Muscle Injury Grading

Question 1

Grade 1

Answer 1

Mild
Minimal stretch of fibres

Question 2

Grade 1 S+S

Answer 2

Mild P with activity, muscle guarding, local mild Jt motion Rx
No bruising or loss of function
Minimal P with motion, mild P with palpation
DOMS classified as Grade 1
Usually self-limiting unless there is repetitive trauma

Functional healing time- 2-7 days
Structural healing- 4-14

Question 3

Grade 2

Answer 3

Moderate to severe tearing of fibres

Question 4

Grade 2 S+S

Answer 4

Mod to severe P. guarding, loss of unction, bruising and oedema, dec ROM
Antalgic limp, muscle weakness
Mod to severe P with palpation
Significant loss of strength w muscle testing

Functional healing time- 1-10 weeks
Structural healing- 3-12+

Question 5

Grade 3

Answer 5

Complete tearing
Full thickness

Question 6

Grade 3 S+S

Answer 6

Severe P at time of injury, then minimal or no P after, significant guarding/bruising
Loss of function/strength
Palpable defect- balls under skin

Functional healing time- 10/52-6/12
Structural healing time- 12+ months

Question 7

Principles for muscle healing- acute

Answer 7

1-5/7
RICE
Avoid aggravating activities
Inc protein, magnesium, calcium, water
Avoid re-injury- complete full rehab

Question 8

Acute stage

Answer 8

Hematoma formation
SHARP- swelling, heat, a loss of function, redness + P
May not reach peak until 5-7 days post injury

Question 9

Acute- dietary

Answer 9

Consider protein, vit A, vit C (neutrophil migration and lymphocyte transformation)

Question 10

Acute- clinical objectives

Answer 10

Relieve P
Prevent further injury
Initiate vasoconstriction
Inc circulation
Maintain muscle tone
Reduce effects of ishcemia
Addres psychosocial

Question 11

Principles of muscle healing- post acute

Answer 11

2/7-6/52
Begin P free ROM
Switch to heat for BF
ST mob and manipulation to improve ROM and reduce contracture (regular stretching)

Question 12

Post acute repair/proliferation

Answer 12

Scar tissue formation
Synthesis and deposition of collagen- macrophages/phagocytes remove cell debris, erythrocyte and fibrin clot

Question 13

Post acute repair/proliferation- dietary

Answer 13

Inc vit C- promotes type 1 collagen synthesis
Zinc, magnesium, calcium- portein synthesis

Question 14

Post acute repair/proliferation- clinical objectives

Answer 14

Prevent early adhesions
Orient repair tissue along line of tension
Relieve P
Maintain normal muscle tone, ROM
Reduce oedema
Prevent transition to chronic (psychosocial)

Question 15

Principles of muscle healing- remodelling phase

Answer 15

1/52- 12 months
Functional recovery
Proprioception improvement
Proper warm-up before activity
Address technique issues or biomechanical imbalances
Strengthening exercises
Stretch after for flexibility

Question 16

Remodelling

Answer 16

Collagen remodelled to inc functional capabilities of the tissue in direction of stress imposed upon it
New collagen forms to inc tensile strength of wounds
Scar tissue- 80% as strong as oringial tissue

Question 17

Remodelling- clinical objectives

Answer 17

Maintain nutrition
Proper alignment of repair collagen
Inc elasticity of scar tissue
Reduce fibrotic adhesions
Relieve muscle spasms
Inc strength
Inc ROM
Normalise Jt and muscle activity
Address psychosocial- stop chronicity