A soft tissue injury involves a “soft” structure of the body, this means not bone. Examples of these injuries are muscular strains, ligament sprains, tendopathies and other tissue injuries (eg fat, myofascial tissue, joint capsules, skin and other connective tissue). These types of injuries are often as a result of a sudden unexpected or uncontrolled movement like stepping awkwardly off a curb and rolling over your ankle. These are injuries our Physiotherapists see every day at our Ellenbrook Physiotherapy clinic. However, soft tissue damage can also occur as a result of excessive overuse or chronically fatigued structures, especially muscles and tendons. An example of this would be following a long run when you may already be fatigued, then it is possible to cause trauma or a strain to key running musculoskeletal structures like your calf muscles or Achilles tendons.
Have you ever pulled a muscle or rolled an ankle while playing your favourite sport and not sure where to start in the management for this injury? Here are some quick and handy tips to assist you in your recovery.
Compression/support
When soft tissue is injured it likes to feel supported. One major mechanical benefit of compression/support of an injury is swelling reduction. When a tissue is injured, swelling occurs to help in the recovery process. Excessive prolonged swelling however delays the healing process so if this can be managed in the early stages it will assist you in a quicker recovery. Here at the clinic we can offer you taping to enable your injury to feel supported if indicated otherwise we can administer you with a tubigrip bandage as an alternative option to allow the injury to feel compressed or supported. If swelling is quite pronounced elevation should be added as adjunct to assist with drainage.
Gentle mobility
It is important to attempt to regain full mobility of the joint following a soft tissue injury. In the early acute phase this may not be possible using weightbearing exercises as this may in the irritate the sensitised structures. It is recommended you regain this range with gentle active or active assisted exercises as tolerated. Hydrotherapy is also known to be a great alternative to regaining mobility without aggravating the structures too much.
Isometric exercises
An isometric exercise can be defined as a static contraction of a muscle. This means the muscle contracts without associated movement of joint in which the muscle acts upon. These types of exercises are often given as the first strength exercises following injury especially when pain irritability is high and/or immobilisation needs to occur. Low level pain needs to be reported by the patient for this treatment to be of benefit. The benefit of isometric exercises is to minimise muscle atrophy associated when a joint undergoes immobilisation. It has also been shown to reduce swelling using muscle pump actions and to enhance neural inputs to the muscle. Ideally the exercise should consist of a minimum of a 5 second hold with a rest time doubled in nature in the early days following injury. The frequency of these exercises can be performed several times a day and consist of multiple sets of 10 reps. For specific parameters and guidance with these exercises one our physiotherapists will be able to set you up with an individualised home program.
Heat/Ice therapies
Which one goes first you might be asking yourself?
Ice is preferred for the initial 48 hours post-injury. Apply ice for 20 minutes each two to three hours for the first few days until the “heat” comes out of the injury. Ice should also help to reduce your pain and swelling in traumatic soft tissue injuries, such as ligament sprains, muscle tears or bruising.
It is preferable to avoid heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. Once the “heat” has come out of your injury, heat packs can be used to stimulate blood flow. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. Heat Wheat Packs and Flexall warming gel are both an excellent home solution for a multitude of conditions.
Alternative therapies
To assist in the management of your recovery of your soft tissue injury the physiotherapist may offer you adjunct treatments dependent on your symptoms and impairments. Ultrasounds, TENS, Joint mobilisation, Soft tissue release and Dry needling are common alternative therapies that a physiotherapist may offer you at our clinic if it is indicated. To find out whether you are suitable candidate or to find out more information for any of these therapies discuss with your physiotherapist.
By Brooke Lavell
Physiotherapist
