The television segment on Sky Sport continues. In the episode airing on Saturday, November 23, 2024, Francesco Della Villa, Director of our Education & Research Department, discussed muscle injuries.
What is meant by a muscle injury?
A muscle injury refers to a range of alterations to a muscle. These can be either functional in nature (less severe and without macroscopic lesions) or structural in nature (more severe, involving actual muscle tears, which require longer recovery times).
Are these injuries common? And which sports are most at risk?
These injuries are common, and the sport most at risk is soccer. A team of 25 players can expect between 15 and 20 muscle injuries per season. In fact, they are the most problematic injuries in the world’s most popular sport. However, they are also common in other sports, such as rugby and basketball, as well as individual disciplines like track and field.
Which muscles are most often affected by injuries?
The most commonly affected muscles are those of the lower limb, particularly the muscles that control the movement of two joints. Four muscle groups are most frequently impacted:
- In first place are the FLEXORS (the muscles at the back of the thigh), particularly the biceps femoris.
- In second place are the ADDUCTORS, particularly the adductor longus muscle.
- The calf muscles, or TRICEPS SURAE, particularly the soleus muscle or the medial gastrocnemius, a typical injury for tennis players.
- And finally, the QUADRICEPS, specifically the Rectus Femoris muscle.
How do they occur?
They occur in 83% of cases independently (without contact with an opponent) during various actions and movements. However, there are typical scenarios for each muscle group. Flexors are more likely to tear during high-intensity running, while calf muscles typically tear during accelerations from a standstill (it’s common for a player to look behind, thinking someone has struck them). Quadriceps injuries almost always occur while kicking, as do adductor injuries (this time with an inward motion), which are more complex and often associated with excessive stretching movements.
How can I determine if the injury is serious or not?
In the case of an actual tear (a structural injury), a sudden, sharp, and well-localized pain is felt (easy to pinpoint) during a movement. In these situations, the player must be substituted and typically experiences pain while walking.
In the case of “functional” muscle injuries, the pain is more subtle, less localized, and the player can often finish the game.
What should be done if a muscle injury is suspected?
The first step is to clearly understand what happened and make an accurate diagnosis. Along with a sports medical examination, an ultrasound is recommended (to be performed at least two days after the injury), and in selected cases, an MRI may be necessary.
Once the diagnosis is clear, it is possible to estimate recovery time and plan the return-to-sport pathway.
What is the treatment?
In the vast majority of cases, the treatment is conservative (non-surgical) and involves a rehabilitation program of varying duration depending on the type of injury. As shown in the animation, tears (structural injuries) have significantly longer average recovery times.
How is the recovery process structured?
Using a tear as an example, the recovery process unfolds in various phases, progressing based on specific objective criteria.
- In the very first phase, we need to protect the injured muscle; the area is compressed and elevated.
- When the patient can walk without pain, work begins on flexibility and initial strengthening.
- Once the patient can run without pain and clinical tests allow it, eccentric strengthening (strengthening while lengthening) begins, along with more complex movement control exercises.
- The final phase takes place on the sports field, where GPS parameter monitoring is key to restoring the patient’s sport-specific profile.
What are the latest developments regarding muscle injuries?
The most significant development in recent years has been to not only focus on the injured muscle but also consider the adjacent joints and the biomechanics of the entire body.
The detailed study of injury dynamics, combined with the analysis of movement during recovery, offers interesting opportunities to optimize functional outcomes.
The other key aspect is the monitoring of GPS parameters on the field, a recent advancement that is incredibly helpful in the return-to-sport process.
