Sprains, Strains, and Other Soft-Tissue Injuries

The most common soft tissues injured are muscles, tendons, and ligaments. These injuries often take place during sports and exercise activities, but sometimes simple everyday activities can lead to an injury. If you're in Mexico, Columbia, Fulton, Jefferson City, or Moberly, Missouri and feel that you may possibly have one of these, Dr. Weaver of Audrain Orthopaedics has info that you're going to want to know.

Sprains, strains, and contusions, and tendinitis and bursitis, are common soft-tissue injuries. Even with proper treatment, these injuries may require an extended amount of time to heal.


Soft-tissue injuries fall into two simple categories: acute injuries and overuse injuries.

•   Acute injuries result from an abrupt trauma, like a fall, twist, or blow to the body. Examples of an acute injury are sprains, strains, and contusions.

•   Overuse injuries occur progressively over time, when an athletic or other activity is repeated so often, areas of the body don't have enough time to heal in between occurrences. Tendinitis and bursitis are typical soft-tissue overuse injuries.

Enthesopathy of Knee Hip Sprain Hand Fracture Gait AbnormalityCommon Acute Soft-Tissue Injuries

Acute soft-tissue injuries vary in type and severity. When an acute injury occurs, initial treatment with the RICE protocol is typically quite effective. RICE is short for Rest, Ice, Compression, and Elevation.

•   Rest. Take a break from the task that resulted in the injury. The doctor might recommend that you use crutches to avoid putting weight on your leg.

•   Ice. Use cold packs for twenty minutes at a time, several times a day. Don't apply ice directly to the skin.

•   Compression. To avoid additional swelling and blood loss, put on an elastic compression bandage.

•   Elevation. To reduce swelling, elevate the injury higher than your heart while resting.


A sprain is a stretch or tear of a ligament, a strong band of connective tissue that connect the end of one bone to another. Ligaments stabilize and support the body's joints. For instance, ligaments in the knee join the thighbone with the shinbone, allowing individuals to walk and run.

The parts of your body that are most at risk of sprains are your ankles, knees, and wrists. A sprained ankle can take place when your foot rotates inward, placing intense tension on the ligaments of your outer ankle. A sprained knee can be the result of an unexpected twist, and a wrist sprain may occur whenever falling on an outstretched hand.

Sprains are classified by severity:

•   Grade 1 sprain (mild): Slight stretching and some harm to the fibers (fibrils) of the ligament.

•   Grade 2 sprain (moderate): Partial tearing of the ligament. There is abnormal looseness (laxity) in the joint when it is moved in particular ways.

•   Grade 3 sprain (severe): Complete tear of the ligament. This will cause considerable instability and makes the joint nonfunctional.

While the intensity differs, pain, bruising, swelling, and inflammation are widespread to all three categories of sprains. Treatment for mild sprains includes RICE and in some cases physical therapy exercises. Moderate sprains typically require a period of bracing. The most severe sprains might require surgery to mend torn ligaments.


Many people in the Central Missouri area are afflicted with strains too. A strain is an injury to a muscle or tendons. Tendons are fibrous cords of tissue that attach muscles to the bone. Strains often occur in your foot, leg, (usually the hamstring) or back.

Similar to sprains, a strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination. Typical signs of a strain include pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping.

Soccer, football, hockey, boxing, wrestling, and other contact sports put athletes in danger of strains, as do sports that feature quick starts, such as hurdling, long jump, and running races. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping have a high incidence of hand sprains. Elbow strains frequently occur in racquet, throwing, and contact sports.

The suggested treatment for a strain is exactly like for a sprain: rest, ice, compression, and elevation. This ought to be followed by simple exercises to alleviate pain and restore mobility. Surgery may be necessary for a more severe tear.

Contusions (Bruises)

A contusion is a bruise caused by a direct blow or repeating blows, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion might occur from falling or jamming the body against a hard surface. The discoloration of the skin is triggered by blood pooling around the injury.

Most contusions are minimal and respond well with the RICE protocol. If symptoms persist, medical care should be sought to avoid permanent damage to the soft tissues.

Common Overuse Soft-Tissue Injuries


Tendinitis is an inflammation or irritation of a tendon or the covering of a tendon (called a sheath). It is caused by a series of small stresses that repeatedly aggravate the tendon. Symptoms generally include swelling and pain that worsens with activity.

Professional baseball players, swimmers, tennis players, and golfers are prone to tendinitis in their shoulder and arms. Soccer and basketball players, runners, and aerobic dancers are prone to tendon inflammation in their legs and feet.

Tendinitis may be treated by rest to eliminate stress, anti-inflammatory medication, steroid injections, splinting, and exercises to correct muscle imbalance and improve flexibility. Persistent inflammation could potentially cause considerable damage to the tendon, which may require surgery.


Bursae, are little, jelly-like sacs which are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They have a small amount of liquid, and are positioned between bones and soft tissues, acting as cushions to help decrease friction.

Bursitis is inflammation of a bursa. Repeated small stresses and overuse can cause the bursa in the shoulder, elbow, hip, knee, or ankle to swell. A lot of people experience bursitis in association with tendinitis.

Bursitis can generally be relieved by changes in activity and potentially with anti-inflammatory medication, like ibuprofen. If swelling and pain do not react to these measures, your physician may recommend getting rid of fluid from the bursa and injecting a corticosteroid medication into the bursa. The steroid medication is an anti-inflammatory drug that is more powerful than the medication that can be taken by mouth. Corticosteroid injections generally work well to alleviate pain and swelling.

Though surgery is hardly ever needed for bursitis, if the bursa becomes infected, an operation to drain the fluid from the bursa may be necessary. Also, if the bursa continues to be infected or the bursitis comes back after all nonsurgical treatments have been tried, your physician may suggest removal of the bursa.

Removal (excision) of the bursa may be done with a standard incision (open procedure), or as an arthroscopic procedure with little incisions and surgical instruments. Your physician will talk with you about the best procedure for your medical needs.


Injuries often take place when people suddenly increase the duration, intensity, or frequency of their activities. Many soft-tissue injuries may be prevented through proper conditioning, training, and equipment. Other prevention tips include:

•   Use appropriate equipment. Replace your athletic shoes as they wear out. Wear comfortable, loose-fitting clothes that let you move freely and are light enough to discharge body heat.

•   Balanced fitness. Establish a balanced fitness program that integrates cardiovascular exercise, strength training, and flexibility. Add activities and new exercises cautiously. Whether you've been sedentary or are in good physical shape, don't try to take on too many activities at once. It is best to add a maximum of one to two new activities per workout.

•   Warm up. Loosen up to get ready to exercise, even before stretching. Run in place for several minutes, breathe slowly and deeply, or gently rehearse the motions of the exercise to follow. Warming up increases your heart and blood flow rates and loosens up other muscles, tendons, ligaments, and joints.

•   Keep yourself hydrated. Drink sufficient water to prevent dehydration, heat exhaustion, and heat stroke. Drink 1 pint of water 15 minutes before you begin exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.

•   Cool down. Make cooling down the last phase of your exercise program. It should take two times as long as your warm up. Slow your motions and lessen the intensity of your movements for at least ten minutes before you stop totally. This phase of a safe exercise program should conclude whenever your skin is dry and you have cooled down.

•   Stretch. Start stretches slowly and carefully until reaching a point of muscle tension. Hold each stretch for 10 to 20 seconds, then slowly and carefully release it. Inhale before every stretch and exhale as you release. Do each stretch only once. Never stretch to the point of pain, always keep control, and never bounce on a muscle that's fully stretched.

•   Rest. Schedule regular days off from vigorous exercise and rest when tired. Fatigue and pain are excellent reasons to not exercise.

•   Avoid the "weekend warrior" syndrome. Try to get at least 30 minutes of moderate physical exercise every day. If you are truly low on time, you can break it up into 10-minute chunks.

Whether an injury is acute or due to overuse, if you develop symptoms that linger, contact your physician. Should you not already have a doctor to deal with this kind of injury, get in touch with Dr. Weaver at Audrain Orthopaedics today.

We walked many a mile and saw lots of beautiful scenery!  Thanks for fixing my knee!

S.D. age57