LBP + SIJ Dysfunction

Pain with overhead activity, tenderness with palpation over tendon most commonly supraspinatus (+ teres minor tendon), painful arc often between 70-120 degrees.

Impingement tests: Neers, empty/full can, Hawkins Kennedy, apprehension test, ER against resistance (weakness with supraspinatus).

Ice/rest/avoid agg activity, strengthen rotator cuff, progress to eccentric exercises, scapula control exercises, surgery for full thickness tears in younger athletes.

<p>Monitoring methods: Pain (0-10, VAS 0-100), self-reported function (disease specific), functional strength testing (30s STS), walking (10MWT, stair climb test), balance (step test, functional reach). Strategies for promoting adherence: Positive therapeutic alliance, agreed SMART goals, consideration of barriers and facilitators, individualized care plan.</p> Signup and view all the answers

<p>Structural changes precede OA diagnosis, including cartilage volume and thickness due to swelling, not actual cartilage growth, cartilage defects, bone marrow lesions post-ACLR, and cartilage composition/degeneration.</p> Signup and view all the answers

<p>Contributing factors include neuro-biomechanical, biomechanical, and joint structure factors.</p> Signup and view all the answers

<p>Neuro-biomechanical changes post-ACLR include increased knee extension, external tibia rotation, weakness, reduced quad contraction/force, increased co-contraction, and reduced knee flexion movement.</p> Signup and view all the answers

<p>Lower knee joint forces/loading are associated with increased risk of OA, suggesting underloading may be more concerning than overloading in OA pathogenesis.</p> Signup and view all the answers

<p>Evidence shows underloading in both TFJ and PFJ contact forces following ACLR, increasing the risk of OA.</p> Signup and view all the answers

<p>Strategies include early return to play (RTP), weight management, physical activity, muscle strength, fear of movement, diet, inaccurate/unrealistic beliefs, playing/running surface, and footwear.</p> Signup and view all the answers

<p>Evidence is lacking for the most effective exercise protocol for back pain.</p> Signup and view all the answers

<p>The three main domains to assess are patho-anatomy, movement, and psycho-social factors.</p> Signup and view all the answers

<p>Patho-anatomy includes vertebral segments, discs, spinal cord, dura mater, conus medullaris, epidural fat, and cauda equina.</p> Signup and view all the answers

<p>Disc degeneration is categorized as specific vs. non-specific, and evidence shows disc degeneration does not necessarily present with pain.</p> Signup and view all the answers

<p>Moderate evidence supports a movement-based driver of lower back pain.</p> Signup and view all the answers

<p>Understanding emotional responses to pain impacts injury and recovery.</p> Signup and view all the answers

<p>Peripheral sensitisation refers to pain originating at the peripheral nerves, while central sensitisation is pain originating from the brain/spinal cord where modulation of the pain pathway occurs and interferes with how pain is experienced.</p> Signup and view all the answers

<p>Genetic factors, pathoanatomical factors, physical factors, neurophysiological factors, psychological factors, and social factors.</p> Signup and view all the answers

<p>Considerations include recurrent, chronic, acute, specific vs non-specific, mechanical vs non-mechanical vs mixed type of pain, social factors, general health, family history, co-morbidities, and psychological factors.</p> Signup and view all the answers

<p>The movement-based classifications include movement impairment syndromes and the McKenzie approach for mechanical diagnosis and therapy.</p> Signup and view all the answers

<p>Movement impairment refers to pain provoked due to maladaptive loading patterns leading to muscle guarding and co-contraction, while control impairment refers to pain provoked due to the patient not being able to avoid performing provocative movement.</p> Signup and view all the answers

<p>Physical assessment methods include provocation testing (slump test, SLR), sensory testing (sharp pressure, two-point discrimination, hot/cold), myotome/dermatome/reflex testing, and observation of static posture and dynamic movement.</p> Signup and view all the answers

<p>The summary includes addressing and changing unhelpful mindset/perspective, behavior, encouraging an active lifestyle, educating about the positive effects of exercise, and utilizing cognitive functional therapy, strengthening exercises, lifestyle management, and manual therapy.</p> Signup and view all the answers

<p>The MDT approach involves routine assessment of activity limitations, thrust manipulations, non-thrust mobilization, trunk coordination/strengthening/endurance exercises, and repeated exercises in specific directions to improve mobility and reduce pain.</p> Signup and view all the answers

<p>When tissue damage occurs, it increases the sensitivity of peripheral nerves, leading to sensations such as primary hyperalgesia and allodynia.</p> Signup and view all the answers

<p>SIJ dysfunction can be due to hypermobility (e.g., with pregnancy) or hypomobility. Physical examination for SIJ pain includes observing static posture/dynamic movement, checking for leg length discrepancy, observing gait, trigger point assessment, and specific tests like Laslett’s test.</p> Signup and view all the answers

<p>SIJ injection is used to confirm the diagnosis of SIJ pain, as pain relief after the injection indicates SIJ dysfunction as the source of pain.</p> Signup and view all the answers

<p>MRI/imaging should only be referred if serious pathology is suspected.</p> Signup and view all the answers

<p>The categories of low back pain presentations include specific causes, isolated LBP, LBP with limb dominant, and abnormal pain behavior.</p> Signup and view all the answers

<p>Management strategies include referral, therapy, medication, and surgical options for each category of low back pain.</p> Signup and view all the answers

<p>The umbrella term 'spondylarthritis' includes conditions like ankylosing spondylitis, reactive arthritis, and psoriatic arthritis.</p> Signup and view all the answers

<p>The criteria for diagnosing inflammatory back pain include specific symptoms and clinical manifestations such as morning stiffness and improvement with exercise.</p> Signup and view all the answers

<p>Assessment and differential diagnosis for ankylosing spondylitis involve distinguishing it from conditions like mechanical back pain and osteitis condensans ilii.</p> Signup and view all the answers

<p>Hamstring injuries are classified into high-speed running and excessive stretching types.</p> Signup and view all the answers

<p>The prognosis and management of hamstring tears involve different phases of treatment and specific exercises.</p> Signup and view all the answers

<p>The neurological assessment for hamstring pain includes indications and contraindications for certain tests.</p> Signup and view all the answers

<p>The mechanism of ACL injury involves understanding how the ligament tears, and treatment options include conservative and surgical approaches.</p> Signup and view all the answers

<p>Outcomes following ACL reconstructions include thigh muscle strength and knee function.</p> Signup and view all the answers

<p>There is an increased risk of knee osteoarthritis in ACL injury patients 10-15 years post-injury.</p> Signup and view all the answers

<p>Muscular strength, endurance, and agility play an important role in the conservative treatment of ACL injuries, aiding in rehabilitation and prevention of re-injury.</p> Signup and view all the answers