Treatments
ORTHOPAEDIC CONDITION-2
HYPERLORDOSIS

hyperlysis 2

SYMPTOMS
• SLUMPED, HUNCHED/ ROUNDED SHOULDERS, PROTRUDING ABDOMEN, CAVED-IN CHEST.
• POT BELLY
• KNEES FLEXED WHILE WALKING/STANDING.
• NECK & BACK PAIN

FLAT BACK SYNDROME

• LOSS OF LUMBAR LORDOSIS WITH ACTUAL KYPHOSIS

SYMPTOMS-
• DIFFICULTY STANDING UPRIGHT
• THIGH AND GROIN PAIN



KYPHOSIS

There are three types of deformities:

1. Knuckle – prominence of one spinal process
2. Gibbus - prominence of two or three spinal processes
3. Kyphus - diffuse rounding of vertebral column

SCOLIOSIS

LATERAL CURVATURE OF THE SPINE WITH VERTEBRAL ROTATION.



FACET JOINT DYSFUNCTION


• FACET JOINTS ARE SET OF SYNOVIAL, PLANE JOINTS B/W ARTICULAR PROCESSES OF 2 ADJACENT VERTEBRAE. THERE ARE 2 FACET JOINTS IN EACH SPINAL MOTION SEGEMENT.
• BIOMECHANICAL FUNCTION- TO LIMIT THE MOTION OF SPINAL SEGMENT & PROTECT THE SEGMENT AGAINST ANT. SHEAR FORCES, EXCESSIVE ROTATION & FLEXION.

SYMPTOMS-

• INTERMITTENT & UNPREDICTABLE EPISODES OF PAIN DURING ALL MOVTS.
• U/L PAIN WITH SIDE BENDING & EXTENSION.
• JOINT INSTABILITY CAUSING IMPAIRED POSTURE.
• IMPAIRED SPINAL EXTENSION WITH PERSISTENT POINT TENDERNESS & STIFFNESS.
• AGGRAVATING FACTORS- SITTING & TRAVELLING, BENDING FROM BACK, IMPROPER LIFTING, PRONE LYING ON SOFT SURFACE, SLOUCHED SITTING.

PROLAPSED INTERVERTEBRAL DISC

• IVD’S ARE SOFT, RUBBERY PADS FOUND B/W THE HARD BONES (VERTEBRAE) MAKING UP THE SPINAL COLUMN.
• IVD’S ACTS AS SHOCK ABSORBERS/ LUBRICATING/ CUSHIONING AGENT PROVIDING PAINFREE FLEXION & EXTENSION MOVTS. ADDING LENGTH TO THE VERTEBRAL COLUMN.
• PIVD MEANS THE PROTRUSION/ EXTRUSION OF NUCLEUS PULPOSUS THROUGH A WEAKNESS IN THE OUTER PART OF THE DISC THAT IS, ANNULUS FIBROSUS


SYMPTOMS-

• LOW BACK ACHE WITH OR WITHOUT RADIATION TO THE BACK OF LEG. (MOSTLY ASSOCIATED WITH SCIATICA) OR FRONT OF THIGH (FEMORAL NERVE).
• PARAESTHESIA & TINGLING IN ONE LEG THAT CAN BEGIN IN BUTTOCK OR BEHIND THE KNEE & EXTEND TO THIGH, ANKLE, OR FOOT.
• MUSCLE WEAKNESS U/L OR B/L.
• PAIN WORSE AT NIGHT OR WITH COUGHING/SNEEZING/ LAUGHING, AFTER STANDING/ SITTING, FLEXION
• LATER, MUSCLE ATROPHY.

ANKYLOSING SPONDYLITIS

IT IS A CHRONIC GENERALISED INFLAMMATORY DISEASE OF SPINE WITH THE INVOLVEMENT OF PERIPHERAL JOINTS & NON-ARTICULAR SURFACES, MORE COMMON IN MALES.
STRONG ASSOCIATION WITH HLA-B27
SIGNS & SYMPTOMS-
• BACKACHE WORSE IN THE MORNING/ DURING INACTIVITY/ AT NIGHT
• INTERCOSTAL TENDERNESS
• FLATTENING OF LOWER BACK
• DIFFUSE TENDERNESS OF SPINE
• NCREASE THORACIC KYPHOSIS
• GENERALISED OSTEOPOROSIS
• SACROILITIS


SCIATICA

sciatica

sciatica.png1CHARACTERISED BY ONE/ COMBINATION OF THE FOLLOWING—
• CONSTANT PAIN ONLY ONE SIDE OF BUTTOCK/ LEG
• DULL ACHE / PAIN WORSE WITH SITTING/ STANDING UP/ COUGHING
• LEG PAIN ASSOCIATED WITH BURNING/TINGLING
• WEAKNESS, DIFFICULTY IN WALKING

PIRIFORMIS SYNDROME
  • THE SYNDROME CHARACTERISED BY PAIN AND INSTABILITY OVER THE ISCHIAL TUBEROSITY.
  • LOCATION OF PAIN- HIP, COCCYX, BUTTOCK, GROIN, DISTAL PART OF THE LEG.
    CLINICAL PRESENTATION
  • PAIN & WEAKNESS ON RESISTED ABDUCTION & EXT. ROTATION OF THE THIGH.
  • TENDERNESS OVER ISCHIAL TUBEROSITY.
  • INTOLERANCE TO SITTING.
  • NATURE OF PAIN- RADIATING (MAY BE ) WHICH WORSENS WITH WALKING/ SQUATTIN

PIRIFORMIS SYNDROMEPIRIFORMIS SYNDROME.png1PIRIFORMIS SYNDROME.png2

S.I.JOINT DYSFUNCTION

SYMPTOMS-
• DULL ACHE, SHARP/ STABBING
• PAIN- BUTTOCKS/ BACK OF THIGH/ LOW BACK
• UNILATERAL OR BILATERAL
• WORST– PROLONGED SITTING / TWISTING MOVT
• MORNING STIFFNESS
• PAIN OVER POSTERIOR SUPERIOR ILIAC SPINE
• RADIATION ABOVE THE KNEE
• RESOLVES WITH EXERCISE GENERALLY

 

ON EXAMINATION-
• FORWARD BENDING- NORMAL/BLOCKED MOVT
• PSIS ON INJURED SITE MOVES SOONER THAN NORMAL
• SLR- PAIN INC. AFTER 45*
• SIDE BENDING- PAIN INC. ON I/L SIDE
• UPSLIP- PSIS & ASIS HIGHER
• ANTERIOR ROTATORY FALL- ASIS LOWER & PSIS HIGH WITH TIGHT HIP FLEXORS & WEAK GLUTEALS
• POSTERIOR ROTATORY FALL- ASIS HIGHER, PSIS LOWER WITH TIGHT PIRIFORMIS/GLUTEALS/HIP FLEXORS

 

 

S.i.joint dysfunction

STENOSIS

THE SPINAL CANAL NARROWS & COMPRESSES THE SPINAL CORD & NERVES AT THE LEVEL OF LUMBAR VERTEBRAE, MAY BE CONGENITAL OR ACQUIRED (DEGENERATIVE / SPONDYLOSIS/ TUMOR/ HYPERTROPHY)

STENOSISPAINFUL EXTENSION MOVEMENT.
DETERIORATION OF FINE MOTOR SKILLS IF CERVICAL INVOLVEMENT
IT MAY BE U/L OR B/L WITH SEVERAL DERMATOMES AFFECTED
INCOORDINATION
TREATMENT IS GIVEN IN FLEXION-BIAS

ILIOTIBIAL BAND SYNDROME

IT IS A MOST COMMON OVERUSE INJURY TO THE KNEE, MOSTLY DUE TO RUNNING, CYCLING, HIKING, WEIGHT LIFTING OR SQAUTTING. ILIOTIBIAL BAND SYNDROME

SYMPTOMS-

  • LATERAL KNEE PAIN WITH SWELLING OVER THE KNEE.
  • PAIN WHEN FOOT STRIKES THE GROUND AND AFTER ACTIVITY.
  • PAIN INCREASES WITH TIME.
POTT’S SPINE

IT IS THE TUBERCULOSIS OF THE SPINE WHERE THE INTERVERTEBRAL JOINTS ARE AFFECTED. TISSUE NECROSIS AND BREAKDOWN OF INFLAMMATORY CELLS RESULTS IN PARASPINAL ABSCESS.

POTT’S SPINE

 

 

SYMPTOMS-

  • HIGH FEVER WITH CHILLS
  • ABSCESS FORMATION
  • PERSISTENT BACK PAIN
  • DEFORMILTIES- SCOLIOSIS/KYPHOSIS
  • SENSORY DEFECTS
  • SPASTICITY
  • BLADDER INVOLVEMENT
  • LOCALISED TENDERNESS AND PARAVERTEBRAL MUSCLE SPASM
  • DISC SPACE NARROWING
CERVICOGENIC HEADACHE



PAIN OR DISCOMFORT B/W ORBIT AND OCCIPUT, ARISING FROM THE PAIN SENSITIVE STRUCTURES SYMPTOMS- DIFFUSE,DULL, ACHING, BAND-LIKE HEADACHE WITH DIZZINESS

VERTIGO

VERTIGO IS NOT A MEDICAL CONDITION BUT IT IS A SYMPTOM WHEN A PERSON FEELS THAT THE OBJECTS AROUND HIM ARE MOVING/SPINNING, A KIND OF DIZZINESS, WHICH LASTS FOR MORE THAN A MINUTE. IT MAY BE ASSOCIATED WITH NAUSEA, VOMITING, SWEATING OR DIFFICULTY WALKING, BLURRED VISION, FALLS , HEADACHE, HEARING LOSS, SWEATING.

TORTICOLLIS

THE SPASM OF STERNOCLEIDOMASTOID MUSCLE MAY BE IDIPATHIC/ CONGENITAL.

THE MUSCLE ON ONE SIDE GETS FIBROSED AND FAILS TO ELONGATE AS THE CHILD GROWS DUE TO ISCHAEMIC NECROSIS AT BIRTH/ BREECH PRESENTATION/ HEMIATLAS

SYMPTOMS-
• HEAD IS TILTED ON ONE SIDE AND CHIN FACES THE OPPOSITE SIDE
• BABY DOESN’T LOOK IN ONE PARTICULAR DIRECTION
• FLATTENING ON ONE SIDE OF FACE DUE TO UNRATED LESION
• SCM TENDON BECOMES TIGHT AND CORD-LIKE-RESISTED MOVEMENTS AWAY FROM THE AFFECTED SIDE

FROZEN SHOULDER

frozen solder• CHARACTERISED BY PAINFUL & STIFF GH JOINT D/T LOSS OF RESILIENCE OF JOINT CAPSULE , POSSIBLY WITH ADHESIONS B/W ITS SYNOVIAL FOLDS.
• DENSE ADHESIONS, CAPSULAR THICKENING, CAPSULAR RESTRICTIONS IN FOLDS OF JOINT CAPSULE
• GLOBAL LOSS OF ACTIVE & PASSIVE GH MOTION.
• LOSS OF ER *HALLMARK*
frozen solder 1

IMPINGEMENT SYNDROME

ROTATOR CUFF TENDON IS COMPRESSED DURING SHOULDER MOVEMENT CAUSING PAINFUL MOVEMENT (60* - 120* FORWARD FLEXION)
SYMPTOMS:-
• CHARACTERISED BY PAINFUL & STIFF GH JOINT D/T LOSS OF RESILIENCE OF JOINT CAPSULE , POSSIBLY WITH ADHESIONS B/W ITS SYNOVIAL FOLDS.
• DENSE ADHESIONS, CAPSULAR THICKENING, CAPSULAR RESTRICTIONS IN FOLDS OF JOINT CAPSULE
• GLOBAL LOSS OF ACTIVE & PASSIVE GH MOTION.
• LOSS OF ER *HALLMARK*
• GREATER UPWARD ROTATION

SLAP LESION

 

THE TEAR IN THE SUPERIOR GLENOID LABRUM WHERE THE LONG HEAD OF THE BICEPS TENDON IS ATTACHED, THE TEAR WILL EXTEND FROM ANTERIOR TO POSTERIOR FROM THE BICEPS TENDON. THIS IS MOST COMMONLY SEEN IN THROWERS, WEIGHT LIFTING, BASEBALL PLAYERS.

ROTATOR CUFF TEAR

THE INJURY TO THE ROTATOR CUFF MUSCLES - SUPRASPINATUS, INFRASPINATUS, TERRES MINOR, SUBSCAPULARIS, EITHER PARTIAL OR FULL, LEADING TO THE SHOULDER DYSFUNCTION.

CLINICALLY,
• PATIENT IS UNABLE TO LIFT HIS ARM AND FEELS PAIN IN OVERHEAD ABDUCTION.
• DISTURBED ACTIVITIES OF DAILY LIVING.
• SWELLING AND TENDERNESS IN SHOULDER JOINT.
PAINFUL RESISTED UPWARD MOVEMENTS

SHOULDER DISLOCATION

 

SHOULDER DISLOCATION 1 SHOULDER DISLOCATIONSIGNS & SYMPTOMS-
• PAIN ALONG THE ARM WITH NUMBNESS
• RESTRICTED ABDUCTION & EXTERNAL ROTATION
• PROMINENT ACROMION
• ARM LOCKED IN PLACE
• SPACE BELOW ACROMION APPEARS EMPTY
• ABNORMAL SHOULDER CONTOUR
• INSTABILITY IN SHOULDER JOINT
• PATIENT IS UNABLE TO TOUCH THE OPPOSITE SHOULDER
• DAMAGE TO THE AXILLARY ARTERY