Soft tissue injuries are the most common injury in sport, but they also occur on a regular basis in the workplace, as a result of car accidents, in slip-and-falls, and even in our day-to-day lives. Needless to say, their impact on our quality of life as a result of pain, inflammation, and reduced mobility is just as prominent. Luckily, with the latest technological advances in medicine, it’s now possible to speed up the healing of soft tissue injuries while limiting long-term effects, so you can get back to your regular routine faster. Here, we explore the different kinds of soft tissue injuries and the types of healing technologies that may be the perfect addition to most traditional physiotherapy treatment plans.
Soft tissue injuries occur when muscles, ligaments, or joints become damaged through direct trauma (sudden strain or overloading, such as whiplash following a car accident) or indirect trauma (repeated strain or overloading, such as tendonitis). Injuries usually present themselves in three categories or stages: acute, overuse, and chronic. Acute injuries are a result of direct trauma from sudden overloading, such as a strain when lifting something a little too heavy. Overuse injuries occur as a result of repeated microtrauma leading to a steady degradation of the affected tissue, such as carpal tunnel syndrome from daily typing. Finally, chronic soft tissue injuries are a result of repeated and sudden overloading, such as tendonitis or tennis elbow.
Soft tissue injuries heal in three stages:
In the first 72 hours post-injury, the body reacts to the injury via inflammatory responses that may manifest pain, swelling, redness, and increased warmth in the injured area. Tissue continues to experience damage as the body works to form a clot and remove dead cell debris to prevent further damage. Next, the body moves into the regeneration and repair phase, increasing fibroblasts and boosting the production of collagen fibers to mend the wounded area. This stage can begin in the first 48 hours following injury and last up to six weeks. In the body’s rush to repair damage during this phase, collagen may be laid haphazardly rather than neatly cross-linking. Finally, in the remodeling phase, which may span from three weeks to 12 months post-injury, collagen fibers create tight, strong scar tissue and collagen production declines. Because of this formation of scar tissue, the remodeling phase generally does not restore tissue to its same level of strength or flexibility prior to the injury. This leads to the need for advanced treatments to help better restore mobility and reduce the risk of chronic pain and inflammation.
With advancements in medical device technologies, healing no longer needs to be left to the traditional treatment protocols like RICE (rest, ice, compression, and elevation) to help manage inflammation and allow the body to naturally heal. Generally speaking, these treatment protocols, if not properly accompanied by alternative therapies, may not improve healing time and could even lead to the body ineffectively repairing injured tissue in a way that could inhibit movement and impact quality of life. Alternatively, the inclusion of alternative therapies can support healing, increase comfort, and improve mobility.
To begin, the following are the top three categories of treatment technologies designed to manage the symptoms of soft tissue injuries:
While utilizing cryotherapy (cold therapy) in the initial phases of healing can be beneficial to help reduce inflammation around the injured area, thermal therapy (heat) in the later stages is beneficial to speeding up the body’s natural wound-healing cycle. By applying heat to the injured area, blood vessels dilate, boosting blood circulation and bringing the nutrients necessary to support the proper healing of damaged tissues. Thermal therapy also offers relief from pain and spasm while easing stiffness for improved outcomes when combined with targeted physiotherapy exercises. Careful delivery of thermal therapy is required to avoid damage to the skin’s surface and reduce the risk of increased inflammation, particularly if an injury is still in the inflammatory phase of healing. Thermal therapy may be delivered via electrical heating pads, paraffin wax baths, hot packs, or additional methods and may also be a factor in energy-based therapies.
Mechanical therapy refers to massage or pulse-based therapies. These treatment modalities work to apply pressure and manipulate soft tissue to evoke a relaxation response while improving blood circulation and the normalization of the targeted soft tissue. In other words, massage and pulse-based therapies release tension in nerves and deeper connective tissues while relaxing soft tissue for a reduction in pain and inflammation. Massage therapy can also help to prevent the tightening or shortening of tissues during the regeneration or repair phase of healing for improved range of motion.
There are a variety of energy-based treatment modalities your provider may suggest, including electrical stimulation, laser, ultrasound, and radio frequency-based devices.
Electrical Stimulation (TENS) Treatments
Electrical stimulation devices are often referred to as Transcutaneous Electrical Nerve Stimulation (TENS) treatments. Utilizing electrode pads applied to the skin’s surface, TENS treatments deliver an electrical shock to targeted sensory nerves in the injured area, exciting them and causing a sort of distracting sensation for pain relief. Effects are temporary and these treatments do not directly stimulate any healing responses below the skin’s surface.
Since the 1940s, therapeutic ultrasound therapies have been utilized in physiotherapy for their proven benefits in stimulating living tissue. Ultrasound treatments deliver energy below the skin’s surface via a probe placed directly on the skin. Sending ultrasonic energy to the affected tissues, vibrations are converted to heat energy. Local circulation is improved while swelling and inflammation are reduced, speeding the healing of soft tissue injuries. While the benefits of ultrasound therapies on living tissue have been well researched, there is reportedly limited evidence to support the reported benefits of ultrasound treatment for soft tissue injuries.
Deep tissue laser treatments utilize laser therapy to kickstart the body’s natural healing process while temporarily reducing pain and inflammation for up to 24 hours post-treatment. Light energy is emitted from the applicator tip and transfers to photon particles that are absorbed by cells in the treatment area, which stimulates the further formation of healthy cell structure and restores tissue function. Laser therapies are best used in the relief of pain and inflammation, as well as a potentially strong addition to a holistic physiotherapy treatment plan that accelerates healing. As with any laser device, extra care may be required for those with darker skin tones, as there could be a higher risk of damage from the laser.
Radio Frequency Treatments
Regarded as safe for all skin types, radio frequency-based treatments have the potential to reduce healing time, minimize the risk of negative side effects during healing, and improve mobility and quality of life, especially when combined with a holistic treatment plan that includes massage. Utilizing radio frequency energy, these treatments deliver heat below the skin’s surface for even healing. Treatments that synergistically combine RF with Pulsed Electro Magnetic Fields (PEMF) may utilize pulsed electricity to promote the creation of additional fibroblasts, speeding collagen production and expediting recovery. When combined with massage, these treatments are able to effectively target injuries by affecting connective, muscle, and vascular tissue with noticeable results in as little as three treatments. In fact, in some cases, pain relief may be noticeable after just one treatment.
Interested in learning more about how you can incorporate RF-based soft tissue injury treatments into your customized physiotherapy treatment plan? Use the search field below to locate a certified treatment provider near you.
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