Return to play after treating acute muscle injuries in elite football players with radial extracorporeal shock wave therapy

James P M Morgan,Matthias H Brem,Christoph Schmitz,Mario Hamm

doi:10.1186/s13018-021-02853-0

Abstract

BackgroundTo compare lay-off times achieved by treating acute muscle injuries in elite football players with a multimodal therapy approach that includes a specific protocol of almost daily radial extracorporeal shock wave therapy (rESWT) with corresponding data reported in the literature.MethodsWe performed a retrospective analysis of treatments and recovery times of muscle injuries suffered by the players of an elite football team competing in the first/second German Bundesliga during one of the previous seasons.ResultsA total of 20 acute muscle injuries were diagnosed and treated in the aforementioned season, of which eight (40%) were diagnosed as Type 1a/muscular tightness injuries, five (25%) as Type 2b/muscle strain injuries, four (20%) as Type 3a/partial muscle tear injuries and three (15%) as contusions. All injuries were treated with the previously mentioned multimodal therapy approach. Compared with data reported by Ekstrand et al. (Br J Sports Med 47:769–774, 2013), lay-off times (median/mean) were shortened by 54% and 58%, respectively, in the case of Type 1a injuries, by 50% and 55%, respectively, in the case of Type 2b injuries as well as by 8% and 21%, respectively, in the case of Type 3a injuries. No adverse reactions were observed.ConclusionsOverall, the multimodal therapy approach investigated in this study is a safe and effective treatment approach for treating Type 1a and 2b acute muscle injuries amongst elite football players and may help to prevent more severe, structural muscle injuries.

Highlights

To compare lay-off times achieved by treating acute muscle injuries in elite football players with a multimodal therapy approach that includes a specific protocol of almost daily radial extracorporeal shock wave therapy with corresponding data reported in the literature
In the guidelines for muscle injuries outlined by the Italian Society of Muscles, Ligaments and Tendons, Maffulli et al [8] recommended a multimodal therapy approach comprising RICE, optimized loading, manual therapy, functional compression bandages, low-level laser therapy, pulsed ultrasound therapy, electroanalgesia, training and functional rehabilitation, without reference to specific evidence in the literature or modifying the treatment plan to cater for different types of injury severity
By comparing the use of our treatment protocol for muscle injuries with other treatment protocols and the differences in lay-off times, respectively, one can conclude that non-compliance did not affect the treatment effect of our retrospective analysis. This is the first report concerning the course of recovery times following acute muscle injuries suffered by the players of an elite football team during an entire season that incorporated radial extracorporeal shock wave therapy (rESWT)/Focused extracorporeal shock wave therapy (fESWT) into the treatment protocols of these injuries

Summary

Introduction

To compare lay-off times achieved by treating acute muscle injuries in elite football players with a multimodal therapy approach that includes a specific protocol of almost daily radial extracorporeal shock wave therapy (rESWT) with corresponding data reported in the literature. During the past few years, studies using animal subjects with acute muscle injuries and in vitro studies have shown that radial and focused extracorporeal shock wave therapy (rESWT, fESWT) may be of benefit in treating acute muscle injuries [9, 10]. This form of treatment has already become well-established in successfully managing other pathologies of the musculoskeletal system, such as in the treatment of tendinopathies and fracture malunions [11, 12]. Studies on rESWT/fESWT for the treatment of acute muscle injuries in elite football players (or other sportspeople) have not yet been published

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Results

Discussion

Conclusion