Muscle tears comprise up to 55% of all injuries sustained in sport and account for significant time on the sideline for many elite athletes and weekend warriors. Typical muscles that get torn are hamstrings and calf in the lower limb and biceps and rotator cuff in the upper limb.
HOW DO THEY HAPPEN?
Muscle tears occur when the force applied to the tissue generates greater strain than the tissue can withstand. This damages the myofibrils (muscle fibres) as a result of rapid lengthening contractions, often during acceleration or deceleration movements. Muscle tears typically occur at the beginning of an activity (when not properly warmed up) or towards the end of the activity (when fatigue plays a part).
WHAT ARE THE RISK FACTORS FOR MUSCLE TEARS?
Muscles that pass over two joints - like hamstrings
Muscles that contract eccentrically - like quadriceps
Muscle with a higher percentage of fast twitch fibres
Other modifiable factors include
inadequate warm up
previous injury
poor range of motion
weakness or fatigue
poor recovery (nutrition, hydration, sleep)
HOW BAD IS MY MUSCLE TEAR?
A simple grading system can be seen in the table below.
Classification | %fibres torn | Pain/Inflammation | Functional deficits | Recovery time |
Grade 1 (Mild) | Mild tear and <5% | Minimal swelling; mild pain | Minimal loss of strength, ROM and function | 7-21 days |
Grade 2 (Moderate) | Partial tear (up to 50%) | Significant pain and associated swelling | Evident decrease in strength, ROM and function | 2-3 months |
Grade 3 (Severe) | Complete Rupture 100% | Severe swelling and pain | Complete los of strength and function | up to 6 months + (maybe even surgery) |
These gradings are not set in stone as there are many variations between people and muscle tears. The injury site can have a significant imact on the recovery time. The closer the tear is to the bone attachment, the longer the recovery time.
Muscle tears most commonly occur at the myotendinous junction (MTJ) - where the muscle and tendon join together, when force ids being transferred from the muscle to the tendon.
A more accurate grading system uses MRI to get a better prognosIs for the injury - great for professional athletes but not necessary for the weekend warrior.
WHY IS IT IMPORTANT TO MANAGE MUSCLE TEARS WELL?
Muscle tear recurrence rates are greater than 30%, leading to more time off the playing field.
MUSCLE TEAR HEALING PHASES
All muscle tears go through the following phases of healing.
Phase 1 - Degeneration/Inflammation Phase
Rupture and necrosis (death) of myofibers
Inflammatory response: haematoma, swelliing and clotting of blood within the muscle tissue)
Treatment
Ice and Compression are useful in controlling pain
Avoid complete rest
Heat, alcohol, running and massage are to be avoided in the first few days
Phase 2 - Regeneration Phase (starts within a couple of days)
Phagocytosis of dead cells
Satellite cell activation and proliferation (creation of new muscle cells to replace torn ones)
Regeneration of myofibres
Scar tissue formation
Treatment
Commence mobilisation/loading as early as is practical to benefit the healing process and reduce scar tissue build up
Manual Therapy
Phase 3 - Remodelling Phase
Maturation of myofibres
Scar tissue reorganisation
Treatment
Perform strengthening exercises
Gradual increase in load
Return to sport specific activities
Increase speed
HOW DO WE PREVENT RE-INJURY?
Ultimately, rehabilitation for muscle tears is not complete when you are pain free or returned to pre injury levels of function. Rehab should continue until the structures are more resilient than pre injury levels.
Returning to your sporting activity too early often results in recurrence and a longer time away from sport than the original rehabilitation time
Our physiotherapists are experts at diagnosing muscle tears, providing treatment and creating a plan to successfully return you to your activity as quickly as possible. Call us on 9838 8449 or book online here and make sure get the best care for your muscle tear!
コメント