Return to sport after muscle injury

Abstract

Skeletal muscle injuries are among the most common sports-related injuries that result in time lost from practice and competition. The cellular response to muscle injury can often result in changes made to the muscle fibers as well as the surrounding extracellular matrix during repair. This can negatively affect the force and range of the injured muscle even after the patient's return to play. Diagnosis of skeletal muscle injury involves both history and physical examinations; imaging modalities including ultrasound and magnetic resonance imaging (MRI) can also be used to assess the extent of injury. Current research is investigating potential methods, including clinical factors and MRI, by which to predict a patient's return to sports. Overall, function of acutely injured muscles seems to improve with time. Current treatment methods for skeletal muscle injuries include injections of steroids, anesthetics, and platelet-rich plasma (PRP). Other proposed methods involve inhibitors of key players in fibrotic pathways, such as transforming growth factor (TGF)-ß and angiotensin II, as well as muscle-derived stem cells.

Role of transforming growth factor-β in muscle damage and regeneration: focused on eccentric muscle contraction

“…According to some studies, postdamage TGF-β inhibition by suramin facilitates improvement of muscle strength by reducing scar tissue formation and promoting differentiation of myoblasts and muscle-derived stem cells ( Chan et al, 2005 ; Nozaki et al, 2008 ). In addition to suramin, decorin, interferon, and losartan are also used as anti-fibrotic agents ( Wong et al, 2015 ). Based on these findings, TGF-β inhibition should be considered in accordance with the type and severity of muscle damage.…”

“…Repeated high-intensity eccentric muscle contraction induces muscle damage ( Stauber et al, 1990 ). Following injury, muscles recover through a number of steps involving degeneration, inflammation, muscle regeneration, and fibrosis ( Quintero et al, 2009 ; Wong et al, 2015 ). Various cytokines, such as interleukin-1 beta, interleukin-6, tumor necrosis factor-alpha (TNF-α), fibroblast growth factor, and transforming growth factor-beta (TGF-β), are involved in this healing process ( Wong et al, 2015 ).…”

The Immediate Effects of Graston Instrument-Assisted Soft-Tissue Mobilization and Self-Stretching on the Muscular Properties of the Gastrocnemius in Athletes

“…Athletes are relatively more susceptible to musculoskeletal diseases than the general population because of the high intensity of movements and repetitive motions [1]. Athletes can overuse the soft tissue during athletic events, and the control of musculoskeletal pain caused by overactive muscles has a huge effect on their performance [2]. The gastrocnemius muscle is usually dam-aged in sports, such as sprinting, jump-based track and field events, soccer, and weightlifting, or in any activity where athletes must endure strong resistance [3].…”

Extracorporeal Shock Wave Therapy Accelerates Regeneration After Acute Skeletal Muscle Injury

“…The regenerative capacity of skeletal muscle tissue is of particularly high relevance in competitive sports, because muscle lesions are among the most common injuries in athletes. 23,47 Sports-related muscle damage is frequently associated with recurrence and can involve chronic pain, dysfunction, and even compartment syndrome, 12 which can delay or hinder an individual’s training or participation in competition for several weeks. 47 Although this generates a high demand for treatment, skeletal muscle injuries often present a challenging problem to therapists because damaged muscle heals slowly and often with incomplete functional recovery, 21 and therapies available in current clinical practice often prove unsatisfying.…”