Care Plan 4: Acute Lifting Injury
With Strained Contractile Tissue

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

ETIOLOGY:   Muscle strain is common from lifting and loading.   This is usually painful throughout active ROM.   May be associated with joint dysfunction and/or sprained ligamentous structures.   This is easily relieved by reducing muscle spasm and freeing the associated joint restrictions.

APPROPRIATE CARE:   Myofascial work, adjusting and gentle active exercise.    Healing should occur quickly, without residuals.

EXPECTED FREQUENCY AND DURATION OF CARE:   Three sessions per week for 2 weeks, reducing to 2 sessions per week for another 2 weeks.   Follow-up over next 4-6 weeks at 1/2 sessions per week.

TOTAL:    12-14 visits over 8-10 weeks.

WEEK	CARE	PROGRESS	M	T	W	T	F	S
1-2	Pain control Gentle SMT Gentle myofascial work	50% subjective pain reduction 25% improved ROM 3 /week	X		X		X
3-4	Adjusting Myofascial work Home exercise	75% subjective pain relief 75% imp. ROM 2 /week		X			X
5-10	Myofascial work PRN Adjusting PRN Home exercise	Discharge 2-4 / month				X

ATTENUATING FACTORS: The degree of initial injury and the conditioning of the patient prior to injury as well as compliance with home care all contribute to recovery.

SMT = spinal manipulative therapy (adjusting)

PRN = per required need (patient requests)

ROM = range of motion

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