Praktijk MSS: OL
Praktijk MSS: OL.............................................................................................................1
Heup...............................................................................................................................2
Heupfractuur...............................................................................................................5
Heupluxatie.................................................................................................................6
Osteonecrose..............................................................................................................6
Arthritis.......................................................................................................................7
Corpus Liberum...........................................................................................................7
Coxarthrose...............................................................................................................8
Heupprothese.............................................................................................................9
Stressfractuur...........................................................................................................10
Adductorenstrain......................................................................................................10
Clicking/ snapping hip...............................................................................................10
Bursitis heupregio.....................................................................................................10
Osteitis pubis............................................................................................................10
Gerefereerde pijnen..................................................................................................10
Periartticualire calcificaties.......................................................................................10
Intra-art pathologie...................................................................................................11
Knie..............................................................................................................................14
Algemene reva knie..................................................................................................14
KB letsels..................................................................................................................14
Spierletsels...............................................................................................................14
Ligamentaire letsels.................................................................................................14
PFP............................................................................................................................15
VKB-letsels................................................................................................................16
Meniscusletsel..........................................................................................................17
Knieprothese.............................................................................................................18
Peesletsels – tendinopathie......................................................................................19
Chondromalcia..........................................................................................................20
Patellapeestendinitis/ tendinopathie........................................................................21
Iliotibiaal frictiesyndroom.........................................................................................22
M popliteus tendinitis/ tendinopathie.......................................................................22
Biceps femoris tendinopathie...................................................................................23
Pes anserinus tendinopathie.....................................................................................23
1
, Kraakbeenletsel........................................................................................................24
Arthrose....................................................................................................................24
Ligament letsels........................................................................................................24
AKB letsel..................................................................................................................25
Voet..............................................................................................................................26
Enkeldistorsie...........................................................................................................26
CAI............................................................................................................................28
Heel pain/ plantaire heel pain...................................................................................29
Hallux Valgus............................................................................................................30
Compartimentsyndroom...........................................................................................31
Chronisch compartiment..........................................................................................32
Hallux rigidus............................................................................................................32
Achillespees..............................................................................................................33
Achillodynie- tendinopathie...................................................................................33
Achillestendinose...................................................................................................33
Peritendinitis..........................................................................................................33
Inesrtietendinopathie............................................................................................33
Ruptuur: partieel/ volledig.....................................................................................34
Xanthoma..............................................................................................................34
Differentiaaldiagnose................................................................................................35
Subcutane bursitis.................................................................................................35
Ziekte v sever........................................................................................................35
Ontsteking hielpad................................................................................................36
Stress fractuur calcaneum.....................................................................................36
Post impigmentsyndroom......................................................................................36
Tendinopathie TP...................................................................................................36
Tendinopathie mm peronei...................................................................................36
Tendinopathie FHL.................................................................................................36
Shin splints............................................................................................................37
KB letsels..................................................................................................................37
° arthrose...............................................................................................................37
Praktijk......................................................................................................................38
Zenuwletsels................................................................................................................39
Heup
Anamnese vragen
2
, - Oorsprong klacht + LOKALISATIE PIJN
- Actualiteit – symptoomreducerend/-provocerend
- Causaliteit: traumatisch – klacht verergerd
- Hulpvraag – act/ participatie
Post tilt
- Romp nr voor: flexiecontractuur
- Spieract post: glut max en ham + lordose (trekken op paravert, onvoll
spierF)
Herstel ROM Hext P & A
Heuppathologie
- Heup add eerst aangedaan (adductoren hypertonie, luxerende werking)
- AB slecht werken -> lich gew slechte zijde over middellijn
- Dwarse spieren trainen: gemelli + AB (stab/ compr gewr)
-> drukken verlagen in art heuppathologie: vermageren – trager
stappen - kleinere paslengte – krukken
-> Minder compr F lgut med = minder pijn
Intra art pathologie: flexie en rot : klachten verergeren
-> ° inklemming bindweefsel/ bot
-> HOGE SENS: Fabertest (intra art patho) = pijn
wekedelen (psoas, bursa) of SIG
Algemene revalidatie postop heup
FASE 1
- Bescherming herstellend weefsel
- Inhibitie pijn en infl: medicatie & ijs
- Behoud ROM: P en ang mob (fietsen zonder R)
- Preventie spieratrofie
- Behoud ADL capaciteiten
Naar F2: min pijn – ROM 75% NA zijde – nrml motor control – FWB
Oefentherapie: BP bridging – leg press – heupflexie zit
FASE 2 (4-6w)
- Bescherming herstellende weefsel
- ROM
- Gangpatroon
- Ftraining
- Cv-training: home trainer – crosse trainer
3
, Naar F3: pijnvrij – full ROM – F flex 60% ext IR ER AB AD 70%
Oefetherapie: mob & stretching – UP stand (evt romprot) – side
bridiging
FASE 3 (6-8w: nodenanalyse PA)
- Krachttraining
- CV training
- NM coord + EW
Naar F3: F flex 70% ext IR ER AB AD 80% + Functionele oefenT
FASE 4
- Nodenanalyse PA: ADL/ sport
- Nrml ROM
- L & R ≠ 15%
HOOS: vragenlijst voor heupproblematie
Sympt – pijn – ADL – kwali – sport/ vrije tijd
Score: 5 punts likert scale -> hoger = beter = minder klachten
4
Praktijk MSS: OL.............................................................................................................1
Heup...............................................................................................................................2
Heupfractuur...............................................................................................................5
Heupluxatie.................................................................................................................6
Osteonecrose..............................................................................................................6
Arthritis.......................................................................................................................7
Corpus Liberum...........................................................................................................7
Coxarthrose...............................................................................................................8
Heupprothese.............................................................................................................9
Stressfractuur...........................................................................................................10
Adductorenstrain......................................................................................................10
Clicking/ snapping hip...............................................................................................10
Bursitis heupregio.....................................................................................................10
Osteitis pubis............................................................................................................10
Gerefereerde pijnen..................................................................................................10
Periartticualire calcificaties.......................................................................................10
Intra-art pathologie...................................................................................................11
Knie..............................................................................................................................14
Algemene reva knie..................................................................................................14
KB letsels..................................................................................................................14
Spierletsels...............................................................................................................14
Ligamentaire letsels.................................................................................................14
PFP............................................................................................................................15
VKB-letsels................................................................................................................16
Meniscusletsel..........................................................................................................17
Knieprothese.............................................................................................................18
Peesletsels – tendinopathie......................................................................................19
Chondromalcia..........................................................................................................20
Patellapeestendinitis/ tendinopathie........................................................................21
Iliotibiaal frictiesyndroom.........................................................................................22
M popliteus tendinitis/ tendinopathie.......................................................................22
Biceps femoris tendinopathie...................................................................................23
Pes anserinus tendinopathie.....................................................................................23
1
, Kraakbeenletsel........................................................................................................24
Arthrose....................................................................................................................24
Ligament letsels........................................................................................................24
AKB letsel..................................................................................................................25
Voet..............................................................................................................................26
Enkeldistorsie...........................................................................................................26
CAI............................................................................................................................28
Heel pain/ plantaire heel pain...................................................................................29
Hallux Valgus............................................................................................................30
Compartimentsyndroom...........................................................................................31
Chronisch compartiment..........................................................................................32
Hallux rigidus............................................................................................................32
Achillespees..............................................................................................................33
Achillodynie- tendinopathie...................................................................................33
Achillestendinose...................................................................................................33
Peritendinitis..........................................................................................................33
Inesrtietendinopathie............................................................................................33
Ruptuur: partieel/ volledig.....................................................................................34
Xanthoma..............................................................................................................34
Differentiaaldiagnose................................................................................................35
Subcutane bursitis.................................................................................................35
Ziekte v sever........................................................................................................35
Ontsteking hielpad................................................................................................36
Stress fractuur calcaneum.....................................................................................36
Post impigmentsyndroom......................................................................................36
Tendinopathie TP...................................................................................................36
Tendinopathie mm peronei...................................................................................36
Tendinopathie FHL.................................................................................................36
Shin splints............................................................................................................37
KB letsels..................................................................................................................37
° arthrose...............................................................................................................37
Praktijk......................................................................................................................38
Zenuwletsels................................................................................................................39
Heup
Anamnese vragen
2
, - Oorsprong klacht + LOKALISATIE PIJN
- Actualiteit – symptoomreducerend/-provocerend
- Causaliteit: traumatisch – klacht verergerd
- Hulpvraag – act/ participatie
Post tilt
- Romp nr voor: flexiecontractuur
- Spieract post: glut max en ham + lordose (trekken op paravert, onvoll
spierF)
Herstel ROM Hext P & A
Heuppathologie
- Heup add eerst aangedaan (adductoren hypertonie, luxerende werking)
- AB slecht werken -> lich gew slechte zijde over middellijn
- Dwarse spieren trainen: gemelli + AB (stab/ compr gewr)
-> drukken verlagen in art heuppathologie: vermageren – trager
stappen - kleinere paslengte – krukken
-> Minder compr F lgut med = minder pijn
Intra art pathologie: flexie en rot : klachten verergeren
-> ° inklemming bindweefsel/ bot
-> HOGE SENS: Fabertest (intra art patho) = pijn
wekedelen (psoas, bursa) of SIG
Algemene revalidatie postop heup
FASE 1
- Bescherming herstellend weefsel
- Inhibitie pijn en infl: medicatie & ijs
- Behoud ROM: P en ang mob (fietsen zonder R)
- Preventie spieratrofie
- Behoud ADL capaciteiten
Naar F2: min pijn – ROM 75% NA zijde – nrml motor control – FWB
Oefentherapie: BP bridging – leg press – heupflexie zit
FASE 2 (4-6w)
- Bescherming herstellende weefsel
- ROM
- Gangpatroon
- Ftraining
- Cv-training: home trainer – crosse trainer
3
, Naar F3: pijnvrij – full ROM – F flex 60% ext IR ER AB AD 70%
Oefetherapie: mob & stretching – UP stand (evt romprot) – side
bridiging
FASE 3 (6-8w: nodenanalyse PA)
- Krachttraining
- CV training
- NM coord + EW
Naar F3: F flex 70% ext IR ER AB AD 80% + Functionele oefenT
FASE 4
- Nodenanalyse PA: ADL/ sport
- Nrml ROM
- L & R ≠ 15%
HOOS: vragenlijst voor heupproblematie
Sympt – pijn – ADL – kwali – sport/ vrije tijd
Score: 5 punts likert scale -> hoger = beter = minder klachten
4
