Hyperbaric Oxygen Therapy in Sports Musculoskeletal Injuries

Abstract

Hyperbaric oxygen therapy (HBOT) is a well-established treatment for a variety of conditions. Hyperbaric oxygen therapy is the administration of 100% oxygen breathing in a pressure vessel at higher than atmospheric pressure (1 atmosphere absolute = 101 kPa). Typically, treatment is given daily for between 1 and 2 h at pressures of 2.0 to 2.8 ATA, depending on the indication. Sporting injuries are often treated over 3 to 10 sessions. Hyperbaric oxygen therapy has been documented to be effective and is approved in 14 medical indications by the Undersea and Hyperbaric Medical Society, including, but not limited to, carbon monoxide poisoning, compromised skin grafts and flaps, crush injuries, necrotizing soft tissue infections, and nonhealing ulcers with arterial insufficiencies. Recently, HBOT for sports musculoskeletal injuries is receiving increased attention. Hyperbaric oxygen therapy may allow injured athletes to recover faster than normal rehabilitation methods. Any reduction in collegiate and professional athletes’ rehabilitation period can be financially significant for top-level sports teams; however, further research is required to confirm HBOT’s benefits on sports musculoskeletal injuries. The purpose of this review to discuss the current understanding of HBOT as a treatment modality for common musculoskeletal injuries in sport medicine. Moreover, we will highlight the advantages and disadvantages of this modality, as well as relevant clinical and research applications.

Effects of Hyperbaric Oxygen Therapy on Inflammation, Oxidative/Antioxidant Balance, and Muscle Damage after Acute Exercise in Normobaric, Normoxic and Hypobaric, Hypoxic Environments: A Pilot Study

“…As exercise-induced muscle damage is caused by acute or long-term damage to muscle cells and tissues, it is possible to indirectly estimate the level of damage from the levels of enzymes like CK and LDH that are released into the blood from muscle tissues during exercise [ 7 , 15 ]. Serum muscle enzyme levels increase not only in the body of athletes who exercise intensively but also in ordinary people after exercise.…”

“…Serum muscle enzyme levels increase not only in the body of athletes who exercise intensively but also in ordinary people after exercise. The increased inflammatory response and repetitive muscle damage by exercising can cause injury, negatively impact the length of rehabilitation after an injury, and reduce the ability to exercise [ 7 , 15 , 16 ]. In this study, we analyzed the levels of serum CK and LDH to verify the changes in muscle damage after exercise in the NN and HH environments, and establish the recovery effect of HBOT treatment.…”

“…The strategies remain controversial, but some of them were proven to be effective. Recently, studies reported that hyperbaric oxygen therapy (HBOT) could be effective in early recovery from exercise-related muscular injury due to its beneficial effect on cell recovery and tissue repair [ 15 , 16 ]. HBOT is a treatment procedure where the patient is intermittently given 100% pure oxygen under pressure higher than atmospheric pressure (1 atmosphere absolute [ATA] = 101 kPa) in a hyperbaric chamber.…”

“…HBOT is a treatment procedure where the patient is intermittently given 100% pure oxygen under pressure higher than atmospheric pressure (1 atmosphere absolute [ATA] = 101 kPa) in a hyperbaric chamber. The typical range of pressure is 2–2.8 ATA and it is effective at 1.4 ATA or greater pressure [ 15 ]. HBOT is a treatment that can be applied to various conditions, including carbon monoxide poisoning, compromised skin graft and flaps, crushing injuries, necrotizing soft tissue infections, and non-healing ulcers with arterial inefficiencies.…”

“…HBOT is a treatment that can be applied to various conditions, including carbon monoxide poisoning, compromised skin graft and flaps, crushing injuries, necrotizing soft tissue infections, and non-healing ulcers with arterial inefficiencies. Moghadam et al [ 15 ] suggested this as a possible treatment for sports musculoskeletal injuries as it can enhance oxygen delivery, reduce edema and pathologic inflammation, and mitigate ischemia/reperfusion injury. Chen et al [ 16 ] applied HBOT treatment to 41 athletes with exercise-related muscle damage and reported that muscle damage indices like CK, glutamic oxaloacetate transaminase (GOT), and myoglobin were significantly decreased.…”