Massage therapy (Rattray)

Frozen Shoulder  Painful, significant restriction of active and passive ROM at the shoulder Most frequently in abduction and external rotation Frozen shoulder theories Subacromial bursitis, biceps tendon pathology, disuse, supracapsular nerve entrapment leading to muscle dysfunction, small rotator cuff tears Joint capsule is primarily involved, with secondary involvement of the surrounding structures Close association among frozen shoulder, referred neck pain, rotator cuff tears and impingement syndrome Normally, the superior joint capsule attaches proximal to the greater tuberosity of the humerus and runs medially to the bony rim of the glenoidd fossa of the scapula Inferior joint capsule hangs in the fold or pleat called the “auxiliary recess” This fold is stretched out when the humerus is abduct Contractures have been noted in the coracohumeral ligament, which may limit external rotation  Idiopathic frozen shoulder may also be d/t hyperkyphosis causing an alterati

Bursitis Inflammation of a bursa Cause Overuse of structures surrounding the bursa, leading to excessive friction and inflammation of the bursa walls Usually secondary to other conditions such as tendinitis Contributing factors are mxl imbalances, poor biomechanics, postural dysFCN such as scoliosis or hyperkyphosis and a lack of flexibility Overuse of the shoulder, especially with the arm in an overhead position is the most common cause Common location Types of bursitis More details on individual bursa (page 449-452) Acute SXS Inflammation, heat, swelling Pain is deep and burning, at rest or on activity ROM is restricted Contraindication : Acute bursitis: Avoid compressing the bursa or applying tech that place a drag on the surrounding tissues On-site tech are contraindicated with acute bursitis If infective (or Septic) bursitis is suspected,the client is referred for medical attention Assessment Observation and palpation Swell

Tendinitis Inflammation of a tendon or tendons NOTE : What is the difference between "Tendinitis" and "Tendinosis"? The main difference between  tendinosis  and  tendinitis  is time.  Tendinosis  is a chronic (persistent or recurring) condition caused by repetitive trauma or an injury that hasn't healed. By contrast,  tendinitis  is an acute (sudden, short-term) condition in which inflammation is caused by a direct injury to a tendon (from Google search) Another Link regarding this difference HERE   Okay, From here below, informations are taken from Rattray textbook! Tendon : Made of  regularly arranged, dense collagen fibrils. It appear in 2 shapes: Cord-like structures and broad, sheet-like structures called aponeuroses Limited blood supply compared to Mxl and that makes it slow down of healing process Cause Chronic overload of the tendon leading to micro tearing and inflammatory response in the tendon Cont

Periostitis (Shin splint)  &  Compartment Syndrome *Periostitis* Inflammation of the periosteum Cause Overuse, poor biomechanics, excessive pronation of the foot Treatment Acute Cold hydrotherapy,NM tech, Rhythmic mobilization, lymphatic drainage to reduce swelling  Chronic Deep moist heat hydrotherapy, compensating structures in lower back, gluteals and thigh are treated with NM tech, fascial tech to treat shortened mxl, passive stretching, cross fibre frictions on adhesions in soleus, tibias posterior, and flexor digitorum longs, Jt play for subtalar jt  Self care self massage to posterior compartment, strengthening affected mxl, refer for orthotics if necessary

Overuse condition resulting in inflammation of the plantar fascia Cause Overuse, poor biomechanics, short gastrocnemius and soles mxl, improper footwear, Wt gain SXS unilateral or bilateral mild to severe pain in the heel no hx of injury or trauma Repetitive mvt of plantar fascia causing inflammation Pain occurs with the first steps after non-wt bearing such as getting out of the bed first in the morning Pes planes, pes cavus and achilles tendinitis are often present Bone spur may develop on the medial aspect of the calcaneus Assessment Postural assessment, Palpation of anteromedial aspect of the plantar surface of the calcaneus is painful, palpable adhesions may present Testing AROM of metatarsophalangeal jt is painful, mxl length test for soles and gastrocnemius, Contusion of base of the heel may occur d/t overuse, Tarsal tunnel syndrome, stress fx may occur Treatment Acute: cold hydrotherapy,NM tech, TrP make sure to work on calf mxl

Whiplash Acceleration-deceleration injury to the head and neck    Quebec task force classification Grade0 : ZERO complaint, No physical sign Grade1 : Complaint of neck pain, stillness, or tenderness only Grade2 : Neck complaint of pain, stiffness or tenderness, MSK signs of decreased ROM Grade3 : Neck complaint of pain, stiffness or tenderness,  Neurological signs  decreased or absent of DTR, weakness and sensory deficit  Grade4 : Neck complaint and Fx or dislocation

Break in the continuity of a bone Type of fracture Transverse, oblique, spiral, comminuted, avulsion, osteochondral Common fx names Stage of healing 1. Hematoma within 72H of initial trauma 2.Inflammatory rxn, proliferation of osteoblasts at the periosteum 3.Soft callus or splint is formed from mass of proliferating osteoblast, repair is still incomplete 4.Consolidation occurs as the immature woven bome is changed into mature lamellar bone This is a complete repair 5.Remodeling of the irregular outer surface and reshaping of the marrow space inside the bone take place through alternating osteoclastic and osteoblastic activity Complications of Fx Compartment syndrome This can occur in the forearm and lower legs following fx Nerve compressions This may be indicated by paresthesia in the tissues under the cast Untreated vascular damage It may be indicated by an increase in observable distal red, black or blue bruising Refer to MD!! Bone

Abbreviations I have been using certain abbreviations since I was a Medical Assistant before and also as a Registered Acupuncturist now and soon to be RMT!!  I will be posting some abbreviations up here I will put more and more as I go If you find something in my blog and don't know what it means, please leave comment on the each subject, I will look into it and add some over here 😉 Thanks! A ADL: Activity of Daily Living Ant.: Anterior B b/o: Because of C CI: Contraindicated or Contraindication C/S: Cervical Spine CV: Cardiovascular D DDD: Degenerative disc disease DysFCN: Dysfunction d/t: Due to DTR: Deep tendon reflex dysFCN: Dysfunction dz: disease F FCN: Function Fx: Fracture G GH: Glenohumeral H Ht: Height J Jt: Joint L LCL: Lateral Collateral Ligament Lig: Ligament L/S: Lumbar Spine M MC: Most common MD: Medical Doctor Mobs: Mobilization MSK: Musculoskeletal Mxl: Muscle Mvt: Movement N