Return to play after treating acute muscle injuries in elite football players with radial extracorporeal shock wave therapy

Abstract

Background To compare lay-off times achieved by treating acute muscle injuries in elite football players with a multimodal therapy approach that includes a specific protocol of almost daily radial extracorporeal shock wave therapy (rESWT) with corresponding data reported in the literature. Methods We performed a retrospective analysis of treatments and recovery times of muscle injuries suffered by the players of an elite football team competing in the first/second German Bundesliga during one of the previous seasons. Results A total of 20 acute muscle injuries were diagnosed and treated in the aforementioned season, of which eight (40%) were diagnosed as Type 1a/muscular tightness injuries, five (25%) as Type 2b/muscle strain injuries, four (20%) as Type 3a/partial muscle tear injuries and three (15%) as contusions. All injuries were treated with the previously mentioned multimodal therapy approach. Compared with data reported by Ekstrand et al. (Br J Sports Med 47:769–774, 2013), lay-off times (median/mean) were shortened by 54% and 58%, respectively, in the case of Type 1a injuries, by 50% and 55%, respectively, in the case of Type 2b injuries as well as by 8% and 21%, respectively, in the case of Type 3a injuries. No adverse reactions were observed. Conclusions Overall, the multimodal therapy approach investigated in this study is a safe and effective treatment approach for treating Type 1a and 2b acute muscle injuries amongst elite football players and may help to prevent more severe, structural muscle injuries.

Effects of Exposure of Musculoskeletal Tissue to Extracorporeal Shock Waves

“…Furthermore, ESWs were shown to induce disturbed integrity of myelin sheaths combined with reduced nerve conduction velocities in palmar digital nerves in horses [190], as well as a reduced number of epidermal nerve fibers in the skin [189]. In summary, these results suggest that ESWT can reduce peripheral nerve function and conduction, without affecting the performance of professional athletes [227]. This mechanism may be central to the reduction of pain perception following ESWT, given the possibility that the transmission of nociceptive signals via peripheral nerves is impaired.…”

“…The second take-home message of this study is that different tissues respond to the same mechanical stimulus in different ways. Based on many years of clinical experience and numerous clinical studies, various pathologies of the musculoskeletal system are nowadays known that can be successfully treatet with ESWT [8][9][10][11]200,227,229]. These indications include mainly degenerations and injuries of muscle, bone and cartilage tissue.…”

Effects of repeated injection of 1% lidocaine vs. radial extra-corporeal shock wave therapy for treating myofascial trigger points: a randomized controlled trial

“…Because rESWT does not share the disadvantages of injections of lidocaine (rESWT is not invasive, does not cause potential bacterial and viral contamination of the treated muscle, and is not myotoxic), rESWT appears to be the better choice if one is interested in effective and safe treatment of MTrPs of the UTM with lasting effects. The latter is indicated by results of a recent study on treatment of functional and structural muscle injuries in professional athetes using the same rESWT device that was used in this study [49].…”

Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes

“…Unlike these interventions, athletes may continue activities as tolerated with ESWT [ 24 ]. R-SWT for acute muscle injuries was tolerated well by elite European football players, even when applied on a daily basis [ 25 ]. Furthermore, while F-SWT alone was not shown to be beneficial in jumping athletes, the athletes continued to participate in both training and matches without noticeable adverse events during treatment [ 21 ].…”

“…There are some case series and reports that support the use of ESWT on physically active or athletic populations with early outcomes for sports injuries including acute muscle injuries [ 25 ], myositis ossificans [ 30 , 31 ], plantar fasciitis [ 32 ], Achilles tendinosis [ 33 ], proximal hamstring tendinopathy [ 33 ], and non-union stress fractures [ 24 , 34 ]. Future high-quality studies should aim to capture larger cohorts of athletes as well as early outcomes such as 3 and 6 weeks, not limited to outcomes 12 weeks or beyond that have been commonly reported.…”