Muscle traumas

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The leading cause of sport discontinuation, muscle traumas are common and vary in severity, from light pain requiring short sport discontinuation to acute, sudden muscle strain that may lead to several weeks of sport discontinuation

There are 2 mechanisms leading to muscle problems:

  • Direct shock to the muscle, the common "crush injury" caused by compression of the muscle.
  • Too intense or sudden muscle contraction during effort - this leads to muscle strain.

Classification of muscular problems

Light traumas or pains

Three common affections without muscular lesion

Cramps

A cramp is a pain occurring during exertion, requiring to stop exertion and healed by stretching and compressing the affected muscle.

The pain is sharp, but stops quickly.

A light recovery massage may be recommended before resuming sports

Sore muscles

Post-workout sore muscles, also called DOMS (Delayed Onset Muscle Soreness) are lesion-free delayed muscle pains experienced after an unusual effort that caused an inflammatory reaction of the connective muscular tissues, resulting in diffuse cellular micro-injuries. These micro-injuries lead to very small bleeding and therefore to an increase of muscular pressure that causes delayed pains and contractures within 6 to 48 hours after a workout

Muscle contractures

A contracture is a pain appearing during exertion or at rest. The difference with muscle sores is not always obvious, but it is believed that the muscle lesion is deeper in contractures, and require discontinuing sports for at least 24/72 hours. Sports can be resumed when stretches no longer revive pain

Muscle injuries or lesions with many torn muscle fibres

Pulled muscle

A pulled muscle occurs following accidental and excessive contraction of the muscle. The pain is caused by a            few torn muscle fibres and can sometimes go unnoticed during exertion, but always appears during the recovery phase. It is a limited, non sharp pain causing discomfort during exertion called "functional impotence".

Sports should be discontinued for 10 to 15 days.

Muscle strain

A strain is a sudden muscle injury occurring during exertion, with an initial pain that is more or less sharp, and can even be searing and syncopal. The athlete must stop exertion and rest. The pain prompts functional impotence, all the affected area is painful and there is a hematoma.

Sports activities should be discontinued for 15 to 30 days, depending on the lesion severity.

Muscle tear or disinsertion

Musculotendinous tearing is an important, severe and very disabling muscle trauma. The initial pain is violent, like stabbing during exertion, and requires immediate cessation of exercise.

There is immediately severe swelling, a large haematoma in the area of the affected muscle, sometimes extending to nearby muscles.

The athlete suffers a lot, develops anxiety, not wanting to be touched and contracting. S/He cannot move his/her muscle. S/He has full functional impotence and hyperalgia.

The management will be very specific, including complete rest and unloading with crutches

 Sports should be discontinued for 30 to 90 days.

Medical diagnosis of muscle traumas

Comparative physical examination of other muscles and other leg then>>>>>

An ultrasound scan is the preferred imaging exam for all muscle pains - it can also be used to drain any bleeding

MRI may also be useful when a deep lesion is suspected

Pro tip: Field care: Immediately apply ice and stop exertion

RICE principle (Rest, Ice, Compression, Elevation)

Do you know some of the most common muscle injuries?

The tennis leg or calf muscle strain occurs for example while playing tennis

Hamstring strain occurs in sprinters or when shooting in the air

Biceps strains or tears occur during a violent effort of the upper limb

Treatment

Depending on the severity: rest, ice, unloading, physiotherapy and gradual return to   sports

 Some rare lesions require surgical management

Conclusion

Muscle injuries are common with various severity and cannot always be avoided, but their outcome depends on an appropriate reflexes when it happens, with immediate discontinuation of exertion

The best prevention: good fitness, appropriate practice, adequate equipment, and proper diet and hydration

 

Docteur Patrick Bacquaert

Médecin chef de l'IRBMS

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