SKEB 2513 Basic Rehabilitation: Musculoskeletal Conditions

Study Notes

General Consideration: Primary causes of shoulder impingement include subacromial or subcoracoid impingement of the rotator cuff, with secondary causes being abnormal glenohumeral and scapulothoracic motion.
Static Stabilizers: The glenoid labrum and glenohumeral ligaments are static stabilizers of the shoulder.
Dynamic Stabilizers: The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) are dynamic stabilizers of the shoulder.
Pathogenesis: The deltoid and supraspinatus muscles provide superior translational forces to the humeral head, while the infraspinatus, teres minor, and subscapularis muscles provide inferior translational forces. Unopposed superior translational forces can lead to supraspinatus impingement.
Clinical Findings: Signs and symptoms include pain on resisted motion, and a positive finding in special tests such as Neer's sign, Hawkins' sign, Empty Can test, and Speed's test.
Imaging Studies: Radiographs can show narrowing of the subacromial space, while MRI can demonstrate both bony and soft tissue abnormalities.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and surgery.

General Consideration: Lateral ankle sprains are the most common type of ankle sprain, accounting for 85% of ankle sprain injuries.
Pathogenesis: Forced ankle plantar flexion, supination, and inversion can lead to spraining of the lateral ligaments.
Clinical Findings: Signs and symptoms include swelling, ecchymosis, and limited range of motion. Special tests such as the anterior drawer test, talar tilt test, external rotation test, and squeeze test can help diagnose ankle sprains.
Grades of Ankle Sprains: Ankle sprains can be classified into three grades: Grade I (mild), Grade II (moderate), and Grade III (severe).
Imaging Studies: Radiographs can rule out fractures, while MRI can provide insight into osteochondral defects, bone bruises, and stress or occult fractures.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and rehabilitation programs that focus on pain control, gait normalization, and return to daily activities and sports.

General Consideration: Discogenic low back pain is caused by a degenerated or herniated intervertebral disc, and can affect up to 40% of chronic low back pain sufferers.
Pathogenesis: Degenerative disc disease, intervertebral disc disruption, and disc herniation can lead to discogenic low back pain.
Clinical Findings: Signs and symptoms include axial low back pain with or without radiation to the limb, tenderness over the spinous processes and paraspinal muscles, and pain exacerbated by trunk flexion and relieved by extension.
Imaging Studies: Radiographs can show structural changes, while MRI can demonstrate both bony and soft tissue abnormalities.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and rehabilitation programs that focus on stabilization of core muscles, proper spinal bracing, and traction. In severe cases, surgery may be necessary.