Muscle and ligament strains, sprains and haematomas (bruising)

Ligament Sprains

Ligaments are fibrous (rigid) bands of tissue that hold two bones together.

Ligaments are sprained when a sudden movement causes them to tear. Assessment by a chartered physiotherapist or doctor as possible after the injury is advised.

Physiotherapy Treatment:

The aims of physiotherapy are to restore full pain-free movement and strength to the affected joint. Initially as well as using R.I.C.E. principles below, electrotherapy such as ultrasound and interferential may be used to reduce pain and swelling. Deep friction massage to minimize scar tissue formation is also helpful. As pain and swelling settles, exercise is progressed from gentle range of motion exercises to balance and strengthening work.

Tears from ligament sprains can be classified as 1st, 2nd or 3rd degree and treatment directed accordingly

  • 1st Degree: Mild sprains with minor pain, swelling and only very temporary dysfunction. Usually do not require medical or physiotherapy intervention to resolve fully.
  • 2nd Degree: Moderate Sprains- pain, swelling and dysfunction (e.g. limp).
     This type of sprain will recover quicker and better with physiotherapy.
  • 3rd Degree: Major sprain- pain, swelling and major dysfunction (e.g. unable to walk). This type of sprain needs medical intervention for surgical repair and or immobilisation in a cast or splint.

Until your injury has been assessed and for the first 48 hours you should follow the R.I.C.E. principle:

REST:   do not use the affected joint.

ICE: for 10 minutes at a time as often as possible especially in the first 24 hrs.

COMPRESSION: apply a firm bandage.

ELEVATION: raise the injured joint above the level of the heart (to help drain swelling).

Muscle Strain (pull/tear)

Muscles are made up of elastic/stretchable tissue. They are anchored to our bones by tendons (which are not elastic). Strains happen when they are overloaded. Prompt assessment and treatment by a chartered physiotherapist will speed up recovery time and minimize the chance of recurrence.

Strains are classified as 1st, 2nd and 3rd degree:

  • 1st Degree: Mild sprains with minor pain, swelling and only very temporary dysfunction. Usually do not require medical or physiotherapy intervention to resolve fully.
  • 2nd Degree: Moderate Sprains- pain, swelling and dysfunction (e.g. limp).
     This type of sprain will recover quicker and better with physiotherapy.
  • 3rd Degree: Major sprain- pain, swelling and major dysfunction (e.g. unable to walk). This type of sprain needs medical intervention for surgical repair and or immobilisation in a cast or splint.

Until your injury has been assessed and for the first 48 hours you should follow the R.I.C.E. principle:

REST:   do not use the affected joint.

ICE: for 10 minutes at a time as often as possible especially in the first 24 hrs.

COMPRESSION: apply a firm bandage.

ELEVATION: raise the injured joint above the level of the heart (to help drain swelling).

Physiotherapy will restore full pain-free stretch and strength in the injured muscle. Early treatment is vital because if bleeding is unchecked a large amount of swelling can occur, leading to a much more extensive area of scarred tissue (hard inflexible scab like tissue). This will then need to be treated prolonging recovery time considerably.

Initially treatment will aim to decrease pain and swelling using electrotherapy (ultrasound and interferential) and the R.I.C.E. principle. Once bleeding/swelling has stopped, stretching and strengthening exercises will be prescribed. A detailed assessment of care, strength, general flexibility and bio-mechanics will be made to identify any possible predisposing factors (e.g. flat feet, tight hamstrings, stiff back, weak core muscle groups). A comprehensive rehab program will then be devised.

 

HAEMATOMAS

A deep muscle bruise which may or may not be visible on the surface of the skin. It is common infield sports such as football, hurling, camogie,rugby and soccer and when occurs in the thigh is usually referred to as a “Dead Leg”. It can be very painful and the involved muscle is difficult to move.

Physiotherapy will initially aim to minimise the bleeding using the R.I.C.E. principle mentioned above. It is important that the involved muscle regains normal strenght and flexibility otherwise it will be at risk of tearing when the patient returns to sport. Electrotherapy, massage and exercise will be prescribed to attain this in the shortest time possible.