At some point in our lives we will all have all had a Soft Tissue Injury and everybody will have probably heard this term used before, either by a doctor or therapist. But what exactly is meant by an injury to the “soft tissue”? That question itself leads on to other questions;
Firstly, what do we mean when we talk about ‘soft tissue’?
Well, simply, the term soft tissue refers to the tendons, ligaments, muscles and fascia of your body. The composition of soft tissue consists mainly of elastin and collagen – collagen is widespread in the body and gives connective tissue strength and flexibility, Elastin is a protein that returns to its original shape after being stretched
How do we injure Soft Tissue?
The injury part can be subdivided into 2 categories; Chronic, and Acute.
Chronic refers to physical injury, illness, or disease that develops slowly and is persistent and long-lasting, or even constantly recurring over time. Many chronic injuries have mild symptoms and pain level to start with, and are often ignored or simply overlooked for months or even years. Ignoring such mild aches and pains can lead to a persistent chronic injury that is more difficult to heal.
Acute injuries are often a traumatic incident – i.e. a fall, a tackle, a misplaced foot. The result is mostly the same; pain, swelling, redness, heat and instability being the most common symptoms. If you don’t think soft tissue injuries are common, consider this list; tennis elbow, ankle sprain, strained back muscles, cruciate ligament damage, stiff neck. We all suffer from soft tissue injuries just like “athletes” do. There are all kinds of injuries that fall under the category of soft tissue…
What type of Soft Tissue Injury are there?
A few common causes of soft tissue damage include;
Strains: A strain is a stretching or tearing of muscle fibre or tendon. Muscle strains are very common and mostly make full recovery with the right course of treatment. Tendon is slightly different. A tendon is a fibrous band of tissue that connects your muscles to your bones and doesn’t have the same level of blood supply as a muscle, so can take longer to heal. There are also different types of tendon injury – see below.
Sprains; Ligaments are tough, elastic-like bands that connect bone to bone, holding your joints in place. A sprain is an injury to a ligament caused by tearing of the fibre’s of the ligament. This could be a partial tear, or it could be completely torn (or ruptured). Sprained ligaments swell rapidly and are very painful. Most common in the ankle and knee, early treatment is vital to full rehabilitation.
Over-use: A dreaded term for serious athletes! Putting repeated stress on a muscle, tendon, or even ligament will eventually cause injury. Repetitive stress causes micro-tears to the tissue which over a period of time will create a knock effect resulting in a greater injury. If not treated immediately, and correctly, this can result in a large tear or even stress fracture. A stress fracture to a bone is an example of an overuse injury.
Tendinopathy: Tendon injuries used to be grouped under the umbrella term Tendonitis, which isnt actually correct, as –it is insinuates inflammation. There are a multitude of potential causes of Tendon pain (Inc. inflammation, degeneration, disease) which each need treating differently.
Others: A haematoma or contusion is quite simply a fancy word some therapists like to use for for a bruise. They are often the result of a blow to soft tissue, but are also associated with strains and sprains. The area will become discolored due to broken blood vessels, and will usually be tender to the touch, sometimes limiting range of motion. Bursitis is an inflamed bursa, which is fluid filled sack providing a cushion between bones and tendons and/or muscles around a joint. The bursa helps to reduce friction between the bones and allows free movement. An example of bursitis is “housemaids knee”.
Muscle, Ligament, Tendon
Treatment of Soft Tissue Injury
Each and every injury is different so this section is a very generalised answer, however initial treatment should always be the P.O.L.I.C.E protocol. Once the acute stage has passed (generally 2-3 days post incident) postural and functional assessments can be carried out to assess the cause of the symptom. This is very different from looking at the symptom in isolation. Once pain management is under control, a graded, progressive treatment and rehabilitation plan relevant to the injured person can be put in place – sometimes with a return-to-play action plan.
Prevention of Soft Tissue Injury
There are a number of ways to try to reduce the risk of injury. However by its very nature, in sport an injury is sometimes somewhat inevitable – certainly in high impact sports. It is important to do a sport specific warm up and cool down before and after training and/or matches. Specific strength training and stretching regularly will help keep your muscles and joints limber and less prone to injury (1). We should also remember the importance of proper form, whether that be your Squat Position or running style. Bad form can place extra stress on our body, which can lead to injury. Lastly, fatigue can also cause injury and at the very least increases the risk, which leads to the importance of good recovery.
REFERENCES
For more information please visit www.dc-injuryclinic.co.uk