DTFM to infra-patellar tendon (Cyriax technique)

-


This following technique is very effective in infra-patellar tendinitis. So may times it is associated with jumping injuries.

The lesion: 1. Cause: It occurs nearly always as a result of overuse but occasionally over load is also responsible.
2. Site: Lies at the insertion of the tendon into the inferior pole of patella. The area is 1.5 cm long.

How to identify it? 1. PROM- A full and painless ROM of knee.
2. No warmth or fluid is detected.
3. Resisted test- Resisted knee extension cause pain at the exact site.
4. Palpation- Tenderness is found at the insertion of the tendon into the patella.

Patient cues: Supine lying with the knee fully extended and the quadriceps muscle relaxed.

Therapist cues: Therapist arrange himself suitably facing the affected knee at the mid-thigh level.
Stabilization of the upper pole of the patella (UE towards the head end of the patient): He presses downwards on the upper pole of the patella with the web of his thumb, his fingers to one and his thumb to the other side of the knee.

The grip of hand at the superior pole of the patella not only steadies the patella and at the same time tilts the lower pole forwards, thus bringing the teno-periosteal junction into a more accessible position.

UE towards the foot end of the patient: He places the ulnar border of the ring finger of his other hand, reinforced by the middle finger, or the middle finger reinforced by the index finger, against the lower pole of the patella.

DTFM act: Pressure is applied & maintained by the adductors of the arm while applying the seesaw movement at the TPJ (teno-periosteal junction).

Comments

Post a Comment

Popular posts from this blog

Entrapment of medial calcaneal nerve (MCN)

-
Image
Peripheral nerve entrapment is a rare, but important, cause of foot and ankle pain that often is underdiagnosed and mistreated. A peripheral nerve may become entrapped anywhere along its course, but certain anatomic locations are characteristic (2). The medial calcaneal nerve (MCN) The Tibial nerve is called the planter nerve in the sole. The tibial nerve passes to the sole of the foot takes a turn on the medial side of the calcaneum is called MCN. The medial calcaneal nerve arises from tibial nerve of the inner side of the ankle, perforates the laciniate ligament, travels downwards passing below the bony projection on the inner side of the ankle, and supplies the skin over the medial aspect of the heel. Hence it is the most important nerve for heel sensations. MCN have 2 branches. The anterior branch dominate the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominate the sensation of the posterior an
Read more

Review of Labral Tears of shoulder

-
Image
The glenoid labrum of the shoulder has extensive anatomic variation but appears to be important for contributing to shoulder stability and for increasing the depth of contact between the glenoid labrum and the humeral head. Tears of the labrum are commonly seen in association with other pathologic entities, such as instability and rotator cuff tears, and treatment of the labral pathology may be incidental to treatment of the other more significant pathology. However, conditions isolated to the labrum do occur and can be a significant source of shoulder problems. Effective treatment of these lesions may result in significant improvement in the patient's symptoms (4). Labral lesions are difficult to diagnose, and special diagnostic studies and, frequently, arthroscopy are required. How much we can rely on clinical tests is a question. Shoulder complaints are frequently recurrent. Instability might cause some of these complaints (3). History taking and clinical tests are commonly used
Read more

Differential diagnosis of Anatomic (Radial) snuffbox pain: It is not always DeQuervain’s tenosynovitis.

-
Image
Tendon, Bone & Ligament causes: 1. DeQuervain’s tenosynovitis: Swelling of tendon of APL (Abductor pollicis longus) & extensor pollicis brevis at lateral wrist near anatomic snuff box.  The primary complaint is radial sided wrist pain that radiates up the forearm with grasping or extension of the thumb. The pain has been described as a “constant aching, burning, pulling sensation." Pain is often aggravated by repetitive lifting, gripping, or twisting motions of the hand. Swelling in the anatomical snuff box, tenderness at the radial styloid process, decreased CMC abduction ROM of the 1st digit, palpable thickening of the extensor sheaths of the 1st dorsal compartment and crepitus of the tendons moving from the extensor sheath may be found upon examination. Other possible findings include weakness and paresthesia in the hand. Finkelstein’s diagnostic test will present positive provoking the patient’s symptoms. If left untreated, the inflammation and progressive narro
Read more