RA, complications
could impair blood flow-lead to clots
Bunions: big toe deviates inward
woman 10:1
Bursitis: inflammation of bursa
adrenal imbalance, inflammatory diet
make sure not infection
Dupuyten Contracture: palmar aponerousis tighten with 4-5th digit fingers tighten up (palmar fascitis)
men>women, idiopathic, can lose function
Ganglion Cyst: pouch on jt, capsule or tendenous sheath; most common on extensors
local contra
Hernia: hole in abdominal wall, diaphragm
men7:1
all types of hernias
tx- surgical repair
complications: strangulation and all kinds of stuff
Osgood-Schlatter Disease: bones not grown as fast as mm
inflammation at tibial tuberosity with pull from quad mm
local contral
Pes Planus (flat feet)
Pes Cavus (big arches/caved/jammed)
feet=shock absorbers
footwear, adrenals, posterior tibialis
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