UPDATE IN MUSCLE INJURY. FROM HISTOLOGY TO THE RETURN TO PLAY

This past weekend in Barcelona we have organized a seminar on update of the muscle injury. Limited to 40 people.

Feedback from attendees was really good. This fact compels us to make a second edition probably next year.


Here I leave the complete program. You can also follow the best tips on twitter with the hashtag #muscleBCN (except most of my speeches because I was speaking... )

Actualización de la lesión muscular en el deporte. De la histología a la readaptación

En los últimos años ha existido un gran avance en el conocimiento de los factores de riesgo, en la calidad del diagnóstico por imagen mediante ecografía y resonancia magnética y en el tratamiento de las lesiones musculares en el deporte.

Uno de los principales condicionantes de este hecho es la progresión en el conocimiento anatómico, los factores de riesgo, y la localización exacta de las lesiones musculares. Todo esto provoca que el tratamiento pueda ser cada vez más individualizado y, por tanto, mucho más específico para cada tipo de lesión, deportista, deporte e incluso posición en el campo.

Es por este motivo que creemos, con el Dr. Ramon Balius (@Dr_Ramon_Balius), que es un buen momento para poder revisar y actualizar algunos de los conceptos que conciernen a las lesiones en los distintos grupos musculares.

Como novedad, y debido al auge del concepto del return-to-play, especialmente en ese delicado periodo de tiempo que abarca la readaptación final a la actividad deportiva con el resto del grupo, se ha intentado dotar a las distintas ponencias de este componente.

Para esto contamos con la presencia, a parte de la del Dr. Balius y de la mís propia, de destacados ponentes conocidos por todos por su trayectoria como son el Dr. José Peña, el Dr. Gil Rodas, el Dr. Ricard Pruna i el especialista en readaptación Dr. Toni Caparrós.

Toda la información así como el programa y las inscripciones se puede encontrar en el siguiente enlace.

http://www.geyseco.es/lesion_muscular/index.php?go=inicio

Anterior Chronic Exertional Compartment Syndrome of the Leg

I am really proud for the publication of our latest work in Journal of Ultrasound in Medicine as a Technical innovation.



Ultrasound-Guided Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg

Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise. After a US examination, fasciotomy under US guidance was performed. Preoperative and postoperative pain and activity levels were assessed as well as number of days needed to "return to play." All patients had a decrease in pain, and all except 1 returned to presymptomatic exercise levels with a median return to play of 35 days.

J Ultrasound Med. 2016 Mar 9. pii: 15.04058. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/26960800

Differential Diagnosis of Calf pain in athletes

Calf pain in athletes has a very varied aetiology. When you visit an athlete with calf pain you don't have to think only in a muscle strain (although it is probably the most common cause).

There is an amount of possible diagnosis. After reviewing the literature I adapted an schema of the whole differential diagnosis of the calf pain in athletes.

Most of this causes can be diagnosed with the use of ultrasond, you just have to think about them and, obviously, speak with the patient.

* Bibliography

- Burrus et al. Chronic Leg Pain in Athletes. The American Journal of Sports Medicine, Vol. XX, No. X. DOI: 10.1177/0363546514545859

- Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012;4(2):121-127

- Brukner P. Exercise-related lower leg pain: bone. Med Sci Sports Exerc. 2000;32(3):S15-S26.

- Edwards PH Jr, Wright ML, Hartman JF. A practical approach for the differential diagnosis of chronic leg pain in the athlete. Am J Sports Med. 2005;33(8):1241-1249.

- Fabre T, Montero C, Gaujard E, Gervais-Dellion F, Durandeau A. Chronic calf pain in athletes due to sural nerve entrapment: a report of 18 cases. Am J Sports Med. 2000;28(5):679-682.

- Gallo RA, Plakke M, Silvis ML. Common leg injuries of long-distance runners: anatomical and biomechanical approach. Sports Health. 2012;4(6):485-495.

- Pell RFT, Khanuja HS, Cooley GR. Leg pain in the running athlete. J Am Acad Orthop Surg. 2004;12(6):396-404.

- Rajasekaran S, Kvinlaug K, Finnoff JT. Exertional leg pain in the athlete. PM R. 2012;4(12):985-1000.