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What is Strain
A strain is an injury to a muscle or tendon caused by overuse, torn or stretching Strains can be classified as acute or chronic Acute strains are caused by stretching or pulling a muscle or tendon. Chronic strains are the result of overuse of muscles and tendons through prolonged, repetitive movement. In severe strains, the muscle, tendon, or both are partially or completely ruptured, resulting in serious injury. Some muscle function will be lost with a moderate strain, in which the muscle, tendon, or both are overstretched and slightly torn. With a mild strain, the muscle or tendon is stretched or pulled slightly. Strains are most common in the knees, feet, legs and back.
Incidence of Strain
- Strain account for 40% of football injury
- Strain is one of the most common form of workplace injury
- About 628,000 strains happens annually
Risk factors of Strain
- Athletes
- History of prior sprains or strains,
- Overweight
- People who are starting physical activity or exercise programs for the first time
- People with neurologic problems
- People with balance disorders.
Pathophysiology of Strain
A muscle strain occurs when muscle fibers tear due to extensive mechanical stress either by the muscle has been stretched beyond its limits or it has been forced to contract too strongly. It is a contraction-induced injury in which muscle fibers cannot cope with the demands placed on them by exercise overload and leads to tearing of the fibers
Signs & Symptoms of Strain
- Muscle spasms
- Trouble moving the muscle
- Muscle weakness
- Inflammation
- Cramping
- Pain
- Swelling
- Bruising
Diagnostic Investigations of Strain
- History taking
- Physical examination of the area of injury
- X-ray
- Ultrasound
- Magnetic Resonance Imaging
- Bone scanning test
Medical Management of Strain
- Muscle relaxants
- Analgesics (e.g. acetaminophen) to facilitate close reduction
- Non-steroidal anti-inflammatory agents (e.g. ibuprofen, naproxen)
Nursing care of Strain
The goals of acute treatment are to control pain, minimize swelling, and maintain or regain ROM.
- Assess and evaluate the level of injury
- Ensure patient have relative rest to promote healing
- Relative rest is advocated, because it promotes tissue healing.
- Educate the patient and family members to look out for danger signs and symptoms when exercising to prevent further injuries.
- Advise the patient to avoid activities that cause increased pain or swelling.
- Encourage patients to take their ankle out of their brace and move it through a pain-free ROM.
- Use ice to control swelling, pain, and muscle spasm.
- Encourage elevation of the injured ankle to facilitate the reduction of swelling.
- Restrict the activity and cut back on regular exercises and activities of daily living.
- Apply an ice pack to the injured area for 10-15 minutes every two or three hours.
- Use an elastic compression bandage to wrap the affected area to reduce swelling.
- Protect the area of concern from further injury by trying to immobilize the area
Complications of Strain
- Muscle fibrosis
- Muscle atrophy
- Chronic ligament instability
Preventions of Strain
- Take part in a conditioning program to build muscle strength.
- Do stretching exercises every day.
- Always wear shoes that fit properly.
- Nourish the muscles by eating a well-balanced diet.
- Warm up before any sports activity, including practice, and use or wear protective equipment that's right for that sport.
- Avoid high impact sports and activities without any adequate training
- Wear protective footwear during activities that place stress on the ankle and other joints.
- Make sure that shoes fit the feet properly.