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Soft tissue injuries
Definition:
The term soft tissue implies of skin , muscles ,
subcutenoues tissue , fasscia , tendon, bursa ,
synovium, capsule,nerves etc
...

Indirect:
Due to injuries, muscle pull,ligament sprain etc
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2
...

4
...

 prevention of blood loss or control it
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 Minimise odema & pain
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 Long term goals:
 Restore movement
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 Restore ADLs
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 Teach proper safety manners to prevent injury
in future
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1
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Reasons:
 sudden arbut action or move may tear the
muscle
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Types:
 Acute:
due to sudden violent force or direct
trauma
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Severity of strain:
4 grades
Grade 1: (mild contusion)
-due to blunt injury or due to direct truma
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-Bleeding in minimal
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 c/f:
- localised pain
- tenderness
- spasm
- function is not impaired to greater extent
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- Gentle massage
- Gentle active muscle streach
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-Compression bandaging
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 Grade 2:
-due to serious truma
Pathology:
-greater no
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-there is more bleeding
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-heametoma is localised
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- Tenderness is severe
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- Unable to do movement
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Of muscle
fibers are involved
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- Fascia is partially torn
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- Severe pain and loss of function
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For first 24 hrs
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- Compression bandage
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- Limb immob
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- Isometrics to the muscle which are
immob
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2
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- Streaching within pain limit
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- Massage to releve spasam
...
ber
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Rest of the measures are same as above
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For 48-72 hrs:
-more various active movements are
done
...
ber
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After 72 hrs:
- Pressre bandage is totally removed
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max
,according tp fowlers tech
...
ber
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 Grade 4:
- -severe truma
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- Fasica is torn
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- Gross swelling
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- Palpable gap btwn the muscles felt
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- Active mov
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- Muscle spasam is very severe
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- direct mucles repair is avoided
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- Active execerise to the unaffected joint
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Isotonic exe
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- Non wt
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- Use of low frq, current (faradisam ) to
obtain passive contaction
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Sprain :
-Injury to ligament
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- Streach test is +ve
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- Active movements to unaffected joints
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- Isometric exe
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- Rest of the measures are same as above
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- Lig
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- Swelling is severe
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- Movement is grossly restricted
...
ber
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- Function is severe affected
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- Comprssion bandaging or knee cap
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 Grade 3:
- Severe violence
- Gross swelling
- Pain and tenderness is quiet severe
...
Is unstable
...
ber
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- Compression band
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- Isometric exe
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- Active exe
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 Surgical:
- If the lig
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- Isometric exe
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- Non wt be
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- Pressure band
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- Limb elevation to prevent odema
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- Active exe
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Begun slowly and
progressively
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- Passive rom exe
...
&self resisted exe
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- Wt
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- Pt
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Synovitis:
- Inflammation of synovium
...
,TB,
hemophillia
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c/f:
-

swelling of jt
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Pain present over the injured area
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Limb will be in flexion attitude due to accomodtion
of fuiled
...
feel sudden pain at back of the knee while stir
climbing or rtting up from chair
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during 24hrs:
- Ice therapy
- Compression band
- Elevation of limb
- Isometric of aft
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- Active movement of unaf
...
Part
...
after 24 hrs:
- Aspiration of jt
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- Small range of gradual active movement
- Partial wt
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- GRADUALLY PRE
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Chronic :
c/f:
- firm swelling
- muscle atrophy
- jt
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Mx:
- Res
...
To affected limb
- Isometric exe
...
Limb
- Passive ROM exe
...

- Propaer gait training
- US,TENS,SWD, other heat modality to over come
heat and spasm
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Causes:
Truma :single blow or repetitive blow
Infection :acute or chronic
Metabolic disorder:gout
Abnormal external pressure:hip ischial tubrocity,
student’s elbow etc
Inflammatory disorder:RA

Common sites :
UL: subacromion , olecranon

LL: prepattelar
- Tendoachilles
- Medial side of grt toe
- Lat
...
Is painfull
- tenderness
mx:

 due to friction:
- rest
- thermotherapy:US, TENS, SWD,
- cryo
- restricted wt
...

- Isometric exe
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- Joint mobilization if there is restriction
- Injection of hydrocortisone in intractable cases
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 Chronic case:
- Appropriate support like pad, footwear etc
- Avoid repetitive frictional movement
- Relexed passive movements
- Active limited ROM with strong isometric
- PRE
- US,SWC,TENS
- Deep friction massage
- Active exercise to unaff
...

- Isometrics with limb elevation

Tenosynovitis:
- This is due to inflamtion of synovial of the tendon
sheath
...

Types:
 Irritavtive :
- Due to abnormal or excessive friction
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- Watery effusion due to sheath inflamtion
...

Mx:
 Irritative:
- Rest
- Spilting
- Bandaging
- US,SWD,TENS
- Shoe modification
- Surgical excision if nedded
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- Immobilisation 2-3 months
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Tenovaginitis:
Eg; de quervain’s disease
- Inflammation of fibrous sheath
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Mx:
As same as tenosynovitis

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