Skip to main content

Cruciate & Miniscal injury

Cruciate & meniscal injury

It is important as RMT to be able to differentiate between cruciate or meniscal injuries and collateral Lig injuries

Massage has a direct effect on collateral ligaments b/o its anatomical location (palpable)

Assessment

Acute w/swelling
AROM-limited, PROM-mxl guarding

mxl strength testing: mxl crossing the knee should be Painless and indicated normal strength
If there is pain, accompanying mxl might be injured
Presence of swelling

Early/Late subacute and Chronic
AROM-limited, PROM-limited where jt locking is present, unable to fully extend the knee
Mxl strength: Quadriceps may be reduced with disuse atrophy

Special test: Lachman's test, Ant./Post. drawer test, Valgus/Varus test
Miniscal injury:McMurray's test, Bragard's sign, Apley's compression test, Helfet's test

Massage of cruciate injury

Acute/Subacute
RICE
Elevate the limb
Primary focus of tx is the compensating structures (High tone, TrP)
ACL injury: Initial focus of AROM is on hamstrings
Lymph drainage tech proximal to the knee could be used to reduce swelling
Isometric full knee extension against the gravity
Distally, mxl squeezing and careful jt play for the ankle and foot are indicated

 Chronic
After 4-6 weeks focus on both affected and unaffected knee and lower back
Fascial tech, skin rolling, cross fibre friction can be used
Heat hydrotherapy

Massage of Meniscal injuries

Acute/Subacute
RICE
Patellofemoral Jt mobs, Gentle PROM into pain free extension
In the late subacute, cross fibre friction to the lision are indicated

Chronic
Lower back, Gluteals, and legs being treated for hypertonicity, fascial retractions and TrP
Caution: Joint play for the tibiofemoral joint can be introduced in the 3rd week if hypo mobility is present

Self Care

Acute/Subacute
Straight leg raise, hip adduction, gastrocnemius setting in week 1

Chronic
If there is tear or partial menisctomy has full ROM, Isometric exercise are progressed to isotonic exercise for quadriceps &  hamstrings & gastrocnemius

Resistance exercise are added over 3-week period

Healing time
Grade 3 sprain takes up to 4 months to recover
Minor meniscal tear takes 3-4 weeks









Comments

Popular posts from this blog

Tendinitis

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

Dislocations

Dislocations Complete dislocations of the articulating surfaces of a joint Subluxation is when the articulating surfaces of a joint remain in partial contact with each other Cause Trauma related sudden twist or wrench of the Jt beyond its normal ROM Risk factors Pathologies such as RA, paralysis, NM dz Congenital ligament laxity, Jt malformation Previous dislocation MC location of dislocation Ant. GH jt Lunate dislocation by fall on the outstretched hand, forcing the hyper extension Elbow dislocation is usually accompanied by Fx Palpation Acute : Heat, tender to touch, firm edema, protective mxl spasm Subacute : Heat diminishes, tenderness still present, Adhesion starts to form High mxl tone, TrP are present  Chronic: cool to touch d/t ischemia Tenderness to the lesion site Adhesions to jt. capsule and injured lig. High tone mxl and TrP Disuse atrophy may be present d/t casting or taping Testing Acute: AROM, other testing are contraindicated Chron

Frozen Shoulder

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