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What causes tendinitis?
- Continuous irritation.
- Chronic overload of the tendon leading to microtearing and triggering an inflammatory process in the tendon.
- Overload leads to decreased blood flow to dendons through compression, friction, and torsion of the tendon.
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Unders stress, tendons can easily stretch to what percentage greater than their resting length?
4%
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What happens when tendons are stretched beyond 8% of their resting length?
Collagen fibers start to fail
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What is a general term for any overuse tendon lesion?
Tendinitis
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What is an irritation of the inner surface of the tendon sheath by roughened surface of the tendon?
tenosynovitis
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What is a chronic degenerative change to a tendon?
Tendinosis
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What is the most commonly impinged structure with Impingement Syndrome?
Subacromial bursa
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Contraindications for Cyriax (4)
- Acute or early subacute stage of healing
- Client is currently taking anti-inflammatory medications
- Compromised tissue health in area of lesion
- Use with caution if client is on a blood thinner
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Red flag indicators for tendinitis (5)
- Sharp localized pain
- Will be able to point to area of greatest pain
- Loss of strength with contraction
- The more severe, the greater the descriptive terms used to describe pain
- NSAIDS help
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Positioning for supraspinatus tendinitis
- Client supine or seated
- Arm extended and internally rotated (grab something under table)
- Tendon addressed between anterior and middle deltoid fibers
- Cross-fiber direction is parallel to clavicle with proper arm positioning
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Positioning for infraspinatus tendinitis
- Client prone
- Client at edge of table so entire arm can hang in full flexion (straight to floor)
- Tendon is addressed just inferior to the lateral most spine of the scapula
- Cross fiber direction is perpendicular to the lateral spine of the scapula
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Positioning for subscapularus tendinitis
- Client supine
- Client near edge of table
- Client's humerus is held near side of body and with elbow flexed to 90 degrees, externally rotated fully (place support under forearm so client doesn't have to contract to hold position)
- Tendon is addressed just lateral to coracoid process
- Cross-fiber friction is parallel to humerus
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What is a neurological and/or vascular compression/entrapment of the brachial plexus, ulnar nerve and/or subclaivan artery/vein?
TOS!
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What are the four structures involved with TOS?
- Anterior scalene
- Middle scalene
- Pec minor
- Clavicle/first rib
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TOS can cause n/t of which group of fingers?
4th and 5th digits
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What does the intrascalene triangle consist of?
- Anterior scalene
- Middle scalene
- First rib
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What type of TOS treatment technique is contraindicated if client is on anti-inflammatories?
Deep transverse friction techniques
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