Soft Tissue Injury
·
Proper warm up
·
Cooling down
·
Protective equipment
·
Good technique and sensible
training schedules
·
Sprain: partial tear of ligament
or joint capsule but the joint is still stable. Site of tear is tender and
there may be bruising. Symptomatic treatment and protection from stress until
healing is complete
·
Partial Rupture: If rupture is
incomplete, treat conservatively (ranging from rest and analgesia to casting
for 6 weeks). Recurrence common
·
Complete Rupture: Poor healing as
scar tissue is not as tough as the ligament. May attempt surgical repair – but
it may not help
·
Due to sudden, violent
contraction
o Most common is Achilles Tendon Rupture.
·
Can also rupture long head of
biceps and supraspinatus
· Other tendon injuries:
o Paratendonitis: Inflammation due to friction of the paratendon (fatty tissue in the fascial compartment through which a tendon runs). Usually Achilles or wrist tendons. Try good footwear or rest in a splint. Steroid injection (but not into the tendon itself) may be effective. NB steroid injections around the Achilles are controversial – may weaken the tendon
o Tendonitis: irritation/tearing of fibres due to repeat trauma. Pain
worse on contraction. Rest + NSAIDs
·
Formation of ice-crystals in the
skin and soft tissues when temperature < -3 ºC
·
Presentation: tissue is pale,
grey, and doughy – or frozen solid. May
develop without person knowing
·
Treatment:
o Warm slowly – this will be painful
o Blisters may form over several days.
May develop blackened shell as blisters burst
o Dry, non-adherent, strictly aseptic dressings and prevention of further
trauma (tissues are numb)
o Recovery takes weeks. Surgery may
be required
·
Characterised by direct trauma to
a muscle group with subsequent pain and swelling due to bleeding within the
muscle
·
Management:
o Rest, ice, mild compression and elevation to control swelling, bleeding
and pain
o Intermittent icing for up to 48 hours
o Maybe NSAIDS – but may increase the bleeding
o Exclude other injuries, including compartment syndrome
o Once swelling has settled, aim is to restore function, beginning with
gentle isometric muscle exercises
·
Torn, ragged wound
·
Treat for bleeding: expose wound
to assess for blood loss, cover, direct pressure, elevate, pad and bandage
·
If severe then sutures. However,
muscle divided transversely will not hold sutures well enough to stop muscular
contraction pulling the edges apart
· Inflammation at the site of attachment of bone to a tendon, ligament or joint capsule
·
Elbow: See Tennis and Golfer‟s
Elbow. Treatment:
rest and strapping. Steroid injection if severe
·
Plantar Fasciitis:
o Insertion of the tendon into the calcaneum
o Pain on standing and walking
o Is isolated, or with sero-negative arthritis
o Treatment: heel pads, reduced walking, steroid injection
·
Caused by  tissue
pressure in a closed fascial space ® ¯ circulation to muscles and
nerves
·
Presentation: pain or deep ache
over compartment. Usually after prolonged exercise. Usually bilateral. May have
palpable muscle hernias
·
Diagnosis: difficult. Elevated
pressure within the compartment during/after exercise with slow return to
resting pressure
·
Treatment: decrease exercise (® ¯muscle
bulk) or elective fasciotomy (can affect muscle strength)
·
„Shin Splints‟: Shin soreness in
unfit runner: can be due to a combination of muscle tears, mild anterior
compartment syndrome or stress fracture
·
Muscle disease: polymyositis,
polymyalgia rheumatica, tendon inflammation, compartment syndrome
·
Bone disease: osteomyelitis,
osteomalacia, osteoporosis, tumours
·
Vascular disease: Arterial or
venous (eg DVT)
·
Neuropathy: nerve entrapment,
neuropathy
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