Muscle injuries

MEDICAL INFORMATION

Muscle injuries can be fundamentally differentiated into lesions with or without loss of continuity—that is, whether or not a rupture of muscle fibers exists. Aside from spasticity, the most common injuries currently treatable with shock waves and radial pressure waves are cramps, DOMS, muscle contractures, contusions, and chronic muscle injuries involving fibrosis or painful scarring. According to recent studies, complications such as myositis ossificans could also be treated, or preventive treatments for muscle injuries could be performed, although these are not yet included by the ISMST. Ultrasound is essential for diagnosis and follow-up.

APPLICATION TECHNIQUE

The positioning of the patient and the therapist depends on the affected muscle group. Generally, we use the supine position for the quadriceps or the prone position for the hamstrings, biceps femoris, or triceps surae. For upper limb treatments, the patient may be positioned in supine, prone, or seated positions.

It should be noted that for muscle injuries, protocols combining focal shock waves with radial pressure waves can be implemented. In these cases, focal wave treatment is confined to the injury site, while radial pressure waves perform a sweep of the lesion and the rest of the damaged muscle, along with other muscle groups that may present reflex contractures.

REVIEWS

Depending on the injury and the patient, reviews can be conducted 10-15 days after completing the cycle for athletes or occupational environments, or at one month for more extensive or chronic injuries, always allowing for the 12-14 week period required for the regenerative effect of mechanotransduction to take place.

Note: In the case of athletes, it is crucial to coordinate with other concurrent physiotherapy treatments and ensure proper functional recovery to prevent relapses.

SOURCE: Dr. Juan Miguel Morillas Martínez. (SETOC Quick Reference Guide for Extracorporeal Shock Wave Medical Treatment Protocols).