Soft Tissue Injury

Sprains

A sprain is an injury to a ligament. Ligaments are the connectors that hold the bones together and add stability to the connective tissue joint capsule. Their structure allows little stretch and almost no rebound and hence they limit and control the range of motion at a joint whilst allowing motion to occur. If a ligament is stressed enough through injury it tends to tear before it stretches although if it does get stretched it will not rebound to its original length. A sprain can also happen when a bone brakes or a severe strain has occurred. The most common areas affected by sprains are:

  • Stifle or Knee (see later for Cruciate ligament injury)
  • Hock or Ankle
  • Toes
  • Wrist or Carpus

Depending what text you read there can be three or four degrees of sprains identified. These are:

1st Degree or Grade I – Mild sprain where a portion of the ligament is torn but the ligament is still functional. Swelling and pain may be apparent
2nd Degree or Grade II – Moderate sprain where ligament is partially torn or significantly stretched. The ligament still connects one bone to another however it does not have the strength to function normally causing laxity in the joint. Swelling, pain and inability to fully use the joint may be seen
3rd Degree or Grade III – Severe sprain which is the worst type of damage as the ligament is completely torn or ruptured and no longer connects the two bones to one another There is excessive movement and flexibility of the joint
4th Degree or Grade IV – This is where the ligament remains intact but tears the bony attachment away from the main bone structure – known as an avulsion fracture. This additional bone tearing is often included within the definition of a Grade III sprain

As with humans dogs suffer sprains as a result of sudden and hard twisting of a joint. Think about when you have stumbled and twisted your ankle and how painful it can be. Well the same is for dogs when they suddenly stop and twist as is often the case when chasing after balls. So please bear this in mind when you think about taking the ball launcher out with you on a walk. Dogs won’t stop to think ‘This may be dangerous for me’ they will run flat out and then slam on the breaks and in a second the damage can be done.

Sprains can also be the result of injury during sports such as agility and flyball where sudden breaking and twisting movements are involved.

But it is not just sporty or active dogs that can suffer from sprains simply catching a foot down a hole when out walking or running or slipping on surfaces with little or no grip i.e. laminate flooring, can be enough to cause a sprain.

So always ensure your dog is properly warmed up prior to any sport, games or activity, and use carpet runners at home, to minimise the likely hood of injury.

Signs and symptoms of a Sprain

  • Bruising
  • Swelling
  • Pain with or without touch
  • Yelping or crying
  • Unable to use leg or weakness in affected area
  • Unable to weight bear on affected limb
  • Persistent Lameness
  • Sitting with one leg positioned out to the side

How can Massage help canine Sprains?

Massage is an invaluable therapy for sprains as your dog will naturally overcompensate for their pain by shifting their weight to other limbs and areas of the body.
How it helps is by:

  • Speeding up the natural healing process within the body
  • Reducing pain
  • Reducing inflammation
  • Improve weight bearing
  • Improving or shortening the recovery time and helps to encourage use of affected limb
  • Helping to rebuild wasted muscles
  • Reducing and resolving painful areas of overcompensation helping your dog to be more mobile

 

Strains

A strain is an injury to a musculotendinous unit commonly referred to as a pulled muscle. It is where the muscle is subject to either a partial or complete tear. Causes can be sudden overstretching of the muscle or an extra contraction of the muscle against resistance i.e. something the body is unprepared for. However, muscle strains and other soft tissue injuries may often appear in the context of chronic, cumulative overuse with no specific start point or where there is a history of previous strains and altered biomechanics that place stress on the muscle. Either way strains can be very painful and debilitating and often go undiagnosed.

There are 3 classifications of strain severity ranging from 1st degree where there is minor damage to a few fibres to 3rd degree where either partial or complete rupture of the muscle or an avulsion fracture of the tendinous attachment occurs.

As with sprains strains are not injuries that are restricted to only sporting or working dogs. All dogs going about their daily lives can strain muscle fibres and therefore it is important that you always ensure your dog is fully warmed up before undertaking any games or athletic activities.

Signs and symptoms of a Strain

Following the injury pain will be present but not all dogs will openly show this so always take note of any changes in behaviour. You may well feel heat and see swelling or inflammation and bruising around the affected area.

If your dog has a severe Grade II strain or a Grade III full tear, the muscle will not be able to be used resulting in total loss of strength and range of motion.

Other things to look out for are:

  • Yelping/crying
  • Hobbling/limping
  • Off their food or not behaving like their normal selves
  • Signs of depression
  • Sudden inability to walk or not their usual self when walking
  • Intermittent or occasional lameness
  • Abnormal gait or not walking normally
  • Stiffness
  • Worse after rest
  • Unable to jump
  • Unable to go up and down stairs
  • Not weight bearing normally on all four limbs

How can Massage help canine Strains?

When a muscle has been strained scar tissue will form as part of the healing process. This scar tissue over time can restrict the natural functioning movement within the muscle and prevent it from moving correctly. This can cause recurring issues resulting in intermittent lameness where the dog seems fine for a while and then suddenly it goes lame again with no apparent cause. It is likely your vet will prescribe anti-inflammatories which of course may help with the pain and swelling but they won’t change the underlying scar tissue.

Massage and Myofascial release are two therapies that can help both an initial injury and also the remodelling of the scar tissue formed by older injuries by:

1) encouraging the formation of scar tissue in alignment with the muscle fibres and limiting adhesions and

2) to help in the break down and restructuring / realignment of existing scar tissue to improve circulation and allow increased flexibility .

Massage can really make the difference between a one-time muscle strain that takes a few weeks to heal compared to a painful, limiting and chronically recurring condition that makes some movement and activities for your dog impossible.

In addition massage can relieve tension and release trigger points that have developed in compensating muscle groups as well as support the nervous system and reduce stress and anxiety initiated by the pain of injury.

Please be assured I always respect the Veterinary Surgeons Act 1966 and Exemption Order 2015 by never working on a dog without gaining your vets prior consent.

 

Scar Tissue

Scar tissue is a collagen based tissue that develops as a result of the inflammatory process following injury. This inflammatory process and the production of scar tissue are necessary for healing damaged tissue i.e. skin, muscle, tendon, ligament, fascia or nerve. Unlike the tissue it is replacing that has layers of uniform fibres, collagen fibres are laid down in a random pattern creating a darning effect. When the collagen used to mend the injury matures it is referred to as scar tissue and it is weaker then the tissue it is replacing.

Depending on the severity of the injury or Grade of the strain or sprain repair can take from as little as 1 week to several months. The scar tissue laid down whilst successfully binding the soft tissue fibres lessens its flexibility as it tightens the area of tissue and this can have the affect of seeming to age a dog overnight. As with humans this can often be misdiagnosed as arthritis in the joint but arthritis is a condition of gradual onset. Please see common orthopaedic conditions.

What to look out for in your dog:

  • Lameness
  • Altered gait
  • Strange leg carriage
  • Roached (curved) back
  • Swayback (dipped back)
  • Difficulty rising
  • Difficulty going up and down i.e. stairs / in and out of car
  • Stiffness in movement
  • Change of character i.e. grumpy or miserable
  • Off their food or having difficulty eating from bowl on floor
  • The agility dog may be measuring, coming out of weaves, knocking poles

Massage can have a significant positive effect on the formation and restructuring of scar tissue – please see above under strains.

 

Spasm

A spasm is described as an involuntary, sustained contraction of a muscle and whilst spasms and cramps are often discussed together spasms are considered to be low grade, long lasting contractions as opposed to cramps which tend to be short-lived very acute contractions. Word of caution: If your dog is experiencing reoccurring cramp then it is vital to see your vet as soon as possible.

Spasms often occur in muscles or muscle groups that are particularly over used and over worked. The muscle(s) become extremely tight and will remain in spasm to protect the area from any further injury also known as muscular guarding. This over contraction will cause shortening of the muscle fibres thus reducing range of motion. If left untreated spasms can lead to the development of trigger points or can create the environment for strains to occur i.e. when extreme tightness causes stress or overload on muscle or tendon fibres.

Causes of Spasms can include:

  • Prolonged uncomfortable activity
  • Weakness in the muscle
  • Aggravation of an underlying existing issue

Again massage can be of significant benefit by loosening tight muscles before they go into spasm or if already in spasm before trigger points can develop. It is always true to say that prevention is better than cure