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9.15 Muscle Strains and Tears


Presentation

Strains occur during or after a vigorous overstretching of a muscle bundle that leads to an insidious development of pain and tightness which is worse with use and better with rest. Tears of the muscle belly tend to be partial, with sudden onset of pain and partial loss of function. Often a tear occurs with considerable bleeding which can lead to remarkable hematomas, causing swelling at the site and dissecting along tissue planes to create ecchymoses at distant, uninvolved sites. Complete tears are more likely in the tendinous part of the muscle, and produce immediate loss of function, and retraction of the torn end, creating a deformity and bulge.

What to do:

Discussion

Some restrict the term "strain" for muscle injuries, and "sprain" for ligament injuries. A complete tear of the plantaris tendon in the leg is difficult to differentiate from a partial tear of the gastrocmius muscle, but the treatment for both is the same.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
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