Tendinopathy
Kohlstadt Ingrid, Cintron Kenneth in Metabolic Therapies in Orthopedics, Second Edition, 2018
Although the tendon may be thickened it is weaker than normal tendon. There are numerous biochemical changes in tendinopathy. There is an upregulation of vascular endothelial growth factor (VEGF) and an increase in metalloproteinases (MMPs). MMPs lead to the degradation of the extracellular matrix. There may be some upregulation of prostaglandin E2 (PGE2), which can inhibit Type 1 collagen synthesis. There appears to be repetitive microtrauma with failure of repair. This repetitive overload may overcome the ability of the tendon to repair. Cumulative microtrauma may weaken colla gen cross-linking and also affect the non-collagenous matrix and the vascular elements of the tendon. Neovascularity and associated nerve proliferation occurs in tendinopathy and is the primary reason for the condition’s sensitization and pain (Yang, Coleman, Pugh and Nokes, 2012).
Personal and Situational Factors Affecting Psychological Response to Sport Injuries
Adam Gledhill, Dale Forsdyke in The Psychology of Sports Injury, 2021
Injury onset and recovery status refer to the idea that athletes' perceptions and realities concerning their injury onset and recovery status affect psychological response to sport injuries across a sport injury lifespan (Wiese-Bjornstal et al., 2018). Russell and Wiese-Bjornstal (2015) found during the onset of microtrauma injury among novice marathon runners that the psychological narrative reflected two behavioural themes: self-diagnosis and self-treatment, and not taking time off. There appears to be an interval before athletes with microtrauma injuries recognize and acknowledge injury, occurring prior to them seeking treatment from sports medicine providers. Ruddock-Hudson et al. (2014) documented dynamic fluctuations in psychological response to injury in studies among male Australian Rules football players out of play from 9 weeks to 10 months. Their results showed that cognitive, affective and behavioural themes differed across three injury phases: reactions to injury, reactions to rehabilitation and reactions to return to play (Ruddock-Hudson et al., 2014).
Low Back Pain and Sciatica: Pathogenesis, Diagnosis and Nonoperative Treatment
Gary W. Jay in Practical Guide to Chronic Pain Syndromes, 2016
When interviewing a patient with spinal pain, it is important to establish the portion of the pain that is axial relative to its distribution in the ipsilateral (and contralateral) extremity. Cumulative microtrauma that occurs over time and injury-induced macrotrauma to spinal structures produce spinal and extremity pain in various combinations, but with similar characteristics. This process of aging and recurrent trauma is thought to cause progressive degeneration of spinal motion segments. Nevertheless, the presence of degenerative changes is typically seen in patients who complain of mechanical pain syndromes. Establishing that the patient’s LBP is mechanical in character is the most important initial goal. Therefore, pain should be aggravated by static loading of the spine, long lever activities, and levered postures. Mechanical LBP is characteristically eased when the spine is balanced by multidirectional forces and when the spine is unloaded.
Can clinical assessment differentiate partial thickness rotator cuff tears from full thickness rotator cuff tears? A secondary analysis
Published in Disability and Rehabilitation, 2020
Anne Edwards, Judy Chepeha, Allyson Jones, David M. Sheps, Lauren Beaupré
We found participants with partial thickness tears were more than twice as likely to recall a specific injury as those with full thickness tears. This is contrary to the results of Fukuda, who reported increasing incidence of trauma for patients with full thickness tears, but also noted that trauma led to different sub-types of partial tears [36]. Intratendinous tears were very frequently traumatic (92%), while bursal sided tears were very infrequently traumatic (8%) [36]. Uchiyama et al. also found a high incidence of trauma in participants with intratendinous partial tears [11]. Mechanism of injury may be difficult to compare across studies as “traumatic mechanism” could include both repetitive microtrauma or a single incident of trauma. It also relies on patient recall and their interpretation of the significance of an event involving the shoulder.
Two pediatric cases of post-traumatic facial paralysis with delayed onset
Published in Acta Oto-Laryngologica Case Reports, 2018
Taku Ito, Hiroki Watanabe, Motomu Honjo, Tomoaki Asamori
Post-traumatic facial paralysis is usually associated with temporal bone fractures, but it can sometimes occur in the absence of radiologically demonstrable bone disruptions [5]. In those cases, microtrauma causing nerve edema can be assumed. Microtrauma would be due to severe traction and stretching of the greater superficial petrosal nerve, potentially leading to the formation of an intraneural hematoma and secondary edema that extends in a retrograde direction along the proximal nerve [6,7]. Neural edema in such a case has the same deleterious effect as that in inflammatory palsy and, therefore, enhanced MRI is sensitive to such nerve edema and can clearly display the nerve itself [8,9]. Moreover, MRI can also show a thickened geniculate ganglion. Even in cases of facial paralysis without any bone fractures seen on CT, MRI can reveal abnormal findings in the geniculate ganglion [9]. Actually, case 2 showed abnormal signal intensity around geniculate ganglion on MRI without apparent bone fractures on CT, which would be helpful in surgical procedure.
Lumbar intravertebral disc herniation secondary to idiopathic calcific discitis
Published in British Journal of Neurosurgery, 2019
Ahmed-Ramadan Sadek, Christopher Dare, Stephen McGillion, Ali Nader-Sepahi, Vasileios Skiadas
The paucity of literature attributing ICD as a cause of back pain in adults is possibly related to the relatively short-window during which patients experience symptoms. It is likely that ICD is a heavily under diagnosed cause of back-pain. Our case as well those previously described highlight that conservative symptomatic management with non-steroidal anti-inflammatories is the primary treatment. Surgery may play a role in those with neural compromise. Despite conclusive evidence to explain the aetiology of these lesions a combination of microtrauma, inflammation and micro-vascular compromise are likely to be contributive to lesion formation. Repeated axial cyclical loading involving an affected nucleos pulposus gives rise to intravertebral migration of the calcific nodule through endplate structural weaknesses.
Related Knowledge Centers
- Injury
- Muscle
- Connective Tissue
- Tendon
- Bone
- Wolff'S Law
- Ligament
- Callus
- Inflammation
- Back Pain