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Presentation - Hong Kong Branch
Pathologies of MSDs Presented by Max Wong( RPT) 1 Outline • • • • • • What is MSDs Physiology Changes in MSDs Identify the common MSDs Management approaches Importance of exercise Q&A 2 Musculoskeletal Disorders • MSDS stand for musculoskeletal Disorders • Musculo- muscles • Skeletal - bones • Other structures including ligaments, capsules, tendons, cartilages 3 Musculoskeletal Disorders • Disorder - is a functional abnormality or disturbance - normally involving the lesion/damage of structures - resulting in sign of inflammation 4 Musculoskeletal Disorders • “ Pain “ is the major concern • “Pain” caused, by 1. structures lesions/damages 2. Inflammation 5 Musculoskeletal Disorders What is inflammation?? 6 Musculoskeletal Disorders • Inflammation Pathogenic type VS Non pathogenic type 7 Musculoskeletal Disorders • Inflammation Pathogenic type VS Non pathogenic type 8 Musculoskeletal Disorders • Most of the structures has its own self healing process Process of inflammation 9 Musculoskeletal Disorders • Inflammation - non specific protective process - remove the injurious stimuli - natural healing process for the tissue 10 Common MSDs • Prolapsed Intervertebral Disc (PIVD) • Tennis elbow • Golfer elbow • Dequervain Disease 11 Common MSDs- PIVD -Spinal Problems - Chances to happen Lx >> Cx >> Tx Lx > 15 times of Cx Cx ~ 8% Tx ~ 1-2% 12 Common MSDs- PIVD 13 Common MSDs- PIVD • Types of PIVD 14 Common MSDs- PIVD • Common Causes - heavy lifting - forceful coughing/sneezing - prolonged/ excessive spinal forward bending 15 Common MSDs- PIVD Back Front 16 Common MSDs- PIVD Posteriolateral aspect 17 Common MSDs- PIVD • - Common Signs and Symptoms Pain Worse when bending, sneezing, coughing + /- neurological deficits including 1. paraesthesis/ Numbness 2. muscles weakness 3. diminish in jerk reflex 18 Common MSDs- PIVD 19 Common MSDs- PIVD • Management approaches - Acute phase - Sub-acute phase - Chronic phase 20 Common MSDs- PIVD • Management approach Acute phase Pain and inflammation management by - Medication - Injection - Physiotherapy( physical modalities + exercise) 21 Common MSDs- PIVD • Management approach Acute phase To identify the main courses by, 1. basic clinical assessments 2. Imaging like MRI, X-ray 22 Common MSDs- PIVD • Management approach Sub-acute/ chronic phases - Symptomatic control including pain and neural signs - Functional mobility rehabilitation 23 Common MSDs- PIVD • Management approach Sub-acute/ chronic phases Conservative treatments VS Operation 24 Common MSDs- PIVD • Common Operation - Laminectomy 25 Common MSDs- Tennis Elbow General term for tendonitis over outer part of the elbow 26 Common MSDs- Golfer’s Elbow General term for tendonitis over inner part of the elbow 27 Common MSDs- Tennis Elbow & Golfer’s Elbow Tendonitis = Incurable ??? 28 Common MSDs- Tennis Elbow & Golfer’s Elbow Tendonitis = Incurable 29 Common MSDs- Tennis Elbow & Golfer’s Elbow • - Common Causes Contusion Excessive loading Repetitive strain injury (RSI) 30 Common MSDs- Tennis Elbow & Golfer’s Elbow • - Common Signs and Symptoms Pain Swelling Heat Pain level proportional to activities level Worse when griping, drying towel, lifting and some other movements related to wrist movements 31 Common MSDs- De quervain Disease • The two tendons concerned - tendons of the extensor pollicis brevis(EPB) - tendons of the abductor pollicis longus(APL) 32 Common MSDs- De quervain Disease EPB APL 33 Common MSDs- De quervain Disease EPB APL 34 Common MSDs- De quervain Disease • Known as the inflammation of synovial sheath synovial sheath 35 Common MSDs- De quervain Disease • - Common Causes Contusion Excessive loading Repetitive strain injury (RSI) 36 Common MSDs- De quervain Disease • - Common Signs and Symptoms Pain Swelling Heat Pain level proportional to activities level Worse when griping, drying towel, lifting and some other movements related to thumb movements 37 Common MSDs- De quervain Disease • Quick self test Finkelstein Test 38 Common MSDs- Tennis & Golfer’s Elbow and De quervain Disease • Management approach Acute phase Pain and inflammation management, by - Rest - Ice - Medication - Physiotherapy 39 Common MSDs- Tennis & Golfer’s Elbow and De quervain Disease • Management approach Sub-acute/ chronic phases - Symptomatic control - Functional mobility rehabilitation - Modify the daily routine activities 40 Common MSDs- Tennis & Golfer’s Elbow and De quervain Disease • Management approach Sub-acute/ chronic phases - Symptomatic control - Functional mobility rehabilitation - Modify the daily routine activities 41 Common MSDs- Tennis & Golfer’s Elbow and De quervain Disease • Management approach Sub-acute/ chronic phases If it is still not too responsive, injection need to be considered. 42 Importance of exercise Exercise should be introduced ASAP Rest = Immobility 43 Importance of exercise Types of exercise - Stretching - Strengthening - Proprioception training - Agility training - Cardiovascular training 44 Importance of exercise Exercise - Specificity exercise target on certain disorder and result in treatment response - Intensity exercise dosage 45 Importance of exercise - Exercise is a kind of Therapy - Should be individualized 46 Importance of exercise Exercise for PIVD 47 Importance of exercise Exercise for PIVD 48 Importance of exercise Exercise for PIVD 49 Importance of exercise Exercise for tennis elbow 50 Importance of exercise Exercise for golfer’s elbow 51 Importance of exercise Exercise for De quervain Disease 52 Q&A 53
