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OP-Journal 2016; 32(01): 27-33
DOI: 10.1055/s-0035-1568629
Artikel zum Leitthema
Georg Thieme Verlag KG Stuttgart · New York

Behandlung von Muskelverletzungen

Treatment of Muscle Lesions
Frieder Mauch
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Publication History

Publication Date:
20 September 2016 (online)

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Zusammenfassung

Muskelverletzungen stellen die häufigste Sportverletzung dar. Die 4 großen Muskelgruppen (Hamstrings, Adduktoren, Gastroknemius und die Kniestrecker) stehen hier im Mittelpunkt der Behandlung. Meist handelt es sich um akute Verletzungen, die durch exzentrische Krafteinwirkungen entstehen. Die Diagnose beginnt mit einer genauen Anamneseerhebung des Traumas, gefolgt von einer exakten klinischen Untersuchung. Die Bildgebung mit Sonografie und Kernspintomografie (MRT) stellt einen wichtigen Baustein in der Diagnostik dar mit dem Ziel, die strukturelle Verletzung von der funktionellen Störung zu unterscheiden und das Ausmaß der Verletzung festzustellen. Die häufigste Therapieoption in der Behandlung der Muskelverletzung stellt die konservative Therapie dar und orientiert sich an den Phasen der Muskelheilung. In vielen Fällen (Freizeitsport) reicht eine konservative Therapie nach dem RICE-Prinzip mit nachfolgender beschwerdeabhängiger Aufbelastung aus um die Rückkehr zum Sport zu gewährleisten. Die Infiltrationstherapie einschließlich Platet-rich-Plasma (PRP) kann eine Therapieoption darstellen, soll aber nicht zur Beschleunigung des Heilungsprozesses eingesetzt werden. Die operative Versorgung von Muskelverletzungen ist seltenen Indikationen vorbehalten.

Abstract

The commonest sporting injuries are muscle injuries. Hamstrings, adductors, gastrocnemius and the knee extensor muscles are most often affected. Most injuries occur during eccentric tension impact. Diagnostic testing begins with taking the exact medical history and a detailed clinical investigation. Imaging with ultrasound and MRI is important for differentiation between structural lesions and functional disorders and determines the extent of the injury. Treatment is most often conservative and depends on the three phases of the healing process. In most cases (leisure sports) the RICE concept with subsequent pain-adapted load increase suffices for a return to sport. Infiltration therapy, including platelet-rich plasma (PRP), is an additional therapeutic option, but should not be used to accelerate the healing process. It is only rarely that surgery is needed to treat muscle injuries.

 

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