Term
| what is an example of a trauma that could cause patellofemoral pain syndrome |
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Definition
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Term
| what are insidious causes of PFP |
|
Definition
| body weight, weakness, work situation, training errors, shoes |
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Term
| what weak muscles contribute to PFP |
|
Definition
| weak hip abductors/Ers llow femur to IR |
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Term
| what training errors lead to PFP |
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Definition
| terrain, distance/time, speed, force |
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Term
| what are signs/symptoms of PFP |
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Definition
| effusion, patellar facet tenderness, crepitus, pain with activity,LE malalignments |
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Term
| what activities are often painful with PFP |
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Definition
| sitting, stairs, incline/decline |
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Term
| what LE malalignments are common with PFP |
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Definition
| faulty patellar mechanics, tight retinacula, feet pronated, hips antetorsioned |
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Term
| how to tell the difference between OA and PFP |
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Definition
| OA leads to loss of knee extension. |
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Term
| how common is knee crepitus |
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Definition
| 80% of adults over age 30 have knee crepitus. Of these, 20% have a problem. |
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Term
| what should the path of the patella be as knee goes from flex to extend |
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Definition
| S or straight. C = faulty |
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Term
| what special tests implicate PFP |
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Definition
| patellar compression, step up test, mcconnell isometric tests |
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Term
| what closed chain exercises are good for someone with PFP |
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Definition
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Term
| why is it painful to flex the knee more in closed chain |
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Definition
| increases quads force, which increases patellar force, which makes PFP more painful |
|
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Term
| do open or closed chain exercises for PFP? |
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Definition
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|
Term
| when is the quads force on the patella greatest |
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Definition
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|
Term
| where is patellar surface area with the femur greatest |
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Definition
|
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Term
| can you separate vasti forces? |
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Definition
| no. doesn't matter if you ER/IR with knee extension. You can't separate the quads because they all have the same insertion |
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|
Term
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Definition
| modify activity, attenuate GRF with orthotics, address flexibility and patellar mobility, muscle imbalances, mobilization, bracing, taping |
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Term
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Definition
| shaving off bad cartilage |
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Term
| what is tibial tubercle realignment/transfer and lateral release |
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Definition
| snip along lateral side at vastus lateralis tendon until patella releases and centralizes. Release the structures that are holding the patella laterally. Realignement is a more severe surgery. Rather than cutting the lateral retinaculum, they cut out a piece of the tibia and tendon, change its angulation, and reinsert it. They have to cut a section of bone out and then screw it back in place. The screws hold it until the bone heals (person will be immobilized) |
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Term
| what is osteochondral microfracture |
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Definition
| poke holes into the hyaline cartilage and subchondral bone to bleed out into joint and promote healing. |
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Term
| what is osteochondral autograft transfer |
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Definition
| take a graft to plug in a hole/fill in a defect that is within the area of contact for the joint |
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Term
| what are post surgical considreations following chondroplasty |
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Definition
| resume non-surgical/normal routine quickly |
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Term
| post surgical considerations after TT and lateral release |
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Definition
| short wait period (longer for TT), begin ROM, institute non-surgical program |
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Term
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Definition
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Term
| post surgical considerations after chondral repairs |
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Definition
| slow return dictated by surgeon. Protect the area by not putting too much joint surface pressure into the area too early on |
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|
Term
| what is osteochondritis dissecans |
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Definition
|
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Term
| what is the mechanism of an osteochondral lesion |
|
Definition
| traumatic detachment chondral segment |
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Term
| what demographic is most likely to get osteochondritis dissecans |
|
Definition
| young, well developed male |
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Term
| what is the classic site of ostechondritis dissecans |
|
Definition
| medial femoral condyle near the intercondylar notch |
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|
Term
| what are signs/symptoms of osteochondritis dissecans |
|
Definition
| wilson test, xray/mri, tenderness at femoral condyle |
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|
Term
| how to treat osteochondritis dissecans |
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Definition
|
|
Term
| what is an osteochondral autologous implant |
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Definition
| take some of your hyaline cartilage cells from somewhere, send them to a lab, put cells back down at surgical site, lay periosteal membrane on top. |
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Term
| what are some extensor mechanism problems |
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Definition
| fat pad, osgood-schlatter's, plica, IT band |
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|
Term
| what usually causes fat pad syndrome |
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Definition
|
|
Term
| what are signs/symptoms of fat pad syndrome |
|
Definition
| tender medial/lateral to patellar tendon in extension; pain with quad activation because it compresses the fat pad; hypertrophic fat ad |
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|
Term
| how to treat fat pad syndrome |
|
Definition
| anti-inflammatory modalities, avoid aggravating activities, protective padding, injection with corticosteroids can confirm diagnosis and provide temporary relief, may require surgical removal |
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Term
| what are signs/symptoms of osgood-shclater's |
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Definition
| tender tibial tubercle, pain with quad resistance, squatting increases pain, tightness in quads/hamstrings/gastrocs |
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|
Term
| how to treat osgood schlatters |
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Definition
| stretch tight muscles, attenuate GRF, protective bracing, modify training habits |
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|
Term
| how is osgood schlatters self-limtiting |
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Definition
| problem is gone as soon as skeleton closes |
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|
Term
| what braces are good for osgood schlatters |
|
Definition
| chopat = rubber tube that fits around knee and compesses patellar tendon to take pressure off tibial tuberosity. Horse shoe brace takes pressure off tibial tuberosity |
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|
Term
| what is the MOI that causes medial patellofemoral plica |
|
Definition
| gradual onset that increases with flexion loading |
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|
Term
| signs and symptoms of medial plica syndrome |
|
Definition
| ttp at medial femoral condyle, popping at medial aspect with F/E, medial tissue thickened, +plica test, mimics other conditions |
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|
Term
| treatment of medial patellofemoral plica |
|
Definition
| treat with modalities to decrease inflammation and lengthen tissue, friction massag |
|
|
Term
| describe medial patellofemoral plica problems |
|
Definition
| plica thickens, ticks off tissue in area causing redness and swelling. Irritated by the plica band that rubs across the aspect of the medial femoral condyle. Thumps. Pain shuts the muscle down. |
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Term
|
Definition
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|
Term
| what is the MOI for patellar tendonitis |
|
Definition
| gradual onset, increased pain with increased activity, training errors, jumping sports, after ACL |
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|
Term
| what are S/S jumper's knee |
|
Definition
| tenderness to palpation at inferior patellar pole, pain with activation of quads, pain with stretch of quads, patellar tendon thickenting |
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|
Term
| treatment for jumper's kene |
|
Definition
| rest, ROM, deal with inflammation, friction massage, progressive loading |
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|
Term
| why do friction massage for patellar tendonitis |
|
Definition
| irritate the area to create inflammation to start off the healing process |
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|
Term
| what are MOI for IT band syndromes |
|
Definition
| gradual onset of knee or hip pain, structural/functional dysfunction, activity changes, training errors, ilial rotations |
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|
Term
| what are S/S of IT band friction syndrome |
|
Definition
| snapping lateral knee, pain lateral knee, + ITB compression test/Noble test |
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|
Term
| how to treat ITB friction syndrome |
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Definition
| anti-inflammatory modalities, ITB flexibility, friction massage, progressive loading, control foo mechanics, attenuate GRF, mobilize/manipulate pelvis |
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|
Term
| what are knee immobilizers used for |
|
Definition
| restrict motion. Allow joint protection while healing. |
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|
Term
| what are rehabilitative braces |
|
Definition
| allow protected motion during rehab. May have adjustable stops for ROM control.outcomes not clearly better with or without brace |
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|
Term
| describe functional braces |
|
Definition
| increase stability for unstable knees. |
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|
Term
| describe prophylactic bracing/taping |
|
Definition
| prevent or reduce severity of injuries. Allow normal function while limiting injury. Research not consistent. |
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|
Term
| can neoprene stop varus/valgus forces on the knee |
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Definition
|
|
Term
| what is the literature consensus on bracing |
|
Definition
| in favor of rehab bracing for short term protection during healing. Divided over functional bracing and prophylactic bracing |
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|
Term
| what to stretch to reduce moment arms around the knee |
|
Definition
| quads, hams, ITB, triceps surae, glutes/hip rotators |
|
|
Term
| what to mobilize to help the knee |
|
Definition
| patella, retinacula, scars, tibfib joint |
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|
Term
| starting level closed chain exercises for the knee |
|
Definition
| modified wall slides, heel raises, stool scoots |
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|
Term
| starting level open chain exercises for the knee |
|
Definition
| isometric hams/quads/glutes; SAQ; SLR; HS; AROM hip, knee ankle |
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|
Term
| intermediate open chain exercises for the kene |
|
Definition
|
|
Term
| intermediate closed chain exercises for the knee |
|
Definition
| wall slides, controlled step exercises, balance/proprioception, pyrometrics, lunges, weight training |
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|
Term
| advanced exercises for the knee |
|
Definition
| closed chain: plyometrics, jumping, ball/foam roll, weight training, slide board, balance, work simulation, sport simulation |
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