Strains, Sprains and…Automobiles?!

October 1, 2010
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This month we’re taking on the topic of commonly suffered injuries by our most beloved National Football League players.  As mentioned last week, it’s hard for us to be sympathetic towards players who suffer injuries we think they are capable of playing through.  The hope is that with a little more understanding of their injuries, our sympathy might go a stitch further…although probably not too far!

Last week we discussed turf toe including the limitations and long-term implications this injury can have on a professional athlete if not treated properly.  As promised, this week we will be discussing muscle injuries!  In order to do so, there are a few distinctions that must first be made.

  1. A strain describes an injury to a muscle.  Essentially a strain describes a series of “micro-tears” in a muscle belly, which may also be referred to as a “muscle pull.”
  2. A sprain describes an injury to a ligament.  Ligaments are bands of tough (fibrous) tissue that connect bone to bone and provide support to joints (ankle, knee etc) preventing motion of the joint in an abnormal direction.  Sprains will not be the focus of this week’s blog.
  3. A torn muscle describes a partial or complete tear that is typically much more debilitating to the athlete than a strain would be.
  4. A ruptured muscle is also a torn muscle, but only refers to a complete tear in the muscle and typically indicates shortening of the muscle fibers, making repair and recovery much more difficult.

Now that we’ve clarified those few terms, lets discuss how an athlete, who may be among the most “in-shape” individuals, suffers an injury to their muscle.  A muscle becomes strained, torn or ruptured when a sudden, extreme force is applied to the muscle and stretches the muscle fibers beyond their capacity.  This may occur by a direct force to a joint for which the muscle or the muscle tendon may cross, or may also occur with an abnormal motion of the muscle in a direction in which it is not designed to act.  No matter which mechanism occurs, if you’ve ever watched an athlete suffer a muscle injury, you will notice that they immediately grab the area of injury, indicating the instant pain and inflammation that occurs!

To differentiate between a strain, torn, or ruptured muscle, the best and most definitive study would be an MRI (Magnetic Resonance Imaging).  It is able to capture defects in the muscle belly in addition to inflammation in and around the area of complaint.  However, testing the strength of the injured muscle compared to the healthy side can also provide an indication as to the extent of injury and help classify it as a strain, partially torn or ruptured muscle.

Initial treatment for a muscle injury includes ice and rest, in addition to anti-inflammatory medications.  After several days of this, gentle and passive stretching (meaning by a physical therapist and not by the athlete) can be initiated.  This stretching will prevent the muscle fibers from healing in a shortened position, which would predispose the muscle to becoming re-injured.  The best indicator of healing is the amount of pain, or the decrease in pain the athlete is suffering from.  However, an increase in muscle strength from initial examination after the injury is also indicative of healing.  In the most benign of muscle injuries (strains) the athlete can be back in action within two weeks.  However, with a torn muscle (one that is not completely ruptured) this process can take much longer, sometimes more than a month!  In the worst-case scenario where the muscle has been ruptured, surgical repair is often recommended, for which recovery can be months long!

As with most things that we’ve discussed over the last year, prevention of muscle injuries provides the best scenario for the athlete and for his/her supporters.  Of course, athletes must focus on flexibility and strength through training, but proper stretching and ensuring adequate warm-up before and cool-down after activity will also help prevent muscle injuries.  It is important that at the first sign of possible injury, the athlete be evaluated by their “on-staff” Podiatrist, Orthopedist or Athletic Trainer to prevent further or more detrimental injury!  Early evaluation can make the difference between a simple strain, or a strain that turns into rupture.

Check back next week, as I’ll be blogging about tendonitis!

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