Thursday 31 December 2009

Stages of the healing process: BIP-R


BLEEDING


INFLAMMATION
PROLIFERATION


REMODELLING




These stages are NOT mutually exclusive (they don't just happen one at a time individually) they overlap!

Soft Tissue Wound Healing



"Wound healing refers to the body's replacement of destroyed tissue by living tissue"



2 essential components (REG & REP)



  • Specialised tissue is replaced by proliferation of surrounding undamaged specialised cells


  • L.T replaced by G.T which matures to form S.T

  • Lost tissue is replaced by granulation tissue which matures to form scar tissue







Factors known to delay healing

GENERAL

Steroids & NSAIDS

Temperature (lower rate when colder)


Protein Deficiency


Age



LOCAL

  • Poor blood supply / ischaemia
  • Adhesion to bone or other underlying tissue
  • Continued inflammation
  • Drying of wound
  • Excessive movement (restarts inflammation)

"Tissue healing is a complex and dynamic system which enables effective repair of damaged tissue."

Monday 28 December 2009

Connective Tissue


Most abundant tissue in the body (ABUNDANCE)

Derived from the mesoderm of embryonic tissue (MESODERM)


Help to bind and support other tissues (BIND & SUPPORT)

Relatively few cells (NOT MANY CELLS)

Several types (BBLDC) Bone, Blood, Loose, Dense, Cartilage










Leukocytes - Soldiers of the body

NEUTROPHIL





  • Most common type of leukocyte


  • Involved with degradation of foreign material through phagocytosis


  • Contain multiobed nucleus


  • Cytoplasm grainy in appearance due to high number of lysosomes (digestive enzymes)


  • Grows around foreign matter, lysosomes help digest foreign body and then it's removed


  • Duty to defend using lysosomes to digest


  • On a constant patrol, destroying harmful things in the body


MACROPHAGE (monocytes)




  • Destroy bacteria through phagocytosis

  • Larger in size than neutrophils

  • Found in LUNGS and LYMPH NODES (first line of defence)

  • Creates hostile environment for bacteria so that it si harder to get ill (causes sore throat etc)

LYMPHOCYTES (B & T)



  • B lymphocytes secrete antibodies which destroy bacteria

  • T lymphocytes are involved in cell destruction

  • Some specialised lymphocytes go into cell to destroy it, others send antibodies out







BLOOD






BLOOD - A liquid connective tissue used for:





1. TRANSPORT: respiratory gases (oxygen/carbon dioxide, nitrogen), nutrients, waste products



2. DEFENCE: provides cells for clotting and antibodies to fight infection











3. TEMPERATURE REGULATION (distributes heat)







4. PRESSURE (provides pressure)

Saturday 26 December 2009

Hematoma

Hematoma in acute stage - 6 days after injury
HEMATOMA - Internal bleeding (a collection of blood outside the blood vessels)
Usually the result of a hemorrhage (loss or escape of blood from the circulatory system - bleeding!)



Wednesday 23 December 2009

Phagocytosis



Products of PHAGOCYTOSIS along with plasma and blood cells form EXUDATES*


(any fluid that filters from circulatory system into lesions or areas of inflammation*)

Exudates accumulate causing SWELLING (tumor) and PAIN (dolor)


Exudates are composed of serous fluid, red blood cells, fibrinogen OR tissue debris and white blood cell breakdown products








APOPTOSIS

Programmed cell death
(as opposed to necrosis = uncontrolled cell death)

Normal Ranges of Movement

Hip Flexion: 120 degrees
Hip Extension: 15 degrees
Hip Abduction: 50 degrees

Inversion: 45 degrees
Eversion: 20 degrees

Knee Flexion: 130 degrees

Sunday 13 December 2009

Cross Fit WOD 13/12/09


Buy in

500m row
10 pull ups x 2
10 push ups x 2
10 sit ups x 2
10 squats x 2

Skill

Weighted pull ups

3-3-3-3 (12kg)

Weighted muscle up

1 (12kg)

'Helen'

3 rounds: 400m run, 21 kb OHS (24kg), 12 pull ups

Friday 11 December 2009

Proprioceptive exercises





Good proprioception (awareness of limb position in space and time) is essential for all tasks, whether complex or simple. Picking up the remote to watch TV or doing a single leg squat on a BOSU all require varying degrees of proprioception or neuromuscular control. Essentially proprioception is this relationship between the neurological system and the muscular system and any injuries that occur e.g. trauma can cause a disruption between the the communication of these two systems. Sensory (afferent) feedback is interupted (like your Mum asking you to do the washing up when you're on the phone) and this has reprecussions on motor control (you drop the phone!)


5 ways to progress proprioceptive exercises!



  1. REMOVING VISUAL STIMULI









2. ALTERING BASE OF SUPPORT

          3. INCREASING WEIGHT BEARING






          4. INCREASING SPEED


          5. MAKING AN EXERCISE MORE COMPLEX (e.g. adding pertubation)


























          Thursday 10 December 2009

          Proprioceptors


          Ruffini end Organs

          (slowly adapting)

          Monitor position of limb in space






          Pacinian Corpuscles



          (slowly adapting)




          Detection of acceleration/deceleration or sudden mechanoreceptor deformation














          Mechanoreceptors !


          MECHANORECEPTORS: Any sensory nerve ending that responds to mechanical stimuli e.g touch, pressure, displacement, sound ...

          Wednesday 9 December 2009

          Sag Sign


          Sag sign looks at the contour of the tibial tubercles. A rupture of the PCL will cause tibia to sag back (from the force of gravity alone). Sag sign is good to do before a PA drawer test because this can produce false positive results (the excessive anterior translation would just be pulling the tibia to neutral)

          Lachman's Test (modified PA drawer)


          Lachman's Test is a modified PA drawer test looking for a rupture in the anterior cruciate ligament (ACL). The modification in position stops the patient's hamstrings from resisting the movement.

          Rectus Femoris (Has 2 heads)


          Rectus Femoris has 2 heads: straight (originating from the AIIS) & reflected (originating from ilium just superior to acetabulum)
          The tendons of origin combine to form a FUSIFORM muscle belly!

          Cross Fit 9/12/09

          GOALS

          - 30 kettlebell swings (32kg)
          - 3 consecutive muscle ups (DONE! 4 ring muscle ups in a row)
          - 30 muscle ups for time in 12 minutes
          - Back squat 3 rep max above 100kg (DONE! 102.5 kg)
          - 2 consecutive bar muscle ups

          Today worked on acrobatics, muscle ups, kettlebell swings, handstand push ups, K2E, and back squats.

          Was happy with everything but back squat needs work, tech for muscle ups in a row needs some practice to make it efficient. Good sesh!

          Monday 7 December 2009

          Contraindications to ICE



          • The elderly
          • Circulatory Problems
          • Radiotherapy/chemotherapy
          • Raynaud's Disease
          • Diabetes
          • Hypersensitivity
          • Cardiac Problems

          *Raynaud's disease is a vascular disorder which effects blood flow to the extremities (toes,nose,fingers,ears) when exposed to cold temperatures or psychological stress.

          *The elderly: skin is thin and risk of ice burns

          *Diabetes: blood becomes viscous, ice will force thick blood though a small vein

          MOVE THE ICE TO THE LIMB NOT THE LIMB TO THE ICE!

          USE A BARRIER BETWEEN ICE AND SKIN TO PREVENT BURNS!

          REGULARLY MONITOR BODY FOR EXCESSIVE CIRCULATION LOSS!

          DURATION OF TREATMENT SHOULD MATCH SIZE OF AREA BEING TREATED!

          Should be 10-20 minutes every 2 waking hours over the acute and sub-actute stages until demand no longer necessary

          Mobilisation

          What is mobilisation?

          Slow, controlled, preferably unloaded movement of a joint through a full ROM (pain free) in all available planes of motion.

          Mobilisation will improve/maintain mobility of a joint

          Remember: Psychologically people might refrain from certain movements because it has hurt them in the past. Passive movements can promote confidence and encourage them to start moving the joint again :)

          Contraindications to joint mobility work:

          • Pain
          • Heat/inflammation (swelling)
          • Recent unstable fractures
          • Neurological symptoms (spasms, numbness, pins & needles, dead shoulder = nerve impingment)
          • Mechanical blocks (e.g. bursas trapped under acromion head)

          Energy Expenditure

          10% exercise
          20% lifestyle (or physical activity)
          70% RMR (resting metabolic rate)

          Thursday 3 December 2009

          Cross Fit WOD 03/12/09 Muscle Ups

          WOD: 30 ring muscle ups for time

          Jay - 13.49

          My target for next time is 12 mins or under. I found with this that muscle fatigue and rate of recovery plays such a big role. To begin with I was getting out 5 reps at a time quite quickly but then it got to a point where after one rep my arms would just not get me up! The dip and the lock out where the most demanding parts. Keeping good form and technique helped A LOT! I was glad I'd watched a vid on tech before I headed down to the gym. Aside from that for a first stab at it I don't think I did too bad at all. The dip is the part that needs work :)

          Wednesday 2 December 2009

          Gluteus Maximus



          ORIGIN - Iliac crest, sacrum and coccyx
          INSERTION - Upper Posterior femur and ITB
          ACTION - Extension of the hip and lateral rotation of the hip
          75% inserts into ITB
          25% inserts into posterior femur

          Function of the Patella





          "The patella is a BIOMECHANICAL PULLEY THAT IMPROVES THE EFFICIENCY OF THE QUADRICEPS TENDON"

          CROSS Fit WOD 2/12/09

          CROSS FIT TOTAL!

          3 rep max training:

          Power Clean - 70kg
          Shoulder Press 50kg (2.5 reps 55kg)
          Deadlift - 155kg PB