Purvi shah soft tissue injury ppt
- 1. SOFT TISSUE INJURY -PURVI SHAH (B.P.T)
- 2. Introduction Soft tissue is defined as complex of non epithelial tissue excluding the Skeleton, joints, CNS, hematopoietic. There are different types of soft tissue found in the body. 1.Fat tissue 2.Fibrous tissue 3.Muscle, Tendon & Ligaments 4.Synovial tissue 5.Blood vessels & lymph vessels 6. Nerves
- 3. Continue Soft tissue connect & support other tissue; surround the organs in the body. It give shape & structure to the body, protect the organs. Fat is the softest tissue found in body. PREDESPONDING FACTOR FOR MUSCLE STRAIN : - Two joints muscle -Muscle with high percentage of type 2 fibers
- 4. Etiology of Soft tissue Injury: Trauma Overuse Diseases & Chemical agent Severity of soft tissue injury Grade 1 Mild Grade 2 Moderate Grade 3 Sever
- 5. Muscle Injury Strain is term related to muscle injury. Eg.: Hamstring strain, Rotator cuff strain, Quadriceps strain. Grading Severity Grade 1. Pain without muscle weakness Grade 2. Pain with partial muscle weakness Grade 3. Minimal or no pain with complete muscle weakness Grading is based on number of fibers disrupted according clinical & imaging investigation.
- 8. Qudriceps Strain Rectus femoris is the commonest seat of strain in the quadriceps muscle. Muscle acts on both the hip & knee joints. Diagnostic sign of strain is pain during combination of hip flexion & knee extension. Rarely; vastus medialis , vastus lateralis, vastus intermedius may develop strain. Resisted knee extension is painful, terminal range of knee flexion is also painful.(Stretching elongation of strained muscle)
- 9. It’s treated with PRICE protocol Isometric exercise of knee (SQE) CPM in relaxed manner AAROM,AROM,RE Electrical stimulation (Avoid extension lag ) Strengthening exercises Graded weight bearing & gait training ( Avoid limp) Exercises should be made vigorous to achieve full function by 5 to 6 week
- 10. Hamstring Strain The commonest site of hamstring strain is at the fibular insertion of biceps femoris muscle. Resisted knee flexion & active full extension are extremely painful Knee may locked in slight flexion due to spasm in the strained hamstring.
- 12. Calf Strained Strain in the calf muscle frequently occurs in the athletes due to sudden over stretching of calf muscle. Resisted plantar flexion is painful with loss of toe push off while walking Though painful, it is possible for the patient to stand on the toes, raising heel from the ground.
- 13. Stages of Tissue Healing Acute stage: Inflammatory stage Impairment in acute stage Pain, swelling, tenderness, Impaired movement, Spasm of muscle, decresed use of associated area.
- 14. Subacute Stage: Repair & Healing Impairments in subacute stage Pain when available ROM is reached, decresing soft tissue swelling, decresed functional use of the part & associated areas, developing muscle weakness & contractures
- 15. Chronic Stage: Maturation & remodeling Impairment in chronic stage Decresed muscle performance, inability to function normally in an expected activity, contracture & adhesions that limit norma ROM
- 16. How to assess muscle strain??? Physical examination Patient’s symptoms history NOTE: A set of motions, positions & palpations design to provoke symptoms
- 17. Management of Soft Tissue Injury Conservative 1. Immobilization (Bandage) 2. Mobilization 3.Rehablitation (Endurance training) Surgical
- 18. Medication : NSAID Ibuprofen/paracetamol platelet-rich- plasma (PRP) injections which have been shown to accelerate recovery from non-surgical muscular injuries
- 19. Physiotherapy In Acute stage: Patient education PRICE protocol (24 to 72 h) P = Protection R = Rest I = Ice Application ( 15 to 20 min) C = Compression E = Elevation Gentle oscillation grade 1 or 2 in pain free positions.
- 20. After 24 h: Electrotherapy: US (low dose & low power) TENS Phonophoresis PEMF Massage Isometric exercises
- 21. PROM of involved part & AROM or AAROM of associated area. Modified aerobic exercises Adaptive or assistive device Sub acute stage : Patient education Protection of healing parts PROM to AAROM to AROM Stretching exercise (NOTE : Avoid too much motion)
- 22. Chronic stage: Submaximal to Maximal resisted exercises Stretching techniques Home exercises