TENDON AND LIGAMENT DISORDERS

REFERENCE FOR BSC NURSING 2ND YEAR STUDENTS

1. Tendon and ligament disorders PRESENTED BY : MRS. HARMEET KAUR NURSING TUTOR UCON, FARIDKOT

2. introduction Tendon : A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Ligament : In anatomy, a ligament is the fibrous connective tissue that connects bone to other bones and is also known as articular ligament, articular larua , fibrous ligament, or true ligament.

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4. Causes of tendon and ligament injuries ACUTE INJURIES OVERUSE INJURIES Caused by: A sudden trauma from a fall or blow. Twisting of the tendon and ligament into an awkward position. Example: sprain, strain, and contusion. Overuse injuries occur gradually over time. When an athletic or other activity is repeated so often, areas of the body don't have enough time to heal between occurrences. Weakness in the surrounding muscles due to a sedentary lifestyle. Tendinitis and bursitis are common soft tissue overuse injuries.

5. Tendon injuries Tendon injuries are relatively common, especially in people who play sports. An estimated 30-50% of sporting injuries involve tendon problems. The common tendon injuries include: Strain Tendinitis Tendinosis Subluxation Tendon rupture

6. Strain An injury that involves damage to a tendon or the muscle to which it connects. The injury can be very painful. Severe strains may take weeks or months to heal.

7. pathology Trauma from falling or sudden twisting can cause strain . People who are inactive may be more vulnerable to strains, especially if they suddenly become active or either due to degeneration or wear and tear.

8. tendinitis

9. causes It may be caused by trauma, such as strain, but it is most commonly overuse injury. There are many activities that may cause tendinitis, including: Tennis Golf Painting Carpentry Throwing and pitching scrubbing

10. Sign and symptoms The symptoms of tendinitis include: Pain Inflammation (swollen joint) Local joint stiffness Warm to touch Loss of motion

11. tendionosis Tendionosis is a type of tear that is similar to a strain, but it usually happens over many months or years because of overuse or incorrect athletic technique.

12. subluxation Subluxation is a tendon disorder where tendon moves out of place ( a partial dislocation). A person may hear a pooping or snapping sound when it happens and then experience pain and weakness in the affected joint. Sometimes, pain may come and go. It is more likely in people with certain genetic anatomical differences, but can also result from an injury.

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14. Tendon rupture Tendon rupture is a condition in which a tendon separates in whole or in part from tissue to which it is attached, or is itself torn or otherwise divided in whole or in part. Examples include: Achilles, biceps, knees and quadriceps tendon rupture.

15. Ligament injuries An injury to the ligament is termed as a sprain . A sprain occurs when a ligament stretches or tears. It can be a temporary, minor inconvenience or a debilitating injury that takes month to heal. The knees, ankles and wrist are highly vulnerable to sprains from falls.

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17. Ankle sprains

18. Classification of sprains

19. Cont... GRADE 1 GRADE 2 GRADE 3

20. Soft tissue injuries It is a type of inflammation that may feel like an injury to the tendon or ligament. This inflammation often happens because of overuse or extreme stress on the joint.

21. etiology Bursitis is caused by: Overuse of joint Minor impact/stronger impact Old age Affect from other problem nearby : infection or arthritis.

22. Parts affected by bursitis

23. Signs and symptoms Pain: the pain increases with movement or pressure; Tenderness is often felt without movement; Swelling; Loss of movement; If bursitis is caused by infection it is called Septic Bursitis. The patient may have the following additional symptoms: Fever; Redness and warmth over affected area.

24. Diagnostic evaluation An x-ray to make sure no bones are fractured. Blood tests to check for rheumatoid arthritis. A CT scan or MRI to check if there is a torn tendon.

25. management PRICEM P: (Protection) immobilize the affected area to prevent from further injury; R: (Rest) splint an injured part, use sling for an arm or crutches for leg or foot injury to provide rest to the sprained or strained area. I: (Ice) Apply cold compress for 20 minutes every hour. Never put ice directly against the skin or it may damage the skin. Use a thin towel for protection. C: (Compression) compress by wrapping an elastic bandage or sleeve lightly around the joint or limb to remove swelling.

26. Cont.... E: (Elevate) elevate the area above heart level if possible. M: (Medication) give an over the counter NSAID (non-steroidal anti inflammatory drugs) like Ibuprofen (Advil, Mortin ), Acetaminophen (Tylenol), or Aspirin. {Avoid giving Aspirin to anyone under age 19.}

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28. Cont... Treatment of sprains and strains depend on the severity of the injury and the joint or muscle involved. In mild to moderate cases of sprains and strains, rest and ice is sufficient treatment. In severe case, immobilization with brace and splint is necessary. Some people find relief from physical therapy, especially if they suffer from chronic or overuse injury. In rare case of severely ruptured tendon, ligament or muscle surgery may needed.

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30. Cont... Bursitis and tendinitis often heal on their own, but in some case bursa can become infected. When this happens fluid may be drained or even infected bursa may be removed. Treatment of subluxation depends on its severity and underlying cause. In many cases a person need surgery and physiotherapy. In case of underlying condition doctor may recommend additional treatment or lifestyle modifications.

31. Cont..... In case of tendinitis if it doesn't heal on its own corticosteroid injections may provide relief. In chronic and severe tendinitis doctor may recommend surgery to remove inflamed or damaged tissue.

32. Nursing management Acute pain related to soft tissue injury or surgical incision. Impaired physical mobility related to pain, restricted movement or unfamiliarity with the use of immobilization devices. Self care deficit related to physical limitations present with cast or immobilizers.

33. Cont... 4. Risk for Infection related to Inadequate primary defenses: broken skin, traumatized tissues or Invasive procedure. 5. Deficient knowledge related to unfamiliarity to information resources.

34. Patient education Exercise regularly to keep your joints and muscles strong.  Use protective equipment when playing sports.  Wear shoes that fit well. When exercising, wear shoes that have a soft, even sole.  Maintain a healthy weight. Extra weight puts more stress on your muscles and joints. Your healthcare provider can determine your ideal body weight.

35. Cont... Eat a well-balanced diet to keep your muscles healthy. When you pick up something heavy, hold it close to your body, keep your back straight and your feet apart, and bend your knees. Lift using your legs, not your back. Don't twist your body or reach while you're lifting. Doing daily stretching exercises. Yoga is a good low-impact way to stretch muscles. Warming up and stretching before participating in vigorous sports.

36. THANK YOU