Muscle injuries are most common in sports and everyday life, they have a high recurrence rate, and they are often not treated properly. Injuries to the muscle tissue account for about a third of all sports injuries.
Muscle damage can be the result of contact (by hitting them or landing awkwardly) or non-contact injury (acute or chronic overload, insufficient warm-ups, poor treatment of former injuries). On a three-grade scale for assessing muscle fibre damage, full muscle rupture or a fully torn muscle represents a grade III injury, characterised by intense pain, hematoma that can form in the muscle or on its surface, and full muscle dysfunction with the inability to activate or contract the affected group of muscles.
Full muscle rupture most commonly occurs after a sudden movement in combination with a cold muscle group that has not been warmed up, after a poorly treated former muscle tear or rupture, intense muscle fatigue, or contact injury where the muscle is externally deformed due to an external factor (a cut, stronger hits, car accidents).
A ruptured group of muscles can be diagnosed by manually inspecting the tissue since the deformation of the overall normal muscle shape is externally visible and a more extensive hematoma is visible on the surface. In any case, undergoing MRI and ultrasound diagnostics is recommended to determine the exact extent of muscle fibre injury and the location of the rupture since the tissue deformation and hematoma oftentimes make it difficult to determine the injured spot.
After a muscle rupture, it is important to immediately stop exercising and immobilise the spot where the rupture happened.
A muscle rupture causes the muscle fibres to tear, intense inflammation, and reabsorption of hematoma. Muscle fibre tears have a high potential for self-healing, which consists of regeneration with new muscle fibres and scar formation (granulation tissue).
Surgical treatment of a muscle group rupture aims to ensure as little scar tissue as possible, reduce the extent of the muscle’s structural deformation, and restore full function to the affected group of muscles.
In the first 24 hours after muscle rupture, it is important to reduce the hematoma formation, prevent the development of additional micro-injuries of the muscle, and normalise the patient’s pain. We lift the injured extremity off the ground and immobilise it – in the event of full muscle rupture, it is important to immobilise the two neighbouring joints. We wrap the injured muscle over the entire surface using an elastic bandage and apply cooling to the rupture site.
At night while waiting for surgical treatment, we apply warm compresses and cover them with a protective elastic bandage. It is recommended to undergo instrumental physiotherapy, especially therapeutic laser in the period leading up to surgery.
Preoperative physiotherapeutic care is necessary to ensure successful postoperative wound healing. The entire rehabilitation process of full muscle rupture using surgical treatment lasts for a period of 7 to 9 months, in case a larger group of muscles ruptures it can last up to 12 months.
After surgical treatment, combined outpatient physiotherapy is necessary with a controlled transition to therapeutic exercise. It is important to restore the full functionality and strength of the muscle before putting more stress on the muscle. In the case of athletes, it is important to carry out the “return to sport” phase of rehabilitation that includes an intensive exercise programme, which prepares the injured muscle for special overloads typical of sports training.