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SPRAINS, STRAINS, and CONTUSIONS
Whenever you participate in any kind of sports or recreational activity you set yourself up for risk of injury. The most common type of injury that a person may experience is a soft tissue type of injury. Three types of soft tissue injury are sprains, strains, and contusions.
A sprain occurs when there is a painful twist to a joint that results in stretching or tearing of the ligamentous and capsular structures. A joint that is forced beyond its range of motion can stretch, tear and sometimes avulse the connective tissues that stabilize the joint. Sprains describe injury to ligaments, which connect bone to bone, and joint capsule. There are three categories in which sprains can be classified.
| 1o Sprain: | Definition: | Few fibers of ligament and/or capsule are torn. |
| | Symptoms: | Low level of pain, slight point tenderness, minimal loss of function and range of motion, minimal swelling, and little to no discoloration. |
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| 2o Sprain: | Definition: | Approximately half of ligament and/or capsule is torn. |
| | Symptoms: | Moderate level of pain, moderate point tenderness, moderate loss of motion and function, increased discoloration and instability. |
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| 3o Sprain: | Definition: | Complete tear of ligament and/or capsule is present. |
| | Symptoms: | Severe swelling, pain, discoloration, point tenderness, instability, decreased function and motion.
A third degree sprain may also represent a dislocation or subluxation of the joint. |
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A strain occurs when there is a stretch, tear, or rip in the muscle or connecting tissue such as the fascia or muscle tendons. A strain can occur to any part of the muscular unit, including the muscle belly itself and tendons that connect the muscle to bone. Depending upon the amount of force the muscle and/or tendon can be stretched, torn, or even avulsed from its attachment onto bone.
There are three classifications of strains and they are as follows:
| 1o Strain: | Definition: | Few fibers of muscle stretched or torn. |
| | Symptoms: | Local pain, which is increased with stretch, slight loss of strength and stability, moderate swelling, discoloration and point tenderness. |
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| 2o Strain: | Definition: | Approximately half of muscle and/or tendon fibers are torn. |
| | Symptoms: | Significant pain with muscle on stretch, moderate loss of strength and stability, diffuse swelling and discoloration, significant point tenderness with possible palpable defect. |
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| 3o Strain: | Definition: | Complete tear of muscle and/or tendon is present. |
| | Symptoms: | Severe pain with or without movement, significant loss of strength and stability, major loss of function with reflex inhibition, diffuse swelling and discoloration, significant point tenderness with distinct palpable defect. |
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A contusion is defined as a bruise that is caused by a direct blow to any part of the body. The intensity of the contusion can range from superficial soft tissue to deep soft tissue injury. Disruption of the circulatory systems causes an increase in flow of blood and lymph into the surrounding tissues. Blood clots or hematomas can form due to the localization of the blood fluids into clot, which then becomes covered by a capsule using connective tissue membrane. The rate of healing for a contusion depends upon the extent and intensity of the injury.
Contusions are usually graded in three different categories:
| 1o Contusion: | Definition: | When there is minimal loss of movement and function. |
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| 2o Contusion: | Definition: | When there is moderate loss of movement and function. |
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| 3o Contusion: | Definition: | When there is severe loss of movement and function. |
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Whenever you have any type of injury that causes pain, loss of movement and function, swelling, and discoloration, it is beneficial to you to make an appointment with your family physician to have the injury evaluated. Your family physician will be able to decide if you need special testing and further treatment.
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