Soft Tissue Injury

Soft Tissue injury

 1. Muscle Strain

A stretch, tear, or rip to a muscle or an adjacent tissue that can range from a mild tear to complete muscle rupture and usually involves large force producing muscle.

Healing time may depend on the level of severity of the injury which are as follows:

      Grade I

 Some muscle fiber tearing

•  tenderness and painful movement but full range present

   Grade II

 Many torn muscle fibers

•  active contraction is painful, usually a depression or divot is palpable, some swelling and discoloration result

  Grade III

 Complete rupture of fibers

•  significant impairment initially with a great deal of pain that diminishes due to nerve damage

 

Muscular pain may be a result of:

Muscle spasms or guarding are the reflex reactions caused by trauma. There are two types which are as follows:

Clonic - Alternating involuntary muscular contractions and relaxations in quick succession

Tonic - Rigid contraction that lasts a period of time

 

To prevent muscle spasms, a splint may be used as an effort to minimize pain through limitation of motion.

 

Muscle soreness is the overexertion in exercise or unaccustomed activities resulting in muscular pain

Two types of soreness

1)  Acute-onset muscle soreness (AOMS)

- Transient muscle pain and fatigue immediately after exercise

2)  Delayed-onset muscle soreness (DOMS)

-  Pain that occurs 24–48 hours following activity that gradually subsides (pain free 3–4 days later)

-  Slight microtrauma to muscle or connective tissue

 

Muscle soreness is prevented with a gradual buildup of the intensity of exercise.

 

 2. Tendon Strain

Caused by collagen re-absorption which occurs with repeated microtrauma resulting in weakening tendons. Collagen re-absorption also occurs with immobilization which weakens the tissue and requires gradual loading and conditioning.

Tendinitis

The inflammation or irritation of a tendon — the thick fibrous cords that attach muscle to bone. The condition causes pain and tenderness just outside a joint.

While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees, and heels.

 

 

 

 

 

Tendinitis should be properly addressed as it is linked to other complications such as:

 

Tendinosis

The poor healing of tendinitis - degenerates and results in tendinosis. Visibly, it will become less inflamed and more swollen, sometimes a tender lump will appear. Tendinosis causes stiffness and a restriction on motion

 

Tenosynovitis

Inflammation of synovial sheath which ranges from acute cases (rapid onset, crepitus, and diffuse swelling) to chronic cases (thickening of tendon with pain and crepitus). This is common in long flexor tendon of the digits and the biceps tendon.

 

 3. Ligament Sprain

A result of traumatic joint twist that causes stretching or tearing of connective tissue

  

Pain level depends on the ligament sprain grade:

Grade I

·         Some pain, minimal loss of function, no abnormal motion, and mild point tenderness

Grade II

·         Pain, moderate loss of function, swelling, and instability with tearing and separation of ligament fibers

Grade III

·         Extremely painful, inevitable loss of function, severe instability and swelling, and may also represent subluxation

 

 How do I treat my injury?

A mix of rest and light or supervised exercise instructed by a therapist

As with most injuries, it’s natural for an individual to stop moving the injured area and wait for it to heal. Ironically, this is counterproductive. Restricting movement causes the tissue to weaken, become less flexible and receive less circulation. In fact, gentle stretching and exercise is the best way to resolve the injury by getting it moving and increasing circulation.

Myofascial trigger points

Hypersensitive nodule within tight band of muscle or fascia after injuries or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the entire muscle.

An injury may have active or latent trigger points:

•  Active = pain at rest

•  Latent = pain with pressure

During myofascial release therapy, the therapist locates myofascial areas that feel stiff and fixed instead of elastic and movable under light manual pressure. These areas, though not always near what feels like the source of pain, are thought to restrict muscle and joint movements, which contributes to widespread muscle pain. The focused manual pressure and stretching used in myofascial release therapy loosen up restricted movement, leading indirectly to reduced pain.

Written by Karen Nasr (Kinesiology student at York University)