Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise.

Stefano Palermi,Carlo Ruosi,Domiziano Tarantino,Bruno Massa,Paolo De Blasiis,Alfonso Maria Romano,Felice Sirico,Marco Vecchiato,Fiore Mazza,Mariano Giuseppe Di Salvatore,Elisabetta Della Valle

doi:10.3390/jfmk6030075

Abstract

Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.

Highlights

Muscle injuries (MI) are the most common trauma in team and individual sports and are responsible for most of the time lost in both training and competition [1,2,3]
It is a common opinion that rehabilitation protocols designed for muscle injuries should be built mostly on available structure and therapeutic options [10], rather than on scientific knowledge
The Italian consensus conference gave useful advice [101]. General assessment about this process is made up of some key points: absence of clinical symptoms [105,106,107]; absence of pain or tenderness during muscle palpation [10,107,108,109]; absence of pain on passive and active stretching [110]; absence of pain on isometric, concentric and eccentric contraction [10]; completion of the prescribed rehabilitation program [108]; Magnetic Resonance Imaging (MRI) and US imaging [111,112]; subjective feelings of the player taken into account [113,114,115]

Summary

Introduction

Muscle injuries (MI) are the most common trauma in team and individual sports and are responsible for most of the time lost in both training and competition [1,2,3]. In subjects affected by muscle injuries, the diagnostic and rehabilitative approach relies on several factors, such as age, gender, athletic demands, muscular groups involved and type of injury. To this scope, several classifications have been proposed over the years. The aim of the present paper is to review proposed therapeutic algorithms for indirect structural muscle injuries of the lower limb, with a particular insight on hamstrings, adductors, rectus femoris and calf muscles rehabilitation

Muscle Injuries Rehabilitation

Specific Exercise Rehabilitation

Findings

Conclusions