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When should you return to play after a muscle injury?

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New research could help provide an accurate return-to-play time for athletes with a sports-related muscle injury.

Researchers at the Polytechnic University of Catalonia (UPC), in collaboration with the medical team at Futbol Club Barcelona, explored the use of a technique known as localised bioimpedance measurement (L-BIA) to help quantify the damage to soft tissue structure in injured muscles.

They tested the technique on 18 professional footballers’ injuries at FC Barcelona, and found that L-BIA gave a clearer picture of the damage than ultrasound (US) or magnetic resonance imaging (MRI) scans.

Injuries to skeletal muscles are common in competitive sport, particularly in football, where they account for about 30% of injuries.

Such injuries are generally assessed with US or MRI, explained UPC’s Dr Lexa Nescolarde, lead author of the study.

“However, these systems don’t allow clinicians to give a clear prognosis on the time it will take to return to play, because that is governed by the severity of the injury and the muscle gap — or muscular fibre retraction — which cannot be measured by US or MRI,” she said.

L-BIA is a low cost, accessible and non-invasive technique which can support the image from US or MRI to help quantify the disrupted soft tissue structure in injured muscles, said Dr Javier Yanguas, from FC Barcelona’s medical team. It works by sending a low-intensity alternating current through healthy muscle tissue and then comparing that with readings from injured tissue.

In the study, the researchers took measurements soon after the footballers were injured and again when they returned to play, and compared them with healthy muscles.

Through this they identified two types of classical partial muscle tears, which an MRI scan could not differentiate between. They could then work out the severity of the injury and the players’ likely recovery time.

“The prognosis of the injury and the return-to-play time will depend, among others things, on the severity of the injury. These will be wrong if the classification of the injury is mistaken,” Dr Yanguas said.

“It is therefore essential to differentiate the group of partial tears into two subgroups, because significant changes in muscle reactance help us to give the close attention that a muscle injury demands for the best possible prognosis.

“This is precisely what we have found L-BIA enables us to do.”

The findings have been published in the journal Physiological Measurement.