Ketegangan Otot (kecederaan)

Daripada artikel journal yang telah diperolehi, kecederaan otot adalah salah satu trauma paling biasa berlaku dalam sukan. Walaupun kepentingan klinikal mereka, terdapat hanya beberapa kajian klinikal ke atas rawatan kecederaan otot. Kekurangan kajian klinikal adalah yang paling mungkin disebabkan kepada fakta bahawa terdapat bukan sahaja kepelbagaian yang tinggi dalam keterukan kecederaan, tetapi juga kecederaan yang berlaku dalam otot yang berbeza, menjadikan ia sangat mendesak untuk menjalankan ujian klinikal.

Sehubungan itu, prinsip rawatan semasa kecederaan otot telah sama ada telah diperolehi daripada kajian eksperimen atau telah diuji secara empirikal sahaja. Klinikal, pertolongan cemas bagi kecederaan otot berikut prinsip BERAS (Rehat, Ais, Mampatan dan elevation). Objektif NASI adalah untuk menghentikan pendarahan disebabkan oleh kecederaan ke dalam tisu otot dan dengan itu mengurangkan takat kecederaan. Pemeriksaan klinikal perlu dijalankan sebaik selepas kecederaan dan 5-7 hari selepas trauma awal, di mana titik keterukan kecederaan boleh dinilai dengan lebih tepat. Pada masa itu, pencirian lebih terperinci kecederaan boleh dibuat menggunakan kaedah pengimejan diagnostik (ultrasound atau MRI) jika dikehendaki. Rawatan otot rangka yang cedera perlu dijalankan oleh pelumpuhan segera otot tercedera (klinikal, imobilitas relatif / mengelakkan pengecutan otot ). Walau bagaimanapun, tempoh pelumpuhan harus terhad kepada tempoh yang cukup untuk menghasilkan parut kekuatan yang mencukupi untuk menanggung daya yang disebabkan oleh remobilisation tanpa pecah semula dan kembali ke aktiviti (mobilisasi) maka perlu dimulakan secara beransur-ansur dalam had kesakitan. Pulangan awal kepada aktiviti diperlukan untuk mengoptimumkan pertumbuhan semula penyembuhan otot dan pemulihan fleksibiliti dan kekuatan otot rangka cedera kepada tahap pra-kecederaan. Program pemulihan harus dibina di sekitar ketangkasan progresif dan latihan penstabilan batang, sebagai senaman ini seolah-olah untuk menghasilkan hasil yang lebih baik untuk cedera otot rangka daripada program eksklusifnya berdasarkan kepada regangan dan pengukuhan otot cedera.

Menurut laman web eksiklopedia bebas Wikipedia , Ketegangan Otot (kecederaan) didefinisikan sebagai suatu proses yang bertujuan meningkatkan prestasi manusia melalui aktiviti fizikal Ketegangan adalah kecederaan kepada otot atau tendon di mana gentian otot lusuh sebagai hasil overstretching . Ketegangan Otot juga colloquially dikenali sebagai otot ditarik. Kecederaan bersamaan dengan satu ligamen adalah terseliuh . Strain (injury)

This article is about the injury. For other uses, see Strain.

Strain (injury)

Classification and external resources

ICD-10M

HYPERLINK "http://apps.who.int/classifications/icd10/browse/2010/en" \l "/M62.6" 62.6, T

HYPERLINK "http://apps.who.int/classifications/icd10/browse/2010/en" \l "/T14.3" 14.3

ICD-9848.9

MeSHD013180

A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching. A strain is also colloquially known as a pulled muscle. The equivalent injury to a ligament is a sprain.[1]

The musculo-tendinous junction extends deeply into the muscle

Muscle strain is an injury to the musculotendinous junction. The tendinous junction is where the muscle fibers meet the tendon, and the shape of it varies in different muscles. In many muscles, the tendon extends deeply into the muscle creating a long musculo-tendinous junction (figure). This area is especially important in a trauma setting, because it is often involved. The epimysium is the fibrous tissue that lies at the edge of the muscle. It becomes the muscle sheath that fuses with the tendon. This is also an important area to consider because when there is a tear in the muscle, fluid tends to leak out and collect in the epimysium.

The pattern of edema in muscle strain will depend on the architecture and shape of the musculotendinous junction involved. The image on the left nicely demonstrates the feather-like arrangement of the musculotendinous junction in an atrophic muscle.

The image on the left demonstrates edema surrounding the musculotendinous junction in a feather-like arrangement. This is a complete tear to the rectus femoris (arrows).Symptoms

Two images of the same strain. One of the pictures was shot through a mirror.

Typical symptoms of a strain include: localized pain, stiffness, discoloration and bruising around the strained muscle.

CausesStrains are a result of muscular-fiber tears due to overstretching. They can happen while doing everyday tasks and are not restricted to athletes. Nevertheless, people who play sports are more at risk of developing a strain due to increased muscle use.

TreatmentThe first-line treatment for a muscular strain in the acute phase include five steps commonly known as P.R.I.C.E.[2]

HYPERLINK "http://en.wikipedia.org/wiki/Muscle_strain" \l "cite_note-2" [3] Protection: Apply soft padding to minimize impact with objects.

Rest: Rest is necessary to accelerate healing and reduce the potential for reinjury.

Ice: Apply ice to reduce swelling by reducing blood flow to the injury site. Never ice for more than 20 minutes at a time.

Compression: Wrap the strained area to reduce swelling with an ACE soft-wrapped bandage.

Elevation: Keep the strained area as close to the level of the heart as is conveniently possible to keep blood from pooling in the injured area.

The ice and compression (cold compression therapy) will stop the pain and swelling while the injury starts to heal itself. Controlling the inflammation is critical to the healing process and the icing further restricts fluid leaking into the injured area as well as controlling pain.

Cold compression therapy wraps are a useful way to combine icing and compression to stop swelling and pain.

This immediate treatment is usually accompanied by the use of nonsteroidal anti-inflammatory drugs[4] (e.g., ibuprofen), which both reduce the immediate inflammation and relieve pain. However, NSAIDs, including aspirin and ibuprofen, affect platelat function (this is why they are known as "blood thinners") and should not be taken during the period when tissue is bleeding because they will tend to increase blood flow, inhibit clotting, and thereby bleeding and swelling. After the bleeding has stopped, NSAIDs can be used with some effectiveness to reduce inflammation and pain.

It is recommended[5] that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or fractured bone, a sprain, or a complete muscle tear.

Therapeutic ultrasound can be used to break down poorly healed muscle strains and permit them to heal properly.

References1. ^ Fitness For Dummies p 60, Suzanne Schlosberg, Liz Neporent, For Dummies, 2005, ISBN 0-7645-7851-02. ^ Mnemonic at medicalmnemonics.com 2353. ^ T. A. Jrvinen, et al., "Muscle injuries: optimising recovery" , Best Pract Res Clin Rheumatol., 21 (2) Apr 2007, pp. 317-31.4. ^ TJ Noonan and WE Garrett, Jr, "Muscle strain injury: diagnosis and treatment," Journal of the American Academy of Orthopaedic Surgeons, 7 (4), Jul-Aug 1999, pp. 262-9, see web version (accessed Aug. 25, 2008)5. ^ R. Neustaedter, "Natural Treatment for Injuries" (accessed Aug. 25, 200Muscle Strain

Muscle strain is injury to muscle as a result of strenuous activity. Almost anyone can put undue pressure on muscles during the course of normal daily activities, with sudden, quick heavy lifting, during sports, or while performing work tasks. Muscle strain is sometimes referred to as muscle pull. A severe muscle strain can result in a muscle tear. The tearing of the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area). A sprain, in contrast, is an injury to ligaments.

Muscle Strain Symptoms and Signs

Swelling, bruising or redness, or open cuts as a consequence of the injury

Pain at rest

Pain when the specific muscle or the joint in relation to that muscle is used

Weakness of the muscle or tendons (A sprain, in contrast, is an injury to a joint and its ligaments.)

Inability to use the muscle at all

When to Seek Medical Care

If you have a significant muscle injury (or if the home care methods bring no relief in 24 hours), call your doctor.If you hear a "popping" sound with the injury, cannot walk, or there is significant swelling, pain, fever, or open cuts, you should be examined in a hospital's emergency department.

Exams and Tests

The doctor will take a medical history and perform a physical exam. On exam, it is important to establish whether the muscle is partially or completely torn (which can involve much longer healing, possible surgery, and a more complicated recovery).

X-rays or laboratory tests are often not necessary, unless there was a history of trauma or evidence of infection.

Muscle Strain Treatment, Self-Care at Home

The amount of swelling or local bleeding into the muscle (from torn blood vessels) can best be managed early by applying ice packs and maintaining the strained muscle in a stretched position. Heat can be applied when the swelling has lessened. However, the early application of heat can increase swelling and pain.

Note: Ice or heat should not be applied to bare skin. Always use a protective covering such as a towel between the ice or heat and the skin.

Take nonsteroidal anti-inflammatory agents such as aspirin (Bufferin, Ecotrin) and ibuprofen (Advil) to reduce the pain and to improve your ability to move around.

Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the affected muscle. Here's how: First, remove all constrictive clothing, including jewelry, in the area of muscle strain.

Protect the strained muscle from further injury.

Rest the strained muscle. Avoid the activities that caused the strain and other activities that are painful.

Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-inflammatory and pain-relieving agent. Small ice packs, such as packages of frozen vegetables or water frozen in foam coffee cups, applied to the area may help decrease inflammation.

Compression can be a gently applied with an Ace or other elastic bandage, which can provide both support and decrease swelling. Do not wrap tightly.

Elevate the injured area to decrease swelling. Prop up a strained leg muscle while sitting, for example.

Activities that increase muscle pain or work the affected body part are not recommended until the pain has significantly gone away.

Medical Treatment

Treatment is similar to the treatment at home. The doctor, however, also can determine the extent of muscle and tendon injury and if crutches or a brace is necessary for healing. The doctor can also determine if you need to restrict your activity, take days off work, and if rehabilitation exercises are required to help you recover.

Prevention of Muscle Strain

Avoid injury by daily stretching.

Stretch every time before you exercise.

Establish a warm-up routine prior to engaging in strenuous exercise.

Start an exercise program in consultation with your doctor.

Prognosis of Muscle Strain

In most cases, with proper treatment, most people recover completely from muscle strain. More complicated cases are handled on an individual basis by the doctor.

Authors and Editors

Author: William C. Shiel Jr., MD, FACP, FACREditor: Charles P. Davis, MD, PhDPrevious contributing authors and editors:

Author: Shahram Lotfipour, MD, Clinical Teaching Faculty, Department of Emergency Medicine, Pomona Valley Medical Center.

Coauthor(s): Dorris Powell, MD, Senior Consulting Staff, Associate Professor, Department of Emergency Medicine, Henry Ford Hospital.

Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Jeter (Jay) Pritchard Taylor III, MD, Vice-Chief, Compliance Officer, Attending Physician Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Richland Memorial Hospital, University of South Carolina.

REFERENCES:

Heftler, Jeffrey M. "Hamstring Strain." Medscape.com. Nov. 22, 2011. .

Klippel, John H., et al., eds. Primer on the Rheumatic Diseases. 13th ed. New York: Springer and Arthritis Foundation, 2008.

Muscle Strains and their PreventionIn a survey of injuries at a professional football club, it was reported that 26.8% of all injuries involved muscles and tendons (Lewin,1989). Muscles and their tendon attachments combine to form what are known as musculo-tendinous units. These musculo-tendinous units provide the force which is necessary for movement. Football is a dynamic sport which requires explosive movements (such as sprinting, jumping, shooting and heading the ball) with large forces generated by muscles and tendons. It is easy to see why over a quarter of all injuries affect these structures.

How is Muscle Structured?In order to understand how muscles are injured it is helpful to know how the muscle is made up. The muscle is surrounded by an outer sheath or covering. Inside this outer sheath are bundles of muscle fibres which are known as fasicles and are themselves surrounded by another inner sheath. If you looked at the bundles very closely you would just be able to see the individual muscle fibres. (The muscle fibres are made up of even smaller parts but a microscope is required to see them).

A muscle contracts when two of these microscopic parts link together and slide together (causing the muscle to shorten) or slide apart (causing the muscle to lengthen). If the muscle shortens, the result is movement of a joint in one direction; if it lengthens, it causes movement of a joint in the other direction. The co-ordination of this muscle activity by the brain allows us to perform complex movements such as kicking a football or running.

What is a Muscle Strain?A muscle strain is damage caused by over-stretching of muscle tissue. In football, this is thought to occur most frequently when movements such as sprinting, stretching for the ball or kicking the ball are carried out in an unco-ordinated manner. The muscle tissue becomes overloaded and reaches a breaking point where a tear or partial tear occurs. The player will experience pain that will persist if he or she attempts to stretch or contract the muscle. Depending on their severity, muscle strains are categorised into Grades 1, 2 or 3:

GRADE 1 STRAINThere is damage to individual muscle fibres (less than 5% of fibres). This is a mild strain which requires 2 to 3 weeks rest.

GRADE 2 STRAINThere is more extensive damage, with more muscle fibres involved, but the muscle is not completely ruptured. The rest period required is usually between 3 and 6 weeks.

GRADE 3 STRAINThis is a complete rupture of a muscle. In a sports person this will usually require surgery to repair the muscle. The rehabilitation time is around 3 months.

All muscle strains should be rested and allowed to heal. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.

How does a Damaged Muscle Heal?The healing process of a muscle strain begins with an inflammatory response which can last for three to five days. This is a crucial time during which rest and protection of the injured part is vital in order to prevent any further damage. During the inflammatory reaction the body produces chemicals and cells which remove dead muscle fibres and start the repair process. The repair process consists of three stages:

1. REGENERATION OF MUSCLE FIBRESNew muscle fibres grow from special cells within the muscle.

2. FORMATION OF SCAR TISSUEThere is bleeding in the gap between the torn muscle ends, and from this blood a matrix, or scaffold, is formed to anchor the two ends together. This matrix eventually forms a scar within the muscle that makes the muscle more resistant to further stretch damage.

3. MATURATION OF THE SCAR TISSUEThe collagen fibres which make up the scar tissue become aligned along lines of external stress and are able to withstand more force.

How are Muscle Injuries Treated?The immediate treatment consists of the 'PRICE' protocol: Protection of the injured part from further damage, Rest, Ice, Compression and Elevation. The aim of this protocol is to reduce bleeding within the muscle tissue. Ice therapy in the form of ice pack applications should be continued for the first three days after the injury (never apply ice directly to the skin). The rehabilitation after this period involves gradually stretching the muscle to elongate the scar tissue and progressively increasing the muscle strength. Once this has been achieved, the player can begin sport-specific exercises, such as running, jumping and kicking. To reduce the risk of re-injury, this should be done under the supervision of a chartered physiotherapist.

How can the Risk of Muscle Injury be Reduced?The following measures may have the effect of reducing the chances of sustaining a muscle strain:

Warm up prior to matches and training is thought to decrease muscle stretch injuries because the muscle is more extensible when the tissue temperature has been increased by one or two degrees. A good warm up should last about twenty minutes - starting gently and finishing at full pace activity. Practising match activities such as sprinting and passing helps tune co-ordination and prepare mentally for football. Recovery after training sessions and matches can be enhanced by performing a cool down, which is thought to help muscles get rid of waste products. This is also the ideal time to do stretching execises.Read our guide to warming up >Read our guide to cooling down > Maintaining good muscle strength and flexibility may help prevent muscle strains. Muscle strength allows a player to carry out match activities in a controlled manner and decreases the uncoordinated movements which can lead to injury. Tight muscles are associated with strains and stretching is therefore practised to maintain muscle strength and prevent injury.Read our guide to stretching > Diet can have an affect on muscle injuries. If a player's diet is high in carbohydrate in the 48 hours before a match, there will be an adequate supply of the energy which is necessary for muscle contractions. However, if the muscles become short of fuel, fatigue can set in during training or matches. This fatigue can predispose a player to injury. Carbohydrate and fluids can be replenished during training and matches by taking regular sips of a sports drink.

Common Muscle InjuriesAdductor muscles - these are commonly injured during football because they are put under a great deal of stress during turning activities. They are also very active during side foot passing.

Hip flexor muscles - these are the kicking muscles at the front of the hip which are very active during shooting and striking a ball.

Quadriceps muscles - these powerful muscles of the thigh are responsible for straightening the knee and are active during running, kicking and jumping.

Hamstring muscles - these muscles are located at the back of the thigh and are most active during running, particularly sprinting, which is when they are most often injured.