ACUTE SOFT TISSUE INJURIES: STRAINS, SPRAINS, AND CONTUSIONS

Acute injuries occur when there is sudden, abnormal overloading placed on the tissues, such as a physical blow or a rapid movement, as might occur in muscle injuries in sprinting or blunt trauma in contact sports.

WHAT ARE THE COMMON ACUTE SOFT TISSUE INJURIES?

Sprains

A stretch or tear of a ligament, a connective tissue that connects the ends of two bones and helps to secure the body's joints. The areas of the body that are most vulnerable to sprains are the ankles, knees, and wrists. Signs and symptoms can vary in intensity depending on the severity and may include:

• Audible or perceptible "pop" in the joint at the time of injury
• Inflammation around the joint
• Pain and tenderness localized over the stretched or torn ligament, usually worst when the joint is placed where it stretches the ligament or with the movement of the joint
• Bruising with severe injuries
• Loss of functional ability or the ability to move or use the joint

Strains

Often referred to as pulled or torn muscle, strain results from overstretching or overexerting a tendon or a muscle. Tendons are the end parts of a muscle that attaches it to the bone. A strain may be a simple stretch of a muscle or tendon, or it may be a partial or complete tear of the muscle and tendon. Strains often affect the back, groin, and hamstring. Strains vary in severity depending on how much damage the muscle sustain:

• Audible snap or pop at the site of injury
• Inflammation over and around the site of injury
• Pain when the injured muscle or the joint associated with the muscle is used; pain ta rest in severe cases
• Bruising and tenderness, sometimes a visible “knot”
• Limited range of movement due to either when the injured muscle is stretched or activated
• Muscle weakness and spasms

Contusions

Bruises are due to a direct blow or repeated blows by blunt trauma to the body, such as from falling or jamming the body against a hard surface, crushing the muscle beneath and damaging the blood vessels, causing bleeding into the surrounding tissues and resulting in skin discoloration or hematoma. The most commonly involved is the quadriceps in contact sports.

• Inflammation over and surrounding the contact area
• Hematoma and/or bluish discoloration
• Visible bump over the point of contact
• Muscle tightness with pain at rest, especially on movement
• Limitation of motions due to pain with movement
• In severe cases, it may be accompanied by a broken bone, dislocated joints, or other injuries
• Abdominal contusions may involve internal organs.

WHAT ARE THE IMMEDIATE TREATMENTS FOR ACUTE SOFT TISSUE INJURIES?

Acute soft tissue injuries are initially managed with the PRICE Protocol.

• Protection through the use of crutches, braces, splints, or similar devices
• Resting the injured limb for a few days
• Ice using cold packs for 15-20 minutes at a time
• Compression with an ace wrap or elastic bandages
• Elevation above the level of the heart

However, it’s emphasized that early mobilizationin the pain-free range should be encouraged to prevent disuse weakness, tightness, and wasting of the associated muscles and soft tissue structures. It is also encouraged to use anti-inflammatory medications only for pain relief so as not to disturb the inflammatory process as it’s an essential part of tissue repair and healing. Once acute symptoms are resolved, physical therapy may be required to rehabilitate the newly repaired muscle, tendon, or ligament. In severe cases, such as when there’s a complete tear of a muscle, tendon, or ligament, surgical treatment to repair the tear may be needed.

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