The soft tissue structures include the muscles, tendons, ligaments, joint capsule, myofascial, and other connective tissues. These structures are often injured during sports participation but even with simple daily activities.
Trauma is the typical cause of soft-tissue and other musculoskeletal injuries,either due to a direct trauma from a blunt blow or indirect trauma from repeated submaximal loading, resulting in clinical signs and symptoms. Generally, soft-tissue injuries fall into two categories:
When soft tissue is injured, it goes through three basic stages of wound healing: inflammation, proliferation, and maturation.
Following injury, hemostasis takes place to seal off the bleeding through the formation of a clot via blood vessel constriction. Once hemostasis is achieved, these blood vessels dilate to enhance circulation and allow the flow of oxygen-rich blood, nutrients, white blood cells, antibodies, enzymes, and other beneficial elements to promote good healing and prevent infection. This phase is manifested by the presence of inflammation, characterized by swelling, redness, and warmth at the injured site, and usually lasts up to 72 hours.
In the second stage, the injured site begins to be rebuilt with new tissues. New capillaries or small blood vessels are formed via a process called angiogenesis to bring in a sufficient supply of nutrients and oxygen. Fibroblasts begin to synthesize collagen tissue in random and disorganized orientation. As the process continues, the number of fibroblasts decreases as more collagen is laid down. This phase lasts from 48 hours up to 6 weeks.
The remodeling stage involves a process of reorganization, degradation, and re-synthesis of the extracellular matrix or the structural support in an attempt to create a tight, strong scar, recover the normal tissue structure and increase the functional strength of the soft tissues. The granulation tissue is gradually remodeled, forming scar tissue that fills up the gaps formed by the ruptured ends. This phase is also marked by the resolution of the initial inflammation and lasts from 3 weeks to 12 months.
The initial 48 – 72 hours post-injury of a soft tissue injury is the acute phase. When acute soft-tissue injuries occur, the initial treatment with the PRICE Protocol is usually very effective and provides immediate relief or reduction in the severity of the signs and symptoms, especially pain and inflammation.
Although the PRICE Protocol would be a wise remedy early in the injury, it is advised to begin gentle movements in the pain-free range of motion as soon as possible. This is to encourage blood and lymph flow to the area, supplying the site with beneficial elements for repair and clearing it of waste products while also preventing the muscles and other tissues from becoming weak and stiff from disuse.
Whenever appropriate, overuse injuries are likewise treated with the PRICE Protocol to address the acute symptoms or chronic inflammation. However, the two most crucial parts in the management of overuse injuries are the identification of the cause and implementation of corrective treatments. Overuse injuries in the early stages can be treated with:
Long-term solutions to overuse injuries require corrective strategies of the causative factors, such as training and technique errors.
ADDITIONAL TIPS: Overuse injuries can be prevented with few simple steps to follow: