Procedures 2

pain from a nerve either orgin or destination

• is stiff and will not elongate
• found in all connective tissue
• amino acids are it's building block

• parallel arrangment prevents forces mostly one way but random fibers to prevent unwanted motions in other planes
• knee MCL -runs superior to inferior therefore prevents valgus forces

• Adaptive shortening
• Weakening of CT
• Decreased mobility
• ^ Results in decreased neural input & decreased motion changed joint mechanics

• mechanism of injury
• how long
• severity

• loss of contractile proteins
• loss of type 1>type 2 fibers
• decreased motor unti recruitment
• loss of strength after 2, 3 days

• decrease weight, size, and strength
• 8 weeks 20% decrease in strength

after 3 weeks 55-60% normal strength d/t loss of loading/unloading

stop prostaglandin formation that cause pain associated with inflammation

not acute

rarely trauma

• Protection phase
• mm guarding is natural immobilization
• they have pain at rest

• Controlled motion phase
• decreased inflammation
• pain with tissue resistance
• weakness
• limited ROM & function

• Return to function
• absence of inflammation
• pain after tissue resistance

• Inflammation
• impaired movement
• joint effusion
• decreased use of effected areas

• Protection & Biomechanical rest
• decrease inflammation
• maintain normal function where possible
• wound healing
• PT education

• Stretching
• Resistance exercises
• Tx that increases pain or inflammation
• (usually active movement of site)

• Brace
• stop activtiy
• splint
• tape
• cast

• Cold
• Compression
• Elevation
• Massage
• Rest

• passive movements within limits of pain
• muscle setting and/or ES

• pain at end ROM
• decreasing inflammation
• developing adhesions
• developing mm weakness from reduced weakness
• decreased functional use & associated areas

• Continue protection
• increase movement as tolerated

stress in the appropriate movements help lay down collagen in a effective and less random pattern

• Pt education-HEP
• modify protection and biomechanical rest
• promote healing
• PROM>AAROM>AROM
• Improve mm & neuromuscluar perfromance
• (Emphasize control &proper mechanics)

• discomfort after a few hours
• rsting pain
• fatigue
• increased weakness
• spasms