The body will respond to an exercise stress in one of three ways and there may be primary and secondary damage to the tissues as a result of exercise stress. The three responses the body will take to an exercise stress are, the tissues may adapt to the stress and no damage occurs, the tissues may become injured, or the tissues will die. In athletics, athletes often stress their bodies to the point of tissue injury and tissue death. The body’s primary reaction to an injury is tissue destruction.
The degree of tissue destruction will greatly depend on the injurious force. Secondary damage may occur from cell death. Cell death occurs because of the hypoxia associated with the injured area. The damage done in the primary stage is irreversible; however with a good rehabilitation program the secondary damage can be contained and limited.
When the body is injured a sequence of events is initiated that leads to the eventual repair of the injury site.
The first stage in this process is inflammation which is followed by tissue healing and repair. The inflammatory response is the body’s natural response that immediately occurs following tissue damage. Its main functions are to defend the body against harmful substances, dispose of dead or dying tissue and to promote the renewal of normal tissue. The inflammatory reaction is normally characterized by five distinct signs, each of which is due to a physiological response to tissue injury; Pain (due to chemicals released by damaged cells).
Swelling (due to a build up of fluid into the damaged region). Redness (due to vasodilatation- the widening of blood vessels and bleeding in the joint or structure). Heat (due to an increase in blood flow to the area).
Loss of function (due to increased swelling and pain).
An example of an injury that involves inflammation would be a head injury. If tow rugby players bang heads, they usual collide at such a force where both participants feel pain of the head and their head swells up. In the case that this would happen ice should be applied to the place where the inflammation has occurred this prevent the build up of fluid and blood at the damaged tissue and helps stop the inflammation. Soft tissue refers to the muscles, ligaments and tendons in the body. If any of these parts are injured, the condition is called soft tissue injury. Usually injury is caused due to continued stress of the joints, ligaments or tendons. Redness of the injured area, swelling and pain are the common symptoms of soft tissue injury. Depending on the severity of the injury, the doctor would prescribe you the required treatment. Injury to soft tissues is usually classified in two categories, chronic or acute. The former begins with a nagging, mild pain which does not go away.
On the other hand, the latter is caused due to sudden twisting motion, fall or collision. The most common soft tissue injuries are strains, sprains and tear of muscles, ligaments and tendons. When a person has soft tissue damage, then he or she needs to avoid certain things during the first three days of the injury in order to ensure faster recovery. Heat should not be applied to the injury site as it can aggravate swelling. Massaging should also be strictly avoided as it can worsen the symptoms. When a muscle is torn or strained, scar tissue begins to form. Untreated scar tissue is the major cause of re-injury, sometimes months after the initial injury. Scar tissue once formed, binds itself to the damaged soft tissue in an effort to draw the damaged fibres back together for repair. However, what results sometimes is a bulky mass of fibrous scar tissue completely surrounding the injury site. Scar tissue is a very weak inflexible material and has a tendency to contract and deform the surrounding tissues. Physiotherapy may be required to get rid of the scar tissue this can be a slow process and sometimes a painful process.
Specific to Injury
A sprain is an injury to a ligament, the tough, fibrous tissue that connects bones to other bone. Ligament injuries involve a stretching or a tearing of this tissue. A sprain typically occurs when people fall and land on an outstretched arm, slide into base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground. This can result in an over stretch or tear of the ligaments supporting that joint.
Common type of sprains would be in the ankle and in the wrist. The ankle is one of the most common injuries in professional and recreational sports and activities. Most ankle sprains happen when the foot abruptly turns inward or outward as an athlete runs, turns, falls, or lands after a jump. One or more of the lateral ligaments can be injured if this occurs. Wrists are often sprained after a fall in which the athlete lands on an outstretched hand.
The usual signs and symptoms of a muscle sprain include pain, swelling, bruising, and the loss of functional ability. Sometimes people feel a pop or tear when the injury happens. However, these signs and symptoms can vary in intensity, depending on the severity of the sprain.
1st Degree Sprain: A 1st Degree sprain causes overstretching or slight tearing of the ligaments with no joint instability. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint. 2nd Degree Sprain: A 2nd Degree sprain causes partial tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has some difficulty putting weight on the affected joint and experiences some loss of function. An x-ray or MRI may be needed. 3rd Degree Sprain: A 3rd degree sprain results in a complete tear or rupture of a ligament. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x-ray is usually taken to rule out a broken bone. This type of a muscle sprain often requires immobilization and possibly surgery. It can also increase the risk of an athlete having future ligament sprains in that area.
When diagnosing any sprain, the doctor will ask the patient to explain how the injury happened. The doctor will examine the affected joint, check its stability and its ability to move and bear weight.
A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is caused by trauma or an injury such as a blow to the body; it can also be caused by improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse – prolonged, repetitive movement of the muscles and tendons.
Contact sports such as rugby, football, hockey, boxing, and wrestling put
people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racket sports, throwing, and contact sports.
Typically, people with a strain experience pain, muscle spasm and muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a more severe strain, some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.
Strains are categorized in a similar manner to sprains.
1st Degree Strain: This is a mild strain and only some muscle fibres have been damaged. Healing occurs within two to three days. Stretching and icing the strain will speed up recovery. 2nd Degree Strain: This is a moderate strain with more extensive damage to muscle fibres, but the muscle is not completely ruptured. Healing occurs within two to six weeks. 3rd Degree Strain: This is a severe injury with a complete rupture of a muscle. This typically requires a surgical repair of the muscle; the healing period can be up to three months. An example of this would be when Derek Redman competed in the Olympics; he had a rupture of the hamstring which caused him to fall to the floor in pain. He continued to limp after he fell to the finish but this can cause further damage to a ruptured muscle.
Intramuscular haematoma is a collection of blood within a muscle. In sport this is usually the result of direct trauma, e.g. a direct blow to thigh or calf in contact sports or muscle tears in non-contact sports. Treatment is aimed at limitation of bleeding (rest, ice, compression and elevation). The collection of blood causes pain, related to either limitation of movement or the increase in pressure in the tissues. If local pressure compromises the circulation, surgery is required to relieve it and to prevent tissue necrosis by draining the haematoma An intermuscular haematoma is bleeding around the muscle tissue is called an intermuscular haematoma. this type of haematoma is much less severe than an intramuscular haematoma because the blood can escape can escape from the damaged muscle and into the surrounding tissues, so there is less pressure in the area and the injury can recover more quickly.
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