Soft tissue strains and sprains
Soft tissue injuries (STI's) vary in type and severity and by definition is an injury to a 'soft' structure such as muscles or tendons, ligament (join bone to bone), tendons (join muscle to bone), skin, joint capsule, fat, myofascial and other connective tissue. An injury to muscles or tendons such as a twisted ankle or sprained wrist leads to microtrauma, bleeding and swelling around the damaged tissue which causes pain. This pain encourages the body to 'rest' the affected area and whilst initially this is useful to aid healing, the consequence of this after a few days is muscle weakness and reduced movement from disuse. Usually, this is easily restored when the pain and swelling settle but sometimes it helps to have Physiotherapy, especially if you are keen to return to sport, as the evidence is that we can speed up the healing process and achieve a safer and speedy return to activity.
The early stage of a soft tissue injury is known as the acute phase of injury and is the first 48 – 72 hours post-injury
Pain Relief of Soft Tissue Injuries
Nonsteroidal anti-inflammatory drugs (NSAIDs) are regularly used to accelerate the return of injured athletes suffering from acute soft tissue injuries to competition. Evidence demonstrates that while anti-inflammatory medication may speed recovery after acute soft tissue injuries, long-term healing may be compromised
is a type of bleed (haematoma) of tissue in which capillaries are damaged, causing bleeding into the surrounding tissues.
is damage to one or more ligaments in a joint, often caused by trauma or the joint being taken beyond its functional range of motion.
is an injury to a muscle in which the fibres tear as a result of overstretching. A strain is also known as a pulled muscle or torn muscle.
- mild tear/bruise of structure. Follow PRICE below
- moderate tear/bruise of structure. Follow PRICE below
- complete rupture – needs medical intervention ASAP to determine
For the initial 48-72 hours after an STI, you should avoid HARM. This means that you should avoid:
- HEAT - heat treatments such as hot baths, saunas or heat packs as this can increase bleeding due to increased blood flow and swelling
- ALCOHOL - drinking alcohol following a sprain or strain will increase blood flow and swelling, slowing the healing process.
- RUNNING - or any other forms of exercise that could cause more damage should be avoided.
- MASSAGE - massage in the first 72 hours may promote blood flow which can increase bleeding and swelling and should be avoided.
PRICE is a mnemonic for the 5 elements used to treat soft tissue injuries.
- PROTECTION - This may be the use of tape, braces or crutches.
- REST - you need to cease the activity which caused the injury in the first place resting the injured muscle or joint.
- ICE - for the first 48 through to 72 hours after the sprain or strain injury apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes. Do not allow the ice pack to touch the skin directly as this can cause an ice burn.
- COMPRESSION - normally a compression bandage to the injured area where possible. This limits further swelling and movement preventing further damage. This may be an elasticated tubular bandage (Tubigrip) or taping to control swelling.
- ELEVATION - Keeping the injured affected area elevated and if possible above the level of the heart, supporting the area will assist in reducing swelling if you have injured your leg avoid having a long period of time when the leg is not raised. Do not elevate and compress at the same time
After the initial 48 hour period gradually start to return to activity as pain allows. This will start to strengthen, return flexibility and resume normal balance (proprioception)
Treatment of Soft Tissue Injuries
Physiotherapy treatments can speed up the rate of healing, this can depend upon the levels of soft tissue damage and ease the pain using treatments such as taping, acupuncture, ultrasound, microcurrent therapy, TENS, soft tissue and joint mobilisations. Advice on returning to normal activity is crucial in making an effective and efficient return to normal function
Most soft tissue injuries can take a few weeks to heal, this is dependent upon the severity of the sprain or strain as well as the general health of the patient.
Good habits can prevent soft tissue injuries which includes warming up, stretching and cooling down, gradually increasing in intensity and duration of training, wearing appropriate protective equipment such as shin pads, gum shields, appropriate footwear. Keeping well hydrated during, before and after periods of exertion.
Get in touch with Abbey Physiotherapy to book you in for our initial assessment of your conditions.