Muscle diseases and disorders Myopathy Muscle diseases and disorders

Strains and Tears Strains – injuries caused by overstretching the tendons or the muscles Range from slight (pulled muscle) to complete muscle tear or tendon rupture Symptoms of muscle/tendon injury vary with severity

Types of Strains Mild strain No tearing of tendons or muscle fibers Results in mild pain or stiffness Moderate strain Some tearing of muscle or tendon fibers Cause more severe pain, bruising, and weakness Severe strain A complete muscle / tendon tear results in severe pain Swelling, extensive bruising, and complete loss of movement (often, not always)

Diagnosis of Strains / Myopathy Physical examinations are necessary MRI, X-ray, Ultrasound, and Med History Moderate and severe strains should be treated by physician Early stages of injury need RICE or sometimes PRICE Protection (Rest, Ice, Compression, and Elevation)

Acetaminophen can be used for pain or NSAID’s (non-steroidal anti-inflammatory drugs) like ibuprofen or advil can be used. After first 72 hours of injury, gradual rehab is required (PT and heat) After a few weeks if therapy is not working, then surgery may be required

Chronic tendon injuries Tendonitis – incorrect name because there is rarely inflammation (-itis) Tendinosis – degenerative disease leading ot breakdown and scarring of tendons Caused by failure of tendons to repair themselves after injury Those most vulnerable: rotator cuff, patellar, achilles, and tibialis posterior tendons

Fibromyalgia Syndrome Myalgia – pain or tenderness in muscle Symptom of many disorders (acute injury and viral infection) FMS - chronic pain syndrome charac by pain of at least three months duration, bilateral tenderness, fatigue, sleep disorders, depression, anxiety, and exercise intolerance. Found in 2% of population in US and Canada Majority of patients are women

Common in patients with rheumatological disorders Primary – FMS only Secondary – with pain related to another disorder Caused by hyperactive stress response or by neurological problems that leads to increased sensitivity to pain (mult. Scler) Diagnosed by recognizing pain in 11-18 tender points No definitive treatment other than pain management

Duchenne’s muscular dystrophy DMD – genetic, incurable myopathy Most common childhood form of MD Carried on X chromosome, so it is mostly found in boys (why?) 1 in 3500 live male births Mistake in gene coding for a protein called dystrophin Dystrophin holds muscle fibers together

Without dystrophin, fibers degenerate All muscle types affected (skel, card, smth) Symptoms Muscle weakness Scarring Fatty deposits replace muscle fibers Very progressive, leading to paralysis First diagnosed at age 4 in boys

Wheelchair bound by age 10, average life span is 17 years Death usually due to cardiac/respiratory failure Diagnostic symptoms Abnormal gait in toddlers Progressive myopathy Overdeveloped calves Electromyogram – stim group of muscles to gage contraction strength

PT should NOT be used, since it increases breakdown of muscle fibers Gene therapy and stem cell research are the only options for good prognosis

Myasthenia Gravis Grave muscle weakness Autoimmune disorder in which immune system attacks and destroys a large number of acetylcholine receptors. So muscles cannot respond to motor neuron Eye muscles are usually first affected Progressive Rare disorder, found in women, hard to treat

Tetanus Aka lockjaw Muscle disorder caused by untreated bacterial infection Bacteria Clostridium tetani release toxins that keeps a muscle contracted constantly Less than 1 mg of toxin required to cause disease Diagnosed by physician and lab test

Treatment is easy if caught soon, most patients end up in ICU Symptoms of tetanus Muscle spasm, rigid paralysis and stiffness, pain Spasms caused with loud noises or lights Fever Progressive and can eventually paralyze the diaphragm, causing respiratory failure Treatment is easy if caught soon, most patients end up in ICU Vaccinations available to prevent it

Myasthenia gravis DMD lockjaw *tetanus*