Muscle Injuries

Abstract

Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, few clinical studies exist on the treatment of these traumas. Thus, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested only empirically. Although nonoperative treatment results in good functional outcomes in the majority of athletes with muscle injuries, the consequences of failed treatment can be very dramatic, possibly postponing an athlete's return to sports for weeks or even months. Moreover, the recognition of some basic principles of skeletal muscle regeneration and healing processes can considerably help in both avoiding the imminent dangers and accelerating the return to competition. Accordingly, in this review, the authors have summarized the prevailing understanding on the biology of muscle regeneration. Furthermore, they have reviewed the existing data on the different treatment modalities (such as medication, therapeutic ultrasound, physical therapy) thought to influence the healing of injured skeletal muscle. In the end, they extend these findings to clinical practice in an attempt to propose an evidence-based approach for the diagnosis and optimal treatment of skeletal muscle injuries.

Effects of GaAs laser and stretching on muscle contusion in rats

“…The rats were euthanized 4 weeks after contusion. Thus, probably these muscles were already restored, accordingly to the duration of the skeletal muscle repair, i.e., approximately 21 days 5 . Also, in the group subjected only to stretching we did not observe any difference in the CSAMF, but we found a decrease in the percentage of connective tissue when compared to the group injured and treated with laser and stretching.…”

“…Different physiotherapeutic intervention techniques are used to accelerate the muscle repair process and reestablish function, such as: cryotherapy 2 ; therapeutic ultrasound 3 ; laser 4 ; and early mobilization and exercises 5 . However, the skeletal muscle adaptations to these techniques are not entirely elucidated 5 .…”

“…Koh et al 15 found that a single bout of stretching protected skeletal muscle from contraction-induced injury. It has been shown that early mobilization induces more rapid and intensive capillary ingrowth into the injured area, better regeneration of muscle fibers, and more parallel orientation of the regenerating myofibers in comparison to immobilization, the previously preferred treatment for injured muscle 5 .…”

“…However, it is not yet known exactly how this therapy combination affect muscle repair 4,5,7,17,18 .…”

Muscle injury in rats induces upregulation of inflammatory cytokines in injured muscle and calcitonin gene–related peptide in dorsal root ganglia innervating the injured muscle

“…Upregulation of various inflammatory cytokines in injured muscle has been proposed as a pathomechanism of muscle injury pain 8, 11, 12, 13. Muscle injury induces upregulation of sensory neuropeptides in the sensory nervous system 14…”