Terapia extracorpórea por ondas de choque no tratamento da lesão muscular crônica / Extracorporeal shockwave terapy to treat chronic muscle injury

Objetivo: Avaliar o tratamento com terapia por ondas de choqueextracorpórea (TOCE) de baixa energia associada à fisioterapia notratamento das lesões musculares crônicas graus 2 e 3 nos membrosinferiores de atletas amadores. Métodos: Oito atletas com lesãomuscular do membro inferior há mais de três semanas foram tratadoscom fisioterapia e TOCE. Foram avaliados os seguintes parâmetrosdurante o tratamento: presença de gap palpável, força muscular,dor, e escala de Tegner, bem como as características de imagemultrassonográfica e a capacidade de retorno ao esporte. Resultados:O tempo médio de lesão na primeira avaliação foi de 8,75 semanas.Todos os pacientes evoluíram com força muscular grau V após oitosemanas. A dor passou de 5,75 para 0,5 pontos da escala visualanalógica de dor (EVA) ao final do tratamento. O questionário de Tegnerapós o tratamento atingiu em média seis pontos em sua escala.Os pacientes retornaram ao esporte em média após 8,14 semanas.Conclusão: TOCE associada à fisioterapia mostrou ser eficaz notratamento da lesão muscular de longa data, com boa evolução ecapacidade de retorno ao esporte de todos os pacientes avaliados.Nível de Evidência IV, Estudo Prospectivo de Série de Casos.

Objective: To evaluate the low energy extracorporeal shock wavestherapy (ESWT) associated with physical therapy in the treatmentof chronic muscle injuries classified as grades 2 and 3 in thelower limbs of amateur athletes. Methods: Eight athletes presentingwith lower limb muscle injury for more than three weeks weretreated with physiotherapy and ESWT. We evaluated the followingparameters during treatment: palpable gap, muscle strength,pain, and Tegner score, as well as ultrasound image features andthe ability to return to sports practice. Results: The average timeof the first evaluation of the injury was 8.75 weeks. All patientspresented muscle strength grade V after eight weeks. The painscore evolved from 5.75 to 0.5 points of the visual analoguescale (VAS), at the end of the treatment. The Tegner score aftertreatment was six points on average. Patients returned to sportspractice after 8.14 weeks. Conclusion: ESWT associated withphysical therapy proved to be effective to treat long-term muscleinjury, with good performance and the ability to return to sportpractice for all patients. Level of Evidence IV, Case Series,Prospective Study.

Twin athlete brothers with open physes operated for ACL reconstruction on the same day, but with different elapsed times after injury: a 5-year follow-up.

We present the case of twin brothers with open physes who practiced judo to a high level and were operated on the same day for anterior cruciate ligament reconstruction. One of them was injured a year before surgery, and the other was injured a month before the procedure. The brother who chose to undergo a conservative treatment sustained meniscus injury afterwards and showed lower objective results when evaluated 5 years after surgery.