Kathy Fagan, Mpt University Of Evansville

Clinical Geriatric Orthopedics

Kathy Fagan, MPT University of Evansville

The Aging Process • 2 handouts • Developing the optimal mindset for working with older patients – – – – – – –

Myths Statistics Medical study Physiological age changes Deleterious effects of bed rest Lack of motivation Efficacy of exercise programs

Common musculoskeletal changes with age • • • •

Loss of flexibility Strength changes Postural changes Arthritic changes

Osteoarthritis

Rheumatoid arthritis

Common musculoskeletal changes with age •Loss of flexibility •Strength changes •Postural changes •Arthritic changes •Gait and Balance problems

Tinetti gait and balance assessment

Video link

Common musculoskeletal changes with age •Loss of flexibility •Strength changes •Postural changes •Arthritic changes •Gait and Balance problems •Pain

Back pain and aging

• Some general statistics • Common causes of back pain in the elderly – Disc herniation – Spondylosis – Spondylolisthesis – Osteoporosis – Myeloma – Metastatic bone tumors – Osteomyelitis – Lumbar stenosis – Flexion Extension Assymetries – Facet syndromes – SI joint dysfunctions

Healthy Hips • A review of hip anatomy – Osteology – Articular cartliage – Ligaments and capsules – Synovium – Bursae – Nutrition – Biomechanics

Healthy Hips • Functional hip AROM • Hip Pain – Bony and muscular tender points – Diagnostic clues of hip pain – Piriformis syndrome – Bursitis

Healthy Hips • Pathologies of the hip – OA – Hip Fracture – Total Hip Arthroplasties

LUNCH TIME •WE’LL MEET BACK HERE AT 1:00 P.M.

Knowledgeable knees • Review of pertinent knee anatomy – Osseous structures – Menisci – Ligaments – Bursae, synovia, and fat pads

Knowledgeable knees • Biomechanics of the femoro-tibial joint – Flexion / extension – Transverse rotation – Pathomechanics at the knee • Structural alterations • Intrinsic movement abnormalities • Common loading conditions due to trauma

Knowledgeable knees • Knee AROM • PFPS – Patellar tendonitis – Chondromalacia patella – Patellar malalignment

Knowledgeable knees • Osteoarthritis of the knee • Total knee replacement

Treat the feet • Overview of anatomy of the foot • Biomechanics • Congenital and acquired foot deformities • Pt education • Plantar Fasciitis • Systemic disease

Supple shoulders • Anatomical considerations – Osseous structures – Ligaments and capsule – Bursae – Vascularization of the rotator cuff – Biomechanics of joint stabilization – Influence of the joint capsule on movement

Supple shoulders • AROM • Shoulder impingement syndromes • Rotator cuff injuries • Adhesive capsulitis • Humerus fractures • Total shoulder arthroplasty

Functional upper limbs • • • •

AROM Radial head fractures Carpal tunnel syndrome Colles fracture

The end