muscle injuries

Question 1

what are some acute muscle injuries

Answer 1

• contusions / hematomas
• compartment syndrome
• mytosis ossificans
• strains

Question 2

what is a contusion

Answer 2

a contusion is an injury to the muscle

Question 3

what are implications of contusions

Answer 3

bleeding from contusions can get into the muscle
this causes Hematomas

Question 4

hematoma

Answer 4

abnormal collection of blood outside blood vessel

Question 5

intra-muscular

Answer 5

blood within the intact muscle fascia
- often more swollen than bruised
- more pressure causes more pain
- facia still in tact press on nocioceptors

Question 6

inter-muscular

Answer 6

the fascia surrounding the muscle is torn and the blood has free access to spread into the interstitial space
- look worse due to more bruising
- less painful

Question 7

what causes muscle bruising

Answer 7

results from muscle being compressed against the bone

Question 8

what is Acute Compartment Syndrome

Answer 8

Swollen muscles compress blood vessels and nerves

Question 9

what causes ACS

Answer 9

normally
- fascia forms compartments which can’t stretch or extend
- this means muscle pressure is optimal for venous return
during compartment syndrome
- fascia not torn
- hematomas create too much pressure for the blood vessels
- occluded blood vessels
- lose blood flow

Question 10

what signs do you look for in ACS

Answer 10

• pain
• pulse (lack of)
• Pallor
• Paraesthesia
• Paralysis

Question 11

what is Myositis Ossificans

Answer 11

• Rare complication of contusion when osteoblasts invade hematoma and lay down bone
• Unknown aetiology
• Should be suspected when symptoms don’t go within the normal time frame
• self limiting
• manage with non-painful stretch / strength

Question 12

muscle strains/tears

Answer 12

• excessive tensile forces within the muscle cause muscle fibres and surrounding connective tissue to fail
• quads, hamstrings + gastroc
• usually during rapid acceleration/ deceleration

Question 13

classification of muscle tears

Answer 13

GRADE 1 - minor strain with pain but no loss of strength
GRADE 2- moderate strain with greater pain, swelling
GRADE 3- significant symptoms, complete rupture

Question 14

how do you manage muscle injuries

POLICE

Answer 14

Protection
Optimal
Load
Ice
Compression
Elevation

Question 15

how do you manage muscle injuries

PEACE & LOVE

Answer 15

Protection
Elevation
Avoid anti-inflams
Compression
Education
Load
Optimism
Vascularisation
Exercise

Question 16

what to consider for trearment

Answer 16

• Scar is the weakest point of the injured muscle early after trauma. Collagen is still type 1/2 not 3 **reinjury **
• Each phase seems to slow and deteriorate with age
• Previous muscle injury and increasing age risk factors for subsequent muscle injury
• Fully generated muscle fibres only occur with optimal loading

Question 17

what options do we have

Answer 17

• POLICE
• short immobilisation (crutches)
• manual therapy (joint mobilisation, massage, soft tissue techniques) neuromodulation
• tissue loadign through appropriate exercise
• surgery if necessary