Järvinen Tero A H, Järvinen Teppo L N, Kääriäinen Minna, Aärimaa Ville, Vaittinen Samuli, Kalimo Hannu, Järvinen Markku
Institute of Medical Technology and Medical School, University of Tampere, Tampere, Finland.
Best Pract Res Clin Rheumatol. 2007 Apr;21(2):317-31. doi: 10.1016/j.berh.2006.12.004.
Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, there are only a few clinical studies on the treatment of muscle injuries. Lack of clinical studies is most probably attributable to the fact that there is not only a high heterogeneity in the severity of injuries, but also the injuries take place in different muscles, making it very demanding to carry out clinical trials. Accordingly, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested empirically only. Clinically, first aid for muscle injuries follows the RICE (Rest, Ice, Compression and Elevation) principle. The objective of RICE is to stop the injury-induced bleeding into the muscle tissue and thereby minimise the extent of the injury. Clinical examination should be carried out immediately after the injury and 5-7 days after the initial trauma, at which point the severity of the injury can be assessed more reliably. At that time, a more detailed characterisation of the injury can be made using imaging diagnostic modalities (ultrasound or MRI) if desired. The treatment of injured skeletal muscle should be carried out by immediate immobilisation of the injured muscle (clinically, relative immobility/avoidance of muscle contractions). However, the duration of immobilisation should be limited to a period sufficient to produce a scar of sufficient strength to bear the forces induced by remobilisation without re-rupture and the return to activity (mobilisation) should then be started gradually within the limits of pain. Early return to activity is needed to optimise the regeneration of healing muscle and recovery of the flexibility and strength of the injured skeletal muscle to pre-injury levels. The rehabilitation programme should be built around progressive agility and trunk stabilisation exercises, as these exercises seem to yield better outcome for injured skeletal muscle than programmes based exclusively on stretching and strengthening of the injured muscle.
肌肉损伤是体育运动中最常见的创伤之一。尽管其具有临床重要性，但关于肌肉损伤治疗的临床研究却很少。临床研究匮乏很可能是由于以下事实：损伤严重程度不仅存在高度异质性，而且损伤发生在不同肌肉，这使得开展临床试验极具挑战性。因此，目前肌肉损伤的治疗原则要么源自实验研究，要么仅经过经验性检验。临床上，肌肉损伤的急救遵循RICE（休息、冰敷、加压包扎和抬高患肢）原则。RICE的目的是阻止损伤引起的出血进入肌肉组织，从而将损伤程度降至最低。应在受伤后立即以及初次创伤后5 - 7天进行临床检查，此时可更可靠地评估损伤严重程度。如有需要，届时可使用成像诊断手段（超声或磁共振成像）对损伤进行更详细的特征描述。受伤骨骼肌的治疗应通过立即固定受伤肌肉来进行（临床上，相对固定/避免肌肉收缩）。然而，固定时间应限制在足以形成具有足够强度的瘢痕，以承受重新活动所产生的力量而不再次断裂的时间段内，然后应在疼痛限度内逐渐开始恢复活动（活动）。需要尽早恢复活动，以优化愈合肌肉的再生，并使受伤骨骼肌的柔韧性和力量恢复到受伤前水平。康复计划应围绕渐进性敏捷性和躯干稳定性练习构建，因为这些练习对于受伤骨骼肌似乎比仅基于受伤肌肉拉伸和强化的计划能产生更好的效果。
