Massage for Strains and Sprains – Massage School Notes

Definitions:
Sprain – tearing of a ligament

Strain – tearing of a muscle and/or tendon

Where are strains most likely to occur?

Predisposing factors that contribute to the occurrence of strains:

overuse, fatigue, muscular imbalances, muscle stiffness, inadequate warm-up before an activity

Signs/Symptoms:

Levels of severity: determined by passive range of motion assessment for sprains, resisted range of motion for strains very difficult to access because of inflammation assessment is best done by a physician. this information is provided so you know what is possible

Sprains: tears in ligaments
Level 1	1-50% tear of ligament fibers and minimal muscle tissue damage some swelling no loss of function joint is stable and painful
Level 2	50-99% tear of the ligament and joint capsule joint hypermobile and unstable decrease in tensile strength of ligament swelling, bruising, bleeding
Level 3	100% tear of ligament no joint end feel present usually no specific pain, but compensational pain needs physician attention

Strains: tears in muscles and tendons
Level 1a	1-10% partial tear of fibers little or no loss of function can hold against resistance with pain
Level 1b	10-50% fiber tear painful, but can hold against resistance as it approaches 50% less ability to hold against resistance swelling muscle guarding
Level 2	50-99% fiber tear can’t hold against resistance may hold against gravity pain, edema, swelling and muscle guarding
Level 3	100% fiber tear usually heard snap at time of injury no resistance possible pain may be present at site compensational pain present Needs physicians attention immediately

Causes: gradual or trauma: increased load on the muscle/ligament that is not strong enough to do hold the weight.
over use, overextended muscles/ligaments, improper warm up before activity,

Treatments: treat according to stage of inflammation treat according to severity of injury ice massage Triggerpoint Myofascial release begin massage treatment as soon as possible to reduce adhesion formation especially with muscular strains.
General guidelines:
Acute stage: lymph drainage, ice massage, passive range of motion,
Subacute stage: cross fiber friction, muscle energy or strain/counterstrain techniques, add strengthening as inflammation decreases, trigger point therapy, myofascial release
Chronic stage: cross fiber friction for ligaments, cross fiber friction of muscles,

Cautions: Traction may aggravate if it over-stretches muscles. Stretching may over-stretch and re-injure muscles. Repeated injury to ligaments can cause the ligament to become looser and more prone to re-injury. Be sure you are trained in treating acute injuries.
Other therapies: acupuncture, prolotherapy for ligaments, chiropractic, naturopathic (provides nutritional support needed for proper healing and functioning)

Resources:

Muscle Strains By Whitney Lowe, LMT, NCTMB

Buy 2 e-book bundle: Save Yourself from a Muscle Strain!

Includes more information on:

What is a muscle strain?

How do you know that you’ve got a muscle strain?

True muscle strain checklist

Could you have a muscle spasm instead of a strain?

Could you have muscle knots instead of a muscle strain?

What is a muscle knot? And how is different than spasm and strain?

Muscle strains that don’t heal have usually been hijacked by trigger points