Immediate external compression in the management of an acute muscle injury

Abstract

In a prospective, non‐randomized study 40 athletes with contusion or distension injuries to the thigh or the calf muscle were followed with tests of range of motion (ROM) of knee or ankle joint, test of serum creatine kinase (CK) and ultrasonography of the injury until completely recovered. An experimental group of 19 injuries where subjects received treatment with application of a maximum compression bandage within 5 min (mean=2 min) of the injury was compared to a control group of 21 injuries where subjects were treated with rest and elevation only, and in some cases non‐maximum compression after 10–30 min. No significant differences were noted with respect to time to complete subjective recovery, ultrasonic size of the injury or time to normal findings on ultrasound between treatment and control groups. Strain injuries, although showing a tendency to be smaller in size, took a longer time to complete recovery than contusion injuries (mean±SD=26±22 days and 19±9 days, respectively, P=0.02). Diagnostic CK values and reductions in ROM were not correlated to the severity of the trauma, while ROM showed weak correlation to the sonographically measured size of the hematoma (r=0.42; P<0.01). Injuries displaying a circumscript anechoic, low‐echogenic or mixed lesion at the diagnostic ultrasound investigation normalized more slowly (P=0.001) and took longer to complete recovery (P=0.001) than injuries with diffuse hyperechogenic lesions. We conclude that in this study the application of a maximum compression bandage within 5 min of a muscle trauma did not significantly reduce the size of the hematoma nor significantly shorten the time to complete subjective recovery compared with no immediate treatment. The diagnostic ultrasound investigation was valuable in predicting the severity of the trauma.

MR Imaging of Muscle Trauma: Anatomy, Biomechanics, Pathophysiology, and Imaging Appearance

“…Contusion results in an admixture of focal intramuscular hematoma and interstitial hemorrhage dissecting through the loosely organized muscle parenchyma. There may be accompanying injury to the subcutaneous tissues, fascia, and/or bone (18,41). While contusions often appear larger than strain injuries, fiber disruption is primarily limited to muscle, which heals faster than tendon, so the recovery time after contusions tends to be shorter than that after strains (2,28).…”

“…While contusions often appear larger than strain injuries, fiber disruption is primarily limited to muscle, which heals faster than tendon, so the recovery time after contusions tends to be shorter than that after strains (2,28). In one large study evaluating thigh injuries in professional soccer players, contusions resulted in half the time lost to sport as compared with strains (41,42). Contusions are managed conservatively with cooling, elevation, compression bandaging, and aggressive rehabilitation (41).…”

“…In one large study evaluating thigh injuries in professional soccer players, contusions resulted in half the time lost to sport as compared with strains (41,42). Contusions are managed conservatively with cooling, elevation, compression bandaging, and aggressive rehabilitation (41). The utility of hematoma aspiration, injection with steroids or platelet-rich plasma, and surgery for such injuries remains controversial (4).…”

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

“…Evidence supporting muscle recovery after HSI, as well as specific investigations into the efficacy of these treatment methods, are lacking. 11,[30][31][32][33][34][35] Participants reported using other treatment methods less frequently (Graston Technique/Astym, laser, and injection therapy), but these also lack evidence to support their clinical effectiveness. [36][37][38][39] The remaining methods (knee immobilizer and joint mobilizations) had lower use rates, yet some limited support exists for their application.…”

Conservative Treatment of Muscle Injuries: From Scientific Evidence to Clinical Practice

“…Although compression reduces the intramuscular blood flow to the injured area, (Kalimo et al, 1997) it is debatable whether compression applied immediately after the injury actually accelerates the healing of the injured skeletal muscle (Thorsson et al, 1997).…”