muscle & tendon strains and tears
what's the difference?
Muscles are strained or torn when some or all of the fibres fail to cope with the demands placed upon them. Muscle strains are amoung the most common sporting injuries. All muscles that are biarthrodial (cross two joints) seem to be the most vunarable to injury; these muscles include hamstrings, quadriceps and gastrocnemius. A muscle is most likely to tear during sudden acceleration or deceleration.
Muscle strains are graded:
Grade I: small number of fibres are involved and causes localized pain but no loss of strength.
Grade II: a tear of a significant number of muscle fibres with accociated pain and swelling. Pain is reproduced on muscle contraction, strength is reduced and movement is limited by pain.
Grade III: is a complete tear of the muscle, this is seen frequently at the muscluotendinous junction.
Management of muscle strains first and foremost requires first aid (RICER: see August 08 Newsletter) to minimize bleeding, swelling and inflamation. Subsequent treatment that promotes efficient scar formation such as ultrasound, massage therapy and stretching. then progressive muscle strengthing enables the muscle to return to full functional strength.
Predisposing factors to muscle strains:
- inadequate warm-up
- insufficiant joint range of motion
- excessive muscle tightness
- fatigue/overuse/inadequate recovery
- muscle imbalance
- previous injury
- faulty technique/biomechanics
- spinal dysfunction
The amount of rehabilitation and the time needed for full recovery after a muscle sprain or strain depend on the severity of the injury and individual rates of healing. A moderate ankle sprain may require three to six weeks of rehabilitation and severe sprain can take eight to 12 months to rehab completely and avoid re-injury
Tendons may rupture completely or partially. Tendons consist of tight parallel bundles of collogen fibres. Injuries to tendons generally occur at the point of least blood supply, for example, witht the Achilles tendon usually 2cm above the insertion of the tendon, or at the musculotendonis junction.
Two most commonly ruptured tendons are the Achilles tendon and the supraspinatus tendon in the shoulder (part of the Rotator Cuff). Partial tears are characterized by the sudden onset of pain and by localised tenderness but they are difficult to distinguish from tendonopathy. MRI and ultrasound can be useful here to distinguish between the two.
Generally acute tendon rupture requires surgical treatment.
Progressive rehabilitation is an important component of the treatment of an acute tendon rupture, eccentric exercises improve tendon strength.
After about 6 weeks the remodeling phase of tendon healing commmences, this takes up to another 4 weeks. After ten weeks, the maturation stage occurs, with gradual change of the fibrous tissue to scar-like tendon tissue over the course of one year.
10 Top Tips To Avoid Injury
1. Have a regular physical
2. Gradually increase your intensity
3. Seek assistance and motivation with a personal trainer
4. Warm up and warm down properly (stretching)
5. Have the correct fuel before your workout (food and drink)
6. Listen to your body
7. Rest and recovery
8. Cross train
9. Dress properly for your training, especially footwear
10. Have a regular massage
Refernces: Clinical Sports Medicine; Brukner & Khan
http://sportsmedicine.about.com/cs/injuries/a/sprains.htm
|
foot massage
hand massage
scalp massage