Spencer Joseph
DCHAc LicZS DipAPNT MNCPS (Prof Accred) CSTII DipITEC D.Hyp BA (Hons) Phil
What are they?
These injuries are some of the most common, misunderstood and inadequately treated. They will happen to the vast majority of people at some time in their lives. Damage can occur as a result of direct trauma (external impact) or indirect trauma (overloading or overstretching). The resulting injuries are classified as either tears/ruptures or haematomas.
Ruptures are viewed as being 1st, 2nd or 3rd degree according to the proportion of fibres that have been torn. Haematomas are muscular bleeds. Intramuscular haematoma begins within the muscular sheath and causes immediate swelling, impaired function, tenderness and increased intramuscular pressure. Intermuscular haematoma begins between muscles and leads to bruising and slow swelling as blood may also leak into adjacent tissue. Rupture and haematoma may lead to scar tissue, calcification and ossification. This reduces flexibility and strength with a corresponding increased risk of further injury.
A tendon attaches muscle to bone and consists mainly of collagen and elastin that respectively provide strength and elasticity. Tendon rupture usually results in a sharp pain and inflammation. Ligaments are inelastic and connect bone to bone. They passively stabilise joints and are largely responsible for healthy joint function. Ligament injury may cause haemorrhage into the joint space and is seen as swelling and bruising.
Treatment
Various approaches are required. In the acute (initial) phase it is usually necessary to use RICE (rest, ice, compression and elevation). However, assuming there is not a complete rupture that may require surgery, it is important to stimulate the blood supply and relieve pain through physical therapy (ie massage), acupuncture and exercise as soon as possible.
