Muscle Injuries

Types of Injuries Strain Contusion Muscle Soreness Tendinitis and Tendinosis Impingement Syndromes

Muscle Strains 3 Grades Only difference between sprains and strains is grade 3 there is massive pain and it does not go away.

Muscle Strains All Strains and Sprains are graded on a 3 tier scale Grade 1 – Mild Local pain w/ little bruising (ecchymosis). Little to no loss of strength. Grade 2 – Moderate Moderate pain/ bruising/ swelling Impaired muscle function (i.e. limping) Grade 3 – Severe Loss of muscle function Palpable defect

Contusions (Bruises) From Direct blows. Tissue explode from force. Discoloration is usually a sign things are improving Hip Pointer Thigh Contusion *Black and blue marks are often associated with bruises. A bruise, or “contusion,” appears on the skin due to trauma. Examples of trauma are a cut or a blow to the area. The injury causes tiny blood vessels called capillaries to burst. The blood gets trapped below the skin’s surface, which causes a bruise. Hip Pointer> a contusion on the pelvis caused by a direct blow or a bad fall at an iliac crest and / or hip bone and a bruise of the abdominal muscles (transverse and oblique abdominal muscles).; a sports injury in which the point of the hip is deeply bruised and painful.

Compartment Syndrome Acute compartment syndrome is a 911 emergency Happens from direct blows to the anterior aspect of lower leg (shin) or a fracture of Tibia Signs: Rapid swelling Foot drop Intense pain Numbness on top of foot Compartment Syndrome In certain cases, rapid bleeding may cause extremely painful swelling within the muscle group of your arm, leg, foot, or buttock. Build-up of pressure from fluids several hours after a contusion injury can disrupt blood flow and prevent nourishment from reaching the muscle group. Compartment syndrome may require urgent surgery to drain the excess fluids. Video included> Compartment Syndrome from Running - Huntington Beach; how to treat

Fasciotomy Fasciotomy or fasciectomy is a surgical procedure where the fascia (a thin sheath of fibrous tissue enclosing a muscle or other organ) is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome.

Myositis Ossificans When a bruise turns really bad. Bone growth in muscles as a protection mechanism Occurs because of repeated trauma to the same area Myositis Ossificans Young athletes who try to rehabilitate a severe contusion too quickly sometimes develop myositis ossificans. This is a condition in which the bruised muscle grows bone instead of new muscle cells. Symptoms may include mild to severe pain that does not go away and swelling at the injury site. Abnormal bone formations can also reduce your flexibility. Vigorous stretching exercises may make the condition worse. Rest, ice, compression, and elevation to reduce inflammation will usually help. Gentle stretching exercises may improve flexibility. Surgery is rarely required.

Soreness Two Types Acute Onset Pain usually gone in 24-48hrs AOMS DOMS Acute Onset Pain usually gone in 24-48hrs Causes muscle improvement

DOMS Delayed Onset Muscle soreness Causes by hypoxic injury to muscle tissue. Cell Death Takes 2-3 days before you feel sore. Pain finally subsides 10-14 days later.

Tendinitis vs Tendinosis characterized by a degeneration of the tendons Chronic Condition Tendinitis caused by an inflammation of the tendons Acute Condition

Achilles Tendinitis vs Tendinosis Overuse or Eccentric Injury Tendinitis is the acute phase (first 21 days) Achilles Tendinosis Chronic Phase (after 21 days) PRP Treatment

Achilles Tendon Rupture Sounds like a gun shot. Weekend Warrior Most commonly had Achilles Tendinitis or Tendinosis Video> Kobe Bryant, Achilles tendon tear, Injury, surgery, recovery , Los Angeles Lakers, Basketball; video explains and describes how Kobe Bryant injured his achilles tendon. I am trying to shed some light and describe the biomechanics or this injury. This might not be exactly where he tore his achilles tendon but most of these injuries are around the same area. *3D Video on Achilles Surgery

Jumper’s Knee Patellar Tendinitis Either an Overuse or Eccentric Injury Usually caused by issues in the foot or muscle weakness in the hip and knee is having to compensate. Video embedded

Runner’s Knee Iliotibial (IT) band Syndrome Tight Hip abductors Pain in Lateral aspect of knee by knee cap Video> Knee Pain: Symptoms, Treatment, and Prevention ; 1st pic

Osgood Schlatter’s and Sever’s Apophysitis Injuires- (Growth plate attachments where muscles are pulling) Occurs during pre-puberty or puberty times Extremely Painful Can lead to future impairments for athletes as grow into adulthood Opposite of Osgood is called Larson-Johannson

Shoulder Impingement Sometimes referred to as Rotator cuff tendinitis this condition is an irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons. Causes: Keeping the arm in the same position for long periods of time, such as doing computer work or hairstyling Sleeping on the same arm each night Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head. Working with the arm overhead for many hours or days (such as painters and carpenters) Poor control or coordination of your shoulder and shoulder blade muscles

Carpal Tunnel Carpal tunnel syndrome is pressure on the median nerve It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers. Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include: Driving Assembly line work Painting Writing Use of tools (especially hand tools or tools that vibrate) Racquet Sports such as Tennis or racquetball

Rotator Cuff Tear and SLAP A SLAP tear is a specific kind of injury to your shoulder. To help make your shoulder more stable, there is a ring of firm tissue, called the labrum (shoulder cartilage), around your shoulder socket. The labrum (say "LAY-brum") helps keep your arm bone in the shoulder socket. SLAP stands for "superior labrum, anterior to posterior"-in other words, "the top part of the labrum, from the front to the back." It refers to the part of the labrum that is injured, or torn What causes a SLAP tear? The labrum frays or tears because of an injury. You may get a SLAP tear if you: Fall on your outstretched arm. Fall on your shoulder. Brace yourself with your outstretched arm in a car accident. Lift heavy objects repeatedly or too suddenly. Do a lot of overhead activities, such as throwing a baseball. *This injury was first identified in the 1980s in athletes, like baseball players, whose sport requires them to do a lot of overhead throwing. *Symptoms of a SLAP tear may include: Popping, clicking, or catching in the shoulder. Pain when you move your arm over your head or throw a ball. A feeling of weakness or instability in the shoulder. Aching pain. People often have a hard time describing or pointing to exactly where the pain is. *Diagnosis requires MRI Supraspinatus tear Commonly involves Long Head Biceps tendon S = Superior L = Labrum A= Anterior P=Posterior

Tommy John Injury Tommy John surgery (TJS), known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which the ulnar collateral ligament in the medial elbow is replaced with a tendon from elsewhere in the body. ESPN Video on Baseball Video also on 3D Surgery