Soft Tissue Injury Repair and Management Chapter 10

Examples of Soft Tissue Lesions: Musculoskeletal Disorders Strain Sprain Dislocation Subluxation Muscle/Tendon Rupture or

Clinical Conditions Resulting From Trauma or Pathology § § § § Dysfunction Joint Dysfunction

Severity of Tissue Injury § Grade 1 (First-Degree) § Grade 2 (Second-Degree) § Grade

Irritability of Tissue: Stages of Inflammation and Repair § Acute Stage – Inflammatory reaction

Management During the Acute Stage § Tissue Response: Inflammation – Cellular – Vascular –

Management Guidelines: Protection Phase § Patient Education § Protection of the Injured Tissue §

Management Guidelines: Protection Phase (cont'd) § Specific Interventions and Dosages – Passive range of

Management Guidelines: Protection Phase (cont'd) § Interventions for Associated Areas – Range of motion

Management During the Subacute Stage § Tissue Response: Proliferation, Repair, and Healing – 10

Management Guidelines: Controlled Motion Phase § Patient Education § Management of Pain and Inflammation

Management Guidelines: Controlled Motion Phase (cont'd) § Initiation and Progression of Stretching – Warm

Management During the Chronic Stage § Tissue Response: Maturation and Remodeling – Maturation of

Management Guidelines: Return to Function Phase § § Patient Education Considerations for Progression of

Cumulative Trauma: Chronic Recurring Pain § Tissue Response: Chronic Inflammation – Inflammatory process is

Etiology of Chronic Inflammation Leading to Prolonged or Recurring Pain § § Overuse, Cumulative

Contributing Factors § Imbalance between the length and strength of the muscles § Rapid

Management Guidelines: Chronic Inflammation § Chronic Inflammation: Acute Stage § Subacute and Chronic Stages

Independent Learning Activities § Critical Thinking and Discussion Copyright © 2013. F. A. Davis

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Examples of Soft Tissue Lesions: Musculoskeletal Disorders Strain Sprain Dislocation Subluxation Muscle/Tendon Rupture or Tear § Tendinopathy, Tendinous Lesions § § § Copyright © 2013. F. A. Davis Company § § § Synovitis Hemarthrosis Ganglion Bursitis Contusion Overuse Syndromes, Cumulative Trauma Disorders, Repetitive Strain Injuries

Clinical Conditions Resulting From Trauma or Pathology § § § § Dysfunction Joint Dysfunction Contracture Adhesions Reflex Muscle Guarding Intrinsic Muscle Spasm Muscle Weakness Myofascial Compartment Syndrome Copyright © 2013. F. A. Davis Company

Irritability of Tissue: Stages of Inflammation and Repair § Acute Stage – Inflammatory reaction § Subacute Stage – Repair and healing § Chronic Stage – Maturation and remodeling § Chronic Inflammation § Chronic Pain Syndrome Copyright © 2013. F. A. Davis Company

Management Guidelines: Protection Phase § Patient Education § Protection of the Injured Tissue § Prevention of Adverse Effects of Immobility – Tissue-specific movement – Intensity of movement – General movement Copyright © 2013. F. A. Davis Company

Management Guidelines: Protection Phase (cont'd) § Specific Interventions and Dosages – Passive range of motion – Low-dosage joint mobilization techniques – Muscle setting – Massage Copyright © 2013. F. A. Davis Company

Management During the Subacute Stage § Tissue Response: Proliferation, Repair, and Healing – 10 to 17 days (14 to 21 days after onset of injury); but may last up to 6 weeks – Synthesis and deposition of collagen Copyright © 2013. F. A. Davis Company

Management Guidelines: Controlled Motion Phase § Patient Education § Management of Pain and Inflammation § Initiation of Active Exercises – Multiple-angle, submaximal isometric exercises – Active range of motion exercises – Muscular endurance exercises – Protected weight-bearing exercises Copyright © 2013. F. A. Davis Company

Management Guidelines: Controlled Motion Phase (cont'd) § Initiation and Progression of Stretching – Warm the tissues – Muscle relaxation techniques – Joint mobilization/manipulation – Stretching techniques – Massage – Use of the new range § Correction of Contributing Factors Copyright © 2013. F. A. Davis Company

Management Guidelines: Return to Function Phase § § Patient Education Considerations for Progression of Exercises Progression of Stretching Progression of Exercises for Muscle Performance – Developing neuromuscular control, strength, and endurance § Return to High-Demand Activities Copyright © 2013. F. A. Davis Company

Etiology of Chronic Inflammation Leading to Prolonged or Recurring Pain § § Overuse, Cumulative Trauma, Repetitive Strain Trauma Re-Injury of an “Old Scar” Contractures or Poor Mobility Copyright © 2013. F. A. Davis Company

Contributing Factors § Imbalance between the length and strength of the muscles § Rapid or excessive repeated eccentric demand § Muscle weakness § Bone malalignment or weak structural support § Change in the usual intensity or demands Copyright © 2013. F. A. Davis Company § Returning to an activity too soon after an injury § Sustained awkward postures or motions § Environmental factors § Age-related factors § Training errors