Soft Tissue Injury
Soft tissue injury is the damage to muscles, ligaments or tendons and can happen to anyone at any age and level of activity.
Such injuries usually occur as a result of a sprain, strain, contusion or overuse.
Bruises (contusions), ligament strains, muscle sprains, tendonitis, bursitis, and stress injuries are common types of soft tissue injury.
The body can regenerate and heal itself after a traumatic event such as a car accident or sports injuries. In many cases, the soft tissue can heal o their own.
However, it is essential to be familiar with the healing stages and the recovery process to ensure proper healing and full recovery.
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Causes of Soft Tissue Injury and Mechanical Pain
Watch the full video by Dr. Saeed Monterrey, PT, DPT, OCS
Soft tissue injuries are categorized into two broad groups:
- Acute injuries that happen due to a sudden movement or trauma.
Such injuries put abnormal stress on the tissue. Examples are an ankle sprain, hamstring strain, and muscle contusion or bruise.
- Overuse injuries that result from repetitive stress on the tissue.
They usually occur when enough recovery time is not given to the tissue to regain its strength. Some typical examples include shoulder bursitis, tennis elbow, and rotator cuff tendonitis.
The pain arising from the use of a damaged tissue due to musculoskeletal injury is called mechanical pain.
The body needs to go through the healing process correctly to address the mechanical pain and prevent it from recurring in the future.
Healing Stages of Soft Tissue Injury
The body has an innate ability to recover from injury, and it starts this process automatically through the stages of inflammation, repair, and remodeling.
These phases of healing often overlap one another without a particular point showing when a specific stage starts or ends.
1. Soft Tissue Inflammation Stage
Inflammation is the initial body reaction to the injury that typically appears within a few hours.
Pain, swelling, redness, and warmth at the site of injury are the signs of the inflammatory phase.
During this stage, the pain and swelling limit the function of injured soft tissue to protect it and prevent further damage.
That is the reason why an individual with a sprained ankle can’t immediately walk and cripples for a while.
In the inflammation stage, the injured tissue releases chemicals to alert the body and to attract the required resources for repairing itself.
This chemical release is the body’s signal to start the repair and remodeling stages.
The magnitude of the inflammatory response and the duration of it can vary depending on the type and the severity of the damage and how it is being treated.
The duration of acute inflammatory response is usually brief and can last between 3 to 5 days. For chronic inflammatory response and severely damaged tissue, it can take longer.
2. Soft Tissue Repair Stage (Proliferation)
The repair (proliferative) phase emerges when the body starts transitioning from the inflammatory response to the repair stage.
It usually occurs when the swelling has lessened, and the pain has subsided.
During the repair stage, the body deposits repairing materials (collagen) into the injured site to create new tissue. This new tissue is commonly called the scar tissue.
The scar tissue starts forming within a few hours of the injury, and most of it is usually created in 4 to 6 weeks after the injury.
However, the produced scar tissue in this period is not fully functional, and it does not possess the qualities of the healthy tissue.
In other words, the structure of the collagen is weak and unorganized, and is subject to re-injury.
As shown in the above diagram, the created scar tissue is a cross-linking of collagen.
This cross-linkage can inhibit normal movement and cause pain. That is why the next stage, remodeling is crucial in the healing process.
3. Soft Tissue Remodeling Stage (Maturation)
When the bulk of scar tissue is created in the repair stage, it needs to be remodeled to function similar to healthy tissue. During the remodeling stage, the tissue becomes organized, stronger and more flexible.
An appropriate stimulus to the injured tissue at the right time during the healing process accomplishes this stage. It helps the scar tissue to look more like a healthy one eventually. With a proper remodeling, the scar tissue can meet the demands of the individual’s normal physical activities.
The remodeling stage usually starts by week 3 or 4 after injury when the scar tissue is reasonably mature. But it can continue for three months or more. In some cases, the remodeling may take years to make the scar tissue function normally.
If the remodeling process is not accomplished fully and is incomplete, there could be consequences. The individual may be bothered by pain, limited function, and reduced mobility and flexibility even long after the injury.
This healing paradigm happens with all types of injury such as ankle sprain, fracture, muscle tear, pinched nerve and even after surgery. It just happens at a different level.
Role of Physical Therapy in The Healing Process
Soft tissue injuries are quite common and physical therapists treat many people with this type of injury.
However, people often overlook the importance of remodeling stage. With physical therapy, they can make sure the remodeling phase is completed correctly.
Research has shown that providing regular stress to an injured tissue under the level of damage can cause the tissue to undergo a chemical and structural change.
Such a change promotes elongation, organization, and strengthening of the tissue.
By employing this method, physical therapy contributes to the remodeling and healing process.
Sometimes a more invasive treatment may be required to stimulate the healing.
If the injury is too significant and the damage to the tissue is severe, therapeutic injections and surgery may be necessary.
Physical therapy as part of the healing process ensures proper remodeling is taking place.
Share Your Thoughts
I hope you found this article helpful.
Now it’s your turn!
Have you ever had a soft tissue injury? What was your experience like?
How was the healing process for you? What did you do for treatment? Does the injured tissue function like it used to?
Please share your thoughts below.
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Please note that the information compiled in this article is from a variety of sources and it may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. Always seek the advice of a doctor or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Learn more