Soft Tissue and Muscular Injuries

A strain is an injury to either a muscle or a tendon that connects the muscle to the bone. It is the result of muscular fibre tears due to overstretching and are caused by a quick twist, pull of sudden movement. Strains can be categorized into grades 1,2 and 3, depending on the severity of the strain.

• Grade 1: There is damage to individual muscle fibres (less than 5% of fibres). This is a mild strain.
• Grade 2: There is more extensive damage, with more muscle fibres involved, but the muscle is not completely ruptured.
• Grade 3: This is a complete rupture of a muscle. This will require surgery to repair the muscle.

Symptoms include: Yelping/crying in pain, swelling, tenderness and stiffness in the affected area, limping, off their food, depressed.

• Begins with the inflammatory response which can last 3-5 days. The body produces chemicals and cells which remove dead muscle fibres and start the repair process. It is therefore a crucial time to rest and protect the part.
• Regeneration of muscle fibres – new fibres grow from special cells within the muscle.
• Formation of scar tissue – there is bleeding in the gap between the torn muscle ends, and this blood, a matrix forms to anchor the two ends together. The matrix eventually forms a scar within the muscle.
• Maturation of the scar tissue – the collagen fibres which make up the scar tissue become aligned along the lines of external stress and are able to withstand more force.

Because these fibres are more haphazard than before injury, they feel more fibrous when palpated and have the effect of shortening the muscle, which can end up in pulling the skeleton out of alignment as well as causing the body to overcompensate in other areas.

Massage will help regain the suppleness and flexibility to the muscle tissue by breaking down this restrictive scar tissue and realign the fibres in the direction of that particular muscle. This is why an indepth knowledge of anatomy is so important when remodeling scar tissue.

It is almost impossible to get rid of scar tissue all together, and areas of injury will start to tighten up again over time, which is why bodyworkers will recommend regular maintenance treatments after an injury has healed.

Adhesions can form following a muscle strain, because the resulting scar tissue is not as flexible as good tissue, creating restrictions in the muscle and the fascia and allowing them to become stuck together causing an adhesion.

When overuse of a muscle occurs, muscle adhesion, inflammation and scar tissue amongst many other problems can manifest. Overuse causes injury where tissue changes in 3 ways:

• The tissue doesn’t get enough oxygen – hypoxia.
• An accumulation of small tears – micro-trauma.
• This can cause the tissue to restrain – the strain/restrain cycle.

These are hyperirritable spots in the muscle tissue and are taut, fibrous bands of muscle fibre – usually found in the belly of the muscle. This tautness of the muscle fibres causes a decrease in blood circulation as well as a decrease in oxygen, resulting in a build up of toxins.

Trigger points occur mostly in response to muscle tension due to overuse or nervous stress although it is sometimes due to a lack of activity resulting in a sluggish circulation. They are very tender to the touch and can cause referred pain in other parts of the body when palpated.

Symptoms may include: Difficulty moving, unwillingness to be groomed/touched, twitching down their back, bad tempered.

Massage is the treatment for trigger points and can initially be painful, requiring myofascial release, to elongate and relieve strain patterns, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop.

A spasm is a sudden, involuntary contraction of a muscle or groups of muscle. In very severe cases, the spasm can cause muscular contractions that are more forceful than the muscle could generate under normal circumstances. This can lead to torn ligaments and tendons. Muscles can also tear when under stress if muscular guarding occurs with overcompensation of tightness by the surrounding muscles to prevent further damage.

Reasons why spasms occur:

• Prolonged uncomfortable activity – muscle overload
• Weakness in the muscle (previous strain)
• Aggravating an underlying existing issue (old injury)
• Insufficient hydration
• Absence of some minerals (such as magnesium)

Symptoms may include:

• Sometimes a sudden burst of pain
• Muscle feels tight and tender to touch
• The muscle may twitch as the dog stretches or bows
• Unable to move in their normal way

If the initial injury is not treated, the spasm forms knots of muscle fibres, which are painful and go on to become part of an ongoing problem and part of the vicious Pain – Soreness – Pain cycle.

Myofascial Pain Syndrome is a form of chronic muscle pain caused by trigger points. Trigger points are small, hyperirritable contraction knots in the muscle that cause referred pain when touched.
These trigger points affect the fascia – which envelops and separates and binds together the muscles, organs and all other soft tissue – and this pain can radiate to other areas or cause referred pain (pain in other areas).

Symptoms may include:

• Deep, aching pain in a muscle
• Pain that persists or worsens over time
• Muscle stiffness
• Joint stiffness near the affected muscle
• Area of tension in the muscle that may feel like a knot or tight spot which is sensitive to touch (trigger point)

Myofascial pain syndrome can be caused by a muscle injury, overuse, or repetitive stress of muscles. Although it is not life threatening, muscle weakness can occur over time due to inactivity, or guarding muscles due to pain. Very unpleasant.

A sprain is an injury to a ligament – caused by a joint being moved beyond its limits.

There are 4 grades of sprains:

Grade 1 – minor tear, where a few fibres are affected

Grade 2 – a 1/3rd more fibres are torn and the area is swollen

Grade 3 – complete rupture of the ligament

Grade 4 – complete rupture of the ligament that takes a piece of bone with it

Symptoms may include:

• Initial sharp pain
• Non-weight bearing, or ‘toe tapping’ which does not improve – your dog will find a way of shifting weight off the affected limb
• If in the stifle joint, sitting with leg abducted
• Loss of muscle tone over time

Ligaments are made up of collagen fibres and have a poor blood supply. These injuries take a long time to heal and grade 3 and 4 will need surgery and a long period of rest afterwards (see cruciate ligament).