Sprained, Strained, or Pained
Before class, one of your students tells you that she's strained a muscle. Or maybe torn the rotator cuff, or sprained an ankle. As teachers, we need to have an idea what's going on with these injuries, and what the implications are for yoga. And, we need to understand how to guide our students in class so that they don't exacerbate the injury.
The words "sprain," "strain," and "tear" are all used to describe soft-tissue damage. Some health care providers use these terms very specifically: for example, "strain" refers to muscle or tendon damage, such as a strained hamstring; and "sprain" refers to a ligament, such as a sprained ankle. However, in general usage, the terms are often used interchangeably; and all refer to internal disruption of the structure, whether it be a mild strain or major tear.
What's The Difference?
First, let's clarify that any soft tissue of the musculoskeletal system—which includes just about everything but the bones—can be injured. These soft tissues hold the bones together and also move, position, and stabilize them. They include ligaments, which join bone to bone; tendons, which connect muscle to bone; and muscles, which move the bones. And let us not forget fascia, connective tissue that comes in myriad forms and generally holds the body together. The fascia might be microscopic, like the tiny fibers that bind individual muscle cells into bundles and hold the skin onto underlying structures; or large, tough, inflexible sheets, like the iliotibial band (fascia lata).
Any soft tissue can be injured by bearing too large a load for its strength and structure. These loads can be applied by overstretching, when the forces trying to pull a structure apart are greater than the intrinsic strength of the tendon, ligament, muscle, or fascia. (Muscles are actually weaker during stretching, because the muscle is relaxing while it's lengthening.) Muscles can also be injured during activities requiring strength, when a muscle is contracting to stabilize, lift, push, or pull too large a load.
Soft-tissue injuries happen when you put an abnormally large load on normal tissue, as when trying to lift a piano, or when you put a normal load on abnormal tissue. "Abnormal tissue" in this case means tissue that is deconditioned due to lack of exercise or load-bearing, or degenerated due to disease, previous injury, or poor circulation. Scar tissue also sets the stage for tearing because it's less mobile and flexible than the normal tissue it replaces, and it can tear under a load instead of stretching. Once the tissue is overwhelmed by the load, it begins to pull apart. These tears can vary from microscopic and mild to a serious and complete tear.
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