Muscle Contusions/strains/tears/weakness Flashcards
Stages of healing
Inflammation
Repair
Remodelling
Inflammatory stage of healing
- Duration
- Key features
24hrs to 3-4 days
- Myofiber rupture and necrosis
- Hematomas
- Inflammatory cell reaction
Repair stage of healing
- Duration
- Key features
5-14 days
- Phagocytosis of necrotic fibers
- Regeneration of myofibers
- Formation of scar tissue
- Capillary ingrowth
Remodelling stage of healing
- Duration
- Key features
14-21+ days
- maturation of myofibers
- Contraction and organization of scar tissue
- Recovery of function
Contusion cause + result
External forces leading to bleeding in deep muscle regions
Contusion Rx in first 48hours
PRICE
No HARM - Heat, alcohol, running, massage
Put muscle on as much stretch as possible (dont want to heal in shortened position)
Crutches if necessary
gentle pain-free ROM/stretch
Progressive exercise after acute phase
Contusion Recovery time Grade 1-3
Grade 1 - 2-3 weeks
Grade 2 - 4-6 weeks
Grade 3 - 6-8weeks
Contusion complications
o Compartment syndrome check capillary refill and sensation, muscle strength
o Myositis ossificans formation of bone within muscle, suspect if haven’t improved after 2-3 wks
Difference between cause of an acute and a chronic muscle strain
Acute = excessive lengthening Chronic = over exertion
Where to the majority of muscle strains & tears occur
In biarticular muscles at the muscle-tendon junction
During what motions do the majority of muscle strains & tears occur
During eccentric loading or high intensity, explosive activities
When are you mostly likely to strain or tear the long head of biceps femoris
During the terminal swing phase of high speed running
When are you mostly likely to strain or tear semimembranous
Concurrent hip flexion and knee extension
Key physiological and clinical features of a grade 1 muscle strain
- Microscopic tearing
- Pain/tightness no weakness
Key physiological and clinical features of a grade 2 muscle strain
- Partial, macroscopic tearing
- pain and structural change (laxity, decreased strength)
Key physiological and clinical features of a grade 3 muscle strain
- Complete tear
- Painless and weak, may see lumb
Muscle strain Rx
- Acute/inflammation: PRICE, Crutches if LEs
- Repair: modalities (US, IF), DTF, strength, stretching
- Remodelling: Strength (increase load + velocity), stretching (static/dynamic
When is RTP safe in a muscle strain
- Symmetrical muscle length, strength, power, no s/s, core control
- Completion of progressive functional progression + sport specific drills + practice session
Laceration Rx
- Requires surgical repair
Inflammation - optimize gait so scar tissue aligns properly - Repair phase - Gradual ROM + strength
- Promote remodelling by gradually increasing the load and velocity
- Careful of muscle force going through sutures
When does DOMS occur
72 hours after unaccustomed exercise
What causes DOMS?
Possible due to local nerve ending response to altered environment: acid, pH, swelling, inflammation
Doms Rx
- Light activity cycling, walking, ankle pumps
- Massage/bath
- Avoid anti-inflammatories if possible
