- Calcification in the muscle (Myositis ossificans):
Muscles which have been subjected to a rupture can from time to time be found to
have some calcification, although the reasons for this are unknown. The
diagnosis is often made due to the rehabilitation not progressing as expected in
relation to the primary evaluation of the extent of the injury. The
calcification can be seen under ultrasound scanning after a few days, and
subsequently on an x-ray after a few weeks
(X-ray picture),
(Ultrasonic image) . A considerably longer rehabilitation period must
be expected if the muscular bleeding is complicated by calcification in the
muscle. Surgery is almost never indicated, as an operation can involve further
calcification. Vigorous massage on the blood accumulation should be avoided on
the same grounds
(article-1),
(article-2).
- Formation of scar tissue in the muscles (cicatricial
tissue).
Formation of scar tissue is often seen after a muscle rupture, and can in some
cases cause permanent discomfort. The formation of scar tissue is often the
cause of the rehabilitation progressing slower than anticipated, as well as
relapses a long time after the injury initially occurring. A local tenderness in
the muscle can usually be experienced, aggravated when activating and stretching
the muscle. It is often possible to detect scar tissue under ultrasound
scanning, however, this can be quite difficult and requires a doctor well
experienced in performing ultrasound scans. An area of
inflammation will often be seen surrounding the scar tissue formation.
- Blood accumulation in the muscle (haematoma
musculi).
Injuries to muscles always involve muscular bleeding to a greater or lesser
extent. In some cases the bleeding is diffuse between the muscle cells, whereas
other cases can involve the bleeding being a larger, well-defined accumulation
in the muscle. The larger the accumulation, the longer period is required for
the accumulation to disappear and allow the muscle to heal. Accumulations of
blood in the muscles often entail more pronounced pain than anticipated in
relation to the primary evaluation of the extent of the injury. The diagnosis is
best made via use of ultrasound scanning. If the accumulation is large it can be
drained, which can advantageously be performed under guidance of ultrasound.
Some recommend advise caution regarding massage to reduce
the risk of myositis ossificans.
- Formation of fluid in the muscle (Hygrom).
A formation of fluid will sometimes appear after an injury to a muscle, and
can be of a considerable size. If the fluid does not diminish following relief,
the accumulation can be drained by use of ultrasound scanning. Fluid accumulations can be the
cause of the rehabilitation not progressing smoothly.
- Acute compartment syndrome:
The groups of muscles on the arms and legs are surrounded by taught muscle
membranes (fascias), which are partially unremitting. Damage to blood vessels
and nerves can be caused if the bleeding and fluid accumulation in the muscles
reaches such a size that the pressure in the muscle group increases. Serious
damage to muscles can be caused in acute cases which result in the blood vessels
closing. The symptoms comprise increasing pain in the damaged arm or leg muscle,
which is often more powerful than expected from the primary evaluation of the
extent of the injury. At the same time sensory disturbances can occur. The
diagnosis is made by performing a pressure measurement in the muscle compartment,
(article). The
treatment comprises acute severing of the muscle membrane. It is imperative for
the continuing function of the muscle that this operation will be acute, which
is, of course, only possible if the athlete seeks acute medical attention, (article-1), (article-2), (article-3).
- Chronic compartment syndrome:
The groups of muscles on the arms and legs are surrounded by taught muscle
membranes (fascias), which are partially unremitting. Pain can be experienced in
a muscle group in the leg after only a few minutes activity following an earlier
muscle injury, or following a very rapid increase in training of individual
muscle groups. There is a sensation that the muscle is “tightened” and becomes
hard, which is accompanied by discomfort. If the activity is stopped the
discomfort diminishes, but returns a short period after the resumption of sports
activity. This can be due to the muscle swelling up (after injury), or growing
quicker than the muscle membrane can manage to keep up to (increase in training
intensity too fast), whereby the pressure on the blood vessels and nerves in the
muscle group increases. The diagnosis can be made with a pressure measurement in
the muscle compartment, (article).
Treatment comprises relief with slowly increasing training intensity after loss
of symptoms. In cases
where there is a lack of progress a surgical severing of the muscle membranes
can be performed, which is usually a minor procedure with good results. (article-1),
(article-2). |