Understanding of MUSCLE INJURY

How muscles get Injured

 Alright, I’m bringing this up because I often hear lots of questions from my clients about their muscle injuries and how it happens and why…etc. I always say IF YOU HAVE ANY MUSCLE PAIN OR TENSION – WATCH YOUR POSTURE!!! This is the first thing you should always pay attention to! Bad posture can cause many many problems and on the contrary – correct posture can reduce them! Also, you need to know HOW to avoid getting injured and in case if you already did how to take care of it. Please, read carefully! 🙂

Factors that cause injury

  • POOR POSTURE (one of the most important!)
  • poor body mechanics
  • poor equipment, including shoes
  • hard surface
  • insufficient warm-up or… cool-down
  • overuse or over-training
  • insufficient rest between workouts
  • down-hill running (high impact force)
  • poor diet
  • muscle imbalance or weakness
  • anatomical factors
  • direct flow

There is a fine line between appropriate stress (and adequate time for adaptation which builds an athlete’s body) and excess stress (with inadequate time which breaks down muscle tissue and function).

Warning signs of over-training

  1. lower general resistance
  2. inability to relax
  3. insatiable thirst
  4. “washed-out” feeling
  5. “hangover” from previous workout or event
  6. faster than normal heart rate on awakening
  7. drop in ability in the particular sport
  8. pain in muscles, tendons, joints
  9. insomnia

Hints for Reducing Risk of Injury

  1. avoid over-training
  2. practice good body mechanics
  3. use safe equipment
  4. don’t overdo exercise
  5. adequate warm-up and cool-down
  6. receive REGULAR sports massage
  7. listen to your body
  8. exercise in a relaxed state of mind
  9. cross training: alternate between different activities; spread wear and tear; build all around muscle strength

 Primary Trauma

  • the injury: a fall, blow, over-stretch occurs, the muscle tears
  • seconds after injury, blood vessels and capillaries break
  • blood flows into the tissue
  • the body reacts with two chemically activated response mechanisms: A&B
  • “A” Blood Clotting: prevents loss of blood; is a reaction to Hemorrhage, which is the escape of blood from a blood vessel as a result in injury
  • blood outside of the vascular system and the subsequent clotting lead to the formation of a bruise – Hematoma – accumulated blood within any part of the body caused by a ruptured blood vessel.

Secondary Trauma

Secondary trauma occurs from swelling, which is the increase in interstitial fluid – inflammatory response – in the area surrounding the primary trauma/injury. Secondary trauma can be more harmful than the primary trauma!

Swelling and inflammation lead to:

  • decrease in available oxygen – HYPOXIA (cell death). This is the inability of blood cells to carry oxygen to tissue fast enough to sustain the needs of the cells.
  • increase of waste products
  • decrease of available nutrients

Now, tissue that is not part of the original damage starts to die – this is Secondary Trauma:

  • creates more debris
  • adds to the size of the primary trauma
  • lengthens recovery time
  • increases amount of scar tissue
  • can start the pain/spasm/pain cycle

One way to deal with this is the application of ice. Ice decreases the metabolism of the injured tissue, thereby reducing the need for oxygen, and thus:

  • limits the extent of the injury
  • reduces swelling
  • decreases recovery time
  • needs to be applied ASAP

Inflammatory response

  • Inflammation – response to tissue injury, WBC’s leave the vascular system to enter interstitial space, and begin cleaning up debris, returning it to the lymphatic system. As interstitial fluid increases, swelling increases and the lymph system function is impaired.
  • inflammation is characterized by: heat, pain, redness, swelling, loss of ROM
  • swelling leads to “splinting” – immobilization of the injured area – loss of ROM
  • swelling occurs – Edema – accumulation of fluid in tissue spaces

 Injury Grading

REMEMBER: Massage Therapist is not a doctor!!! Massage Therapist can not diagnose! However, MTs need to have an idea and clear understanding of some medical terminology.

Grade 1:

  • partial tear (10% or less) of fibers
  • little loss of function
  • will hold against moderate resistance
  • mild tenderness, slight swelling
  • no dislocation
  • usually takes 6 weeks to heal
  • people get in trouble when they don’t give it time to heal properly – it can be re-injured and turn into Grade 2 injury.

Grade 2:

  • more fibers tear (50%)
  • cannot hold against moderate resistance
  • difficulty with weight-bearing activities
  • often a visible compensation, eg. limping
  • swelling, painful, bruising
  • can take 6 weeks to 1 year to heal (longer than broken bones)

Grade 3:

  • complete tearing (100%)
  • will usually hear “snap” at the time of the injury
  • extreme pain and swelling
  • repair usually requires surgery

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