Transcript File - Mary McCarley

Obj: I will describe various types of soft tissues in the body
Obj: I will explain how tissues respond to trauma
Obj: I will describe the types of soft tissue trauma
Obj: I will demonstrate proper procedures for treating various soft tissue trauma
Obj: I will analyze the indication and contraindication for cold application on a
soft tissue injury
Obj: I will analyze the indications and contraindications for heat application on
soft tissue injuries
Warm up
Think of an incident where you
either witnessed or experienced a
soft tissue injury to the skin,
muscle, tendon or ligament. What
happened? What did the injury look
like? How was the injury treated?
Soft Tissue
Soft tissues are the tissues that connect, support, and
surround other structures and organs of the body, not
being bone.
Soft tissues include tendons, ligaments, fascia, skin,
fibrous tissues, fat, synovial membranes (connective
tissues), muscles, nerves, and blood vessels.
Skin
Skin- outer covering of the body
Ligament
Ligament- connects bone to bone
Muscle
Muscle- tissue that when stimulated
contracts and produces movement
Tendons
Tendons- tissue that connects muscle to
bone
Soft tissue Injury
A soft tissue injury is the damage of skin, muscles,
ligaments, and tendons throughout the body.
Common soft tissues injuries usually occur from a sprain,
strain, a blow resulting in a contusion, or overuse of a
particular part of the body
5 Signs of Inflammation
5 signs of Inflammation
Redness- due to vasodilatation and increase
in blood flow
Heat- due to vasodilation and increase in
blood flow
Swelling- due to increase in blood flow to the
injured area and possibly from blood that
leaks into the injured tissue (bruising)
Pain- due to the pressure of fluids or swelling
through the nerve endings
Loss of function- due to swelling and pain
Contusion
 Bruise
 Sudden traumatic blow to
body
 Not penetrate skin
 Usually injury to blood
vessels
 Superficial, deep, or
hemorrhage
 Hematoma: formation
caused by pooling of blood
and fluid w/in a tissue space
Contusion
Contusion
 Symptoms:




Swelling
Point tenderness
Redness
Ecchymosis- purple discoloration of skin
 Treatment:
 PRICE
 Protection- protect from further injury by preventing them




from moving
Rest
Ice- ice during the first 72 hours to reduce swelling and pain
(ice for 15 to 20 minutes every 2 to 3 hours)
Compression-use of pressure with bandage or wrap to
reduce swelling
Elevation- can minimize initial tissue bleeding and swelling
Contusions
Partner Assignment
With a partner, create a short movie which
shows an incident resulting in a contusion.
1. Include at least five signs and symptoms of a
contusion using the body crayons and play dough.
2. Include whether it is superficial, deep, or a
hemorrhage
3. Demonstrate knowledge and application of the
treatment PRICE.
Movie clip should be between 2 to 5 minutes in length.
Use movie maker to transition scene and make the
final production.
Strains
 Strain- stretch, tear, or rip in the muscle and/or tendon
 Severe tension force
 Excessive muscle contraction
 Direct blow to the body
 Common sites:





Hamstring
Quadriceps
Hip flexor
Biceps
Latissimus dorsi
Sports and strains?
In what sports is someone
more likely to get a strain?
Sports and Strains
Soccer, football, hockey, boxing, wrestling, and other
contact sports put athletes at risk for strains.
Sports that feature quick starts (hurdling, long jump,
running races, etc.).
Gymnastics, tennis, rowing, golf-sports that require
extensive gripping-have a high incidence of hand strains.
Elbow strains frequently occur in racquet, throwing, and
contact sports.
Severity of Strains
 Grade 1
 Some muscle fibers stretched or torn
 Some tenderness/pain with range of motion
 Grade 2
 Number of muscle fibers torn
 Active contraction of muscle extremely painful
 Grade 3
 Complete rupture of muscle
 Significant impairment or total loss of movement
Strain: Signs & Symptoms
Signs & Symptoms:
• Localized swelling
• Cramping
• Inflammation
• Loss of function
• Pain
• General weakness
• Discoloration
Strain- Treatment
Treatment
 Reduce swelling & pain through PRICE
 Protection- protect from further injury by preventing them from moving
 Rest
 Ice- ice during the first 72 hours to reduce swelling and pain (15 to 20
minutes every 2 to 3 hours)
 Compression-use of pressure with bandage or wrap to reduce swelling
 Elevation- can minimize initial tissue bleeding and swelling
 Anti-inflammatory drugs such as ibuprofen
Severe Strain could require:
 Hard cast
 Surgery
Strains
Prevention
 Regular weight training
 Proper warm-up
 Stretching
 Proper mechanics
 Proper cool-down/ stretching
 Proper nutrition & hydration
Partner Assignment
With a partner, create a short movie which shows an
incident resulting in a strain.
1. Include at least five signs and symptoms of a strain
using the body crayons and play dough.
2. Include whether it is a grade 1, grade 2, or grade 3
3. Demonstrate knowledge and application of the
treatment PRICE and the use of anti-inflammatory
drugs.
4. Demonstrate knowledge and application of at least 4
prevention techniques.
Movie clip should be between 3 to 5 minutes in length. Use
movie maker to transition scene and make the final
production.
Sprain
Sprain- stretched or torn ligament (connects bone to bone)
Causes:
 Falling
 twisting
 Direct blow
Common sites:
 Ankle
 Wrist
 Knee
Sports and sprains?
In what sports is someone
more likely to get a sprain?
Sports and Sprains
 All sports and exercises, even walking, carry a risk of
sprains. The anatomic areas most at risk for a sprain
depend on the specific activities involved. For example,
basketball, volleyball, soccer, and other jumping sports
share a risk for foot, leg, and ankle sprains. Sports
such as football, basketball and soccer that involve
running with sudden stops, cutting side to side, jumping
and pivoting can increase the risk of a knee sprain.
Severity of Sprain
First Degree: ligament has been stretched but not torn
 mild pain
 some swelling
 joint instability
 difficulty jogging or jumping.
Second Degree (most common): partial tearing of the ligament
 significant swelling
 bruising
 moderate pain
 trouble walking
Third Degree: ligament is completely torn
 Severe swelling
 Severe pain
 Extreme loss of motion
 Walking can be very painful
Sprain: Signs and Symptoms
Signs and symptoms:
 Pain
 Swelling
 Heat
 Redness
 Bruising
 Stiffness or difficulty moving the joint
 At the time of injury, you may hear or feel a pop in the joint
Sprain- Treatment
Treatment
Reduce swelling & pain through PRICE
• Protection- protect from further injury by preventing
them from moving (if ankle sprain, wear a shoe)
• Rest
• Ice- ice during the first 72 hours to reduce swelling and
pain (15 to 20 minutes every 2 to 3 hours)
• Compression-use of pressure with bandage or wrap to
reduce swelling
• Elevation- can minimize initial tissue bleeding and
swelling
Anti-inflammatory drugs such as ibuprofen
Surgery may be needed for a tear in ligaments of the knee
Sprain- Prevention
Prevention
 Balance training
 Strengthen the muscles around the joint
 Flexibility training of the hips, legs, and ankles
 Adequate preparation for the activity
 Taping and bracing the joint
Partner Assignment
With a partner, create a short movie which shows an
incident resulting in a sprain.
1. Include at least five signs and symptoms of a sprain using
the body crayons and play dough.
2. Include whether it is a first degree, second degree, or
third degree
3. Demonstrate knowledge and application of the treatment
PRICE and the use of anti-inflammatory drugs.
4. Demonstrate knowledge and application of at least 4
prevention techniques.
Movie clip should be between 3 to 5 minutes in length. Use
movie maker to transition scene and make the final
production.
Assignment Quiz: Soft tissue and
soft tissue injuries
1. What soft tissue connects bone to bone?
2. What soft tissue connect muscle to bone?
3. What soft tissue makes up the outer covering of the body?
4. What are the five signs of inflammation?
5. What does PRICE stand for?
6. What are three degrees of severity for a contusion?
7. What is the difference between a sprain and a strain?
8. What are two ways to prevent a strain?
9. What are two ways to prevent a sprain?
10.What strain is more severe? Grade 1 or Grade 3?
Soft tissue Overuse injuries
Small amounts of body stress accumulate slowly but steadily.
The result can be damage and pain.
Common soft tissue overuse injuries include:
 Shin Splints: inflammation of the connective tissue that
surrounds the tibia
 Tendonitis: an inflammation or irritation of a tendon, a thick
cord that attaches bone to muscle.
 Tennis Elbow: a painful condition that occurs when tendons
in your elbow are overworked, usually by repetitive motions
of the wrist and arm
Small Group Assignment
As a team of 3, divide the responsibilities to complete the
following tasks:
1. Research the soft tissue overuse injury and type in the
information on the appropriate slides: Causes,
Symptoms, Treatment, Prevention
2. Create a short movie demonstrating knowledge on
that short tissue overuse injury (See Rubric)
3. Present the Causes, Symptoms, Treatment, and
Prevention to the class
Note: After each group presents, all groups will view each
other’s short movie
Tendonitis: Causes
Causes
 The condition is commonly caused by repetition of a
particular movement over time.
 tendinitis develops in people whose jobs or hobbies
involve repetitive movements; aggravating the tendons.
Tendonitis: Symptoms
Symptoms:
 Pain - if the affected area is moved the pain worsens
 A feeling that the tendon is crackling or grating as it
moves. This sensation is more common on
examination.
 Swelling in the affected area
 The affected area may be hot and red
 A lump that develops along the tendon
Tendonitis: Treatment
Treatment
 Rest
 Heat and cold
 Pain relievers
 Corticosteroid injections
 Physical therapy
 Shock wave therapy or surgery
Tendonitis: Prevention
Prevention:
 Strengthening exercise around the tendon
 Stretching and cooling down
 Avoid repetitive movements
Shin Splint: Causes
 Shin splints are caused by repetitive stress on the
shinbone and the connective tissues that attach your
muscles to the bone.
Shin Splint: Symptoms
Symptoms:
 Soreness along the inner part of your lower leg
 Mild swelling in your lower leg
 Muscle pain
Shin Splint: Treatment
Ice your shin
Rest your body
Ibprofen
Physical therapy
Shin Splint: Prevention
 Always wear shoes with good support and padding.
 Warm up before working out, making sure to stretch the
muscles in your legs.
 Stop working out as soon as you feel pain in your
shins.
 Don't run or play on hard surfaces like concrete.
Tennis Elbow: Causes
Cause: Tennis elbow is cause by repetitive motion that
can strain the muscle and stress the tendon.
Tennis Elbow: Symptoms
Symptoms:
 pain
 tenderness
 weakness
Tennis Elbow: Treatment
Treatment:
 Anti-inflammatory drugs
 Ice
 Rest
Tennis Elbow: Prevention
 Stretch
 Strengthen
 Wearing a brace
 Proper techniques
Soft tissue injury and the
Healing Process
https://www.youtube.com/watch?v=8J_GWa1XyNk
Stages of Healing
 Acute - Protection Phase
 Sub-Acute - Repair Phase
 Late Stage - Remodeling Phase
 Chronic Phase - Ongoing Repair and Remodeling
Acute - Protection Phase
Acute Phase:
 From the initial time of injury and while the pain,
bleeding and swelling is at its worst till about two to
four days post-injury
 Your body's aim at this point is to protect your injury
from further damage.
Treatment:
PRICE: Protection, Rest, Ice, Compression, Elevation
Acute - Protection Phase
Sub-Acute - Repair Phase
Sub-Acute Phase
 When the initial acute phase makes a transition to
repairing the injured tissues
 This phase commonly lasts up to six weeks post-injury
 Body is laying down new soft tissue and reducing the
need to protect the injury as the new tissue begins to
mature and strengthen.
Treatment Options:
Heat, massage, electrical stimulation, protective
strapping or bracing, joint mobilization, stretching and
strengthening exercises
Sub-Acute - Repair Phase
Late Stage - Remodeling Phase
Late Phase:
 The period between six weeks and three months post-injury
 At six weeks post-soft tissue injury the healing tissue is
reasonably mature but as it is stretched, strengthened and
stressed the new tissue often finds that it is not strong enough
to cope with the increasing physical demand.
 When the body detects that a repaired structure is still weaker
that necessary, it will automatically stimulate additional new
tissue to help strengthen and support the healing tissue until it
meets the demands of normal exercise or physical function.
Late Stage - Remodeling
Phase
Chronic Phase - Ongoing
Repair and Remodeling
Chronic Phase
 Beyond three months
 Refers mainly to pain that lasts more than 3 months
 Soft tissue is constantly being injured by daily activities
and workouts, only to repair and remodel the tissue to
meet specific exercise demands.
Chronic Phase - Ongoing
Repair and Remodeling
Ice vs. Heat
Treatment
Ice Treatment
Ice:
 Typically ice in the first 72 hours after an injury when
the tissue is red, hot, and swollen.
 Goal of Ice Treatment:




Reduce bleeding into the tissues.
Prevent or reduce swelling (inflammation).
Reduce muscle pain and spasm.
Reduce pain by numbing the area and by limiting the
effects of swelling
 Ice 15 to 20 minute every 2 to 3 hours
Heat Treatment
Heat:
 Use heat after 72 hours
 Heat causes the blood vessels to open wide (dilate).
 Goal of Heat Treatment:
 Bring more blood into the area to stimulate healing of
damaged tissues
 soothing effect and helps to relieve pain and spasm
 eases stiffness by making the tissues more supple.
 Apply heat using a heating pad or a hot wet towel.
 Heat for 10 to 20 minutes but no more than 20 minutes
Case Study
What stage of healing? Ice or Heat?
Case Study
What stage of healing? Ice or Heat?
Case Study
What stage of healing? Ice or Heat?
Case Study
What stage of healing? Ice or Heat?
Case Study
What stage of healing? Heat or Ice or neither?
Case Study
What stage of healing? Ice or Heat or neither?
Case Study
What stage of healing? Ice or Heat?