Soft Tissue Injuries Daily Objectives Content Objectives Review

Soft Tissue Injuries

Daily Objectives �Content Objectives �Review the skeletal and muscular system. �Gain a basic foundational knowledge regarding soft tissue injuries. �Language Objectives �Questions & Answer Sessions �Complete Guided Reading Assignments �Complete Scenario Assignments

Pace Lap �What are the four common characteristics of all muscles?

Guided Reading Assignment �Please read page 315 -316 regarding The Contraction of Skeletal Muscle and complete the Flow Map Puzzle. �Define these three terms: �Motor Unit �Neuromuscular Junction �Acetylcholine 4

Scenario Assignment #1 � An athlete limps into the athletic training room during basketball practice complaining of Right Ankle pain. She states that while coming down from getting a rebound she inverted her right ankle. She states that she felt a “pop” and an intense pain on the lateral part of her ankle. During your observation you note that there is moderate swelling, pain, and some ecchymosis (discoloration). The special test reveal some ligamentous laxity compared to the opposite ankle. � What type of injury do you think that the athlete has? � How are your going to treat it? � When can they return to play? 5

Scenario Assignment #2 �While covering a high school track meet an athlete walks over to you and complains of pain in the posterior aspect of his right upper leg. He states that as he was running and he felt a “pop”. During your assessment you notice that his hamstring is cramping (spasm) and that he can not actively flex the knee without his pain increasing. Active and Passive hip flexion also cause pain. ROM is limited due to pain. � What type of injury do you think that the athlete has? (Be 6 Specific) � How should you manage it? � When can they return to play?

Soft Tissue Injuries �Often occur from external forces or overuse. �Types �Strains �Sprains �Tendonitis �Bursitis �Contusions. 7

Muscle Strains �An injury to the muscle caused by twisting or pulling of a muscle or a tendon. � Mechanism of Injury �Traumatic movement (Acute) �Overuse (Chronic) � Signs and Symptoms �Pain �Spasm �Weakness �Localized Swelling �Loss of Function �Some Ecchymosis 8

Muscle Strain Management �Phase 1 (24 -48 hours) �Goal: Reduce Swelling and Pain �Use of RICE (Rest, Ice, Compression, Elevation) �OTC or Prescription NSAID (Non-steroidal Anti- Inflammatory Drug) �Phase 2 (Rehabilitation) �Goal: Restore function of the injured body part. �Use of exercises and modalities to restore ROM and strength �Time frame depends on the severity of the initial injury. �Gradual return to activity. 9

Ligament Sprain � Injury resulting from a fall, sudden twist, or blow that forces a joint out of its’ normal position. � Grade I (Mild) � Minimal pain and swelling � No loss of function � Grade II (Moderate) � Moderate pain and swelling � Some loss of function � Some ecchymosis � Grade III (Severe) � Sever e pain, swelling, and ecchymosis. � Ligamentous Laxity � Loss of Function 10

Ligament Sprain Management �Refer to physician for X-ray if Grade II or Grade III �Immobilization �Time depends on severity of sprain. �RICE for 24 -48 hours �Rehabilitation exercises to restore full pain free strength and ROM. �Must complete Sports Specific Activities prior to returning to play. 11

Tendonitis & Bursitis �Tendonitis �Inflammation of the tendon. �Bursitis �Inflammation of the bursa. �Mechanisms of Injury �Overuse (Most Common Cause) �Acute blow form and external force (Bursitis only) �Signs and Symptoms �Pain over the affected tissue. �Pain increases with movement. �Pain is worse at night

Tendonitis & Bursitis Management �Prevention is the best form of management. �Gradually increase activity to avoid excessive stress in a short time period. �Avoid activities that cause pain. �NSAIDS �Increase strength and flexibility of injured muscles that support the specific joint articulation.

Contusions �Injury resulting form a direct blow that does not break the skin. �Signs and Symptoms �Ecchymosis �Localized Pain �Treatment �Ice in stretched position �Rehabilitation �Maintain Muscle Activity. �Beware of Myositis Ossificans �A calcification that forms within the muscle.