Whenever a sprain/strain injury occurs it is not just the ligament, tendon, or muscle fibers that are damaged. Often, the embedded neurological structures within these soft-tissue structures are also damaged. These neurological structures (golgi tendon organs, muscle spindles, and joint receptors) are essential for postural control. Any damage to these structures can have the effect of decreasing spinal stability, which can lead to chronic problems.
Both Golgi Tendon Organs and Muscle Spindle Cells are sensory neurons (proprioceptors). Sensory neurons monitor muscle and tendon motion (contraction and stretching) and relay this information back to your brain. This creates a feedback loop system that allows your body to discern its position and postural orientation. Joint receptors are located in joint capsules and respond to deep pressure and to other stimuli such as stress or change in position. They are also part of your body’s neurological feedback loop system. When manual therapy procedures (Active Release, Graston, Manipulation, Massage Therapy) are implemented to break up adhesions or scar tissue, all these structures in your nervous system also benefit from these procedures.
In addition to the neurological structures deep within the tissue, peripheral nerve entrapment syndromes often occur with sprain/strain injuries. It is important to recognize that what is often considered only a sprain/strain injury can have a considerable impact on several areas of your nervous system.
For example, consider the following three examples of sprain/strain injuries and peripheral nerve compression syndromes that can occur with damage to these muscles.
Muscle Involved: Trapezius Muscle (Shoulders and neck)
Muscle Involved: Scalene Muscles (Front and to the side of the Neck)
· Site of nerve compression: Brachial Plexus
· Symptom Pattern: A brachial plexus entrapment can cause pain from the neck and shoulder, down the arm to the wrist. Altered sensation and weakness is common with a brachial plexus entrapment.
Muscle Involved: Psoas Muscle (This hip flexor can be a major factor in chronic low back pain)
· Site of nerve compression: Genitofemoral Nerve
· Symptom Pattern: Genitofemoral nerve entrapment causes altered sensation over the front of the thigh, groin pain, and testicular pain. Pain is often worse with internal or external hip rotation.
Bottom line, your nervous system is often involved in what appears to be a sprain/strain injury. To fully rehabilitate these injuries the correct treatment regime, and a program of progressive functional exercises must be implemented. Beside stretching and strengthening rehabilitative exercise programs must also focus on rehabilitating the nervous system.
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