However, avulsion or macrotrauma
of the levator (defined as disconnection of the puborectalis muscle from its insertion on the inferior ramus and pubis), and microtrauma causing pathological overdistension of the levator, are thought to play a role in some types of POP.[18,19] There is currently scant data describing the association between levator morphology and successful pessary use.
Gearhart, offers a rich narrative, including categorizing injuries according to macrotrauma
(ACL tear, PCL tear, MCL/LCL tears, meniscus tear, patella dislocation, and fracture, as well as microtrauma and overuse injuries).
In each of these forms, the main causes of the inflammation for most parts are macrotrauma
and mechanical damage.
It is also important to collect information about previous direct or indirect trauma (sometimes also called "macrotrauma
") in the orofacial area, particularly chin or TMJ injuries [19, 20].
(21) Acute macrotrauma
has been associated with 30-60% of patients presenting with a PRAF.
(6-8) These causes are multiple and include psoriasis, lichen planus and other immune-mediated inflammatory diseases, chronic microtrauma or macrotrauma
, and local tumors.
occurs as an acute, perhaps dramatic, event such as a concussion, spinal cord injury, fracture or dislocation.
to the buttocks, leading to inflammation of the soft tissue, muscle spasm, or both causing nerve compression.
Pre-existing symptoms of instability prior to the main injury event may be present and therefore it is likely that further injury may occur as a result of a macrotrauma
event on an already damaged area3 since this study did not exclude participants with pre-existing injuries.
We also deal with patients and personalities who seem to seek repeated suffering in the form of both micro-and macrotrauma
. We sympathize with the involuntary, victim-bound suffering, and we cringe at and speculate about the conscious and unconscious degrees of self-sabotage on display.
Achilles tendonitis is a chronic 'stress' injury and can be referred to as 'microtrauma' as opposed to 'macrotrauma
' which are traumatic acute injuries such as a sprained ankle or broken wrist.
Precipitating and perpetuating factors such as macrotrauma
including contusions, sprains and strains may give rise to MPDS acutely but in case of microtrauma the onset is more subtle.