Falls, trauma and sport related injuries cause problems to bones and soft tissue structures. Because soft tissue structures can be strained or even ruptured a grading scale is used to determine damage and proper treatment (Boissonnault, 2011). Grade I soft tissue strain is an over stretch of tissue without rupture. Grade II soft tissue strain is a partial tear in the tissue without disruption to the fascia. Grade I and II injuries cause local tenderness, edema, muscle spasm, bruising and pain with movement (Boissonnault, 2011).
Early treatment for grades I and II consist of rest, ice, compression and elevation. Once the acute swelling and pain subsides approximately 7 to 10 days a referral to physical therapy to restore motion, weight bearing, reduce swelling and pain and restore soft tissue function is necessary.
However, grade III soft tissue injury is more involved resulting in compete tear of soft tissue (muscle) and fasciaresulting in total loss of movement and possible surgical repair. Grade III injuries cause edema, blisters, pain, superficial and deep bruising, and palpable soft tissue defect. Referral to a wound care specialist for debridement and wound healing may be required along with a referral to orthopedic specialist for joint repair. Once the grade III injury is repaired and healing has occurred a referral to physical therapy is protocol to restore motion, reduce swelling and pain, regain weight bearing and normal function.
Boissonnault, W. G. (2011). Primary care for the physical therapist (2nd ed.). St, Louis, Missouri: Saunders.