Feature Article

Soft tissue rheumatism. Part 1: overview, enthesitis and bursitis

Rodger Laurent



Difficulties in treating soft tissue rheumatism can arise if the involved structure has not been adequately identified. Recurrence is often the result of a return to the precipitating activity before normal strength and flexibility have been regained.

Key Points

  • Acute soft tissue injuries should be treated with rest, ice, compression and elevation.
  • While rest is helpful in the acute stage, an exercise program should be continued to minimise the loss of strength and collagen from ligaments, tendons and muscles.
  • Rehabilitation should include stretches, concentric exercises, eccentric exercises, and work- or sport-specific exercises.
  • It is important to exercise both the involved (agonist) muscle and its antagonist muscle, in order to maintain joint stability and to ensure normal pressure distribution across the articular surface. This will decrease the risk of further muscle, tendon or ligament damage.
  • Patients must understand the importance of warm up stretches and exercises. A warm up program including static stretches and a 10-minute run is optimal.