Muscle injuries including strains and ruptures (non-contact) and contusions (contact) are common in sport accounting for approximately 30% of presentations to sports medicine practises. Delayed onset muscle soreness (DOMS) differs from these injuries as the muscle shows adaption to this following heavy training. Refer to the recovery series for more information about “DOMS.” This fact sheet will cover muscle strains and contusions.
Challenges we face
• correct diagnosis
• to optimise tissue healing
• balance between fibrosis (scar) & regeneration
• to speed up ‘normal’ healing & return to sport
• prevent recurrence
Strains
• disruption occurs most common at the junction between the muscle fibres and the tendon
• Can be a complete disruption
• Look for any deformity & a severe functional impact
• Localised pain
• Weakness (damaged muscle fibres will not be able to produce the same force)
• Unlike “DOMS” muscles don’t adapt well
• Improper management leads to ongoing weakness, lack of flexibility, larger scarring, recurrence etc
• The process in the muscle is similar for that of a strain and a contusion
Contusion
- Contact injury also commonly termed “corky”
- Also results in pain & weakness
- Should be assessed & treated similarly to muscle strain injury
- Inflammation & fibre necrosis / degeneration
- Repair
- Scar tissue formation (Huard, Li & Fu 2002)
Stages of Muscle Injury
As you can see, there is cross over between each stage with healing and remodelling. Remodelling of the muscle will continue for a long time after the athlete may have even returned to sport! This is why a considered planned rehabilitation will reduce risk of re-injury.
The key management points
- Proper assessment by your team doctor or physiotherapist is essential
- No anti-inflammatory medication – these reduce the healing capacity. If you are taking anti-inflams for another reason & sustain a muscle injury, speak with your doctor about what is best for you.
- Rest from activity which will pull damaged muscle fibres apart & will therefore prolong your time off ( generally approx 2 days of relative rest but this is depending upon severity & pain which is why individual assessment is vital)
- Ice can help with pain
- Immediate compression (use compression bandage)
- Elevation
- Remember also NO HARM (heat, alcohol, running or exercise or massage in the first 72 hours)
- Your physio will design a rehabilitation program to strengthen your injured muscle and which will be specific to your sport
