Friday, 17 May 2013

Quadriceps Contusion


Commonly referred to as a ‘dead leg’, a quadriceps contusion leg’ is very common in contact sports. An impact to the muscles can cause more damage than you might expect and should be treated with respect. The muscle is crushed against the bone. If not treated correctly or if treated too aggressively then Myositis Ossificans (calcification or bone growth in the muscle) or other secondary complication may result. Athletes often report a ‘knee’to the thigh and although just another word for a bruise, a contusion can be quite problematic, especially if they occur deep inside a muscle. Along with the pain and swelling, secondary complications can occur, leaving the player with a long rehabilitation process.


There are two types of contusions:

Intramuscular which is a tearing of the muscle within the sheath that surrounds it. This means that the initial bleeding may stop early (within hours) due to increased pressure within the muscle, however the fluid is unable to escape as the muscle sheath prevents it. The result is considerable loss of function and pain which can take days or weeks to recover. You are not likely to see any bruising with this type - especially in the early stages.

 Intermuscular which is a tearing of the muscle and part of the sheath surrounding it. This means that the initial bleeding will take longer to stop especially if you do not ice it. However recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. You are more likely to see bruising with this one.

Immediate treatment for any type of muscle injury is to commence three practical yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal between 3 to 6 weeks

Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce bleeding and pain

Compression–Compression assists in the prevention of swelling in the affected area help to reduce the recovery time

Returning from a quadriceps contusion


·         Use compression shorts to keep the muscles warm and supported

·         Always warm up before sporting activity

·         Always cool down after sporting activity

·         Stability exercises

·         Seek the advice of a qualified sports injury specialist


 

Quadriceps Muscle Strain

Injuries to this muscle group are common and can be painful, debilitating and can result in significant time away from training and competition.

Anatomy

The quadriceps is made up of four individual muscles each of which play a role in hip flexion and knee extension. These are all innervated by the femoral nerve.

·         Rectus femoris

·         Vastus lateralis

·         Vastus intermedius

·         Vastus medialus

Quadriceps Muscle Strain

Quadriceps strains are most commonly caused by a strong eccentric contraction during sporting activities such as sprinting, football and basketball.  A quadriceps strain injury normally occurs when the extensor muscles are forced to stretch beyond their limitations, resulting damage to the muscle tissue commonly called a tear. The tear in the muscle is called the strain, and fall into one of three different degrees, depending on its severity.

Grade 1

Grade 1 quadriceps strains do not normally appear until a particular activity like running, jumping or kicking is done. This is often described as a sensation of tightness or feelings of pain when the muscles are contracted or stretched. Continuation of the activity is often report with the discomfort occurring after or the day after participation

Grade 2

Grade 2 quadriceps strains immediately have sensations of pain, far more painful than those of the grade 1 injuries. It also produces severe pain on walking. The grade 2 groin strains are usually confirmed by pains and weakness, especially when muscles are contracted or stretched. This type of strain is normally very sore to touch and may result in bruising at the anterior thigh.

Grade 3

Grade 3 quadriceps strains are described as a full rupture of one of the extensor muscles but are rare. These types keep the athlete from walking with individual normally requiring surgical intervention following this type of injury. For both the grade 2 and 3 strain injuries, a large bruise is normally formed below the injured area after a few days. The bruise is generally caused by bleeding of the damaged tissues.

Immediate treatment for any type of muscle injury is to commence three practical yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal between 3 to 6 weeks
 
Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce bleeding and pain

Compression– Compression assists in the prevention of swelling in the affected area help to reduce the recovery time

Preventing Groin Strain

·         Use compression shorts to keep the muscles warm and supported

·         Always warm up before sporting activity

·         Always cool down after sporting activity

·         Stability exercises

·         Seek the advice of a qualified sports injury specialist

Groin Strain

Groin strains are one of the most common injuries in sports, particularly in football, hockey and rugby where kicking and change of direction is common. A groin strain describes a strain on the Adductor muscles, of which there are five located at the inside of the thigh.

These are:

• Adductor Brevis

• Adductor Longus
• Adductor Magnus
• Gracilis
• Pectineus

A groin strain injury normally occurs when the adductor muscle is forced to stretch beyond its limitations, resulting damage to the muscle tissue commonly called a tear. The tear in the muscle is called the strain, and fall into one of three different degrees, depending on its severity.

Grade 1

Grade 1 groin strains do not normally appear until a particular activity like running, jumping or kicking is done. This is often described as a sensation of cramps or tightness, or feelings of pain when the muscles are contracted or stretched. Continuation of the activity is often report with the discomfort occur after or the day after participation

Grade 2

Grade 2 groin strains immediately have sensations of pain, far more painful than those of the grade 1 injuries. It also produces severe pain on walking. The grade 2 groin strains are usually confirmed by pains, especially when muscles are contracted or stretched. This type of groin strain is normally very sore to touch and may result in bruising at the inner thigh.

Grade 3

Grade 3 groin strains are described as a full rupture of the adductor muscle but are rare. These types keep the athlete from walking without pain and he immediately feels a stabbing pain or burning sensation. The individual with normal require surgical intervention following this type of injury. For both the grade 2 and 3 groin strain injuries, a large bruise is normally formed below the injured area after a few days. The bruise is generally caused by bleeding of the damaged tissues.

Immediate treatment for any type of muscle injury is to commence three practical yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal between 3 to 6 weeks

Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce bleeding and pain

Compression– Compression assists in the prevention of swelling in the affected area help to reduce the recovery time

Preventing Groin Strain

  • Use compression shorts to keep the muscles warm and supported
  • Always warm up before sporting activity
  • Always cool down after sporting activity
  • Stability exercises
  • Seek the advice of a qualified sports injury specialist

Physiotherapy Abbreviations

Physiotherapy Abbreviations

There are many symbols specific to the field of physiotherapy, rehabilitation and health care. Many of the common symbols can be misinterpreted as they often represent different things. This can often be confusing to other physiotherapist's, health care professionals and students alike. This resource was created to review the most common symbols and their meanings. This list is not complete as is this meant as an open project which will be added to as and when. If any viewer would like to comment on the content please feel free to do so.

Also see:
Physiotherapy Symbols

(A, B & C)

Abbreviation
Definition
Acup
Acupunture
a/c jt or ACJ
Acromioclavicular joint
A.N.T
Adverse neural tension
AROM
Active range of movement
ASIS
Anterior superior iliac spine
Ant
Anterior
Agg or aggrav
Aggravating factors
A.S.
Ankylosing spondylitis
a/a
As above
ACL
Anterior cruciate ligament
A.J. *
Ankle jerk
A.J.*
Ankle joint
aa*
Atlanto-axial joint
aa*
Aortic Aneurysm
Abd
Abduction
Add
Adduction
ANS
Autonomic nervous system
Ach T
Achilles tendon
B/T, btw or btwn
Between
B4
Before
Bc
Because
B*
Better
B*
Bilateral
BP
Blood pressure
Bilat
Bilateral
c/o
Complains of
Ca
Cancer
c.f
Compared with
C/sp, Cxsp or Cx
Cervical spine
CMP
Chondromalacia patella
CTD
Carpal tunnel decompression
CTJ
Cervico-thoracic junction
CNA
Could not attend
Canx or canc
Cancelled
Const
constant
CHF
Congestive heart failure
Chol
Cholesterol
CV
Cardiovascular
CVA
Cardiovascular accident
C1-7
Labelled 1st to 7th cervical vertebrae
Circ*
Circumduction
Circ*
Circulation
Ceph
Cephalad
Caud
Caudad
Contra
Contralateral
CMC
Carpometacarpal
CUS
Continuous ultrasound
CTS
Carpal tunnel syndrome

(D, E & F)

Abbreviation
Definition
D/H, DH or DHx
Drug history
D/C
Discharge
Dr
Doctor
D/W
Discuss with
DNA
Did not attend
DNF
Deep neck flexors
DTF*
Deep transverse frictions
DFT*
Deep tissue frictions
DOB
Date of birth
DRAM
Diastasis of rectus abdominus
DF
Dorsiflexion
DL
Double leg
Dist
Distal
DTM
Deep tissue massage
DKB
Double knee bend
d/t
Due to
Exs or X’s
Exercises
Ext
Extension
ER
External rotation
Elev
Elevation
Ep
Epilepsy
Elb
Elbow
EOD
End of day
EOR
End of range
ERP or EoRP
End of range pain
Ev or ever
Eversion
EIL
Extension in lying
EIS
Extension in standing
ERSL
Extended rotated side flexion left
ERSR
Extended rotated side flexion right
Flex or Fl
Flexion
FF
Forward flexion
FROM*
Full range of motion
FROM*
Full range of movement
FFD
Fixed flexion deformity
FHP
Forward head posture
FNT
Femoral nerve test
FIL
Flexion in lying
FIS
Flexion in standing
FT
Fingertips
FRSL
Flexed rotated side flexed left
FRSR
Flexed rotated side flexed right

(G, H & I)

Abbreviation
Definition
G.H.
General health
GH Jt or GHJ
Gleno-humeral joint
GOOB
Getting out of bed
Gluts
Gluteus
Gmax
Gluteus maximus
Gmed or GM
Gluteus medius
Gmin
Gluteus minimus
GP
General practitioner
Gastroc
Gastrocnemius
HEP or HP
Home exercise programme
HPC, HoPC or HxPC
History of present complaint
HBB
Hand behind back
HBH
Hand behind head
H/o
History of
HOS
Hand opposite shoulder
HF
Horizontal flexion
HE
Horizontal extension
HFP
Head forward posture
Hypo
Hypomobility
Hyper
hypermobility
HU
Humero-ulnar
HJ
Hip joint
Hams, h/string or h/s
Hamstrings
IF
Interferential
IRQ
Inner range quadriceps
ILA
Inferior lateral angle
ITB
Ilio-tibial band
ISQ
In status quo or the same
Inf
Inferior
Inf TF
Inferior tibio-fibular joint
Infsp or i.s.
Infraspinatus
IL Lig
Iliolumbar ligament
Imp*
Impression of problem
Imp*
Improved
IR
Internal rotation
Ix or Invest
Investigations
IDDM
Diabetes (insulin dependent)
I/M*
Intermittent
I/M*
Intermuscular
Inv
Inversion
Ipsi
Ipsilateral
IC
Intercarpal
IP
Interphalangeal

(J, K & L)

Abbreviation
Definition
Jt or jnt
Joint
Kn
Knee
KJ
Knee jerk
KTW
Knee to wall
LL
Lower limb
L1-5
Labelled 1st to 5th lumbar vertebrae
L
Left
LLD
Leg length discrepancy
L.H.S.
Left hand side
LLTT
Lower limb tension test
LFT
Lower fibres of Trapezius
Ly
Lying
Lat rotn or LR
Lateral rotation
LBP
Lower back pain
LCL
Lateral collateral ligament
LF
Lateral flexion
Lx, LSp or Lx/sp
Lumbar spine
LSj or L/S
Lumbo-sacral junction
Lat epi
Lateral epicondyle
LG
Lateral glide
Lig
Ligament
LHOB
Long head of biceps

(M, N & O)

Abbreviation
Definition
Men
Meniscus
MAP
Myotatic activation procedure
Med rotn or MR
Medial rotation
MS
Multiple sclerosis
MSU
Mid stream urine
ME
Myalgic encephalitis
MET
Muscle energy techniques
M’s, m or mm
Muscle(s)
Mobs
Mobilizations
Manip
Manipulations
Mx
Management
MCP
Meta-carpo phalangeal
MCL
Medial collateral ligament
MF
Medium frequency
MFR
Myofascial release
MWM
Mobilisation with movement
MG
Medial glide
Mvmt, movt or mvt
Movement
NAD
Nothing abnormal detected
NOF
Neck of femur
NOH
Neck of humerus
NSAID’s
Non-steroidal anti-inflammatory drugs
NIDDM
Non-insulin dependent diabetes
Nag
Natural apophyseal glide
NE
No effect
NB
No better
NW
No worse
NBI
No bony injury
Neuro
Neurological
NRLSR
Neutral rotation left side flexed right
NRRSL
Neutral rotation right side flexed left
N
Nerve
OA*
Osteoarthritis
OA*
Occipito-atlanto joint
O/E
Objective examination
OP
Overpressure
OT or op
Operation
Occ*
Occasionally
Occ*
Occiput
OC
Oral contraceptive

(P & Q)

Abbreviation
Definition
Palp
Palpation
P*
Pain
P*
Pressure
PAIVM
Passive accessory intervertebral movement
PPIVM
Passive physiological intervertebral movement
PWB
Partial weight bearing
PID*
Prolapsed intervertebral disc
PID*
Pelvic inflammatory  disease
PKB
Prone knee bend
PMH or PMHx
Past medical history
P/F jt or PFJ
Patella-femoral joints
PSIS
Posterior superior iliac spine
PT
Physiotherapist or physical therapist
Pt.
Patient
PNF*
Proprioceptive neuromuscular facilitation
PNF*
Passive neck flexion
PROM
Passive range of motion/movement
Pr.ly.
Prone lying
PF
Plantar flexion
Post
Posterior
Prox
Proximal
Pat
Patella
PS
Pubic symphysis
PCL
Posterior cruciate ligament
PUS
Pulsed ultrasound
PC
Presenting complaint
PD*
Provisional diagnosis
PD*
Parkinson’s disease
Prn (Pro re nata)
As required
P1
Onset of pain
P2
Limits of pain
PDM
Pain during movement
PNS
Parasympathetic nervous system
Pron
Pronation
Piri or pir
Piriformis
PA
Posteroanterior
PGM
Posterior gluteus medius
QL
Quadratus lumborum
Quads
Quadriceps
QH
Quadriceps and hamstrings

(R & S)

Abbreviation
Definition
R1
Onset of resistance
R2
Point where resistance limits movement
RHS
Right hand side
Rx
Treatment
R
Right
ROM
Range of motion
RA
Rheumatoid arthritis
R/v, rv or rev
Review
Rotn
Rotation
RSD
Reflex sympathetic dystrophy
RTA
Road traffic accident
RTC
Road traffic collision
RO
Removal of
Ret or retn
Retraction
R.u.
Radioulnar
R.c.
Radiocarpal
RF
Rectus femoris
Rhom or rh
Rhomboids
RBB
Reach behind back
RBH
Reach behind head
RBN
Reach behind neck
R’d
Resisted
SH or SHx
Social history
Sh
Shoulder
SIJ
Sacroiliac joint
SLR
Straight leg raise
SQ/c
Static quads contraction
S1-5
Labelled 1st to 5th sacral segments
St*
Standing
St*
Stiffness/stiff
Sitt
Sitting
STM
Soft tissue massage
STI
Soft tissue injury
S/B
Seen by
SF
Side flexion
S.ly
Side lying
Sup
Superior
Supn
Supination
SCJ or S/C jt
Sternoclavicular joint
SS
Sacral sulcus
Sub occ
Sub-occipital
SP
Spinous process
SCM
Sterno-cleido mastoid
Supsp or ss
Supraspinatus
ST lig
Sacrotuberous ligament
SSTM
Specific soft tissue massage
SNAG
Sustained natural apophyseal glide
SG
Side glide
SGIS
Side glide in standing
SE
Subjective examination
Sl
Slightly
Sx
Surgeon
SHR
Scapulohumeral rhythm
SL/SLS
Single leg/single leg stance
S
Spasm
SNS
Sympathetic nervous system
ST
Sub talar
Scal
Scalenes
SKB
Single knee bend
Scol
Scoliosis
S/T
Spoke to
SNF
Superficial neck flexors

(T, U & V)

Abbreviation
Definition
T
Treatment
TOP
Tender on palpation
TP
Transverse process
Tx/sp, Tx sp,Thx sp or Tsp
Thoracic spine
TA*
Tendo Achilles
TA* or trans abdo
Transverse abdominus
TFL
Tensor fascia lata
T1-12
Labelled 1st to 12th thoracic vertebrae
TP
Trigger point
TPR
Trigger point release
Trap
Trapezius
Tmin
Teres minor
Tmaj
Teres major
Tibfem or TFJ
Tibiofemoral joint
TB
Tuberculosis
TL jxn
Thoraco-lumbar junction
TC or TCJ
Talo-crural (joint)
TN
Talo-navicular
Tx
Treatment
UL
Upper limb
UTA
Unable to attend
ULTT
Upper limb tension test
U/S
Ultrasound
UFT
Upper fibers of trapezius
Uni
Unilateral
VMO
Vastus medialis oblique
V. lat or VL
Vastus lateralis
v.
Very

(W,X,Y & Z)

Abbreviation
Definition
Wt or wgt
Weight
Wb
Weight bearing
W
Worse
WIN
Wake in night