Transcript El Paso CATCH

Musculoskeletal PT
Objectives
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Give an example of each of the following
musculoskeletal conditions: (1) overuse injury, (2)
traumatic injury, (3) surgical condition, and (4)
general medical condition.
Understand why it is important to ask, and be able to
provide several questions involved in a good
musculoskeletal PT examination
Define and give examples of the various tests and
measures used in a musculoskeletal PT examination
Identify, and be able to describe the objective of
physical agents, manual techniques, and therapeutic
exercise used in musculoskeletal PT
Focus on Function
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Musculoskeletal PT
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What are the functional limitations……or
“dysfunctions”
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Often caused by:
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Muscle or bone structural imbalances
Birth defects
Surgery
Degenerative changes in body
Musculoskeletal Dysfunctions
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Can result in:
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Pain
Swelling
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Edema
Effusion
Stiffness
Muscle weakness
Loss of range of motion (ROM)
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Active ROM
Passive ROM
Musculoskeletal System
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Includes
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Bones
Soft Tissue
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Muscle
Tendon
Joint capsule
Ligaments
Bursae
Fascia
Common Musculoskeletal
Conditions
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Overuse injuries
Traumatic Injuries
Surgical Conditions
Medical Conditions
Overuse Injuries
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Repeated stress to soft tissue and bone
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Bursitis
Tendonitis
Nerve entrapment
Stress fracture
Traumatic Injuries
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Bone and soft tissue can be damaged
through a direct blow or excessive
stretch
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Fracture - bone
Sprain - ligaments AND tendons
Strain - muscle
Traumatic Injuries
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Strains and sprains follow a traditional injury
grading scale:
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Grade I
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Grade II
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Fibers stretched with micro-tears
No laxity compared to non-injured side
Fibers stretched with micro-tears
Slight increase in laxity compared to non-injured side
Grade III
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Full tear of ligament or muscle
Requires surgical repair
Surgical Conditions
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Common surgical conditions may
require PT to rehabilitate
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Total joint replacement
Amputation
Ligament reconstruction
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Ex: ACL
Tendon and/or joint repair
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Ex: Rotator cuff repair
General Medical Conditions
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General medical conditions may affect
the musculoskeletal system
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Rheumatoid arthritis
Cancer
Multiple sclerosis
HIV or AIDS
Fibromyalgia
Systemic sepsis
A Brief Review:
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PT Exam includes:
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Patient History
Systems review
Tests and measures
Patient History
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Typical questions included in medical
history in a musculoskeletal PT exam
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Why are you here at PT today?
When did the problem begin?
What is your primary problem?
What provokes or relieves your symptoms?
Medications, or past medical conditions?
Tests and Measures Used in
Musculoskeletal PT
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Pain scale
Range of Motion
Strength
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Flexibility
Functional Tests
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Manual muscle testing
Bed mobility
Transfers
Activities of Daily Living (ADL’s)
Special Tests
(page 148)
Physical Agents
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Body tissue is injured
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Inflammatory process
Repair process
Typical physical agents used in
musculoskeletal PT may include:
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Thermal agents
Electrical stimulation
Thermal Agents
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Superficial Heat
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Deep heat
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Increased blood flow
Decreased pain
Increased healing and
delivery of nutrients
Same as above
(p.152)
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Electrical Stimulation
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Cold
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Same as above BUT has
decreased blood flow
properties as well
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Decreased pain
Decreased
edema/effusion
Muscle re-education
Decreased muscle
spasticity
Promotes wound
healing
Manual Techniques
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Soft Tissue mobilization
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Decrease pain and/or swelling
Relax muscle or fascia tension
Improve ROM
Examples:
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Massage
Trigger point release
Joint mobilization
Therapeutic Exercise
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ROM exercise
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AAROM vs AROM
Resisted exercise
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Muscular strength vs. muscular endurance
Isometric – without movement at joint
Isotonic – movement occurring at joints
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Concentric contraction
Eccentric contraction
Isokinetic – movement at constant speed
Therapeutic Exercise
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Balance and coordination
 proprioception
Cardiovascular endurance
Aquatic therapy
Functional exercises – combination
 Open chain – end segment is free to move
 Kicking leg out while sitting on a chair
 Closed chain – movement at 1 joint affects another
 Performing a squat
Home exercise program
Patient education
Now you Should be able to:
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Give an example of each of the following
musculoskeletal conditions: (1) overuse injury, (2)
traumatic injury, (3) surgical condition, and (4)
general medical condition.
Understand why it is important to ask, and be able to
provide several questions involved in a good
musculoskeletal PT examination
Define and give examples of the various tests and
measures used in a musculoskeletal PT examination
Identify, and be able to describe the objective of
physical agents, manual techniques, and therapeutic
exercise used in musculoskeletal PT
Questions??