Contusions Strains and Sprains

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What are contusions?


A contusion is a soft tissue injury that occurs when a blunt force such as a hard blow, kick or fall. Many small blood vessels rupture by the sheer amount of force applied and which results in bleeding into the soft tissues commonly known as bruising.

A hematoma develops when bleeding is sufficient enough to cause an appreciable and evident collection of blood around the injured area. Local symptoms such as pain, swelling and discoloration can be effectively treated by the RICE method, an abbreviation for rest, ice, compression and elevation of the injured area. Most contusions are normally healed within one to two weeks of rest and limiting mobility of the affected extremity.

What are Strains?

A strain is a pulling of the muscle which occurs when a muscle is abruptly stretched by overuse, over-stretching or excessive stress. Strains are generally graded along a continuum based on post-injury symptoms and loss of function, which reflects the degree of injury. There are three types of strain and these are:

1. First Degree Strains reflect tearing of a few muscle fibers and is attended by minor edema, tenderness and mild muscular spasm without noticeable loss of function.

2. Second Degree Strains involve tearing of more muscle fibers and is manifested by noticeable loss of load-bearing strength with accompanying edema, tenderness, muscle spasm and ecchymosis (bluish discoloration of the skin).

3. Third-degree strain is the most severe type of strain and it involves complete disruption of at least one musculotendinous unit that involves separation of an entire muscle to muscle unit, muscle to tendon or tendon from bone. A patient with this kind of strain normally presents severe and significant amount of pain and complete immobility of the injured extremity accompanied by muscle spasms, ecchymosis, edema and loss of function. An x-ray should be obtained in order to rule out the possibility of fracture (in which a bone fragment is pulled away from the bone by a tendon) which may be associated with a third-degree muscle strain.

What are Sprains?

A sprain is an injury to the ligaments and supporting structures of the musculoskeletal system that generally supports muscle fibers surrounding a particular joint. Is occurs when here is a sudden wrenching or twisting motion of a joint that is more than its normal range of motion. The function of the ligament is basically to help in stabilizing and articulating bones of a joint while permitting decent amount of mobility. A torn ligament results in the loss of stability and integrity of the underlying support structures of the affected joint. When there is a rupture of the blood vessels and presence of edema movement of the affected joint becomes painful. The degree of disability and pain significantly increases within the first 2-3 hours following the injury due to the associated swelling and bleeding. Similarly like strains, sprains are also graded in a similar classification.

  1. A First Degree Sprain is caused by tearing of a few ligament fibers. It is manifested by mild edema, local tenderness, and pain is elicited when the joint is moved.
  1. A Second Degree Sprain Involves tearing of more fibers which results in increased edema, tenderness, pain with motion, joint instability, and partial loss of normal joint function.
  1. A Third Degree Sprain occurs when a ligament is completely torn. It is manifested by severe pain, tenderness, increased edema and immobility of the affected joint.

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