CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(01): 006-012
DOI: 10.1016/j.rbo.2017.09.002
Original Article | Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Treatment of Acute Thigh Muscle Injury with or without Hematoma Puncture in Athletes[*]

Artikel in mehreren Sprachen: português | English
Rodrigo Moreira Sales
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
,
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
,
Moisés Cohen
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
,
Benno Ejnisman
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
,
Carlos Vicente Andreoli
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
,
Alberto de Castro Pochini
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, São Paulo, SP, Brasil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

19. April 2017

05. September 2017

Publikationsdatum:
01. März 2019 (online)

Abstract

Objectives

To correlate the mean time of return of athletes to sport after acute injury of the thigh muscle with hematoma that was punctured or not.

Methods

Study based on clinical intervention, controlled and non-randomized with 20 amateur and professional athletes, divided into moderate and total or subtotal thighs lesions, according with the Munich Consensus Statement. Nine athletes were included in the intervention group and 11 athletes in the control group. In the intervention group, the athletes were submitted to a puncture of the hematoma, associated to physical therapy; the control group did only physical therapy. The variable mean time of return to sport was analyzed using the Mann-Whitney test and a significance level of 5% (p < 0.05; 95% confidence interval [CI]) was established.

Results

The mean group was composed mostly of men, eight of them were amateur athletes. There were three women, two of whom were amateur athletes. The average age of participants was 34.70 ± 12.79 years. There were 13 patients with posterior thigh lesions, 5 with anterior lesions and two with adductor lesions. Considering all injuries, the mean time of return to sport was of 48.50 ± 27.50 days in the intervention group. In the control group, this period was of 102.09 ± 52.02 days, showing a statistically significant difference between them (p = 0.022).

Conclusion

In the present study, hematoma drainage in athletes with moderate and total or subtotal muscle injuries associated with hematomas decreased their return time to sport.

* Study developed at the Sports Medicine and Physical Activity Course, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.


 
  • Referências

  • 1 Cohen M, Abdalla RJ, Ejnisman B, Amaro JT. Lesões ortopédicas no futebol. Rev Bras Ortop 1997; 32 (12) 940-4
  • 2 Pas HI, Reurink G, Tol JL, Weir A, Winters M, Moen MH. Efficacy of rehabilitation (lengthening) exercises, platelet-rich plasma injections, and other conservative interventions in acute hamstring injuries: an updated systematic review and meta-analysis. Br J Sports Med 2015; 49 (18) 1197-205
  • 3 Mishra DK, Fridén J, Schmitz MC, Lieber RL. Anti-inflammatory medication after muscle injury. A treatment resulting in short-term improvement but subsequent loss of muscle function. J Bone Joint Surg Am 1995; 77 (10) 1510-9
  • 4 Orlandi D, Corazza A, Arcidiacono A, Messina C, Serafini G, Sconfienza LM. , et al. Ultrasound-guided procedures to treat sport-related muscle injuries. Br J Radiol 2016; 89 (1057): 20150484
  • 5 Kalimo H, Rantanen J, Järvinen M. Muscle injuries in sports. Baillieres Clin Orthop. 1997; 2 (01) 1-24
  • 6 Warren GL, O'Farrell L, Summan M, Hulderman T, Mishra D, Luster MI. , et al. Role of CC chemokines in skeletal muscle functional restoration after injury. Am J Physiol Cell Physiol 2004; 286 (05) C1031-6
  • 7 Tidball JG. Inflammatory cell response to acute muscle injury. Med Sci Sports Exerc 1995; 27 (07) 1022-32
  • 8 Järvinen TA, Järvinen TL, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. Am J Sports Med 2005; 33 (05) 745-64
  • 9 Järvinen MJ, Lehto MU. The effects of early mobilisation and immobilisation on the healing process following muscle injuries. Sports Med 1993; 15 (02) 78-89
  • 10 Bedair HS, Karthikeyan T, Quintero A, Li Y, Huard J. Angiotensin II receptor blockade administered after injury improves muscle regeneration and decreases fibrosis in normal skeletal muscle. Am J Sports Med 2008; 36 (08) 1548-54
  • 11 Mueller-Wohlfahrt HW, Haensel L, Mithoefer K, Ekstrand J, English B, McNally S. , et al. Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med 2013; 47 (06) 342-50
  • 12 Maffulli N, Oliva F, Frizziero A, Nanni G, Barazzuol M, Via AG. , et al. ISMuLT Guidelines for muscle injuries. Muscles Ligaments Tendons J 2014; 3 (04) 241-9
  • 13 Reid DC. Sports injury, assessment and rehabilitation. New York: Churchill Livingstone; 1992
  • 14 Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR. Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Phys Ther 2007; 87 (03) 337-49
  • 15 Rubin DA. Imaging diagnosis and prognostication of hamstring injuries. AJR Am J Roentgenol 2012; 199 (03) 525-33
  • 16 Ekstrand J, Healy JC, Waldén M, Lee JC, English B, Hägglund M. Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play. Br J Sports Med 2012; 46 (02) 112-7
  • 17 Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med 2011; 39 (06) 1226-32
  • 18 Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med 2013; 47 (06) 351-8
  • 19 Foreman TK, Addy T, Baker S, Burns J, Hill N, Madden T. Prospective studies into the causation of hamstring injuries in sport: a systematic review. Phys Ther Sport 2006; 7: 101-9
  • 20 Prior M, Guerin M, Grimmer K. An evidence-based approach to hamstring strain injury: a systematic review of the literature. Sports Health 2009; 1 (02) 154-64
  • 21 Fernandes TL, Pedrinelli A, Hernandez AJ. Muscle injury - physiopathology, diagnosis, treatment and clinical presentation. Rev Bras Ortop 2015; 46 (03) 247-55
  • 22 Askling CM, Malliaropoulos N, Karlsson J. High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis. Br J Sports Med 2012; 46 (02) 86-7
  • 23 Askling CM, Tengvar M, Saartok T, Thorstensson A. Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics. Am J Sports Med 2007; 35 (10) 1716-24
  • 24 Tok F, Özçakar L, De Muynck M, Kara M, Vanderstraeten G. Musculoskeletal ultrasound for sports injuries. Eur J Phys Rehabil Med 2012; 48 (04) 651-63 , quiz 707
  • 25 Cheng Y, Yang HL, Sun ZY, Ni L, Zhang HT. Surgical treatment of gastrocnemius muscle ruptures. Orthop Surg 2012; 4 (04) 253-7
  • 26 Dave RB, Stevens KJ, Shivaram GM, McAdams TR, Dillingham MF, Beaulieu CF. Ultrasound-guided musculoskeletal interventions in American football: 18 years of experience. AJR Am J Roentgenol 2014; 203 (06) W674-83
  • 27 Peetrons P. Ultrasound of muscles. Eur Radiol 2002; 12 (01) 35-43
  • 28 Askling CM, Tengvar M, Saartok T, Thorstensson A. Proximal hamstring strains of stretching type in different sports: injury situations, clinical and magnetic resonance imaging characteristics, and return to sport. Am J Sports Med 2008; 36 (09) 1799-804
  • 29 Sherry MA, Johnston TS, Heiderscheit BC. Rehabilitation of acute hamstring strain injuries. Clin Sports Med 2015; 34 (02) 263-84
  • 30 Ekstrand J, Askling C, Magnusson H, Mithoefer K. Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification. Br J Sports Med 2013; 47 (12) 769-74