腘绳肌拉伤后的重返运动:是时候考虑自然愈合了。
Return to Play After a Hamstring Strain Injury: It is Time to Consider Natural Healing.
机构信息
Department of Rehabilitation Sciences, Ghent University, University Hospital, Corneel Heymanslaan 10, 3B3, 9000, Ghent, Belgium.
出版信息
Sports Med. 2021 Oct;51(10):2067-2077. doi: 10.1007/s40279-021-01494-x. Epub 2021 Jun 18.
Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time.
重返运动(RTP)标准可帮助临床医生判断运动员是否已准备好安全地恢复先前的运动活动,这对于腘绳肌拉伤(HSI)后非常重要。如今,功能和运动专项训练测试是决策过程中的黄金标准。这些标准导致 1 级或 2 级 HSI 后平均 RTP 时间在 11 至 25 天之间。但是,高再受伤率表明当前 RTP 标准可能存在不足。造成这种情况的一个可能原因是忽视了生物学愈合时间。本综述表明,指出时间可能是 RTP 决策内的一个因素的研究非常少。但是,有关肌肉生物愈合的研究表明,在 RTP 的平均时刻,不成熟的瘢痕组织和不完全的肌肉愈合。25%的再损伤发生在 RTP 后的第一周内,并且与索引损伤的位置完全相同。本综述支持以下观点,即功能恢复先于肌肉的生物学愈合。基于肌肉生物愈合的基础科学研究,我们建议在 1 级或 2 级 HSI 后至少 4 周才能进行 RTP。总之,我们建议进行综合的 RTP 功能测试,同时要尊重自然愈合过程。在决定 RTP 是否准备就绪之前,临床医生应该反思受伤组织是否有可能在生物学上恢复足够的力量来承受特定运动的力量。为了减少有害的伤病循环,现在是时候开始考虑(生物学愈合)时间了。