What do you visualize when you hear “soft tissue injury?” You probably think about that twisted ankle you got last year playing soft ball. Or, the time you started playing golf six days a week and developed hip pain.
A soft tissue injury can be acute caused by a sudden trauma and includes strains, sprains and contusions. Or it can be a gradual injury due to overuse, when the body does not have time to heal between repetitious activity. These typically include tendinitis and bursitis.
Three Levels of Sprain Injuries
A sprain is a stretch and/or a tear of a ligament. Ligaments are strong bands of connective tissue connecting the end of one bone to another. Ligaments stabilize and support joints. Sprains are classified by severity.
Grade one sprains are mild. There is a slight stretching and some damage to the fibers of the ligaments. This injury usually takes one to two weeks to heal. Treatment typically includes rest, ice, compression and elevation (RICE), and sometimes physical therapy. Rest includes taking a break from the activity that caused the injury. Use cold packs for 20 minutes several times a day. Wear an elastic compression bandage to prevent additional swelling and blood loss. And elevate the injury to reduce swelling.
Grade two sprains are moderate. There is partial tearing of the ligament. Abnormal looseness will occur in the joint when it is moved certain ways. Grade two injuries take two to four weeks to heal and treatment consists of bracing for a short period of time as well as RICE.
Grade three sprains are severe. This is a complete tear of the ligament. This causes instability and makes the joint nonfunctional. Surgery may be needed for this type of injury to repair the torn ligament.
Although the intensity of the above varies, pain, bruising, swelling, and inflammation are common to all three categories of sprains.
Some health care professional may add on an additional item to the RICE treatment. They use the PRICE method. The P stands for protection. Minimize using the affected area and avoid stretching the area. This helps to prevent any further damage.
Strains are injuries to the muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscle to bone. As above, there are various levels of strains. It may be a simple stretch of your muscle or tendon, or it may be a partial or complete tear in the muscle and tendon combination. Symptoms of a strain are pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping.
Treatment of strains are the same as sprain, RICE, and simple exercises to relieve pain and restore mobility. More severe strains may require surgery.
Bruises, Tendinitis and Bursitis
Contusions or bruises are considered soft tissue injuries. They are caused by a direct or repeated blow to the skin. The muscle fibers and connective tissue are crushed but the skin is not broken. Treatment should be RICE.
Overuse injuries typically include tendinitis or bursitis. Tendinitis is the inflammation or irritation of a tendon and/or its sheath. Small stresses that repeatedly aggravate the tendon cause swelling and pain that worsens with activity. Tendinitis is treated with rest, anti-inflammatory medication, steroid injections, splinting, and exercise. Surgery may be required for persistent inflammation to avoid significant damage to the tendon.
Bursae are small jelly-like sacs located throughout the body. Positioned between the bone and soft tissue they contain a small amount of fluid to help cushion and reduce friction. Bursitis is the inflammation of the bursae. Many people experience bursitis along with tendonitis. Bursitis is treated much like tendonitis, anti-inflammatory medication and a change in the activity. If those measures do not work, the doctor may recommend removing the fluid and injecting cortisone into the bursae. Surgery is rarely necessary.
Should the injured party go to the hospital or not? You should go if you cannot put any weight on the injured structure. If there is a deformity to the joint or you heard or felt a pop or crack at the sign of the injury. It is better to err on the side seeking treatment instead of seeing if you can “tough it out.”
To prevent these problems, try not to overdo it. Many of these injuries can be prevented by using common sense, proper conditioning, training and equipment. Some things to do to prevent soft tissue injuries is to warm up before beginning any exercise, which includes stretching. Upon completion of exercising, a cool down period is just as important and should take twice as long as your warm up period. Drink plenty of water to keep hydrated and prevent heat exhaustion and heat stroke. Schedule regular days off from a vigorous exercise program and rest when tired. Most important of all is to avoid the “weekend warrior” syndrome. Don’t do all your exercising for the month in one weekend.