Periostitis and Compartment syndromes

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

Compartment syndrome

Result of an increase in pressure within the compartment of the lower leg (structures around tibia and fibula)

SXS

Pain in the shin/tibia

Cause

Trauma, overuse, anatomical configuration, mxl imbalance, improper foot wear

FYI

"Medically" compartment syndrome is dx with compartment pressure testing. With chronic compartment syndrome, a post-exercise pressure of 15mm Hg measured 15mins after exercise stops is considered diagnostic

SXS

Acute compartment syndrome is a medical emergency!

Chronic compartment syndrome sxs are noted with exercise

Aches and tightness over the entire compartment

Assessment

ROM, mxl length testing

Differentiating causes of leg pain

Tibialis posterior tendinitis: Pain is worse on activity and its along the tibia

Tibial stress fx: Sharp localized pain to fx site, pain is constant, medial aspect of the tibia is MC

Deep vein thrombosis: Feeling of local tightness and tenderness in the calf, pain is relatively constant regardless of activity, warm redness on site is classic indicators, but it may be absent

Homan's sign, Ramirez't test used to r/o

Treatment
Fascial release, deep moist heat hydrotherapy, cross fibre frictions to adhesion within tibias anterior followed by an ice application and stretch, jt play

Self care
Rest from activitiesSelf massage to compartment borders, stretching
Refer to orthotics if necessary

Comments

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

Strain VS Sprain

Strain vs Sprain STRAINS s"T"rain = "T"endon Overstretch injury to musculotendinous unit (tendon) Concentric : Mxl contraction as the origin and insertion of the mxl comes closer together, Mxl fibres shorten Eccentric :Origin and insertion move farther apart, the mxl fibres lengthen Eccentric contraction can produce. greater force within the mxl than concentric contraction, predisposing the mxl to injury at this time Hypovascular nature of tendons contributes to decreased tissue health, allowing the tendon itself to rupture Fun fact! The younger people where the epiphyseal plate in the bone has not yet ossified, the mxl and tendons are stronger than the bone! Because tendons are moderately vascularized, they are prone to partial or complete rupture at the area of least blood supply either in the middle of the tendon or at the musculotendinous junction. What is the cause of STRAINS? Sudden overstitching of the mxl Extreme contraction o

Fractures

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

Massage therapy (Rattray)

Search This Blog