Strains, Sprains and Tendonopathies

Strains, sprains and tendonopathies are all injuries to structures that are composed largely of connective tissue fibres. All three have a lot in common in their symptoms, healing and treatment.

Strains

Human Muscle InjuryMuscle strains are an injury to a musculotendinous unit. Basically an injury to a muscle or tendon that results in a partial or complete tear. Causes can be a sudden overstretching of the muscle or an extra contraction of the muscle against resistance. However, muscle strains and other soft tissue injuries may often appear in the context of chronic, cumulative overuse with no specific start point. The first thing that is noticed when you have a strain is pain, stiffness, and occasionally palpable heat and swelling.

There are 3 classifications of strain severity ranging from 1st degree where there is minor damage to a few fibres to 3rd degree where either partial or complete rupture of the muscle or an avulsion fracture of the tendinous attachment occurs.

Massage can help the strain heal through encouraging the formation of the scar tissue in alignment with the muscle fibres, reducing oedema, limiting adhesions and improving circulation and mobility. It can make a difference between a one-time muscle strain that takes a few weeks to heal compared to a painful, limiting and chronically recurring condition that makes it impossible to do some activity that you used to love!

Sprains

Ankle Sprain, Ligament RuptureSprains are injured ligaments. Like strains, sprains can range in severity from a few traumatised fibres to a complete rupture. Ligaments are the connectors that hold the bones together and add stability to the connective tissue joint capsule; their structure allows little stretch and almost no rebound. Ligaments limit and control the range of motion at a joint whilst allowing motion to occur. If a ligament is stressed enough through injury, it tends to tear before it stretches. And if it does get stretched it will not rebound to its original length.

You will recognise a sprain through pain, redness, bruising, heat, swelling and loss of joint function. Again after the acute phase has passed massage is effective for sprains; it can encourage the healthy development of scar tissue and reduce the swelling as well as reducing the stiffness from the temporary loss of joint function.

Tendonopathies

Tendonopathies are injuries or damage to tendons (the end of the muscle that attaches to bone). The symptoms are very similar to muscle strains, though maybe more intense, and will be recognised through pain and loss of range of motion, the pain normally being aggravated by resisted exercise of the damaged muscle-tendon unit. They can be inflammatory or degenerative in nature and as such you will read terms such as ‘Tendonitis’ and ‘Tendinosis’.

Tendonitis describes inflammation of the tendon where chronic overload is thought to cause microscopic tears, which trigger the body’s inflammatory response.

Tendinosis refers to the degenerative changes in the tendon where there is a breakdown of collagen fibres and inflammation is not normally present.

Tendonopathies can be treated by massage after the acute stage has passed i.e. after the swelling has eased. If the injury is sub-acute or chronic then a deep tissue massage would work slowly around the area to reduce tension in the fascia and trigger point therapy can also be used as a supportive technique.


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