Therapeutic Alternatives: Principles and Results

Abstract

Muscle injuries are the most common traumas occurring during sports practice. The heterogeneity of the severity of these injuries probably explains the lack of clinical studies on their treatment. Accordingly, treatment principles are derived from empirical tests or from studies with low levels of proof. The RICE protocol (rest, ice, compression and elevation) is universally recognized. The aim is to fight pain and bleeding immediately after injury and during the first 5 days after the initial trauma. Mobilization of the muscle is recommended as soon as possible when pain at rest has disappeared. Muscle strengthening and stretching should be carried out gradually to induce remobilization without re-rupture and to allow return to daily activities. Rehabilitation programs, based on progressive eccentric, agility and trunk stabilization exercises help to organize the muscle scar and to recover full muscle strength and flexibility. Retraining programs can be built around the specific practices of the sport when no pain is present during muscle contraction and stretching. The duration of these phases depends on the type of muscle injury and the individual possibility of scaring. Evaluations using an isokinetic dynamometer or testing on the field can be used to follow and manage treatment before recovery and return to competition. Several therapeutic alternatives are presented to decrease the duration of the muscle treatment but always need to be evaluated in studies with good methodology.