Early rehabilitation following an acute muscle injury (usually involving the hamstring, quadriceps or calf in a football context) is more effective than delaying treatment.
It is not often that sports medicine research appears in mainstream medical journals like the New England Journal of Medicine. When they do we generally need to take notice!
A randomised controlled trial (involving 50 amateur athletes) was conducted comparing early vs. delayed treatment following an acute injury to either the thigh or calf.1 The early therapy group received treatment starting two days following the injury while the delayed therapy group started treatment after nine days. The group that received early treatment could return to sport more quickly than those who had delayed treatment. Starting rehabilitation early reduced the time to a pain-free recovery and return to sport by about three weeks (21 days).
The participants in this study all completed a standardised rehabilitation programme including:
- daily static stretching in week one;
- progressive isometric loading in weeks 2 to 4;
- dynamic loading with increasing resistance (three times per week) in weeks 5-8;
- functional exercise and heavy strength training in weeks 9-12.
While it can be tempting to delay rehabilitation following an acute injury, either because your patient is in pain or is relatively disabled, this appears to compromise their recovery. Early rehabilitation appears to be safe and is associated with a substantially faster return to sport.
1 Bayer ML, Magnusson SP and Kjaer M. Early versus Delayed Rehabilitation after Acute Muscle Injury. N Engl J Med 2017; 377:1300-1301