Soft tissue injuries typically describe damage to muscles, tendons, and ligaments. They may lead to pain, swelling, and restricted mobility and can occur for many reasons.
Some potential causes include athletes repeatedly overusing their soft tissues and physical trauma.
This article explores the types, symptoms, causes, and diagnosis of soft tissue injuries and how to treat and prevent them.
Soft tissue describes any tissue in the body that is not bone. However, when discussing soft tissue injuries, people are mainly referring to:
- Muscles: These are responsible for
creating force and movement by contracting and expanding. A range of tough fibers make up muscles. - Tendons: These consist of tough tissue that connects muscles to bones. They
transmit strength from the muscles to the bones and joints. - Ligaments: These connect bones to other bones, providing stability.
Types of soft tissue injuries
Soft tissue injuries cover a range of conditions that damage the muscles, tendons, ligaments, and other connective tissues. According to the American Academy of Orthopaedic Surgeons (AAOS), common types include:
- Sprains: These involve the stretching or tearing of ligaments. These commonly occur in the wrists, ankles, and knees.
- Strains: These refer to muscle or tendon damage, often occurring to the hamstring in the back of the leg.
- Contusions: These are bruises resulting from blunt force trauma that squashes muscle fibers underneath the skin without breaking the skin barrier. A bruise’s color forms from blood pooling around the affected area.
- Tendinitis: This is a continuous irritation or inflammation in a tendon that occurs due to overuse. Over time, tiny stresses and tears cause the tendon to flare up.
- Bursitis: The bursae are small sacs between soft tissue and bones that cushion the shoulder, elbow, knee, hip, and heel. Similarly to tendinitis, small stresses over time can cause inflammation and swelling in the bursae.
These injuries often result from sudden twists, impacts, or overuse of a particular muscle or joint.
The different soft tissue injuries often present distinct symptoms, although they usually involve some combination of the following:
However, some injuries may cause other symptoms specific to the injury. The table below provides some examples.
| Soft tissue injury | Common symptoms |
|---|---|
| Sprain | Swelling, bruising, pain, and inflammation |
| Strain | Pain, muscle spasms, swelling, and inflammation |
| Contusion | Pain and skin discoloration |
| Tendinitis | Swelling and pain that worsens during activity |
| Bursitis | Swelling and pain |
Soft tissue injuries are common in sports and exercise. However, they can also occur during everyday activities, accidents, and workplace duties. Causes often involve the following:
- Trauma: Sudden impact or forceful movements can lead to a soft tissue injury. This might occur due to a fall, a slip, or a sharp change in direction.
- Overuse: Repetitive movements or excessive strain on a particular muscle or joint. Overuse injuries are common in people who play sports. Inadequate warmup before physical activity can increase the risk of sporting injuries.
- Overloading: A sudden increase in exercise intensity can lead to a soft tissue injury, according to the United Kingdom’s National Health Service (NHS). This may include lifting much heavier weights without a gradual buildup or running a greater distance with no training.
A healthcare professional may use a combination of clinical evaluation and imaging tests to diagnose a soft tissue injury. The clinical assessment often involves a doctor evaluating symptoms, taking a medical history, and performing a physical examination.
For people with a mild injury, imaging usually is not necessary for diagnosis. However, doctors sometimes may use imaging tests, such as an MRI and X-rays, to create images of soft tissue damage, assess the extent of the injury, and rule out other potential injuries, including fractures.
Treatment for soft tissue injuries depends on several factors, including:
- the severity
- the type of injury
- the particular joint, muscle, or limb affected
People can often self-treat mild soft tissue injuries without seeing a doctor. People with severe, sudden, or continuous pain should speak with a healthcare professional. Likewise, if the pain does not resolve over 2 weeks or it continues to worsen, a person may benefit from a medical opinion.
The main approach to treating an acute injury due to a sudden trauma usually involves the rest, ice, compression, and elevation (RICE) method.
However, ongoing injuries, such as tendinopathy, may require a different approach with more input from a clinician.
- Medications: A doctor can recommend appropriate over-the-counter (OTC) pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs). However, according to the NHS, NSAIDs might actually slow the healing process, if a person takes them too early. Therefore, a person should speak with a doctor before taking any medications.
- Physical therapy: Targeted exercises focusing on load weight, speed of motion, and how often a person repeats movements
can help improve strength, flexibility, and mobility, according to older 2015 research. - Bracing or splinting: Stopping the injured area from moving can
help prevent further damage.
Torn muscles, tendons, or ligaments may need surgery depending on how much of the tendon has torn and how severe it is.
People should speak with a doctor about which treatments may work best for them.
Preventing soft tissue injuries usually involves specific training techniques and conditioning the body to respond better to physical effort.
The following strategies from the AAOS may help prevent injury:
- warming up before and cooling down after exercising
- focusing on maintaining the right technique during workouts
- drinking plenty of water
- scheduling rest days between intense exercises
- practicing stretching and not stretching to the point of pain
- gradually increasing the intensity and duration of exercise
- replacing worn-out training shoes and wearing appropriate exercise clothing
People should pay attention to any pain or discomfort they experience and seek medical attention if needed. It is best to avoid “working through” twinges or pain, as this can risk further injury.
Soft tissue injuries include sprains, strains, and contusions of any tissue that is not bone. This usually refers to tendon, ligament, and muscle injuries. They often result from acute trauma or injury, but also include overuse injuries, such as tendonitis and bursitis.
Symptoms may include pain, swelling, stiffness, weakness, and a reduced range of motion. A person may not need to seek medical attention for mild cases, which they can treat at home with rest, ice, compression, and elevation.
More severe or persistent soft tissue injuries may need physical therapy, medications, and bracing or splinting. A torn ligament or tendon may need surgical repair. A person should speak with a doctor to find out which treatment is most appropriate for them.
People can help prevent soft tissue injuries during exercise by warming up and cooling down, taking time to rest, and maintaining proper technique.