Medical Library
Disclaimer
The information in this medical library is intended for informational and education purposes only and in no way should b e taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, occupational therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.
Sprains and Strains:
Sprains and strains are common injuries that we sustain with daily activities, recreation, and competitive sports. But what is a sprain and what is a strain?
Strains - A Strain is the tearing of muscle fibers.
Muscle fibers are the individual units that make up your muscles. When you call upon the muscle to perform strong or repeated contractions, you may suffer a strain. To further confuse the layperson, strains are classified into grades I, II, and III. Another way to think of these grades is mild (grade I), moderate (grade II), severe (grade III).
A grade I strain is a mild disruption of the muscle fibers. There may be mild swelling, mild tenderness, and it may be painful to stretch and use the injured muscle.
A grade II muscle strain indicates moderate muscle fiber damage. The pain is moderate to severe, it definitely hurts to use and stretch the injured muscle, and ecchymosis may be present. Ecchymosis (commonly called bruising) indicates that there was internal damage to blood essels that resulted in bleeding within and around the muscle. This bleeding is often visible under the skin as a purple, blue, red, yellow, and even green in color.
A grade III strain is the severe. It is the complete tearing of a muscle into two pieces, or separation of the muscle from its associated tendon. There is severe pain, complete loss of muscle strength, swelling is normally present with ecchymosis, and there may be a palpable “ indentiation” where the muscle is torn. Medical intervention is usually necessary. Typically, an orthopaedist (musculoskeletal specialist) will evaluate your condition and surgical repair may be needed.
Sprains - A sprain is a tear of the ligaments and capsules (tissues around joints). Ligaments are made up of bundles of somewhat elastic, collagen tissue and attach one bone to another. Capsules typically partially or completely surround a joint. In a synovial joint, there is lubrication and nourishing fluid with the capsule called synovial fluid.
Like strains, sprains are classified as grade I, II, III in their severity.
A grade I sprain involves a minimal number of ligament fibers. There may be pain, swelling, and only mild loss of function.
A grade II sprain is a moderate or partial ligament tear. There is usually moderate to severe pain, swelling and bruising are typically present, and there is a loss of joint function ( e.g., it is extremely difficult or you are unable to walk on a grade II ligament sprain of the ankle).
A grade II sprain is a complete tearing of the ligament or joint capsule into two pieces. Severe pain, swelling, bruising, and loss of function are associated with a grade III sprain. As with grade III strains, orthopedic intervention or surgical repair may be needed.
Osteoarthritis
Arthritis means inflammation of a joint. Osteoarthritis (OA) is the most common form of arthritis. It is generally described as the degeneration of the cartilage pads that line the joint surfaces. Joint cartilage, called articular cartilage, covers the ends of bones and acts as a friction-free surface and a cushion. The cartilage does not have any nerve ends nor does it have a blood supply so when it is traumatized, you don’t feel much pain nor does it bleed. However, over time these cartilage pads crack and wear away exposing the bone underneath (subchondral bone). The bone thickens, bone spurs (technically called osteophytes) form, and inflammation of the joint occurs.
According to the Arthritis foundation, 21 million Americans have osteoarthritis. It affects middle-aged people as well as seniors. Factors that increase your likelihood of experiencing an osteoarthiritc joint are:
Weight – the heavier you are the more likely you will experience OA.
Trauma – Joints that have exp0-erienced trauma are more likely to develop OA.
Infection – If your joint was infected in the past, it is more likely to develop OA.
Symptoms include joint stiffness, pain, stiffness after prolonged sitting/lying, catching and grinding of the afflicted joint, redness, warmth, swelling, and difficulty using the involved joint.
It is important that you obtain the appropriate diagnosis from your medical doctor. Once diagnosed with OA, there are some things that you can do to slow its progression. Weight loss, strengthening, physical therapy joint mobilization, ice when inflamed, heat with stiffness, and bracing the joint can help. Ask your rehabilitation specialist which is best for you.
A common question that patients ask is, “Does glucosamine help my arthritis? More recent studies seem to indicate that glucosamine sulfate does have a positive effect on osteoarthritis. Glucosamine is one of the “ground substances” or important molecules that make up cartilage. Adding this over-the-counter supplement to your diet may have positive effect on mild to moderate osteoarthritis. Some research indicates that glucosamine can provide pain relief and may decrease the progression of the disease. Though not conclusively proven, it is also theorized that glucosamine may even reverse the progression of the disease.
The last resort is joint replacement.
BPPV and Physical Therapy
Eply Maneuver is Helpful for Vertigo
Vertigo is particular “Benign Paroxysmal Positional Vertigo (BBPV)”, is a common disorder in which the patient complains of spinning and dizziness with rapid changes in head positions. BBPV is typically idiopathic (of unknown cause) in nature, other reported causes are head trauma, vestibular neuritis (inflamed vestibule-cochlear nearve), vertebrobasilar ischemia (inadequate blood flow to the brain), and inner ear infection.
It is hypothesized that small particles, (called otoconia) in the semi-circular canals, over-stimulate the sense organs (hair cells and cupula). This results in patient complaints of dizziness and the observation of nystagmus in the direction of head rotation. The dizziness may last anywhere from a few seconds to a minute and there may be associated nausea.
Brandt-Daroff and canalith repositioning movements (Eply maneuver) are the most common therapeutic interventions. The goal of these treatments is to move the small particles within the stimulated the sense organs within the canal.
Hi-quality research studies show significant numbers of patients that experience a resolution of symptoms and negative diagnostic tests for BPPV after treatment intervention as compared to the control groups.
While BPPV is a common diagnosis for those suffering from dizziness, there are other causes of vertigo (both central and peripheral). It is important to consult your doctor and physical therapist regarding proper diagnosis and treatment of vertigo.
Disclaimer
The information in this medical library is intended for informational and education purposes only and in no way should b e taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, occupational therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.