Soft tissue dysfunction

Question 1

Soft tissue injury vs soft tissue dysfunction

Answer 1

Soft tissue injury: Damage to any biological tissue except for bone
Soft tissue dysfunction: Dysfunctional tissue that is non pathological e.g., free from disease/inflammation

Question 2

Soft tissue injury

Answer 2

Structures are taken beyond their normal range of motion through impact or trauma

Question 3

Types of soft tissue injury

Answer 3

• Muscular strain
• Muscle spasm
• Tendon strain/rupture
• Overuse injury
• Ligament strain
• Bursitis
• Nerve injury
• Intra/intermuscular haematoma

Question 4

Intra/intermuscular Haematoma

Answer 4

Intramuscular Haematoma: Bleeding within a muscle

Intermuscular Haematoma: Bleeding between muscle compartments

Question 5

Strain

Answer 5

Muscle strain: Tearing of muscle/tendon fibres

Tendon strain: Tearing of tendon fibres

Question 6

Overuse injuries

Answer 6

Multiple tiny strains due to excessive repetitive movement or prolonged muscular use

Question 7

Sprains

Answer 7

Joint forced past the limits of movement leading to tears in ligaments

Question 8

Bursitis

Answer 8

Inflammation of bursa (sac-like cavity found in connective tissue)

Question 9

Tendinopathy

Answer 9

Continuum of disrepair and subsequent degeneration \

Question 10

Neuropraxia

Answer 10

Compression/traction of a nerve

Question 11

Nerve injuries

Answer 11

Neurological symptoms such as:
- Loss of sensation (numb)
- Loss of function
- Atrophy of muscle
- Shooting pain
- Tingling

Question 12

Muscle spasm

Answer 12

Protective mechanism in response to injury or can be due to neurological conditions

Question 13

Kinetic chain

Answer 13

Made up of:
- Myofascia system
- Articular system
- Nervous system

KC imbalances = soft tissue dysfunction

Question 14

Movers and stabalisers

Answer 14

Phasic/movers prone to:
- Overaactive, short and hypertonic
- Facilitated

Postural/stabalisers prone to:
- Weakness, fatigues easily and appears ‘tight’
- Inhibited

Question 15

Facilitated vs inhibited

Answer 15

• Stabilising muscles are prone to weakness and are usually underachieve (inhibited)
• Phasic/movers are overactive (facilitated) and fatigue easily, especially during new movement patterns

Question 16

Facilitated (movers)

Answer 16

Short and hypertonic

Question 17

Inhibited (stabilisers)

Answer 17

Long and weak

Question 18

Assessment of soft tissue dysfunction

Answer 18

‘Normal tissue’:
- Feels resilient and pliable
- Blanches when compressed but quickly returns to normal
- No pain upon palpation

Dysfunctional tissue:
- Feels fibrous
- Thickened
- Stiff and tight
- Tissue gives resistance upon palpation
- Pain patterns are wider and duller

Question 19

Palpation findings

Answer 19

• Adhesions, superficial snd deep
• Trigger points
• Scar tissues
• Hypertonicity of muscles

Question 20

Superficial adhesions

Answer 20

• Normally exist between superficial fascination and the skin
• Skin rolling - the skin should move evenly and glide over the underlying structures
• If there were adhesions, the area is stuck or restricted when rolling

Question 21

Deep adhesions

Answer 21

• Deep investing fascia layers that lie between the superficial fascia and muscles
• Function of the deep fascia is to allow muscles to move freely

Question 22

Triggers points

Answer 22

• Hyperirritable spots within muscle fibres
• Upon palpation there is a ‘drag’ in the tissue

Question 23

Hypertonic muscles

Answer 23

• Need to be assessed in response to compressive and stretching forces
• Higher the resting tension, the denser and harder he tissue will be upon palpation
• Can effect whole area or specific bits

Question 24

Assessment of soft tissue dysfunction (other than palpation)

Answer 24

• Reduces ROM
• Muscle weakness and/or hypotrophy
• Asymmetrical changes