[Latest standards of muscle injury prophylactic activities, treatment and rehabilitation].

Muscle injury represents the highest proportion of sport-linked contusions. Experimental and clinical studies aim at increasingly detailed recognition of muscle physiology and pathophysiology. It would allow to set up functional standards and permit to minimize risk of contusions associated with sport activities. In cases of such contusions it would restrict its sequele and would abbreviate the duration of treatment. In the study elements of prophylaxis, treatment and rehabilitation of injured muscles will be discussed, based on current scientific results. Review study includes data from studies investigating prophylactic activities, types of teratment and the effects of different rehabilitation strategy. Latest standards from First European Congress of Football Medicine, Munich 2004, were also taken into account. The prophylactic activities should focus on education attempting to popularize the knowledge of the role of warm-up activities which precede proper physical effort, muscle stretching and activities augmenting muscle strength. The treatment of muscle injury is related to the extent of their damage. First actions should be focused on the RICE principle (Rest, Ice, Compression, Elevation). In case of torn tissues, local injections of anesthetics, anti-inflammatory agents and regeneration-promoting agents used to be applied. Application of NSAIDs and anti-thrombotic prophylaxis is sound but due to their side effects it is recommended as frequently as it is counterindicated by physicians. A threshold in the therapy, not always noted by therapeutists, involves rapid mobilization of the injured tissue. This involves mobility exercises starting at 3-5 days post-trauma, with no load at the beginning, but starting at days 4 to 6 asssociated with appropriate loading. The recently conducted studies aim at stimulation of rapid muscle regeneration, inhibition of scar formation in the site of injury and elimination of already existing scars. The latter seems most difficult due to the high risk of the repeated muscle injury in the same site. The rehabilitation following trauma with particular attention paid to proprioceptive training is equally important. The risk of another contusion cannot be reduced to minimum until the pre-contusion proprioception level is achieved in the contused extremity.