Soft Tissue Injuries
What is a soft tissue injury?
Soft tissue injuries (STI) are when trauma or overuse occurs to muscles, tendons or ligaments. Most soft tissue injuries are the result of a sudden unexpected or uncontrolled movement like stepping awkwardly off a curb and rolling over your ankle. These are injuries our Physiotherapists see every day at our Edinburgh physiotherapy and sports injury clinics. However, soft tissue damage can also occur from excessive overuse or chronically fatigued structures, especially muscles and tendons. For example, if you were to do a long run when already fatigued (from a previous run or exercise), then it is possible to cause trauma or a strain to key running musculoskeletal structures like your calf muscles or achilles tendons, also see: “How to prevent running injuries”.
What are the most common soft tissue injuries?
- Ankle Spain
- Back Strain (see article on back pain)
- Calf Strain
- Golfers/Tennis elbow
- Hamstring strain
Soft Tissue Injuries
What is the difference between a strain and a sprain?
Tendons are fibrous bands that attach muscles to bone. Trauma to muscles or tendons due to overstretching is referred to as a ‘strain’. Ligaments are also fibrous bands that hold bones together. Trauma by over-stretching of ligaments is referred to as a ‘sprain’. Strains and sprains are both very common and can occur from accidents during sport, at home or at work.
There are three levels or grades of severity:
Grade 1 strain or sprain (mild)
- Minimal over-stretching. Possible minor microscopic tearing of fibres
- Mild tenderness and minimal swelling
Grade 2 strain or sprain (moderate)
- Partial tear of fibres
- Moderate pain, tenderness and swelling
- Unable to apply loading to injured area without pain
Grade 3 strain or sprain (severe)
- Complete rupture of structure
- Significant pain and swelling
- Inability to use the injured structure
- Instability of the affected joint
Soft Tissue Injuries
What are the symptoms of soft tissue injuries?
When soft tissue is damaged, there is usually immediate pain along with immediate or delayed swelling (excessive swelling can slow the healing process – see treatment below). Stiffness is also very common as a result of the trauma and swelling. Bruising may also develop after 24-48 hours.
In the case of moderate to severe soft tissue injuries of muscles, tendons and ligaments around a joint, there may be instability experienced, especially to weight-bearing joints like the hip, knee and ankle.
Soft Tissue Injuries
How long will it take to recover from a soft tissue injury?
The recovery time from grade 1 soft tissue injuries in one to two weeks and three to four weeks for a grade 2. Grade three soft tissue injuries require immediate assessment and treatment, with much longer recovery times. Recovery times can also depend on your age, general health and occupation. If you are not sure of the nature or extent of your injury, contact an experienced Specialist Physiotherapist for advice.
Treatment for soft tissue injuries:
There are principally three stages of treatment and recovery from soft tissue injuries like ankle sprains
Stage one: During the first 24-72 hours, it is important to protect the injured area, gain an accurate diagnosis and follow the
PRICE regime (see below). If possible, gentle pain free movement should be encouraged.
Stage two: Reduce swelling and stiffness and begin to regain normal movement.
Stage three: Regaining of normal function and return to normal activities.
Should I go to a hospital with a soft tissue injury?
With severe trauma, there may also be a fracture and as with all severe trauma, it is advisable to go directly to A&E for a detailed assessment and diagnosis. A good gauge for when a soft tissue injury requires a full examination is, for example, if:
- You are unable to put any weight on the injured structure
- There is an unusual deformity or shape
- You heard a pop or crack at the time of injury
- Any surrounding bony structures are painful
- There is presence of neurological signs like numbness or pins and needles (either at the injury site or anywhere else)
PRICE Regime for Soft Tissue Injuries
Protect
Minimise using the affected area the area and initially avoid stretching which could further weaken the damaged tissue.
If trauma is severe, protect the injury from further damage. Stop any activity that will aggravate the injury. Use of crutches to take the weight off an injured knee, hip or ankle injury may be necessary. A sling may help to protect an arm or shoulder.
Rest
Rest and avoid activities that cause significant pain (for example walking, raising your arm). Allow sufficient rehab time for even small injuries. Choose alternative.
Ice
Wrap ice cubes in a damp tea towel, use frozen peas or a sports ice pack. Use the ice pack for 15–20 minutes every three to four hours when awake.
Very cold products can induce hypothermia or cold burns so wrapping the ice in a cloth is advisable.
Compression
Apply a firm bandage that does not restrict circulation or cause additional pain. The bandage should cover the whole joint.
Elevation
Raise the limb above the level of your heart, if possible in order to help reduce the swelling. Support the limb with cushions or a sling to keep it raised when not walking or using the limb.
Pain relief may also be required. If you are not sure what medication to use, your Specialist Physiotherapist, Pharmacist or GP can advise you.
What to avoid when you have a soft tissue injury?
In the first 48-72 hours, it is important to avoid the following:
Heat
Increases blood flow and swelling.
Alcohol
Increases blood flow and swelling, and will slow up the healing process.
Massage
Promotes blood flow and can increase swelling and can, therefore, increase damage if begun too early.
Physiotherapy treatment for soft tissue injuries
An experienced Physiotherapist can assess your injury, and confirm both the diagnosis and extent of damage. They will provide you with advice, hands-on treatment and exercises which will promote a prompt and effective recovery, as well as reduce the risk of further injury in the future. (see also “how to avoid running injuries”) Your Specialist Physiotherapist will also advise you on a progressive return to normal activities and alternative exercises to follow whilst you are injured.
What Exercises are there for Soft Tissue Injuries?
There are so many different types of soft tissue injuries it would be impossible to list the exercises for all of them in this article. Here is an example of an exercise routine after an ankle injury. The program begins with the easiest exercise progressing the hardest as your ankle gets stronger.
Initial Post Ankle Injury Exercise
Tie a length of resistance elastic in front of you at waist level and hold the elastic tightly in one hand.
Lift one leg up (elastic side) and pull the elastic towards you as far as possible, by bringing your shoulder blades together and moving your arm back.
Maintain your balance on one leg with your shoulders back and your trunk stable during the exercise. Slowly return to the initial position and repeat.
Begin with 1 set of 4-6 reps or less depending on how the ankle feels. Progressively build up to 3 sets of 8 reps.
Regaining Balance After an Ankle Injury
Stand up with the injured leg on the rounded part of a Bosu (you can begin with balancing on both legs, to begin with, if the ankle is too sore).
Move the opposite leg in a half circle motion to challenge your balance. Maintain a balanced and upright posture throughout the exercise.
Begin with 3-5 x 10-second balances and progressively built to 3 x 30 seconds.
Ankle Strengthening
Sit in a chair with a physio resistance band tied around your foot and against a stable object.Begin with an easy resistance and progressively increase when your ankle feels ready.
Keep your knee still and your heel in contact with the floor while you move the sole of your foot towards the outside. Return slowly and repeat.
Begin with 1 set of 4-6 reps and progressively increase this to 3 sets of 8 as the ankle allows.
Locations
Find a location near you
The Physiotherapy Clinics - Gracemount
The Physiotherapy Clinics - Leith
The Physiotherapy Clinics - South Gyle
Peebles Physiotherapy
Grant Fitzgerald
2024-03-17
Trustindex verifies that the original source of the review is Google. I can't thank Peter enough for guiding me through my shoulder rehabilitation program over the past few months. His instructions were very clear and the instructional videos made available through the app were really useful. I'd had niggling, low-level pain in my shoulder for around 13 years and then recently I lost full range of motion due to a karate injury; after working with Peter I can honestly say that my shoulder now feels better and stronger than it has done for a very long time! Thanks again 🙂
Julie Grant
2024-03-12
Trustindex verifies that the original source of the review is Google. Very grateful. Great service
Henry Sandercock
2024-01-21
Trustindex verifies that the original source of the review is Google. I received fantastic, friendly help from Biju for a minor leg injury. The treatment and exercises he gave me completely sorted my issue. Would 100% recommend both him and the clinic!
Helen Campbell
2024-01-15
Trustindex verifies that the original source of the review is Google. Had a great experience at this clinic. Antony put together a detailed treatment plan for treating knee pain. He clearly explained how each exercise would benefit the activities I wanted to be able to do. Not only is he a great physio, but he is so friendly and always makes you feel listened to.
Jill Steel
2024-01-13
Trustindex verifies that the original source of the review is Google. Phil has been supporting me a long standing complicated issue, which previous places have been unable to help. Phil's extensive experience and positive approach, coupled with his willingness to think outside the box is making a difference. Recently this approach has included the 3D movement scan. It's very easy to participate in, and it revealed problematic postural and movement detail that would be harder to discover by other means. I recommend the 3D scan as a rehabilitation tool.
Dermot Bailie
2024-01-11
Trustindex verifies that the original source of the review is Google. I highly recommend the physiotherapy clinic South Gyle. I received a detailed assessment of my problem from Phil. He clearly explained the issues I'm having and why, plus the treatment, exercises required to rectify. Really happy with my experience and I would not hesitate to go back. Thanks Phil
Keith Lloyd
2024-01-11
Trustindex verifies that the original source of the review is Google. I first attended the South Gyle clinic to see Anthony Guiducci on February 2023. I was suffering from a very painful trapped nerve in the lower back. Later in the year, with the back issue having been virtually cleared, I developed some nerve pain in the right knee along with general stiffness in the left knee. Finally around late October I had "tennis elbow" on my right elbow.I should say that I am 73 years old and spent many years playing contact sports, mainly rugby and football and now in my twilight years golf. It catches up with you eventually 😁.
All through this time Anthony has been totally professional with a great knowledge of muscle and nerve structure and their interaction. His approach to giving you remedial exercises is well structured to your ability and takes great care that you keep within your capabilities as you build up the strengthening and more testing lessons.
I can highly recommend him to anyone looking for physio help with their injuries or aches and pains.
I must also say that, on the odd occasion when I had to use other physios at South Gyle, due to holiday leave I was equally impressed by the expertise of the staff.
Gary Kendall
2024-01-07
Trustindex verifies that the original source of the review is Google. Came here with a mild hamstring strain, ran a 3:30 marathon 5 weeks later! Anthony Guiducci = legend
Sarah Ingham
2024-01-04
Trustindex verifies that the original source of the review is Google. Really thorough consultation. Excellent advice and follow-up arranged.