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ОглавлениеUnderstanding Soft-Tissue Injuries
Chapter
2
How do Soft-Tissue Injuries Show Themselves?
A serious soft-tissue injury can develop within minutes after an injury occurs, or it may slowly develop over years. A soft-tissue injury is characterized by symptoms such as:
Aching.
Tenderness.
Swelling.
Pain.
Tingling and numbness.
Loss of strength.
Loss of joint movement.
Decreased coordination.
In general, your injury is more serious if the symptoms:
Are more intense.
Are experienced frequently.
Last longer with each occurrence.
Worsen with increased activity.
It is important to realize that symptoms:
May appear in any order and at any stage during the development of a soft-tissue injury.
May not appear during, or immediately after, the activity that is causing the problem.
Are not necessarily experienced at the body part where the actual stress is occurring. For example: Carpal Tunnel Syndrome (CTS) is often diagnosed as compression of the median nerve at the site of the carpal tunnel. In reality, many cases of CTS are due to median nerve compression in the forearm, shoulder, or even the neck.
How do Soft-Tissue Injuries Show Themselves?
Soft-tissue injuries manifest with a broad range of symptoms and conditions. Acute injury and inflammation can result from one or more of the following factors – even without any external forces being applied:
Inflammation - Acute injury, repetitive motion, or the friction involved in lack of translation of adhesed tissue creates inflammation.
Friction, Pressure and Tension - Friction, pressure, and tension are increased when muscles, tendons, ligaments, or connective tissue adhere together. We often think of these factors as external forces, but this is often not the case. Reduced levels of internal tissue translation is sometimes all that is needed to initiate a cycle of inflammation, which in turn can lead to an acute injury.
Adhesions and Fibrosis - Adhesions (scar tissue) and fibrosis (excessive fibrous connective tissue) are a common consequence of soft-tissue injuries, acute pressure, or constant tension. The breaking down of these adhesions and fibrous connective tissue is a key requirement of any treatment protocol that aims to resolve soft-tissue injuries.
Decreased Circulation and Increased Edema: The constant internal pressures caused by a soft-tissue injury limits circulation to the affected tissues, resulting in decreased delivery of oxygen. Decreased oxygen, or hypoxia, causes several biochemical changes in the body including increased production of mRNA and alpha-1 procollagen. These biochemical changes cause an increase in chemotaxis, proliferation of fibroblasts, and leads to the formation of adhesions and scar tissue1.
Cellular Hypoxia - Describes a lack of oxygen to soft-tissues that occurs whenever there is restricted circulation. Hypoxia causes fibrosis and results in the formation of adhesions between tissues.
Weak and Tight Tissues - Repetitive actions tend to make muscles tighten. A short and contracted muscle is a weak muscle. Normally, muscles are amazing structures which are able to store, release, and even recycle energy. They are also great shock absorbers and act to displace force which otherwise would cause injury. Unfortunately, the buildup of adhesions in your muscles causes them to lose both these abilities.
Tear or Crush Injury - A typical tear or crush injury usually involves the application of an external force, such as what occurs with a motor vehicle accident. In addition, a tear or crush injury can also occur as a result of increased internal pressure, tension, or biochemical factors.
With many soft-tissue injuries, repetitive motions cause chronic irritation to soft tissue, resulting in increased friction and pressure, which eventually leads to small tears within the soft tissue. These in turn cause inflammation, decreased circulation, and edema.
Fig 2.1: Effects of Soft-Tissue Injuries on Your Body.
Types of Soft-Tissue Injuries
There are numerous types of soft-tissue injuries, with some of the most common being:
Back and Neck Injuries - Manifests as pain, inflammation, and tenderness to the nerves, tendons, muscles, and other supporting structures of the back. Back and neck injuries include whiplash injuries, disc problems, sciatica, lumbar strains, piriformis syndrome, facet syndrome, and arthritis. See Resolving Neck and Back Pain for more information.
Shoulder Injuries - Common shoulder injuries include Rotator Cuff Syndrome, Frozen Shoulder, Tendonitis, and impingement syndromes. See Resolving Shoulder Injuries for more information.
Elbow Injuries - Manifests as inflammation and pain on the inner and outer portions of the bony prominences known as the medial epicondyle and lateral epicondyle. Initially, it is the tendons that attach the muscles to these areas that become inflamed and injured. Common elbow injuries include Tennis Elbow and Golfer’s Elbow. See Resolving Elbow Injuries for more information.
Carpal Tunnel Syndrome (CTS) - Manifests as numbness and tingling of the hand, wrist pain, a pins-and-needles feeling at night, weakness in the grip, and a lack of coordination. See Resolving Carpal Tunnel Syndrome (CTS) for more information.
Knee Injuries - Common knee injuries include Runner’s Knee, Chondromalacia Patellae, ITB Syndrome, and meniscal and ligament pain. See Resolving Knee Injuries for more information.
Achilles Tendonitis - Manifests as inflammation in the tendons of the calf muscle at the point where the tendon attaches to the heel bone. Achilles Tendonitis causes pain and swelling at the back of the leg near the heel, and over the actual Achilles Tendon. See Resolving Injuries to the Achilles Tendon for more information.
Plantar Fasciitis - Manifests as inflammation, localized tenderness, or pain at the plantar fascia, a structure that stretches under the sole of the foot and attaches at the heel. See Resolving Plantar Fasciitis for more information.
All of these injuries, and many others, can be successfully and effectively treated with Active Release Techniques (ART). This book discusses many of these conditions, and describes both treatment methods and preventive measures that you can take.
Note: Ensure your Doctor first rules out any organic causes of soft-tissue injuries such as arthritis, renal failure, hypothyroidism, diabetes, high blood pressure, and hormonal imbalances. Most remaining cases of soft-tissue injuries are related to specific physical factors and can be successfully treated with ART.
The Cumulative Injury Cycle
The Cumulative Injury Cycle® is a self-perpetuating cycle that describes how acute injuries and soft-tissue injuries can become chronic problems. As we follow the cycle around, it is very easy to see how each factor leads to, or continues to perpetuate, the cycle of injury.
Fig 2.2: The Cumulative Injury Cycle® was formulated, tested, published, and copyrighted by Dr. P. Michael Leahy - developer of Active Release Techniques®.
The Law of Repetitive Motion
(Copyright: Dr. P. Michael Leahy, DC, CCSP)
Dr. Michael Leahy has defined and tested the Law of Repetitive Motion® to describe the physical factors involved in a Repetitive Strain Injury. The Law of Repetitive Motion provides a way to predict the possibility of RSI, and also points to possible solutions for addressing RSI problems by altering the key variables.
Applying the Law of Repetitive Motion
All the above factors must be addressed in order to completely resolve problems caused by repetitive actions. Most of these factors are under your control.
ART can very effectively increase your relaxation time (factor R) by removing the constant pressure and tension that results from the formation of adhesions or scar tissue.
Muscles that are restricted, tight, and adhesed cannot relax. By releasing these restrictions, ART can help you to achieve better muscle function, and prevent the return or reoccurrence of the repetitive strain injury.
Fig 2.3: Applying the Law of Repetitive Motion.
For more information about how the Law of Repetitive Motion applies to your injuries, read Applying the Law of Repetitive Motion to CTS.
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1. Hypoxia-induced VEGF and collagen I expressions are associated with angiogenesis and fibrogenesis in experimental cirrhosis, Christopher Corpechot, Veronique Barbu, Dominique Wendum, Nils Kinnman, Colette Rey, Raoul Poupon, Chantal Housset, Olivier Rosmorduc, Hepatology, Vol 35, No. 5, 2002.
