1. Muscle diseases and disorders
Myopathy
Muscle diseases and disorders

2. 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

3. 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)

4. 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)

5. 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

6. 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

7. 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

8. 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 tender points
No definitive treatment other than pain management

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Myasthenia gravis DMD lockjaw *tetanus*