Soft tissue Lesions

Introduction
Soft tissue:- In anatomy, soft tissues are the tissues
that connect, support, or surround other structures
and organs of the body, not being bone.
Soft tissue includes tendons, ligaments, fascia, skin,
fibrous tissues, fat, synovial membranes, muscles,
nerves and blood vessels.
Soft tissues
Skin
Fatty tissues
Muscles
Blood vessels
Fibrous tissues
Membranes
Glands
Nerves
Soft Tissue Injuries
What is a soft tissue injury?
Basically, this refers to an injury to any part of
your body other than your bones or joints. These
include:
1. Open
2. Closed
Soft Tissue Injuries
Types
Closed
1. Sprain
2. Strain
3. Dislocation
4. Subluxation
5. Muscle/tendon rupture or tear
6. Tendinous lesions/ tendinopathy
7. Contusion
8. Hematoma
Sprain
Sprain
Ligaments are tough strands
of tissue that
hold bones together.
A tear or injury to a
ligament is called a sprain.
Severe stress, stretch, or tear
of soft tissues, such as joint capsule, ligament, tendon, or
muscle.
Term is frequently used to refer specifically to injury of a
ligament and is graded as first- (mild), second-
(moderate), or third- (severe) degree sprain.
Strain
Tendons are tough strands
of tissue that connect
muscles to bones.
An injury or tear to
a muscle or tendon
is called a strain.
Overstretching, overexertion, overuse of soft tissue. Tends
to be less severe than a sprain. Occurs from slight trauma or
unaccustomed repeated trauma of a minor degree.
Term used to refer specifically to some degree of disruption of
the musculotendinous unit
FIRST aid
•You can recognize strains
•and sprains by swelling,
•bruising, and pain at
•the site of the injury.
•Strains and sprains
•can be serious,
•and you should
•get help for them.
Dislocation
Dislocation: Displacement of a part,
usually the bony partners in a joint resulting in loss of
the anatomical relationship and leading to soft tissue
damage, inflammation, pain, and muscle spasm.
Subluxation
An incomplete or partial dislocation of the bony
partners in a joint that often involves secondary trauma to
surrounding soft tissue.
Muscle/tendon rupture or tear
If a rupture or tear is partial, pain is experienced when
the muscle is stretched or when it contracts against
resistance.
 If a rupture or tear is complete, muscle does not pull
against the injury, so stretching or contraction of the
muscle does not cause pain.
Tendinous lesions/tendinopathy
Tenosynovitis is inflammation of the synovial membrane
covering a tendon.

Tendinitis is inflammation of a tendon; there may be

resulting scarring or calcium deposits.

Tenovaginitis is inflammation with thickening of a tendon

sheath.

Tendinosis is degeneration of the tendon due to repetitive

microtrauma.
Soft Tissue Injury
Synovitis: Inflammation of a synovial membrane; an
excess of normal synovial fluid in a joint or tendon sheath
caused by trauma or disease.
Hemarthrosis Bleeding into a joint, usually due to
severe trauma.
Ganglion: Ballooning of the wall of a joint capsule or
tendon Ganglia may arise after trauma, and they
sometimes occur with rheumatoid arthritis.
Bursitis: Inflammation of a bursa.
 Contusion
A traumatic injury to the
tissues beneath the skin
without a break in the skin.
Bruise
Hematoma
Blood collected within the skin, muscles or in a
body cavity. A large hematoma can be seen or
felt.
Similar to contusion
More tissue damage
Involves larger blood vessels
Treatment of Soft tissue injuries
A. Acute
B. Sub acute
C. Chronic
Acute Injuries Treatment
Acute Management
Acute management of the common soft tissue injuries is
still governed by the acronyms RICE or PRICE. Where
P The P is protection of the injured tissues.
R indicates rest, but this is relative rest to protect the
injured structure(s) while maintaining or increasing the
integrity of the surrounding structures

I stands for ice or the application of cold. This therapeutic

modality reduces the heat and decreases the pain of the
inflammatory process.
Acute Management
C entails compression by wrapping the injured area to
prevent increased edema and swelling. This is most
commonly accomplished with an ace wrap, but there
are several options including sleeves, stockinet, or
braces available to accomplish the task.
E implies elevation in an attempt to drain accumulated
fluid away from the injured area.
Open Wounds
1. Abrasion
2. Laceration
3. Avulsion
4. Amputation
5. Crush injury
6. Blast injury
Open Wounds
Abrasion — Damage to the superficial layer of
skin as a result of rubbing or scraping across a rough
or hard surface.
Laceration — A cut in the skin.
Avulsion — Soft tissue that is either torn
completely loose or is hanging as a flap
 Amputations---An amputation is the “cutting
away from the body of a limb or protruding
structure”.
Treatment: Open Injuries
Expose wound
Clean surface of wound
Control bleeding
Provide care for shock
Prevent further contamination
Bandage dressings in place after bleeding is
controlled
Keep patient still
Reassure patient
Cumulative Trauma
A cumulative trauma is a condition where a part of
the body is injured by repeatedly overusing or causing
trauma to that body part.
Repetitive Stress Injury is a syndrome that affects
bones, muscles, tendons, nerves and other anatomical
features. It develops when a minute injury occurs
repeatedly from over or misappropriate use of a body
part.
Signs or Symptoms
 Painful joints
 Pain in wrists, shoulders, forearms, knees, etc.
 Pain, tingling or numbness in hands or feet
 Fingers or toes turning white
 Shooting or stabbing pains in arms or legs
 Back or neck pain
 Swelling or inflammation
 Stiffness
 Burning sensations
 Weakness or clumsiness in hands; dropping things
INCREASED RISK FACTORS
Look for These Indicators
 Awkward Postures
 High Hand Force
 Highly Repetitive Motion
 Repeated Impact
 Heavy, Frequent or Awkward Lifting
 Moderate to High Hand-Arm Vibration
 What causes CTDs?
There could be one or several causes of CTDs. The
repetition of small, rapid movements
working in a static and/or awkward posture for long
periods of time
insufficient recovery time (too few rest breaks)
improper workstation setup
forceful movements
excessive grasping
poor work techniques may contribute to injury.
Some conditions associated with CTDs are:
broken or dislocated bones, arthritis, thyroid gland
imbalance, diabetes, hormonal changes from menopause,
and pregnancy
Common CTD
Bursitis:
Carpal Tunnel Syndrome (CTS)
Cubital Tunnel Syndrome
DeQuervain’s Disease
Epicondylitis
Guyon’s Canal Syndrome
Impingement Syndrome
Radial Tunnel Syndrome
Tendonitis
Tenosynovitis
Trigger Finger
Thoracic Outlet Syndrome
 PREVENTION
Learn about CTDs and their risk factors.
Think about your job and evaluate your work station,
tools, equipment, and work habits.
Write down your concerns regarding possible or
existing cumulative trauma problems.
Take regular breaks from repetitive work and rotate
tasks.
 Stretch and exercise the affected body part(s).
 PREVENTION
Involve your health and safety committee in
ergonomics or set up an ergonomic
committee to identify commonly experienced
cumulative trauma problems and discuss possible
solutions with your employer.
Lastly, if you suspect that you might have a work-
related cumulative trauma disorder, seek medical
treatment as soon as possible to prevent further and
permanent damage