Types of Acute and Overuse Soft Tissue Injuries
Here are some basic facts about the three types of acute injuries to soft tissues:
- • Sprains: A sprain is a stretch or tear of a ligament, which is a band of connective tissue attaching one end of a bone to another. Ligaments support the joints throughout the body. Areas most prone to sprains include the ankles, knees and wrists. Sprains are classified by severity: Grade I (mild, slight stretching to ligament fibers), Grade II (moderate, partial tearing of the ligament) and Grade III (severe, complete tear of the ligament). Pain, bruising, swelling and inflammation are common in all three grades.
- Strains: A strain is an injury to a muscle or a tendon—the cords of tissue that attach muscles to bone. Strains are most common in the foot, leg or back. Strains can be characterized by a slight stretch, or by a partial or complete tear in the combination of muscle and tendon. Symptoms often include pain, muscle spasms, muscle weakness, swelling, inflammation and cramping. Contact sports along with sports featuring quick starts (hurdling, long jump, running, etc.) present risks for strain, as do sports that require extensive gripping or swinging.
- Contusion (bruises): A contusion is a bruise caused by a direct blow or multiple repeated blows. These blows crush muscle fibers and connective tissue without breaking the skin, and generally cause discoloration of the skin due to blood pooling near the injury. Most bruises are mild.
Overuse soft tissue injuries include:
- Tendinitis: Inflammation or irritation of a tendon or the covering a tendon, generally caused by a number of small stresses that aggravate the tendon over time. Symptoms of tendinitis include swelling and pain that gets worse during activity. It can be treated with rest, anti-inflammatory medication, steroid injections, splinting, and exercises to correct imbalances and improve flexibility.
- Bursitis: The body has jelly-like sacs located throughout the body that act as cushions to reduce friction between bones and soft tissues. These sacs are called bursae, and bursitis is the inflammation of these sacs. Bursitis can be caused by repeated small stresses and can be experienced in association with tendinitis. Treatments may vary depending on severity, but can range from changes in basic activity to surgery in rare cases.
RICE Protocol for Acute Treatment
For acute soft tissue injuries, the RICE protocol is generally used:
- Rest: Stop participating in the activity that caused the injury. In some cases, your doctor may recommend crutches, splints or slings.
- Ice: Use cold packs for 20 minutes at a time, several times a day. Don’t apply it directly to the skin.
- Compression: Wear an elastic compression bandage to prevent additional swelling or blood loss.
- Elevation: Elevate the injury higher than the heart while resting to reduce swelling.
Many injuries occur when people suddenly increase elements of their activity like intensity, duration or frequency of exercise. Oftentimes, injuries can be prevented through the right conditioning, training and equipment. Other prevention tactics include:
- Balanced programs: Incorporate cardiovascular exercise, strength training and flexibility into your fitness. Add new activities cautiously to allow the body to adjust.
- Warm up and cool down: Warm up before stretching, and make cooling down your final phase of exercising.
- Water: Drink one pint of water 15 minutes before exercising and another pint after cooling down. Drink some water at least once every 20 minutes during exercise.
- Stretch: Stretch slowly and carefully until you reach muscle tension, then hold each stretch for 10 to 20 seconds before slowly releasing it. Inhale before stretches, and exhale during release. Don’t hold stretches to the point of pain.
- Rest: Schedule regular days off from heavy exercise, and rest when tired.
- Avoid “weekend warrior” syndrome: Try to get at least 30 minutes of moderate exercise each day rather than packing it into weekends or free periods of time.
If you’ve undergone a soft tissue injury or are at risk, your doctor can offer further recommendations for treatment or prevention.