Soft tissue &

TraumaObj: I will describe various types of soft tissues in the bodyObj: I will explain how tissues respond to traumaObj: I will describe the types of soft tissue traumaObj: I will demonstrate proper procedures for treating various soft tissue traumaObj: I will analyze the indication and contraindication for cold application on a soft tissue injuryObj: I will analyze the indications and contraindications for heat application on soft tissue injuries

Warm upThink of an incident where you either witnessed or experienced a soft tissue injury to the skin, muscle, tendon or ligament. What happened? What did the injury look like? How was the injury treated?

Soft TissueSoft tissues are the tissues that connect, support, and surround other structures and organs of the body, not being bone.

Soft tissues include tendons, ligaments, fascia, skin, fibrous tissues, fat, synovial membranes (connective tissues), muscles, nerves, and blood vessels.

SkinSkin- outer covering of the body

LigamentLigament- connects bone to bone

MuscleMuscle- tissue that when stimulated contracts and produces movement

TendonsTendons- tissue that connects muscle to bone

Soft tissue InjuryA soft tissue injury is the damage of skin, muscles, ligaments, and tendons throughout the body.

Common soft tissues injuries usually occur from a sprain, strain, a blow resulting in a contusion, or overuse of a particular part of the body

5 Signs of Inflammation

5 signs of Inflammation

Redness- due to vasodilatation and increase in blood flow

Heat- due to vasodilation and increase in blood flow

Swelling- due to increase in blood flow to the injured area and possibly from blood that leaks into the injured tissue (bruising)

Pain- due to the pressure of fluids or swelling through the nerve endings

Loss of function- due to swelling and pain

Contusion Bruise

Sudden traumatic blow to body

Not penetrate skin

Usually injury to blood vessels

Superficial, deep, or hemorrhage

Hematoma: formation caused by pooling of blood and fluid w/in a tissue space

Contusion

ContusionSymptoms:

SwellingPoint tendernessRednessEcchymosis- purple discoloration of skin

Treatment: PRICE

Protection- protect from further injury by preventing them from moving

RestIce- ice during the first 72 hours to reduce swelling and

pain (ice for 15 to 20 minutes every 2 to 3 hours)Compression-use of pressure with bandage or wrap to

reduce swellingElevation- can minimize initial tissue bleeding and swelling

Contusions

Partner AssignmentWith a partner, create a short movie which shows an incident resulting in a contusion.

1. Include at least five signs and symptoms of a contusion using the body crayons and play dough.

2. Include whether it is superficial, deep, or a hemorrhage

3. Demonstrate knowledge and application of the treatment PRICE.

Movie clip should be between 2 to 5 minutes in length. Use movie maker to transition scene and make the final production.

StrainsStrain- stretch, tear, or rip in the muscle and/or tendon

Severe tension forceExcessive muscle contractionDirect blow to the body

Common sites:HamstringQuadricepsHip flexorBicepsLatissimus dorsi

Sports and strains?

In what sports is someone more likely to get a strain?

Sports and StrainsSoccer, football, hockey, boxing, wrestling, and other contact sports put athletes at risk for strains.

Sports that feature quick starts (hurdling, long jump, running races, etc.).

Gymnastics, tennis, rowing, golf-sports that require extensive gripping-have a high incidence of hand strains.

Elbow strains frequently occur in racquet, throwing, and contact sports.

Severity of StrainsGrade 1

Some muscle fibers stretched or tornSome tenderness/pain with range of motion

Grade 2Number of muscle fibers tornActive contraction of muscle extremely painful

Grade 3Complete rupture of muscle Significant impairment or total loss of movement

Strain: Signs & Symptoms

Signs & Symptoms:• Localized swelling• Cramping• Inflammation• Loss of function• Pain• General weakness• Discoloration

Strain- TreatmentTreatment

Reduce swelling & pain through PRICE Protection- protect from further injury by preventing them from moving Rest Ice- ice during the first 72 hours to reduce swelling and pain (15 to 20

minutes every 2 to 3 hours) Compression-use of pressure with bandage or wrap to reduce swelling Elevation- can minimize initial tissue bleeding and swelling

Anti-inflammatory drugs such as ibuprofen

Severe Strain could require: Hard cast Surgery

StrainsPreventionRegular weight training

Proper warm-up

Stretching

Proper mechanics

Proper cool-down/ stretching

Proper nutrition & hydration

Partner AssignmentWith a partner, create a short movie which shows an incident resulting in a strain.

1. Include at least five signs and symptoms of a strain using the body crayons and play dough.

2. Include whether it is a grade 1, grade 2, or grade 3

3. Demonstrate knowledge and application of the treatment PRICE and the use of anti-inflammatory drugs.

4. Demonstrate knowledge and application of at least 4 prevention techniques.

Movie clip should be between 3 to 5 minutes in length. Use movie maker to transition scene and make the final production.

SprainSprain- stretched or torn ligament (connects bone to bone)

Causes:Falling twistingDirect blow

Common sites:AnkleWristKnee

Sports and sprains?

In what sports is someone more likely to get a sprain?

Sports and SprainsAll sports and exercises, even walking, carry a

risk of sprains. The anatomic areas most at risk for a sprain depend on the specific activities involved. For example, basketball, volleyball, soccer, and other jumping sports share a risk for foot, leg, and ankle sprains. Sports such as football, basketball and soccer that involve running with sudden stops, cutting side to side, jumping and pivoting can increase the risk of a knee sprain.

Severity of SprainFirst Degree: ligament has been stretched but not torn

mild pain some swelling joint instability difficulty jogging or jumping.

Second Degree (most common): partial tearing of the ligament

significant swelling bruising moderate pain trouble walking

Third Degree: ligament is completely torn Severe swelling Severe pain Extreme loss of motion Walking can be very painful

Sprain: Signs and Symptoms

Signs and symptoms:

Pain

Swelling

Heat

Redness

Bruising

Stiffness or difficulty moving the joint

At the time of injury, you may hear or feel a pop in the joint

Sprain- TreatmentTreatment Reduce swelling & pain through PRICE

• Protection- protect from further injury by preventing them from moving (if ankle sprain, wear a shoe)

• Rest• Ice- ice during the first 72 hours to reduce swelling and

pain (15 to 20 minutes every 2 to 3 hours)• Compression-use of pressure with bandage or wrap to

reduce swelling• Elevation- can minimize initial tissue bleeding and

swelling

Anti-inflammatory drugs such as ibuprofen

Surgery may be needed for a tear in ligaments of the knee

Sprain- Prevention

Prevention

Balance training

Strengthen the muscles around the joint

Flexibility training of the hips, legs, and ankles

Adequate preparation for the activity

Taping and bracing the joint

Partner AssignmentWith a partner, create a short movie which shows an incident resulting in a sprain.

1. Include at least five signs and symptoms of a sprain using the body crayons and play dough.

2. Include whether it is a first degree, second degree, or third degree

3. Demonstrate knowledge and application of the treatment PRICE and the use of anti-inflammatory drugs.

4. Demonstrate knowledge and application of at least 4 prevention techniques.

Movie clip should be between 3 to 5 minutes in length. Use movie maker to transition scene and make the final production.

Assignment Quiz: Soft tissue and soft tissue injuries

1. What soft tissue connects bone to bone?

2. What soft tissue connect muscle to bone?

3. What soft tissue makes up the outer covering of the body?

4. What are the five signs of inflammation?

5. What does PRICE stand for?

6. What are three degrees of severity for a contusion?

7. What is the difference between a sprain and a strain?

8. What are two ways to prevent a strain?

9. What are two ways to prevent a sprain?

10.What strain is more severe? Grade 1 or Grade 3?

Soft tissue Overuse injuries

Small amounts of body stress accumulate slowly but steadily. The result can be damage and pain.

Common soft tissue overuse injuries include:

Shin Splints: inflammation of the connective tissue that surrounds the tibia

Tendonitis: an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle.

Tennis Elbow: a painful condition that occurs when tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm

Small Group Assignment

As a team of 3, divide the responsibilities to complete the following tasks:

1. Research the soft tissue overuse injury and type in the information on the appropriate slides: Causes, Symptoms, Treatment, Prevention

2. Create a short movie demonstrating knowledge on that short tissue overuse injury (See Rubric)

3. Present the Causes, Symptoms, Treatment, and Prevention to the class

Note: After each group presents, all groups will view each other’s short movie

Tendonitis: CausesCauses

The condition is commonly caused by repetition of a particular movement over time.

 tendinitis develops in people whose jobs or hobbies involve repetitive movements; aggravating the tendons.

Tendonitis: SymptomsSymptoms:

Pain - if the affected area is moved the pain worsens

A feeling that the tendon is crackling or grating as it moves. This sensation is more common on examination.

Swelling in the affected area

The affected area may be hot and red

A lump that develops along the tendon

Tendonitis: TreatmentTreatment

Rest

Heat and cold

Pain relievers

Corticosteroid injections

Physical therapy

Shock wave therapy or surgery

Tendonitis: PreventionPrevention:

Strengthening exercise around the tendon  

Stretching and cooling down 

Avoid repetitive movements 

Shin Splint: CausesShin splints are caused by repetitive stress on

the shinbone and the connective tissues that attach your muscles to the bone.

Shin Splint: SymptomsSymptoms:

Soreness along the inner part of your lower leg

Mild swelling in your lower leg

Muscle pain

Shin Splint: TreatmentIce your shin

Rest your body

Ibprofen

Physical therapy

Shin Splint: PreventionAlways wear shoes with good support and

padding.

Warm up before working out, making sure to stretch the muscles in your legs.

Stop working out as soon as you feel pain in your shins.

Don't run or play on hard surfaces like concrete.

Tennis Elbow: CausesCause: Tennis elbow is cause by repetitive motion

that can strain the muscle and stress the tendon.

Tennis Elbow: SymptomsSymptoms:

pain

tenderness

weakness

Tennis Elbow: TreatmentTreatment:

Anti-inflammatory drugs

Ice

Rest

Tennis Elbow: PreventionStretch

Strengthen

Wearing a brace

Proper techniques

Soft tissue injury and the Healing Process

https://www.youtube.com/watch?v=8J_GWa1XyNk

Stages of HealingAcute - Protection Phase

Sub-Acute - Repair Phase

Late Stage - Remodeling Phase 

Chronic Phase - Ongoing Repair and Remodeling

Acute - Protection Phase

Acute Phase:

From the initial time of injury and while the pain, bleeding and swelling is at its worst till about two to four days post-injury

Your body's aim at this point is to protect your injury from further damage.

Treatment:

PRICE: Protection, Rest, Ice, Compression, Elevation

Acute - Protection Phase

Sub-Acute - Repair Phase

Sub-Acute Phase

When the initial acute phase makes a transition to repairing the injured tissues

This phase commonly lasts up to six weeks post-injury

Body is laying down new soft tissue and reducing the need to protect the injury as the new tissue begins to mature and strengthen. 

Treatment Options:

Heat, massage, electrical stimulation, protective strapping or bracing, joint mobilization, stretching and strengthening exercises

Sub-Acute - Repair Phase

Late Stage - Remodeling Phase

Late Phase:

The period between six weeks and three months post-injury

At six weeks post-soft tissue injury the healing tissue is reasonably mature but as it is stretched, strengthened and stressed the new tissue often finds that it is not strong enough to cope with the increasing physical demand. 

When the body detects that a repaired structure is still weaker that necessary, it will automatically stimulate additional new tissue to help strengthen and support the healing tissue until it meets the demands of normal exercise or physical function.

Late Stage - Remodeling Phase

Chronic Phase - Ongoing Repair and

RemodelingChronic Phase

Beyond three months

Refers mainly to pain that lasts more than 3 months

Soft tissue is constantly being injured by daily activities and workouts, only to repair and remodel the tissue to meet specific exercise demands.

Chronic Phase - Ongoing Repair and

Remodeling

Ice vs. Heat Treatment

Ice TreatmentIce:

Typically ice in the first 72 hours after an injury when the tissue is red, hot, and swollen.

Goal of Ice Treatment: Reduce bleeding into the tissues.Prevent or reduce swelling (inflammation).Reduce muscle pain and spasm.Reduce pain by numbing the area and by limiting

the effects of swelling

Ice 15 to 20 minute every 2 to 3 hours

Heat TreatmentHeat:Use heat after 72 hours

Heat causes the blood vessels to open wide (dilate).

Goal of Heat Treatment:Bring more blood into the area to stimulate

healing of damaged tissuessoothing effect and helps to relieve pain and

spasmeases stiffness by making the tissues more

supple.

Apply heat using a heating pad or a hot wet towel.

Heat for 10 to 20 minutes but no more than 20 minutes

Case Study

What stage of healing? Ice or Heat?

Case StudyWhat stage of healing? Ice or Heat?

Case StudyWhat stage of healing? Ice or Heat?

Case StudyWhat stage of healing? Ice or Heat?

Case StudyWhat stage of healing? Heat or Ice or

neither?

Case StudyWhat stage of healing? Ice or Heat or

neither?

Case StudyWhat stage of healing? Ice or Heat?