Soft Tissue Injuries

The term ‘soft tissue injury’ is often used to describe injuries mainly to ligaments, tendons and muscles or to the ‘fascia’, the connective tissue that binds the body. Injuries to these structures may be haematoma formations (bleeding in or around the structure) or may be actual tears.

A grading system of 1-3 is used to describe the severity of the injury.

Grade 1: Usually mild and involves up to 10 per cent of the muscle or ligament. Usually recovery will take a few days.
Grade 2: These are moderate tears involving 10-90 percent of the structure and will take several weeks to repair.
Grade 3: Tears are severe and indicate complete rupture of that muscle or ligament. This may actually be less painful then a grade 2 as the injured structure is no longer being stressed. This is a more serious injury and will often require surgery or immobilising in a plaster cast.

soft-tissue-injury1 Probably the most common soft tissue injury is the ‘sprained ankle’. As above, these may be grade 1, 2 or 3 tears of the ligaments about the ankle. Fortunately, most ankle injuries are grade 1 or grade 2. Usually, it is the ligaments on the outer (lateral) side of the ankle that are damaged.

soft-tissue-injury2 Here is an example of a haematoma in the hamstring muscle group.

Immediately after the injury occurs we recommend that you follow the P.R.I.C.E. principals to minimise the local tissue damage and reduce inflammation.

P = Protection

Basically this involves avoiding the risk of further injury. This means not trying to run and continue with the game when you feel a ‘pull’. It can mean reducing the stress through the tissues by using crutches or using a brace or strapping to support and ‘off-load’ the injury.

R = Rest

This means unloading the injured structure. Try to reduce the hours spent on your feet the day after a sprained ankle, even if it is strapped or bandaged. Don’t be too ambitious about getting back to activities too quickly. Accept that things take time to repair properly and will benefit from the relative rest.

I = Ice

The Association of Chartered Physiotherapists in Sports Medicine (ACPSM) recommend crushed ice be applied for at least 10 minutes to reduce pain after an injury. This may also help to avoid excessive swelling from causing further damage to tissues. It is not recommended to keep the ice on for more than 20-30 minutes because this can cause an Ice burn. It can be reapplied every 2 hours, or sooner if more pain relief is required. Protect from skin burns with a damp tea towel as a barrier.

C = Compression

A simple crepe bandage or tubigrip can help to limit swelling in the early stages. This should fit snuggly but not restrict blood flow. Physiotherapists will sometimes add more focal compression under a bandage for example tape or felt.

E = Elevation

This is particularly useful to reduce pain and swelling in injuries. For example, injuries involving the lower limb, if you lie on the floor or bed with your foot up high on the wall the swollen area will be higher than your heart and the fluid will drain more effectively. Gentle movement of knee and ankle whilst elevated will make this even more effective.