Tero A. H. Järvinen, MD, PhD*,, Teppo L. N. Järvinen, MD, PhD*,, Minna Kääriäinen, MD, PhD*,, Hannu Kalimo, MD, PhD, and Markku Järvinen, MD, PhD*,,||
From the * Department of Orthopaedics, Tampere University Hospital, Tampere, Finland, Medical School and Institute of Medical Technology, University of Tampere, Tampere, Finland, Department of Pathology, University and University Hospital of Helsinki and Turku, Helsinki and Turku, Finland, and Department of Pathology, University and University Hospital of Uppsala, Uppsala, Sweden
Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, few clinical studies exist on the treatment of these traumas. Thus, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested only empirically. Although nonoperative treatment results in good functional outcomes in the majority of athletes with muscle injuries, the consequences of failed treatment can be very dramatic, possibly postponing an athletes return to sports for weeks or even months. Moreover, the recognition of some basic principles of skeletal muscle regeneration and healing processes can considerably help in both avoiding the imminent dangers and accelerating the return to competition. Accordingly, in this review, the authors have summarized the prevailing understanding on the biology of muscle regeneration. Furthermore, they have reviewed the existing data on the different treatment modalities (such as medication, therapeutic ultrasound, physical therapy) thought to influence the healing of injured skeletal muscle. In the end, they extend these findings to clinical practice in an attempt to propose an evidence-based approach for the diagnosis and optimal treatment of skeletal muscle injuries.
The American Journal of Sports Medicine 33:745-764 (2005).