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  • Muscles and tendons

    Every athlete knows the problems with muscles and tendons – muscle soreness as well as a rupture of the Achilles tendon. Warming-up may reduce the risk.

    Strained muscles
    Jumper’s knee or patellar tendinopathy
    Rupture of the Achilles tendon
    Rupture of the biceps tendon

    Strained muscles

    One of the most common sports injuries is a strain of the muscle or even a crack or rupture of the muscle. The entire muscular system depends on the one hand from genetic factors and on the other hand from training. A lack of exercise may result in an atrophy of the muscles. An athlete has more muscles than untrained people. There are different muscle fibers for either stamina or strength. A marathon runner looks different than a weightlifter. Every kind of muscle fiber may be trained in a selective way by specific training.

    Symptoms
    Which problems of the muscles may develop during sports activities? Muscle soreness is harmless but unpleasant as every athlete knows. Muscle soreness is caused alongside other factors which are not completely clarified so far, by tiny cracks within the muscle. These develop primarily if the muscles are stretched under tension. The destruction of muscle fibers is a trick of nature: After regeneration the muscle develops stronger structures and is prepared for the next strain. Muscle soreness occurs within 12 up to 24 hours after doing sports and is of short duration. Cramping pain which result from the dynamics of self-motion are an indication of strain (torn muscle fiber) as well as rupture of a muscle. On direct contact with a foreign object a contusion with hemorrhage may develop. A typical sports injury is a strain of the adductor (muscle group on the inside of the thighs) with cramp-like pain. Often there are as well torn muscle fibers in the calf.

    Diagnosis
    The extent of the injury of muscles and tendons is captured by magnetic resonance imaging.

    Therapy
    In case of muscle soreness gentle movement and warmth may accelerate healing. Stretching should be avoided, because cracks may develop. In case of a contusion of the muscles („bruise“) manual lymphatic drainage furthers the reduction of the hematoma and of the products which have developed during the tissue destruction. As a rule you may say that a training break of about 3 weeks is necessary after the occurrence of torn muscle fibers. If more than 75 percent of the muscle cross-section is torn, a surgical intervention makes sense for the active athlete. Hereby the muscle is sewn and if possible, supported with collateral tendon tissue. An immobilization for about four weeks and a training break of a few months are associated with this. If musculature is forced into inactivity, caused by an injury, it diminishes. Only after complete healing of the injury, gentle training may be performed to develop the muscle gradually and to fulfill the requirement for doing sports. That is the reason why some professional athletes with torn muscles make their comeback only after one year. Particularly with regard to muscle injuries the medical and especially physiotherapeutic treatment is of great importance. If there is a muscle hardening which is quite common in sports, it might be helpful to stretch and relax the affected area gently for about one minute. Hereby the pain threshold must never be exceeded.

    Prevention
    You may avoid injuries of the muscles by performing the right „warm-up“and „cool down“. But often there is neither the time nor the patience to do so. The risk is reduced as well by intense stretching of the stressed muscles (3 times for 7 seconds for every muscle group) after the training. In case of muscle hardening as a result of intense strain the sports activity has to be reduced, in order to avoid a torn muscle. The hardened muscles should be loosened with a massage beforehand.

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    Jumper’s knee or patellar tendinopathy

    Knee pain can arise for a number of reasons. The „patellar apex syndrome“– also known as jumper’s knee among athletes – is one reason. The patellar ligament is the continued tendon of the quadriceps muscle groups, which directs the strength along the knee to the lower leg. Of course enormous forces are released. Overuse or chronic misuse may result in an inflammation of the patellar ligament at the top of the kneecap. This often occurs during excessive jumping, jogging, strength training or tennis.

    Symptoms
    A load dependent pain in the area of the top of the kneecap is significant. In an advanced stage the kneecap hurts also in everyday life, for example when going upstairs.

    Diagnosis
    In magnetic resonance imaging the tendon appears strongly thickened and the collagen fibers are swollen.

    Therapy
    The patellar apex syndrome is treated mainly conservative. But the therapy is long and time-consuming. Among athletes cortisone is often used to treat the inflammation. In doing so a quick but only short-term improvement is achieved. Frequent cortisone injections may result in a reduction of the tissue. Damages in the knee and especially the cartilage can be the outcome. The correction of such changes is one of the major problems in knee surgery. Thus the long-term healing of the inflammation is necessary. Ultrasonic, laser or nuclear magnetic resonance therapy (MBST) stimulate the metabolism and promote healing.

    Operation
    Only if there is no improvement by using conservative methods, the tissue has to be removed during a minimal surgical intervention. Afterwards a trainings break of about six weeks is necessary.

    Prevention
    Good muscle stretching, warm-up before doing sports and a moderate increase of the exercise intensity may lower the risk.

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    Rupture of the Achilles tendon

    It can happen during tennis or when playing football – all of a sudden the crack of a whip and the sensation as if a tennis ball hits you hard or as if somebody had kicked your leg. This is exactly the sensation when the strongest tendon of the body ruptures – the Achilles tendon. The rupture typically occurs about three fingers above the base of the heel bone.

    Symptoms
    The short, severe and sharp pain is typical for the rupture of the Achilles tendon. Additional dents and swellings may occur and it is not possible to stand on tiptoes.

    Therapy
    A recommended first-aid-measure would be to cool the area of the heel with ice. Placing the foot of the injured leg should be avoided. Even if the pain and the swelling decrease, a medical therapy is required. A conservative treatment is possible if both parts of the tendon still have contact. For six to eight weeks it is necessary to wear a special shoe with a raised heel bone. ACP Treatment is also very useful. The ability to do sports – excluding cycling, swimming and training on the cross trainer - is given after 6 month at the earliest. Cell-stimulating treatments like nuclear magnetic resonance therapy MBST (see also overloading defects) promote healing.

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    Rupture of the biceps tendon

    Madonna is well-known for her biceps: This muscle is of great importance for the power transfer in the shoulder- and elbow joint. Injuries of the long biceps tendon are common among throwers and power athletes. This tendon is not only exposed to tensile loading but also to a friction of the humerus head.

    First Aid
    During the acute phase the arm should be immobilized (triangular scarf). A cooling pack will help against a hematoma and the pain. It is necessary to seek medical attention as quickly as possible!

    Therapy
    Only when the extent of the injury is known, a treatment can be specified. Surgical intervention is necessary if the tendon is torn at the lower end and at the upper end. By using arthroscopy the severed part is fixated. Afterwards the arm is immobilized in a sling for about four weeks. It is absolutely necessary to operate the rupture of the biceps tendon in the area of the elbow, because here a strong impairment does occur very likely. Afterwards the arm is immobilized with a splint which is adjustable in its bracket and movement extent. In doing so a stiffening of the elbow joint is prevented. As in every Tendon and muscle repair also in this case the application of growthfactors by ACP Therapy is very much recommended.

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