A muscle is made up of groups of tiny little fibres that shorten and lengthen to create movement around a joint. Muscles are flexible tissues that can withstand and create a lot of force. Sometimes movement can place excessive load through a muscle and some or all of the fibres within it can tear. Tearing of muscle fibres is known as a ‘strain’. A muscle will commonly strain when it is overstretched. Think of a soccer player reaching a leg out for the ball, or a gymnast kicking their leg over their head. If the muscle is not able to cope with the demands of the stretch, then the only option is for the muscle to tear. A strain is graded based on the severity of the tearing:
- Grade 1 – a few muscle fibres are torn
- Grade 2 – extensive damage to muscle fibres, but not completely torn.
- Grade 3 – all fibres are torn
Common symptoms of a strain include pain, swelling, bruising, loss of function and weakness. The range of symptoms depend completely on the severity of the strain. A low-grade strain is often painful with minimal loss to function and strength. A high-grade strain is often very painful with swelling, bruising, complete loss of strength and reduced function in the affected body part.
A ligament is a strong band of tissue that joins a bone to a bone, creating a joint. Ligaments provide stability at a joint, making them quite inflexible compared to muscles. They have to withstand extremely large forces that run through the body when we move. Therefore, it makes sense that it requires a very large force to injure one. Take a rugby player who gets tackled with their foot firmly planted on the ground as the opposition player runs into the side of their legs. The excessive force of the tackle on the knee could cause the ligaments to overstretch or tear. Tearing of a ligament is referred to as a ‘sprain’. Just like a muscle, a ligament injury is graded from one to three:
- Grade 1 – the ligament is overstretched but remains intact
- Grade 2 – some ligament fibres are torn, some remain intact
- Grade 3 – all fibres are torn
Ligaments have a very poor blood supply compared to muscles which means they take longer to heal. If you look at muscle tissue it takes on a reddish appearance (i.e., a rich blood supply), compared to the silvery white colour of ligament tissue.
Symptoms of a ligament injury again depend on the severity of the injury and include pain, swelling, bruising, loss of function at the joint, and joint instability… You may well feel a little wobbly on your feet following a severe knee or ankle sprain.
A tendon is what joins a muscle to a bone. It is similar in make up to a ligament in that it also has a much poorer blood supply when compared to a muscle. Tendon injury is referred to as tendinopathy and is usually broken down into acute inflammation of a tendon (called ‘tendinitis’) and chronic degeneration of a tendon (called ‘tendinosis’). Tendons are often injured due to overuse of a body part due to repetitive actions, such as throwing in baseball. Overuse of the tendon can lead to very small tears developing. If complete healing is not achieved before re-injury, the problem can progress. A single large force put through a tendon can result in an acute episode of pain and inflammation. If a force is large enough, or a tendon has become degenerated over time, it is possible for the tendon to tear in part, or completely.
Symptoms of tendon injury include pain (often before and after activity), possible swelling, and reduced function and weakness of the affected body part. Because of the poor blood supply, tendons, like ligaments, can take quite some time to heal fully.
Treatment and prevention of injury
Each one of the injury types above is managed differently, and healing time depends on the severity. With any acute injury you’re pretty safe following the RICER protocol from the off (remember rest, ice, compression, elevation and referral). However, we recommend you get in touch with your us straight away because we will be able to get our hands on you to start treatment, as well as give advice on the whole rehab process. It is especially important to know when to begin putting load through the injured tissues again to ensure you decrease your healing time and any potential after-effects of the injury.
Remember that prevention is always better than cure. We recommend you always warm up before performing your activity. A good rule to follow is warm up with exercises that are going to prepare your body for the activity you are about to perform… For soccer, warm up with ball drills, light jogging, short sprints, jumps and dynamic stretches (i.e., stretches with movement). It’s best to save your static stretches (i.e., held stretches) for your post-match cool down!