Muscle Strain, Tear or Contusion?

Jacky Chiang — Thu, 15 Aug 2019 01:55:36 +0000

Strain or tear?

Muscles are strained or torn when some or all the fibres are unable to cope with the force. These injuries commonly occur in sports. This can affect muscles such as the quadriceps, hamstrings, calves (gastrocnemius or soleus) or the rotator cuffs. Muscles are more prone to tears from training error, sudden acceleration or deceleration. Risk factors involve insufficient warm-up, inadequate rest periods, muscle or joint tightness, muscle weakness or previous injury. The treatment depends on the severity of the injury.

Grades of muscle strain or tear

Grade I – The strain of a small number of muscle fibres, causing pain and minimal decrease in range of motion but usually no loss of strength. Recovery usually take 2-3 weeks.

Grade II – a large number of muscle fibres are torn but not completely ruptured. This causes pain and swelling and a loss of range of motion and strength. Partial tears may require 2-3 months before returning to sports.

Grade III – complete tear of muscle fibres or tendon causing severe pain, swelling, loss of strength and range of motion. Full rupture may require surgery to reattach the fibres. These injuries can take more than 3 months to heal.

Treatment of muscle strain/tear

Acute management of muscle strains or tears is similar to ligament strains treatment. This involves RICE

Rest – Taking care not to make the injury worse avoiding activities that put stress on the muscle. This may include standing for long periods or running.

Ice – Apply an ice or cold pack straight after the injury occurs to prevent and minimize swelling. Apply the ice for 10 to 20 minutes, 3 times a day for up to 48 – 72 hours. Avoid apply ice directly onto the skin.

Compression – Apply a compression bandage to the injury. This will help to reduce swelling.

Elevation – Elevate the injury above the level of the heart, whilst applying ice and when you are sitting or lying down.

Nonsteroidal anti-inflammatory drugs such as ibuprofen will also help to relieve pain and swelling. We may recommend a short period of immobilisation, depending on the severity of the injury. An ultrasound or MRI can be helpful in differentiating the grade of the injury

What is muscle contusion?

The cause of muscle contusion is commonly a direct blow or collision in sports, resulting in localised muscle injury and bleeding. Symptoms can involve pain, swelling, bruising or a lump over the skin called haematoma. In severe cases, this may be related with bone fractures and dislocations. Acute management also involves the RICE protocol for 48-72 hours followed by heat. See your doctor or physiotherapist to determine the severity of the injury. You may need an X-ray, ultrasound or an MRI. Contusions usually heal fast. Rehabilitation will be required to to restore pain-free range of motion, strength and flexibility. This will allow a return to sport.

Relevant Links

Ankle Sprains and Strain Treatment

The link between stress and muscle strain

Knee Injuries Explained

Strains-and-sprains-self-care

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Ankle Sprain Treatments

Jacky Chiang — Wed, 10 Apr 2019 01:22:52 +0000

Treatment for Acute Ankle Sprains

Acute ankle sprains are one of the most common sporting injuries treated by physiotherapists. Fortunately, most are simple to treat and can be managed a series of exercises and stretches taught by your physiotherapist.

What is an ankle sprain?

Ankle sprains cause stretching of ligaments around the ankle which can result in minor to complete tears. The most common sprain occurs when the ankle rolls outward with the foot turned inward. Causes for ankle sprains may be from twisting of the foot on uneven surfaces, falls or trauma from sports activities.

What are the symptoms?

Ankle sprains and ligament tears may cause:

Pain
Swelling
Bruising
Tenderness to touch
Ankle instability

What are the grades for ankle sprains?

Grade I: Minor tear or stretching of the ligament(s) with mild pain and swelling around the ankle. There should be minimal or no pain with weight-bearing activities (e.g. walking).

Grade 2: Partial tear of the ligament(s) with moderate pain, bruising and swelling. Walking is painful and ankle may feel unstable.

Grade 3: Complete tear of the ligament(s) with severe swelling, bruising and tenderness around the ankle. It is usually too painful to walk and the ankle feels unstable. Severe tears may be associated with fractures or high ankle sprains.

What is the treatment for ankle sprains?

Ankle sprains usually heal without surgical intervention. For severe tears, immobilisation with moonboot and crutches is recommended for initial management. Further investigations such as X-ray, ultrasound or MRI may be required for moderate to severe tears.

General initial treatment for ankle sprains in the first 48-72 hours is the RICE protocol (rest, ice, compression and elevation).

R – Rest from any activity that aggravates the pain to promote tissue healing.

I – Wrap a towel around ice pack, a bag of crushed ice cubes or frozen peas. Ice the affected area for 15-20 minutes every two hours. There should be no extreme pain.

C – Apply firm pressure with bandage or brace. Ensure that there is no discolouration or increase in swelling which indicates restricted blood flow.

E – Elevate the affected foot above the level of your heart.

Initial goal is to reduce pain, swelling and restore full range-of-motion. Your physiotherapist may tape your ankle to protect it from twisting or rolling. Next phase of rehabilitation will focus on improving strength, flexibility, balance and then gradual return to activities.

How long does it take to heal?

Grade I	Approx. 2-3 weeks
Grade II	Approx. 6 weeks
Grade III	Approx. 6-12 weeks.

According to a systematic review, ligament healing and mechanical stability of ankle occurs from 6 weeks to 3 months after injury, particularly Grade III ankle sprains. However, you may still experience mechanical laxity or subjective ankle instability up to one year depending on the severity of injury.

Need Help With An Ankle Sprain?

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More information

Foot and Ankle Injuries

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