Rehabilitation of hamstring muscle injuries: a literature review

Effectiveness of cryo plus ultrasound therapy versus diathermy in combination with high-intensity laser therapy for pain relief in footballers with muscle injuries: A prospective study

BACKGROUND

Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes.

OBJECTIVE

The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries.

METHODS

A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, 17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury.

RESULTS

Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p< 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier.

CONCLUSION

HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers.

Overview of Registered Clinical Trials on Manual Therapy: Possible Implications of Genetic Testing for Personalized Treatment

BACKGROUND/AIM

Manual therapy (MT) is a frequently applied intervention offering individualized treatment in the clinic. In addition to the traditional approaches of MT, measuring molecular response to MT may offer better understanding of MT outcomes in order to provide specific personalized treatment. The aim of this study was to summarize MT-related registered clinical trials, as well as to search for any evidence on MT and genetics.

PATIENTS AND METHODS

A comprehensive search was conducted within the Clinical Trials database with predefined keywords mining for all types of MT-related clinical trials.

RESULTS

From the 47 trials, 20 had results and 27 had no results. MT alleviated pain and improved function almost in all trials. One registered clinical trial had investigated molecular outcomes of MT.

CONCLUSION

MT is an effective and individualized treatment offering option in the management of several conditions. Interestingly, a clinical trial was found investigating molecular genetics and MT pinpointing an already existing link between genetics and MT. Therefore, further clinical trials may focus on genetics and MT for providing specific personalized treatment in future.

Effect of therapeutic ultrasound on the quadriceps muscle injury in rats - evaluation of oxidative stress and inflammatory process

Muscle injuries are frequent, both in sports and work, and may be caused by stretching, distension, repetitive effort or bruising. Such lesions can lead to the generation of free radicals, triggering oxidative stress and the release of some inflammatory mediators. Therapeutic ultrasound (UST) is one of the most used electrotherapy resources in the physiotherapist's clinical practice. Our aim was to evaluate the use of therapeutic ultrasound on oxidative stress and inflammatory process in an experimental model of single quadriceps muscle injury in Wistar rats. We used a total of 28 male rats, weighing between 250-300 grams, randomly divided into four groups. In the right quadriceps, a simple impact of contusion was induced by means of a press. The animals were submitted to a daily UST treatment for a total of seven consecutive applications for three minutes each, that started 24 hours after the trauma induction. The results in the Trauma + Therapeutic ultrasound group at TBARS levels and in the enzymatic activity of SOD and GPx presented a significant difference. In the histological analysis of the Trauma + Therapeutic ultrasound group presented a reorganization of the fiber's structure and a reduction of the presence of inflammatory infiltrate. In the results of the immunohistochemistry of iNOS, TNF-α and NF-κB in muscle tissue, we observed that the group treated with ultrasound showed a reduction in the expression of the proteins. The use of UST was effective in protecting muscle tissue from oxidative stress, inflammatory process and in the rearrangement of muscle fibers.

The effect of hamstring flexibility on peak hamstring muscle strain in sprinting

BACKGROUND

The effect of hamstring flexibility on the peak hamstring muscle strains in sprinting, until now, remained unknown, which limited our understanding of risk factors of hamstring muscle strain injury (hamstring injury). As a continuation of our previous study, this study was aimed to examine the relationship between hamstring flexibility and peak hamstring muscle strains in sprinting.

METHODS

Ten male and 10 female college students participated in this study. Hamstring flexibility, isokinetic strength data, three-dimensional (3D) kinematic data in a hamstring isokinetic test, and kinematic data in a sprinting test were collected for each participant. The optimal hamstring muscle lengths and peak hamstring muscle strains in sprinting were determined for each participant.

RESULTS

The muscle strain of each of the 3 biarticulated hamstring muscles reached a peak during the late swing phase. Peak hamstring muscle strains were negatively correlated to hamstring flexibility (0.1179 ≤ R 2 ≤ 0.4519, p = 0.001) but not to hip and knee joint positions at the time of peak hamstring muscle strains. Peak hamstring muscle strains were not different for different genders. Peak muscle strains of biceps long head (0.071 ± 0.059) and semitendinosus (0.070 ± 0.055) were significantly greater than that of semimembranosus (0.064 ± 0.054).

CONCLUSION

A potential for hamstring injury exists during the late swing phase of sprinting. Peak hamstring muscle strains in sprinting are negatively correlated to hamstring flexibility across individuals. The magnitude of peak muscle strains is different among hamstring muscles in sprinting, which may explain the different injury rate among hamstring muscles.