Muscle Injuries Flashcards
(26 cards)
Muscle injuries
Most common traumas in sport
Substantial time loss from both training and competition
48% of all entries track field
30 to 50% of injuries in professional football
30% injuries in rugby league
Highest numbers injury reported in thigh and calf= hamstring
Types of muscle injury
1) DOMs 28/48hrs eccentric training increases this
2) Contusion= extrinsic mechanism eg a hard tackle dead leg
3) Muscle tear over straining myosin fibres occurs at MTJ
Grade 1
Grade 2
Grade 3
Types of muscles that are usually injured
Muscles that cross 2 joints
Hamstrings
Quads
Calf
Acceleration and deceleration and eccentric contractions
Mechanism of injury
Excessive stretch Accelerating Decelerating Change of direction Tackling Kicking Jumping Contact or blunt trauma
Risk factors
Previous injury Age Ethnicity - black fibre type Deficits power strength endurance Imbalance Hyper/hypomobility Fatigue Acute/chronic load Neural
Grades of injuries
Grade 1
Small number of fibres torn minimal bleeding pain and spasm well localised muscle function normal endurance may be reduced
2/3 weeks
Grades of injuries
Grade 2
Large numbers of fibres torn bleeding is contained causing an increase in intramuscular pressure
Palpation reveals definite mass and considerable pain contractility and extensibility of muscles are reduced
4/6 weeks
Grades of injuries
Grade 3
Greater area of muscle affected with muscle facia torn bleeding more profuse and blood tracking distally function is severely impaired
6 weeks+
British athletics grading system
Lack of diagnostic accuracy
Important to coaches and athletes
Should provide prognostic direction
Develop grading system 0–4 based on MRI features
Anatomical diagnosis may give prognostic relevance
Where the muscle is injured
MTJ- may need to be managed a bit differently but only takes a few weeks longer
Intertendinous injury = poorer prognosis
British athletics grading system
Grade 0
A focal neuromuscular injury was normal MRI
Generalised muscle soreness within a normal MRI – DOMs
Maybe neural component + N
British athletics grading system
Grade 1
Small injury tear to the muscle the athlete will present with pain during or after activity
Athletes range of movement at 24 hours will usually be normal and although there is possible pain contraction strength and initiation traction maybe well maintained on clinical examination
British athletics grading system
Grade 2
Motor injury tears to the muscle athlete will preserve and usually with pain during activity which causes them to stop
Range of movement at 24 hours will usually show some limitation with pain on initiation of contraction with detectable weakness
2b= MTJ involvement
British athletics grading system
Grade 3
Extensive tears to the muscle athlete will usually present with sudden onset of pain and may fall to the ground
Range of movement of 24 hours is significantly reduced with pain on walking obvious weakness in contraction
Affects integrity of tendon = reduced power
British athletics grading system
Grade 4
Complete tears to either muscle or tendon
Sudden onset of pain
Immediate limitation of activity
The gap can be felt
Pain maybe less on contraction
Subjective assessment
What do you want to know ?
History
What might the patient tell you ?
How it happened Mechanism of injury Pain and type Can you complete activity Tightness Lack of range
Objective assessment
Comprehensive clinical inspection
Palpation Heat Brushing Swelling Lack of ROM Unusual grade pattern
Objective assessment
Strength and mobility testing
Use of objective markers
Compare right to left
Dynmometer
Special tests
In and through varying ranges medial and lateral ranges must should could list
Early management
See muscle healing core 1
Police= protection of optimal loading ice compression elevation
Prevent atrophy= surrounding muscles early mobilisation
Inhibition= gentle activation isometric contractions
Abnormal movement patterns= opposite side and my be a precursor
Scar tissue= 10 days it’s at it’s optimal loading what to redevelop scar so it can accept the load realignment collagen fibres
Loading tissue
Early versus delayed
Mobilise early- vascularisation and remodelling collagen increases extensibility
Important of early loading detrimental effect to the tendons and muscle structure return the sports earlier
Don’t try to do too much too soon
Doesn’t always go to plan
Rehabilitation
Where do you need to get to
Know your support( positions)
Strengths
Power
Insurance
Flexibility
Progressive Overload
How do you progress load
Isometric Neuromuscular control Bodyweight Add load Add speed Power Endurance Sport specific tasks Objective data
Specificity
Must be specific to the athletes sport want to get them back playing at optimal level
Neural patterning
Optimal performance
Don’t underestimate soleus
Tight cramping
able to run
Present as a niggle
More frequent in older players
Neuro Lx changes
Endurance related training m
Works consistently hard at all running speeds= hard to rehabilitate
