Toxine Botulique de type A et médecine du sport: ­revue de littérature et applications pratiques

Abstract

In sports medicine, Botulinum Toxin type A (BoNT-A) can sometimes be used as an alternative for some of the most common pathologies of the musculoskeletal system. The objective of this narrative review is to identify the main current indications for BoNT-A in common sports pathologies, the technical conditions for its use, the doses used, and the main beneficial or adverse effects expected, in order to allow a practical approach for the clinician. The injections are performed by a Physical and Rehabilitation Medicine or Sports Medicine specialist, and requires an operator trained in EMG and/or ultrasound muscle detection. The main indications are epicondylalgia, plantar fasciitis, chronic exertional compartment syndrome (CECS), the functional popliteal artery entrapment syndrome (FPAES) and patellofemoral syndrome. The main effect sought being muscle-relaxant, undesirable transient paresis may occur, requiring some precautions regarding the dose used and a search for the optimal period in the sports calendar in order to minimize this risk. Despite the multiplication of recent studies on the subject, the current level of evidence remains low and limits the use of BoNT-A to cases of failure or contraindication to first- or second-line treatments, and is performed without any guarantee of financial coverage.