MUSCLE TEAR OF THE THIGH - SOCCER

Abstract

HISTORY A 17-year-old professional soccer forward player received a high impact hit on his left thigh. In the 20th minute of the second half of a midseason game, he received a kick on his front left thigh while he was kicking to the goal, he went out for three minutes for examination then he continued to play. He finished the game walking with difficulties and pain. He went to the General Hospital emergency room and oriented to put some heat on his thigh because it was just a contusion. After 48 hours, he went to the Sport Specialist. PHYSICAL EXAMINATION Examination of the patient revealed a functional inability with 90° maximal knee flexion, mobilization and touching pain (Visual Analog Scale = 8), organized and solid edema and hematoma on the middle third of his front left thigh. DIFFERENTIAL DIAGNOSIS Cuadriceps muscle tear. Front thigh contusion. Cadriceps muscle strain. Femur fracture. TESTS AND RESULTS Left front thigh diagnostic ultrasound: 9 × 3 cms. transverse tear of the middle third of the vastus intermedius of the cuadriceps muscle, encapsulated hematoma and active inflammatory process. Left thigh anterior-posterior and lateral radiographs: no fracture and no bony abnormalities. FINAL/WORKING DIAGNOSIS Vastus Intermedius transverse tear. Active inflammatory process. Cuadriceps muscle strain. TREATMENT AND OUTCOMES First week: two first days diathermy and stretching to re-make worse the muscle tear, from the third to the 7th day cryotherapy, TENS and therapeutic ultrasound as an acute muscle tear. Second week: cryotherapy, TENS, therapeutic ultrasound, stretching and cuadriceps muscular strength at 50% Maximal Isometric Voluntary Contraction (MIVC). Third week: cryotherapy, TENS, therapeutic ultrasound, stretching, cuadriceps muscular strength at 75% MIVC and 30 minutes of aerobic work on ergonomic bicycle. Fourth week: TENS, therapeutic ultrasound, stretching, cuadriceps muscular strength at 85% MIVC and 60 minutes of aerobic work on ergonomic bicycle. Fifth week: The patient was training normally with his team and playing in the regular season without pain and impairment.