Musculoskeletal Disorders / injuries and their impact on adls
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| Dupytren's | wound care (elastomere) extension splinting with AROM
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| Skier's Thumb | Thumb splint (first 4-6 weeks), AROM (6-8weeks), pinch strengthening (8-10 weeks) ADL involvement.
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| Complex Regions Pain Syndrome | Decrease pain and edema, and encourage AROM, ADL involvement, and self-reliance. Splint to prevent contractures and stress loading/weight bearing activities to distract joints.
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| Cumulative Trauma Disorder / Repetitive Strain Injury | Dequervains Thumb Spica Splint - increase strength post surgery. Lateral(ext)/Medial(flex) Epicondylitis - elbow strap/wrist splint
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| Peripheral Nerve Injuries: Pronator Teres Syndrome | pain in forearm with Tinels test
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| Peripheral Nerve Injuries: Cubital Tunnel Syndrome | numbness tingling along ulna with Tinels test
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| Radial Palsy | wrist drop - extension splint
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| Median Nerve Laceration | ape hand (flattening of thenar eminance) & clawing of index and middle fingers
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| High injury of median nerve | benediction sign
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| Ulnar nerve deformity | claw hand, flattened metacarpal arch, & Froments sign (assessment of thumb adductor while laterally pinching paper
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| Amputation: neuromas | nerve endings adhered to scar tissue
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| Burn Classifications: 1st Degree | superficial 3-7 days healing
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| Burn Classifications: 2nd Degree | partial thickness 7-21 days healing. Deep partial thickness burn (hair follicles and sweat glands) 21-35 days healing
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| Burn Classifications: 3rd Degree | Full thickness (nerve endings) -months with a skin graft
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| Burn Classifications: 4th Degree | fat muscle and bone involvement - electrical burn. more severe skin grafts - death possible from injury or infection.
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| Rotator Cuff Tendonitis Conservative treatment: | supraspinatus(abd/flex) Infraspinatus &Teres Minor(ext rot) subscapularis(int rot) Conservative: act.mod, (NO add/int.rot while sleeping, avoid above shoulder level) pain, ROM, & strengthening (below shoulder level).
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| Rotator Cuff Tendonitis post surgical treatment: | supraspinatus(abd/flex) Infraspinatus &Teres Minor(ext rot) subscapularis(int rot). Post Surgical: 0-6 weeks- PROM -AAROM, and pain. 6 weeks: strengthen(ISOMETRICS to ISOTONICS-below shoulder level)/act.mod. 8-12 weeks: leisure/work.
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| Adhesive Capulitis | Frozen Shoulder - restricted PROM(ext/abd/int.rot/flex) due to inflammation and linked to DM2 and parkinsons. Conservative and surgical treatment the same: encourage active use, PROM(immediately), and modalities.
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| Shoulder Dislocations | ROM, pain free ADL use/role activity, and strengthen rotator cuff.
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