Muscular lesion

To start with, muscular injuries may arise due to a received blow (the so called direct trauma injuries or bruises) or a wrong movement (indirect trauma injuries).

To start with, muscular injuries may arise due to a received blow (the so called direct trauma injuries or bruises) or a wrong movement (indirect trauma injuries).

In these cases, according to the extent to which muscular pain limits movement, bruises are defined light (when the range of movement is over half of the normal one), moderate ( between half and a third) or severe (when fatiguing moving the limb, less than a third f the normal range of movement).

When this s the case, the soonest therapies are started, the soonest athlete can return to sports.

More complex is, instead, the classification and diagnosis of indirect traumas.

If pain is accompanied by a spread and increase in the muscle tone and generally occurs at the end of the sports activity, where it is not possible to relate it to a particular trigger or to localise it, it is usually a muscle contracture or shortening.

On the contrary, if pain is easy to localise, increases during sporting activity and makes playing difficult even if still possible, this is likely to be a strain, characterised by the absence of macroscopic evidence of muscle fibre disruption.

If the pain arises accompanied by a diffuse increase in muscle tone, usually at the end of sporting activity, is not referable to a precise moment of play, is not well localized, and the patient indicates it with an open hand, over the entire muscle, we are faced with a muscle contracture.
If, on the contrary, the pain is well detectable on palpation, arises progressively during sporting activity, allows the patient to continue playing even if with fatigue, then we are faced with a strain, characterized by the absence of macroscopic anatomic injury. Again, the sooner treatment is started, the sooner it is cured.

In contrast, muscle injuries or tears (first, second, and third degree) require longer recovery times. In these cases, an anatomical injury, of varying severity, is always present. This severity is directly proportional to the amount of tissue affected, the blood effusion, and the muscle injured.
It is difficult not to detect a muscle injury immediately, because the athlete feels a sudden, sharp pain with a specific reference to a technical gesture; the athlete can even point to the precise location of the injury.
Functional impotence is all the earlier the more severe the injury.

Here the anatomic lesion is instead always present and its gravity is variable. This seriousness is directly proportionate to the quantity of involved tissue, to the haematoma and the injured muscle.
It is difficult not to detect immediately the real muscular injury, since the athlete feels a sudden pain, acute, related to a specific technical gesture; the athlete can even point out the zone where injury occurred. The functional impotence is as precocious as the injury is serious.

Diagnosis is essentially clinical, but it is aided by MRI prescribed 24/48 hours after the trauma. Ultrasound scans can be repeated throughout rehabilitation to keep the outcome under control.
Treatment must take into account the degree and location of the lesion, as well as patient’s lifestyle. Clinical and ultrasound follow-ups are important throughout the process, being aware of the fact that the destiny of muscular injuries depends on the degree and seat of the lesion, as well as on the very common mistakes in treatment.