Soft Tissue Injuries
By Anita Ballmick MOT/CHT
What are Soft Tissue Injuries?
Soft tissue injuries are the result of trauma or overuse to our muscles, tendons, or ligaments. Typically, these injuries occur in sports related incidents where unexpected starts or stops, twisting, or uncontrolled movements may occur. However, these injuries can occur anywhere in our daily life. Generally, soft tissue injuries are not serious unless a tear occurs in the involved structures.
What are examples of Soft Tissue Injuries?
The most common examples for Soft Tissue Injuries include:
Soft tissue Injuries Type: Acute or Overuse
Typically, acute soft tissue injuries vary in severity and type. They occur because of sudden trauma, twisting, a fall, or an impact to the body. These will include sprains, strains, and contusions.
Ligaments are a type of soft tissue that connects our bones to other bones giving support to our joints. ‘Sprains’ are likely to occur from over stretching or twisting in our elbow, wrist, knees, and ankles. An example would be the ulnar collateral ligament (UCL) that connects our upper arm bone (humerus) to the one of our lower arm bone (ulna) on the inside of our elbow.
Our muscles attach to our bones through fibrous bands known as tendons. These tendons cross over our joints allowing us to move our body when the muscles contract. If they are twisted or overstretched, this can lead to a ‘strain’. Symptoms of a strain may include pain, muscle spasms, weakness in the affected muscles, swelling, and inflammation.
Acute Injury: Sprains and Strains Classification
Grade 1 (Mild): Minimal overstretching and some damage of the involved structures. Symptoms include some swelling as well as tenderness to touch. In addition to, Difficulty with weight being applied through the affected joint such as when standing or leaning on the affected area.
Treatment will involve the R.I.C.E Protocol (see below) and Physical Therapy to reduce symptoms.
Grade 2 (Moderate): Partial tear to the structure. The joint will have an abnormal looseness. Symptoms include moderate pain, tenderness, and swelling. As well as being unable to place weight through the affected joint.
Treatments involves everything listed above and in addition, your doctor may recommend a brace or splint to immobilize the affected area and promote healing.
Grade 3 (Severe): Complete tearing of the involved structures. The involved joint will feel as if you can no longer use it and it will be unstable. Symptoms include significant pain and swelling.
Treatment involves everything above, additionally surgery may be a requirement to repair or replace the structures that suffer a tear.
Also known as bruises, contusions are the result of an impact, like a fall, that crushes underlying muscles and connective tissues beneath the skin without the skin being broken. Soon after impact, the area will appear discolored as blood begins to pool around the affected area. Symptoms are generally mild and may include pain, swelling, tenderness, and discoloration. The R.I.C.E. protocol is an effective treatment option for most contusions. More serious contusions will require being examined by your doctor to ensure damage has not occurred to bones, organs, or nerves.
Overuse injuries occur over a longer period where repetition takes place, pitching a baseball for example. This is generally where little time is given in between for the soft tissues to heal. These consist of tendinitis and bursitis.
A common cause for inflammation within our body is the tissues being subjected to overuse. When our tendons, or their protective coverings called sheaths, are placed through repetitive motions, they become inflamed in a condition known as ‘tendinitis’. Commonly affected areas include the shoulder, elbow, wrist, hand, hip, knee, ankle, and foot. The point of inflammation is usually named after the sport that causes the tendinitis such as golfer’s elbow, tennis elbow, swimmer’s shoulder, and jumper’s knee.
Symptoms of Overuse
Symptoms include a sharp, burning pain or swelling that worsens as the joint becomes mobile.
Tendonitis: Treatment for tendonitis should utilize the R.I.C.E. protocol as well. Additionally, A prescription of anti-inflammatory medication can reduce swelling and pain. Strengthening and stretching can be slowly added after resting the affected joint to allow it time to heal. Corticosteroid injections are likely to be recommended in chronic tendonitis cause the pain is continuous. In severe cases, surgery is utilized to repair damaged structures.
Bursitis: Within our joints, there are sacs filled with synovial fluid, called bursa. These sacs cushion our joints, muscles, and tendons, while also allowing these structures to glide over each other with reduced friction. These jelly-like sacs can become inflamed just like tendons and cause a condition known as ‘bursitis’. It is common for bursitis to occur along side tendonitis since the structures tend to work together and then become inflamed together. Bursitis occurs commonly in the shoulder, elbow, knee, ankle, and foot.
Generally, the R.I.C.E. Protocol is an effective treatment for acute soft tissues injuries. R.I.C.E. stands for Rest, Ice, Compression, and Elevation.
Rest: Take a break from any sport or activity that involves the affected area. Your doctor may recommend crutches if the injury occurs in the legs to avoid weightbearing through the injured tissues.
Ice: Use cold packs for 5-20 minutes over the affected area as this will reduce inflammation, decreasing pain and swelling. Do not use ice directly on the skin as this can damage skin tissue with prolonged use.
Compression: Wear compression garments recommended by your doctor or apply compression bandages to reduce swelling over the affected area.
Elevation: Raise the affected area over your heart to help your body get fluids back towards heart in order to reduce swelling in the affected. Examples include: placing a pillow under your affected leg while laying down or a pillow under your arm while sitting down.
Conservative Treatment for a Soft Tissue Injury
Conservative treatment may involve resting the affected area and anti-inflammatory medication. If symptoms persist, your doctor may have to remove fluid bursa in an attempt to reduce pain and swelling. Corticosteroid injections are used for severe pain and swelling that does not respond well to other medications. Surgery will rarely be required, and is typically only used if the bursa is infected, or all other treatments have been ineffective at reducing symptoms. If the bursa remains infected after treatment, your doctor may recommend removal of the bursa, known as a bursectomy.
What are the General Symptoms for Soft Tissue Injuries?
Symptoms for soft tissue injuries will cause immediate tenderness, pain, or swelling. Stiffness is common in the affected joint because of trauma and swelling over the area. There may even be discoloration, or bruising, that will develop within the next 24 to 48 hours. For moderate to severe cases, instability will be evident especially in load bearing joints like the hip, knees, and ankles.
How Long does a Soft Tissue Injury Take to Heal?
Soft tissue injuries healing time varies upon its severity, that being said recovery can span anywhere from 1-12 weeks. For grade 1 injuries, you can expect recovery to be 1 to 2 weeks. Grade 2 injuries will require 3 to 6 weeks. Grade 3 injuries require the longest recovery period due to the extent of the injury; you can expect at least weeks 8 to 12 weeks. Other comorbidities and lifestyle choices affect healing rate. Avoid using heat, alcohol, or massaging the affected area for the first several days. All of these will increase blood flow and subsequently increase swelling making symptoms worse by decreasing your healing process.
Written By: Anita Ballmick MOT CHT
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