Signs and Symptoms • Pain • Swelling • Heat • Redness • Loss of function • Depends on severity of injury
Treatment • R.I.C.E. and possible NSAIDs • Range of Motion (Stretching!) • Strength and Endurance • Neuromuscular Control & Balance • Functional and Sports Specific Progressions • Maintain Cardio Fitness • All depend on severity. • Begin rehab as soon as possible.
What are the two categories of acute muscle injuries? • Contusions • Strains
How does one receive a contusion? Sudden traumatic blow to the body
What is typical in cases of severe contusions? • the athlete reports being struck by a hard blow • the blow causes pain and a transitory paralysis caused by pressure on and shock to the motor and sensory nerves • palpation often reveals a hard area, indurated because of internal hemorrhage • ecchymosis, or tissue discoloration, may take place
What is a strain? A stretch, tear, or rip in the muscle or adjacent tissue such as the fascia or muscle tendon
How are strains most often produced? Abnormal muscular contraction
What is the cause of abnormal muscular contraction? It is fault in the reciprocal coordination of the agonist and antagonist muscles take place. The cause of this fault or un-coordination is a mystery. However, possible explanations are that it may be related to: • a mineral imbalance caused by profuse sweating • to fatigue metabolites collected in the muscle itself • to a strength imbalance between agonist and antagonist muscles.
What is a grade 1 (or 1st degree or 1°) strain? Slight over-stretching to mild tearing (20%) of the muscle fibers. It is accompanied by local pain, which is increased by tension in the muscle, and a minor loss of strength. There is mild swelling, ecchymosis, and local tenderness.
What is a grade 2 (or 2nd degree or 2°) strain? Moderate tearing (20% - 70%) of the muscle fibers. It is similar to a grade 1, but has moderate signs and symptoms (moderate loss of strength, moderate swelling, ecchymosis, and local tenderness).
What is a grade 3 (or 3rd degree or 3°) strain? Has signs and symptoms that are severe (severe swelling, ecchymosis, and local tenderness) with a loss of muscle function and, commonly, a palpable defect in the muscle.
What does a tendon attach? Muscle to bone
What does a ligament attach? Bone to bone
What is a cramp? A painful involuntary contraction of a skeletal muscle or muscle group.
Cramps have been attributed to what? A lack of water or other electrolytes in relation to muscle fatigue.
What is a spasm? A reflexive reaction caused by trauma of the musculoskeletal system
List and define the two types of spasms or cramps: • clonic – alternating involuntary muscular contraction and relaxation in quick succession • tonic – rigid muscle contraction that lasts a period of time.
What are the four specific indicators of possible overexertion? • acute muscle soreness • delayed muscle soreness • muscle stiffness • muscle cramping
List and define the two types of muscle soreness: • Acute-onset muscle soreness – which accompanies fatigue. This muscle pain is transient and occurs during and immediately after exercise. • Delayed-onset muscle soreness (DOMS) – becomes most intense after 24 to 48 hours and then gradually subsides so that the muscle becomes symptom-free after 3 or 4 days. (This second type of pain is described as a syndrome of delayed muscle pain leading to increased muscle tension, swelling, stiffness, and resistance to stretch).
What are the possible causes for delayed-onset muscle soreness? • It may occur from very small tears in the muscle tissue, which seems to be more likely with eccentric or isometric contractions. • It may also occur because of disruption of the connective tissue that hold muscle tendon fibers together.
What is muscle stiffness? Muscle stiffness does not produce pain. It occurs when a group of muscles have been worked for a long period of time. The fluids that collect in the muscles during and after exercise are absorbed into the bloodstream at a slow rate. As a result, the muscle becomes swollen, shorter, and thicker and therefore resists stretch.
What can be done to assist in reducing muscle stiffness? • Light exercise • Massage • Passive mobilization
What is muscle guarding? Following injury, the muscle that surrounds the injured area contract, in effect, splint that area, thus minimizing pain by limiting movement. (Quite often this splinting is incorrectly referred to as a muscle spasm)
The suffix “itis” means inflammation: • Myositis/Fasciitis - inflammation of the muscle tissue • Tendinitis – inflammation of a tendon • Tenosynovitis - Inflammation of the synovial sheath surrounding a tendon • Bursitis – inflammation of the bursa • Periostitis – inflammation of the bone covering
What are the major acute injuries that happen to synovial joints? • Sprains • Subluxations • Dislocations
What is a sprain? Stretching or total tearing of the stabilizing connective tissues (ligaments)
What is a grade 1 (or 1st degree or 1°) sprain? Slight over-stretching to mild tearing (20%) of the ligament. It is characterized by some pain, minimum loss of function, mild point tenderness, little or no swelling, and no abnormal motion when tested.
What is a grade 2 (or 2nd degree or 2°) sprain? Moderate tearing (20% - 70%) of the ligament. There is pain, moderate loss of function, swelling, and in some cases slight to moderate instability.
What is a grade 3 (or 3rd degree or 3°) sprain? It is extremely painful, with major loss of function, severe instability, tenderness, and swelling.
What is a subluxation? Partial dislocations in which an incomplete separation between two articulating bones occurs.
What is a dislocation (luxation)? Total disunion of bone apposition between articulating surfaces
What are several factors that are important in recognizing and evaluating dislocations? • Loss of limb function • Deformity • Swelling • Point tenderness
What is an acute bone fracture? A partial or complete interruption in a bone’s continuity
What is a stress fracture? Rhythmic muscle action performed over a period of time at a sub-threshold level causes the stress-bearing capacity of a bone to be exceeded
What are the typical causes of stress fractures in sports? • Coming back into competition too soon after an injury or illness • Going from one event to another without proper training in the second event • Starting initial training too quickly • Changing habits or the environment
Chondramalacia (Patellofemoral Arthralgia) • Etiology: • Abnormal patellar tracking • Signs & Symptoms: • Pain in the anterior aspect while running, walking, ascending stairs, and squatting. Recurrent swelling, grating sensation during flexion and extension, patellar grind test produces crepitus. • Treatment: • Avoid irritating activities, pain-free isometric exercise to strengthen the quads, anti-inflammatories, orthotics to correct pronation and reduce tibial torsion, possible surgery.