This article had the aim of demonstrating the physiology, diagnosis and treatment of muscle injuries, focusing on athletes and their demands and expectations. Muscle injuries are among the most common complaints in orthopedic practice, occurring both among athletes and among non-athletes. These injuries present a challenge for specialists, due to the slow recovery, during which time athletes are unable to take part in training and competitions, and due to frequent sequelae and recurrences of the injuries. Most muscle injuries (between 10% and 55% of all injuries) occur during sports activities. The muscles most commonly affected are the ischiotibial, quadriceps and gastrocnemius. These muscles go across two joints and are more subject to acceleration and deceleration forces. The treatment for muscle injuries varies from conservative treatment to surgery. New procedures are being used, like the hyperbaric chamber and the use of growth factors. However, there is still a high rate of injury recurrence. Muscle injury continues to be a topic of much controversy. New treatments are being researched and developed, but prevention through muscle strengthening, stretching exercises and muscle balance continues to be the best “treatment”.
Osteonecrosis is a clinical syndrome characterized by osseous necrosis of a load-bearing portion of the femoral condyle, followed by subchondral fracturing, subsequent segmental collapse and arthrosis. It most frequently affects obese women over the age of 55 years. Its treatment is still a matter of controversy in the literature. The authors report the case of a 24-year–old male patient who was a professional soccer player, who presented with a complaint of knee pain one day after physical activity. Imaging examinations performed early on already demonstrated the start of the lesion. The treatment, which was successful, used the following: withdrawal of support, physiotherapy, medications (such as NSAIDs and bisphosphonates) and a hyperbaric chamber. Although hyperbaric chamber therapy is new, its use in association with drug therapy and withdrawal of support may bring good results in treating idiopathic osteonecrosis, even for athletes with high physical demands. However, there is a need for further reports and studies with greater evidence, in order to demonstrate the validity of this treatment.
As lesões musculares são comuns em atletas e indivíduos fisicamente ativos, e causam transtornos e gastos pessoais e institucionais. O tratamento depende do diagnóstico e da monitorização do estado da lesão. Por isso, o diagnóstico é uma etapa fundamental na recuperação das lesões musculares. Neste artigo, são descritos os principais métodos diagnósticos para lesões musculares, divididos em métodos de diagnóstico por imagens e por marcadores bioquímicos. Estes últimos baseiam-se na análise de concentrações de enzimas plasmáticas, como a creatina quinase, lactato desidrogenase, aspartato aminotransferase, miosina, troponina I e interleucina, para indiretamente, diagnosticar danos estruturais no músculo esquelético. Já os exames por imagem, tais como a ultrassonografia, a tomografia computadorizada, a ressonância nuclear magnética e a termografia podem produzir desde um minucioso detalhamento anatômico das partes do corpo sob análise até aspectos relacionados a sua funcionalidade. O conhecimento dos métodos instrumentaliza a decisão dos profissionais de saúde sobre o método que eles vão solicitar ou indicar em cada situação defrontada na prática clínica.
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