Introduction
Soft tissue injuries cover any injury to muscles, tendons and ligaments (and exclude any injury to bone tissue). Tendons are bands of fibrous tissue that connect muscles to bones and ligaments are bands of fibrous tissue that connect bones to other bones. Where there is damage to muscles or tendons these are referred to as 'strains', whereas any damage to ligaments is referred to as a 'sprain'.
Strains are where muscles either contract or stretch too quickly and a partial or complete tear in the muscles and/or tendons occurs. Sprains are where a joint is forced beyond its normal range of motion and one or more ligaments either stretch or tear.
A bruise (also sometimes referred to as a 'contusion' or 'cork') results from any relatively forceful impact to the skin which results in bleeding into soft tissue (a 'haematoma') which in turn causes the skin discolouration.
Soft tissue damage can also occur as a result of repetitive 'overuse' of particular sets of muscles, tendons and ligaments over time, as opposed to being due to one specific incident or injury.
Soft tissue injuries are very common and are the most common sporting injury.
Causes
Although any type of impact or high energy trauma can cause strains, sprains and bruising, most soft tissue damage is caused by falling or by twisting. Any previous injury will also increase the risk of further injury to the same area.
Symptoms
Primary symptoms are pain, swelling and bruising, which may also be accompanied by loss of movement or range of motion and loss of function, including being able to take any weight or pressure on the affected joint. Overuse injuries develop the same symptoms (with the exception of bruising) over a longer period of time.
Tests / Diagnosis
A physical examination can generally establish if the injury is only soft tissue or anything more serious. If there is a suspicion of something more serious, such as a bone fracture, an x-ray may be required.
Treatment
Treatment for soft tissue injuries very rarely require surgical intervention, unless tendons or ligaments have substantially or completely detached (for example ACL rupture). Most soft tissue injuries are treated according to the RICE protocol – Rest, Ice*, Compression, Elevation.
* although there is now a slight question mark over use of ice, as it may in fact delay recovery, even though it may give some immediate pain relief.