Current concepts in the diagnosis and treatment of musculotendinous injuries

A strain, by definition, is a stretching or tearing of a musculotendinous unit. The degree of disability associated with this injury is dictated by the location and severity of the injury and the specific needs of the patient. A strain can be arbitrarily classified as first, second, or third degree. A first-degree strain consists of minimal stretching of the musculotendinous unit without permanent injury; a second-degree strain indicates partial tearing of the musculotendinous unit; and a third-degree strain indicates complete disruption of a portion of this unit. Swelling, bleeding, and localized discomfort accompany the injury which may produce temporary disability. Initial treatment following an acute strain should consist of the use of ice, immobilization of the musculotendinous unit, and subsequent rehabilitation. Depending on the degree of disability and the specific structure injured, surgery may be indicated. Rehabilitation to a normal state following the initial healing phase is required prior to return to athletic competition.