Muscle fiber tear causes diagnosis therapies orthinform

Muscle fiber tears are among the most common muscle injuries. Are also called minor injuries. The diagnosis can usually be made by a simple examination. As a rule, they heal under conservative therapy within 10 to 14 days.

Frequency

A large-scale study by UEFA showed that one third of all injuries in soccer are muscle injuries. Among the structural-mechanical muscle injuries, muscle fiber tears are the most common injuries. Mostly the thigh is affected, whereby here again the back of the thigh, i.e. the so-called hamstring muscles, are most frequently affected. But also the hip groin region. The calf muscles can be affected. A professional football team can expect 10 to 15 muscle injuries per season. Thus, muscle injuries are responsible for most of the lost days in this sport.

Fig. 1: The back of the thigh is often affected by torn muscle fibers. (Source: SENTELLO/Fotolia)

Causes and symptoms

A structural-mechanical muscle injury occurs when an applied force exceeds the elastic limit of the muscle. Initially, there is a stretching of the muscle. With further application of force, first individual, then more and more muscle fibers tear. If the fiber structure is interrupted by less than 5 mm, it is called a muscle fiber tear. If the force continues to act, more and more muscle fibers tear, the gap becomes larger. From 5 mm one speaks of a muscle bundle tear. This can lead up to a complete muscle tear. The most frequent localization within a muscle is the transition from the muscle to its tendon, the so-called musculo-tendinous transition. In the case of a muscle fiber tear, a bruise (hematoma) may occur, but it remains invisible because the muscle sheath (fascia) is not torn as well. Classic symptoms are sharp pain and prere pain, often within a hardened muscle area. Muscle stretching increases pain.

Diagnosis

In addition to the recording of the accident event, the physical examination is the most important component in the diagnosis of a muscle fiber tear. If the athlete stops sport immediately after an acute injury, it must be amed that the injury is structural-mechanical. Palpation of the painful muscle or. of the entire painful region, the so-called palpation, is in the foreground here. If hardening or even gaps are palpable? A great deal of medical experience is required to reliably diagnose even minor muscle injuries. In the further course the injury can be localized exactly by ultrasound examination and its size extension can be determined. In particular, the search for hematomas is important to distinguish between functional lesions and structural injuries. Magnetic resonance imaging is particularly suitable for diagnosing muscle injuries. With their help, a distinction can be made with a high degree of certainty between minor (muscle fiber tears) and major injuries (muscle bundle and muscle tears). However, it bears the risk of overestimating the actual extent of injury in the case of minor injuries.

Therapy

Muscle fiber tears usually heal within 10 – 14 days under conservative therapy. The earliest possible examination is crucial, since both the therapy and the prognosis of minor injuries and major injuries differ considerably in some cases. If a structural-mechanical muscle injury is suspected, the affected region should be wrapped as quickly as possible, for example still on the sidelines, with an ideal bandage cooled with ice water over a large area under strong prere (also called "hot ice"). The prere bandage is repeatedly cooled with ice water over the next few minutes. After 20 minutes, the hot-ice bandage is removed. According to research, every minute missed in the first ten minutes of primary care of a muscle fiber tear means one day of lost time until full strength is restored.

In the first five days after a torn muscle fiber, a break from sports is advisable. During this time physical. Physiotherapeutic measures to be used. Local injections can create optimal conditions for rapid muscle regeneration and scar formation and achieve prere regulation in the affected muscle area. Various medications are used, such as Traumeel, Platelet rich Plasma, Actovegin or local anesthetics such as Mepivacaine. Cortisone injections into injured muscle areas must be strongly discouraged, and not only because of anti-doping regulations. From the fifth day on, running training is possible again, even beneficial. After two weeks, there is usually an unrestricted ability to play sports again.

Literature and further links

Ott, H. / Hirschmuller, A. / Weisskopf, L.: Epidemiology, diagnosis and classification of muscle injuries. OUP 2017, 2:69-74.

Muller-Wohlfahrt, H.-W. / Ueblacker, P. / Hansel, L.: Muscle injuries in sports. Thieme 2010. This dictionary entry contains only general information. Must not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor.

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