Sports Injuries Week 2 Lecture - Tendons

bethdrysdale94's version from 2017-01-12 16:08


Question Answer
What is muscle?contains contractile filaments, changes size, produces muscular force, moves skeleton
What is tendon?connects muscle to bone, has to withstand tensions to transfer muscular force ot bone
What is ligament?connects bone to bone, maintains joint stability
What is cartilage?Firm whitish and flexible tissue that absorbs force between acticulating surface of joints. also aids smooth movement
Which population group suffers from abnormally high prevalence of Achille's tendinopathy?UK military
Which three sports have high %prevalence of patella tendinopathy?Basketball, Volleyball, Handball
What does a positive popeye sign show?Biceps tendon rupture
What is the structure of a tendon?collagen fibrils > collagen fibres > primary bundle > secondary bundle > tertiary bundle > tendon
What causes acute tendon rupture?repetition and overuse, eccentric acitivities, and quick cutting motions that involve rapid acceleration/deceleration
What does tendon rupture result in?unbalanced mobility and stability, results in abnormal loading that could damage other soft tissues, pain and osteoarthrits in long run
What % does chronic tendinopathy account for in all sporting inuries?30-50%
What % does achilles tendinopathy account for in running injuries?7-11%
What % of population over 60 suffer from rotator cuff tears?30%
What is the patient presentation with acute tendinopathy?Mechanical injury; Insidious onset; Specific site of pain; pain on waking or first mobilising; pain on commencing acitvity; eases with warm up; oain after activity; pain on direct palpation
List some causative factors of tendinopathyGait, Age, BMI, Posture, Footwear, Exercise, Steroids
Describe the continuum model of chronic tendinopathyNormal tendon > excessive load etc > reactive tendinopathy > tendon dysrepair > degenerative tendinopathy. OR normal tendon > optimised load > adaptation > strengthen > normal tendon OR other pathway
What is the pathology of tendinopathy?non-inflammatory response secondary to acute tensile or compressive overload. Increased proteoglycans and water, increased tenocyte proliferation. Both cause pain
What is the pathology of dysrepair tendinopathy?Matrix disorganisation and separation. increased thickening due to collagen breakdown and increased ground substance formation. increased VEGF.
What is the pathology of degenerative tendinopathy?significant collagen matrix disorganisation, focus of holes in tendon, increase in type III collagen, tenocyte apoptosis
What are the age ranges for different tendinopathy types?Reactive: 15-25. Dysrepair: 20-35. Degenerative 30+. Reactive on Degenerative: 30+
What is the key management of tendinopathy?Progressive loading to reduce pain and restore function (performed within a pain monitoring framework)
What is the first line treatment of tendinopathy?Ice, load management, compressive loads and positions (NB a period of unloading may be indicated)
What is the first stage of progressive loading?Isometrics - low load. allows addressing of contractile deficits, stimulates collagen synthesis, reduces pain. Avoid compressive element, work within pain tolerance
What is the second stage of progressive loading?Concentric/Eccentric (medium load). Adresses contractile deficits, slow and controlled, open and closed kinetic chain if possible.
What is the third stage of progressive loading?Isotonic loading into compressive range. Eccentric and Heavy slow resistance for Achilles, Only Heavy slow resistance for PTs
What is the fourth stage of progressive loading?Energy Storage Loading
What comes after progressive loading in tendinopathy rehab?return to running/tabbing. continue with load management. monitor pain.
What if conservative management of tendinopathy fails?corticosteroid injection around tendon (short term relief). PRP/Autologous Blood injection into tendon.

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