Although all other tissues of the musculoskeletal system except bone are called "soft tissue", the concept of "soft tissue injury/injury" is mostly used to describe lesions of muscles, tendons, tendon sheaths, bursae and ligaments. Injuries to these tissues are the most common sports injuries in all sports branches.
Injuries to ligaments, tendons, tendon sheaths, bursa, nerves and muscles occur during sports activities, great physical strains or long-term repetitive physical traumas. Inflammation following local tissue damage causes swelling and pain; mobility is restricted, functions are affected. The goal of early treatment of acute soft tissue injury is the control of pain and inflammation. The RICE (Rest-Rest, Ice-ice, Compression-compression, Elevation-elevation) protocol is the basic principle of the first treatment. Physical agents can also provide pain control, exercise and rehabilitation practices should be used to provide functional gains in patients with soft tissue injuries.
They are described according to the formation mechanism, type, affected tissue(s), anatomical region, grade and healing time parameters. The recipe/definition is usually done with more than one parameter. Cases with a prolonged recovery period and overuse injuries are expressed as chronic, and sudden new injuries are expressed as acute.
Injuries can be at various levels;
1-Strain,
2-Sprain,
3-Contusion,
4-Overuse is the most common type of injury.
Grading 1 is between minimal tissue damage and loss of function, and 3 between complete/near complete integrity and loss of function.
Their treatment is often conservative. So it mostly doesn't require surgery. Sometimes, grade 3 tendon and ligament lesions may require surgery.
In conservative treatment, rest, FTR applications, non-steroidal anti-inflammatory and muscle relaxant drugs are used. The time to return to sports varies with the tissue affected and the degree of injury. Grade 1 lesions that do not require surgical intervention are expected to return to sports in 1-3 weeks, and grade 2 lesions in 2-6 weeks.
The detailed history of the patient leads to the clinical diagnosis. After trying to confirm the clinical diagnosis with general and special tests, the preliminary diagnosis is confirmed by imaging methods when necessary. Direct radiographic imaging (x-ray) is the basis for the evaluation of bone structure and joint relationship. In more complex injuries, more detailed evaluation of soft tissue and ligaments may be required; ultrasound may be required for evaluation of extra-articular soft tissue, diagnostic ultrasound also provides dynamic evaluation of damaged tissues; sometimes it creates an advantage when it accompanies the required fluid discharges and injections. Magnetic Resonance Imaging is very important in general, especially in the evaluation of intra-articular structures (cruciate ligaments, meniscus injuries) where the information that ultrasound can provide is limited.
Depending on the type of injury, there are many active and passive, traditional and psychological approaches, from rest, ice, compression and elevation therapy to the use of analgesic and nonsteroidal anti-inflammatory drugs (NSAID) in pain and inflammation control, from local anesthetic and corticosteroid use to electrotherapy applications, from training and manual therapy applications to psychological approaches. The new method is used in the treatment of soft tissue injuries. Many disciplines can use various applications to provide pain and inflammation control, but considering the patient with a holistic perspective in terms of returning to work and social life or sports beyond pain control and planning rehabilitation is the main subject of physical therapy and rehabilitation specialization.