Sprains/Strains for Massage Therapists
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Definitions:
Sprain - tearing of a ligament
Strain - tearing of a muscle and/or tendon
Signs/Symptoms:
Levels of severity:
determined by passive range of motion assessment
for sprains, resisted range of motion for strains
very difficult to access because of inflammation
assessment is best done by a physician.
this information is provided so you know what
is possible
Sprains: tears in ligaments
| Level 1 |
1-50% tear of ligament fibers and minimal
muscle tissue damage
some swelling
no loss of function
joint is stable and painful
|
| Level 2 |
50-99% tear of the ligament and joint capsule
joint hypermobile and unstable
decrease in tensile strength of ligament
swelling, bruising, bleeding
|
| Level 3 |
100% tear of ligament
no joint end feel present
usually no specific pain, but compensational
pain
needs physician attention
|
Strains: tears in muscles and tendons
| Level 1a |
1-10% partial tear of fibers
little or no loss of function
can hold against resistance with pain
|
| Level 1b |
10-50% fiber tear
painful, but can hold against resistance
as it approaches 50% less ability to hold
against resistance
swelling
muscle guarding
|
| Level 2 |
50-99% fiber tear
can't hold against resistance
may hold against gravity
pain, edema, swelling and muscle guarding
|
| Level 3 |
100% fiber tear
usually heard snap at time of injury
no resistance possible
pain may be present at site
compensational pain present
Needs physicians attention immediately
|
Causes: gradual or trauma:
increased load on the muscle/ligament that is not strong enough to do hold
the weight.
over use, overextended muscles/ligaments,
improper warm up before activity,
Treatments:
treat according to stage of inflammation
treat according to severity of injury
ice massage
Triggerpoint
Myofascial release
begin massage treatment as soon as possible
to reduce adhesion formation especially with muscular strains.
General guidelines:
Acute stage: lymph drainage, ice
massage, passive range of motion,
Subacute stage: cross fiber friction,
muscle energy or strain/counterstrain techniques, add strengthening as
inflammation decreases, trigger point therapy, myofascial release
Chronic stage: cross fiber friction for
ligaments, cross fiber friction of muscles,
Cautions:
Traction may aggravate if it over-stretches
muscles.
Stretching may over-stretch and re-injure
muscles.
Repeated injury to ligaments can cause the
ligament to become looser and more prone to re-injury.
Be sure you are trained in treating acute
injuries.
Other therapies: acupuncture, prolotherapy
for ligaments, chiropractic, naturopathic (provides nutritional support
needed for proper healing and functioning)
Resources:
