The first thing to understand is that there are three different kinds of connective tissue relating to your muscles and joints that affect movement and are often injured. Because of their differences they are injured differently and they heal differently.

Muscles

Tissue used to move the body by applying a pulling force across a joint. Muscle tissue is stretchable. It is the red meat in a roast. It has lots of blood flow to it. MUSCLES DO NOT ATTACH DIRECTLY TO BONE, because of the high blood flow muscle tissue can heal in 2 to 6 weeks.

Tendon

This is the tough tissue which surrounds each muscle and ultimately attaches to bone. It is the white, tough, thin and flexible envelop around the red meat in a roast. Muscle fibers pull on the tendon envelop surrounding the muscle which then pulls on the bones across the joint. Blood flow is close to tendon tissue because of the attachment of muscle tissue to it but is not as high as in muscle tissue. It takes 1 to 3 months to heal.

Ligament

This is the hard, barely flexible covering around joints that is left after all the other meat is removed. It attaches bone to bone and works to prevent the bones from moving excessively or separating at the joint. It has almost no blood flow and takes from 2 to 9 months to heal.

Scar Tissue

ALL INJURIES HEAL WITH SCAR TISSUE. Scar tissue is a mass of tiny fibers which are deposited in an area of injury by the body. They begin to form within 24 hours following any injury. The fibers are laid down in an unorganized cross-stitched pattern which is tough and not flexible. Only while being deposited in the early stages of healing can the fibers be stretched and caused to align in directions to make them more flexible. After 4 to 6 weeks of depositing scar fibers they become difficult to realign. After that they must be rebroken and stretched in order to return the muscle, tendon or ligament tissue to normal stretch ability to prevent ongoing problems due to irritating knots of scar tissue in the other tissues.

Strain

An injury or tearing of MUSCLE fibers. This is usually die to direct force to the muscle or overuse or overstretching while the muscle is tight. It heals quickly but does heal with scar fiber knots where the injury occurred. These can cause later problems because of the lack of flexibility of the site of injury.

Sprain

An injury or tearing of the TENDON OR LIGAMENT at the joint. This is usually due to an overstretching of the joint when the muscle has not tightened up fast enough to protect the joint or if there is more force than the muscle can handle. If you bend over to pick up a piece of paper and your back muscles are just a split second late in tightening up to correct for the forward motion a sprain can occur even without having lifted something heavy. If you pick up something heavy and drop it or move a body part faster than you can control you can still experience an injury because the damage was done in the split second before your reflexes caught up to the action.

Testing for a Strain Versus a Sprain

In an injury near a joint you can damage either the muscle or the ligament or both. If the muscle is being used (contracted) while the joint is being moved this si normal but doesn’t differentiate between one or the other.

A - Since a strain is damage to a muscle, test the muscle by causing it to contract or be used while the joint is prevented from moving as in a n isometric contraction.

B - Since a sprain is damage to the ligament or tendon, move the ligament while keeping the muscle totally relaxed by having someone else move the body part.

If A hurts but B doesn’t you have a muscle injury – strain – which can heal quickly. If B hurts but A doesn’t you have a ligament or tendon injury – sprain – which takes much longer to heal. If both A and B hurt your have a combined strain/sprain complex which is considered worse and takes as long as the ligament to heal but must include rehabilitation of some sort to restreghthen the muscle after it heals.

If the pain is non-specific on any movement it is probably a trigger point or tiny knot of scar tissue or spasm within the muscle. Since fractures are always possible without a lot of force, a physician should be consulted especially if the pain continues for more than a few days.

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