Injuries to tendons, ligaments, fascia, joint capsule, articular cartilage and other soft tissues caused by various types of violence or chronic strain are collectively referred to as injured tendons. The range of tendons is relatively wide, injury tendons are the most common disorders of injury. First, the cause of injury tendons (a) external causes external causes mainly refers to external injuries, and the external six evil relations. According to the nature of external forces, generally can be divided into direct violence, indirect violence and sustained strain three. Direct violence, indirect violence impact, contusion, pulling, twisting, etc. can cause acute injury to the tendons; continuous strain can cause chronic injury to the tendons. Some long-term, monotonous, repetitive movements, cumulative strain can also occur strain injury tendon. After the tendon injury, the wind, cold, dampness, local injury and paralysis, so that the tendon injury longer course, slow recovery, easy to turn into chronic tendon injury. (B) internal causes The etiology of injured tendons is closely related to the patient’s age, physique, local anatomical structure and other internal factors. In children, the tendons are not fully developed and are prone to sprains, misalignments and radial tuberosity dislocation. In young adults, there are many activities and sports, so muscle rupture and laceration are more common. The elderly are weak in qi and blood, and the internal organs are exhausted, so joint strain, tendon and muscle adhesions and activity dysfunction are common. Weak, slightly overworked, that is, the tendons and bones are sore, prone to strain injury. Some parts of the anatomy are weaker or have special anatomy that can easily cause some injuries. For example, the shoulder joint has a shallow and narrow pelvis, and the anterior inferior ligament of the joint is weak, so there are more chances of injury than other joints. The external causes are important for the occurrence of tendon diseases, and the internal causes are the basis. Different external factors can cause different tendon injuries, but due to the influence of internal factors, the type, degree and nature of tendon injuries can vary in the same external situation. Only this comprehensive understanding of the causes of tendon injuries, the examination of the cause of treatment, will be the diagnosis of tendon injuries, treatment has a positive guidance role. Second, the classification of injured tendons Currently there are three main ways of classification: 1, according to the course of different classification (1) acute injury tendons: refers to the violence caused by the fresh tendon injury of no more than 2 weeks. (2) chronic tendon injury: refers to acute tendon injury or improper treatment, more than 2 weeks of injury to the tendon. Accumulated labor into injury tendons, chronic strain injury caused by the tendon injury also belongs to this category. Chronic tendon injuries tend to occur in hyperactive joints and weight-bearing areas. Acute injuries tendon patients if not timely and effective treatment, prolonged over time, the injury of qi and blood stagnation, blood does not glory tendon, resulting in contracture of the tendon, pain, activity is limited, into chronic injuries tendon. 2, according to the different forms of violence classification (1) sprain: sprain refers to indirect violence to the limbs and joints around the fascia, muscles, ligaments excessive twisting, stretching, causing injury or tear. Sprains mostly occur in the joints and the tissues around the joints. (2) contusion: mostly refers to direct violence, fall impact, heavy extrusion and other effects on the human body and caused by closed injury, injury symptoms to the direct action of external force parts, mostly caused by the subcutaneous tissue, muscle, tendon and other injuries. Sprains, contusions caused by the injury of tendons often belong to the category of acute injury tendons. 3, according to the different degrees of injury tendon classification (1) tendon position abnormalities: tendon is not broken and the position has changed. Local or may have bruising, careful touch can be found tendons, ligaments position has changed. (2) Tearing of tendons: there is a tear of the fascia, but no rupture of the fascia, tendons or ligaments, which does not cause serious functional impairment. (3) Tendon rupture: Tendon rupture includes rupture of tendons, ligaments and some muscles, loss of normal limb function or abnormal activity, etc. The main symptoms of acute tendon injury are pain, swelling and dysfunction. 1.Early stage Within 2-3 days after injury, qi and blood stagnation, pain is obvious, local swelling, red and purple petechiae, limb dysfunction. 2.Mid-term After 4-7 days of injury, the blood stasis gradually dissolves, the qi flow gradually opens up, the pain gradually decreases, the swelling begins to subside, the petechiae turn into bruises, 10-14 days, the injured tendon can recover, the injured tendon is heavy, the swelling subside is also more significant, the pain is obviously reduced, and the function is partially restored. 3.Later two weeks after the injury, the pain is gradually not obvious, the swelling is partially subsided, the petechiae turn to yellowish brown, the function is mildly impaired, about 3-5 weeks, the symptoms disappear, the function can also be restored. In a few patients, the symptoms may disappear and function may be restored. The symptoms of chronic tendon injury lack a typical evolution. There can be hidden pain, soreness, numbness, swelling, or dysfunction, which must be identified according to the different types of tendon injuries. The main pressure points should be carefully identified during the examination of the injured tendon disease, regardless of whether the patient has an acute or chronic injury, the pressure area is often where the injury is located, which has direct significance for the diagnosis of the injured tendon disease. Although the general radiography can not clearly show the injury of the tendon itself, but through the X-ray radiography can often be found after the injury of the tendon of other tissue structure changes, clinical often indirectly diagnose some injury tendon disease. X-rays can also clarify whether the injury is accompanied by a fracture, which has positive significance for the diagnosis and treatment of tendon diseases. In addition, acute tendon injury must be distinguished from rheumatism, swelling and pain, and damp-heat injection. Chronic tendon injury must also be distinguished from bone consumption, bone tumors, etc. Fourth, the complications of tendon injury 1, avulsion fracture Due to the pulling of the tendon attachment point and cause bone avulsion. 2, nerve injury With the injury of the tendon, the nerve can be damaged by the pull, or by injury hematoma, injury displaced tissue compression, compression and produce limb movement, sensory dysfunction, muscle atrophy, etc. 3.Injury ossification Injury tendon disease damaged the periosteum near the joint, the local hematoma is larger. If not handled properly, as the hematoma mechanizes and bone-like tissue forms, ossification occurs in the soft tissue, causing pain and joint dysfunction, and the X-ray shows uneven calcification shadows. This disease is particularly common in the elbow joint, but also often occurs in the knee and shoulder joints. 4, intra-articular free body Most of the joint cartilage damage, detachment, calcification and become. 5.Osteoarthritis Softening of joint cartilage, deep fissures occur and are worn out during joint activities, and the peripheral cartilage surface that is less worn out becomes hyperplastic, forming a thick cartilage circle at the edge of the joint, and through the ossification within the cartilage, forming a bone superfluous, the whole joint is thus deformed, and joint pain and movement is limited. In addition, failure to treat injured tendons often causes contracture and adhesion of tendons, which restricts joint movement and results in stiffness of the joint, leading to limited osteoporosis or local muscle atrophy. V. Treatment of tendon injuries (a) tendon manipulation tendon manipulation has the effect of activating blood stasis, relieving swelling and pain, relaxing tendons and loosening adhesions. Tendon manipulation is generally based on the four methods of pressure, massage, pushing and holding, according to different situations can also be used to knead, pinch, rub, roll, pulling and stretching traction, flexion and pressure, trembling and shaking, rotation and oblique trigger and other techniques. For acute injuries, tendons or ligaments completely ruptured, the diagnosis is not clear spinal injury, osteomyelitis, bone tuberculosis, bone malignant tumor, pregnancy, infectious skin disease, etc., are not suitable for tendon manipulation. (B) drug treatment 1, topical drugs Injured tendons in the early and middle stages, it is advisable to resolve blood stasis, swelling, qi and pain, commonly used creams such as anti-stasis and pain ointment. After the swelling is seen slowly or the initial swelling of injured tendons is not very available tricolor dressing. For those with mild symptoms, safflower oil can be applied locally to invigorate the blood and relax the tendons. The late stage of tendon injury and chronic tendon injury, pain persists, and the activity function is not favorable, so that the main purpose is to relieve the pain and use the warming and pain relief cream. Also available fumigation formula decoction fumigation of the affected limbs, with warming and pain relief, slippery joint effect. Commonly used fumigation formula has limb injury washing formula. Chen injury hidden pain and wind-cold paralysis pain can be used locally with wind-cold sand, which has the effect of warming the meridians and dispersing cold, dispelling wind and relieving pain. 2, internal medicine The initial stage of tendon injury, qi and blood stasis, swelling and pain is appropriate to activate the blood to dispel stasis, regulate qi and relieve pain, can be served with blood circulation and pain soup, seven percent, etc.; the middle stage of tendon injury, swelling and pain gradually recede, the treatment is appropriate to activate blood and Ying, Shu tendon and blood soup or remit paralysis soup, etc.; the late stage of tendon injury and chronic strain patients, the treatment is appropriate to warm the main meridian, to give the big active luo Dan, small active luo Dan. For elderly and frail patients with wind-cold external evil, it is advisable to tonify the liver and kidneys and to promote paralysis and open the ligaments, commonly used in three paralysis soup, Jian Bu Hu Qian Wan, tonifying kidney and strengthening tendons soup. (C) acupuncture treatment The initial stage of tendon injury can be taken to the A-Yi point, with the main method of diarrhea, can play a role in soothing tendons and relieving pain. In the late stage of acute tendon injury and chronic tendon injury, acupuncture treatment can be combined with the A-Yi point, which has the effect of relieving pain. (D) water acupuncture therapy water acupuncture therapy has a direct and rapid effect on the late stage of tendon injury and some chronic tendon injury patients have better efficacy. Commonly used are angelica injection, safflower angelica Chuanxiong injection, injected directly into the lesion and adjacent acupoints, or with an appropriate amount of 1% procaine plus confirming Yanshusong suspension in the lesion local injection. Water injection therapy must be strictly aseptic to prevent infection. (E) practice activities and fixation Injured tendon patients in the treatment process, must also follow the treatment principles of the combination of movement and static. Movement and static, practice activities and local fixation are relative, should be applied according to the specific flexibility of different patients, disease. Especially in the early and middle stages of tendon injury, it is necessary to make appropriate beneficial activities to promote blood flow and accelerate the recovery of function, but also to appropriately limit the local activities of the injury so as not to aggravate the injury. (F) Surgery For tendons, ligaments completely ruptured or tendons, ligaments ectopic, manual reset failed, may cause serious functional impairment of the limb, according to the injury, consider surgery. The second section of the neck sprain and contusion The cervical collar is a part with more activities and more frequent activities, so there are more chances of injury. In addition to injury to the tendons, neck sprain and contusion may also include fracture, dislocation, or injury to the cervical marrow, which may endanger life. The neck can be injured by sudden twisting or flexion/extension. If the head and neck are injured by sudden deceleration or braking in a high-speed car, or if the neck is twisted excessively or the head is violently impacted, it can cause sprain and contusion of the neck. (A) Identification and treatment (A) Identification of evidence After the injury, the sprained person can have pain on one side of the neck, limited movement of the neck, muscle spasm can be felt at the painful place, and the pain can be radiated to one or both shoulders and the inner side of the scapula; the contusion person has local pain, pressure pain, mild swelling, and limited movement of the neck. X-rays of simple sprain and contusion are often negative, and cervical fracture and dislocation can be excluded by X-rays. (The operator stands behind the patient in a sitting position, holds the patient’s forehead with the left hand, and uses the right thumb, index finger and middle finger to hold the spastic cervical muscle to relax the muscle spasm and relieve the pain, and the starting technique should be light. Then use the right thumb and middle finger to alternately press the Fengchi, Tianzhu and Tianzong points and hold and knead the shoulder well points. Then use the right thumb and index finger to massage the affected side from top to bottom, which can be repeated several times. 2.Medication The main treatment is to activate the blood and regulate the qi, and relieve the pain. External medicine is mainly to dispel blood stasis and relieve pain, and local swelling can be treated by applying external ointment to eliminate blood stasis and relieve pain, while those with insignificant swelling can apply external tricolor dressing. 3.Acupuncture treatment Commonly used acupuncture points include Fengchi, Inner Shoulder, Outer Shoulder, Shoulder Well, Tianzong, Hanging Bell and A-Yi points, etc. The diarrhea method is used. 4.Traction For muscle spasm after injury and neck deviation, traction can be applied to the jaw-occipital belt. 5.Practice activities Practice the head and neck pitching and rotating movements after the symptoms are relieved.