Orthopaedics 1-Muscle Tears

what does strength training cause in the musculature?
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what does strength training cause in the musculature?
microtears
what does muscle strains originate from?
overloaded demand placed on muscle; usually around musculotendinous junction
do muscle strains happen more in concentric or eccentric overload? why?
eccentric bc more cross-bridging. poor form and mechanical positioning can contribute to injury
how do you grade muscle strains? what do they look like?
grade 1:
-small number of fibers torn
-light pain upon occurrence
-little swelling and 5% loss of function

grade 2:
-initial sharp pain
-more fibers torn
-pain and some swelling
-5-50% loss of function

grade 3:
-most of muscle fibers torn
-severe pain and swelling
-50-100% loss of function
about how long does a grade 1 muscle strain heal?
3 days-5 weeks
about how long does a grade 2 muscle strain heal?
3 weeks-3 months
about how long does a grade 3 muscle strain heal?
5 weeks-6 months
what are some areas to look at if someone has a muscle strain?
1. subjective reporting --> specific mechanisms
2. imaging --> CT scan, MRI, diagnostic ultrasound
3. integumentary --> potential bruising and swelling
4. PROM --> "spasm" end feel, pain upon elongation of effected muscle
4. strength testing --> pain upon muscular contraction
what does PT management of muscle strains depend on?
1. grade
2. healing time thus fat
3. location
4. presentation
5. patient values

*go back to foundations of acute, subacute, and chronic stages!!
what should you do for someone with an acute stage muscle strain?
LET THE INFLAMMATION HAPPEN!
-this is where reparative elements come in to help repair damaged tissue --> acute swelling is good but chronic swelling is bad
-pain free ROM appropriate at this time
-NO aggressive stretching
-minimal NSAID use
-isometrics
what should you do for someone with a subacute stage muscle strain?-start to progress to pain free ROM --> still healing and not in maturation phase so not too aggressive! -start to progress with strengthening exercise with GRADUAL loading --> easy for hypermotivated pop, like athletes, to overdo it and cause more harm than goodwhat should you do for someone with a chronic stage muscle strain?-should have FULL pain free (or near pain-free) ROM at this point -strength training should be guided to return to 100% --> if residual swelling following PT session, regress slightly -return to sport exercise can be initiated --> dependent on sport and level of exertion