Special Tests

 












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Pain Science

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  - Pain is a decision by the brain based on perception of threat - You can have an injury and no pain. Think about a bruise that you don't know how you got.­­­­ Statistics - 40% of people with no back pain had a bulging disc. (disc bulges absorb over time which has been shown on repeated scans) - 1/3 of people over age 30 have abnormal findings on MRI - After successful rotator cuff surgery, 90% of people have abnormal findings on MRI - MRI scans of 35% of collegiate basketball players with no knee p­­­ain show significant abnormalities - Over 77% of asymptomatic hockey players demonstrated MRI findings of hip or goin pathological abnormalities - Bulging discs are found in about 30% of 20-year olds and 84% of 80 year olds. Disc protrusion, a type of herniation, are found in 29% of those 20-year olds and 43% of 80 year olds.           -  Jarvik 2002 Finally, over ⅔ of individuals with a herniated disc- symptomatic or not-    ...
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Modalities

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Electrotherapy TENS (Conventional high-rate/sensory TENS) Frequency: 100-150 pps. Pulse Duration: 50-80  µs. Amplitude: sensory. Treatment Time: whenever there is pain. Duration of Action: only while on. Typical Conditions: acute injury or repetitive strain. Duration of application: unlimited. TENS  (Low-rate/motor TENS) Frequency: <10 pps. Pulse Duration: 200-300  µs. Amplitude: small muscle contractions. Treatment Time: maximum 20-30 minutes every 2 hours. Duration of Action: 4-5 hours aftertreatment. Typical Conditions: chronic conditions. Duration of application: 20-30 minutes maximum.  Interferential Current  (Acute pain) Frequency: 100-150 Hz. Time: throughout duration of pain. May be used for 24 hours/day if needed. Modulation: use if available. Amplitude: to produce tingling. Interferential Current  (Chronic pain) Frequency: 2-10 Hz. Time: 20-30 minutes. Modulation: none. Amplitude: to visible contraction. Neuromuscular Electrical Stimulation (NM...
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Knee (Orthopedic)

Posture and general appearance Ambulation Special Tests ROM Strength Joint mobility  (tibiofemoral and patellofemoral joint, also: acetabulofemoral joint) Palpation Muscle length testing (hamstrings, hip flexors) Squatting mechanics Meniscus Meniscus tears can be traumatic or degenerative. Individuals who sustain a meniscal tear report a similar history as an individual with an ACL tear, such as feeling a “pop” while suddenly changing direction with or without contact. The rate of medial meniscal tears increases over time, whereas lateral meniscal tears do not. Prolonged delays in ACL reconstruction are related to increased occurrence of meniscus injuries. Surgical Outcomes: The clinical course for most patients after meniscus injury managed with or without surgery is satisfactory, though these patients will report lower knee function compared to the general population. Patients who have nonoperative management for meniscus tear have similar to better outcomes in terms of ...
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