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Romanian Society for Sports Medicine



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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
INJURIES IN SPORTS


MUSCLES INJURIES IN SPORTS

Konstantinos Natsis,
Greece

Muscle injuries have attracted great attention in recent years because they are misunderstood and maltreated. They are common in sports. Muscle tears and strains comprise 4-15% of all injuries and along with contusion strain and bruising comprise 10-30%
Muscle injuries sustained in sport are essentially no different from those sustained in other activities but the degree of damage, particularly secondary damage such as haemorrhage and haematoma formation may be greater in athlete exercising tissue that is metabolically more active than in tissue at rest.
They are produced by extrinsic trauma and intrinsic trauma and the predisposing factors are immobilization, muscle imbalance, inadequate fitness, inadequate warm up and inadequate warm down-post exercises stretching.
There are three degrees of muscle strain. In first degree strain there is some discomfort during movement. In second degree the muscle contraction is impossible because of pain and in third degree strain there is lack of functional capacity of the muscle.
For the treatment we must use both mobilization and immobilization. The principles of treatment in the first 2-3 days are ice, compression, immobilization, protection, unloading, elevation  and rest. The aim of treatment in the first 2-3 days is to stop bleeding, minimize oedema, prevent further injury, minimize loss of function and to promote healing. In these days we must avoid repeated trauma, massage, heat, ultrasound, cortisone injections and active stretching.
The treatment after 2-3 days includes: Early mobilization and several types of muscle exersices. We apply surgical treatment in large intramuscular haematomas, 3rd degree strain or tear and in 2nd degree when up to 50% of the muscle belly is torn.
A suture should be removed immediately and immobilization is required for 3-10 days
The athlete can return to sports when there is no pain during muscle exersices.
The complications of muscle injuries are compartment syndrome, myositis ossificans, old muscle tear and chronic muscle and tendon strain
The evaluation of the prognosis depends on the type of injury, the treatment time,   the healing time and the value of laboratory tests (CPK, SGOT, SGPT, LDH, Mb)

In conclusion, we can say that muscle injuries are common in sports, the knowledge for treatment is limited, they must be treated seriously and they must be prevented by warming up, stretching, flexibility and training.





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