Return to Play for Muscle Injuries in Elite Football

The evaluation of available studies on ESWT showed its strong positive influence on the treatment of various musculoskeletal disorders. Therefore, the researchers hypothesized that the implementation of rESWT into the multimodal therapy approach can shorten downtime and reduce the reinjury rate.

How does the multimodal approach with the use of rESWT influence recovery time?

To investigate this, the authors conducted an extensive, retrospective analysis of 20 acute muscle injuries diagnosed according to international guidelines. They were classified following Müller-Wohlfahrt et al. as follows:

• 8 (40%) were diagnosed as Type 1a
• 5 (25 %) as Type 2b
• 4 (20 %) as Type 3a
• 3 (15 %) as patients with contusions.

During the playing season, no type 3b or 4 muscle injuries were registered.

Multimodal therapy approach

All patients underwent a customized, multimodal therapy using novel treatment solutions that combined cryotherapy, compression, manual therapy, resistance or strength training, a progressive physiotherapeutic exercise program, and extracorporeal shock wave therapy. An experienced therapist decided whether the application of a radial or focused ESWT protocol was more suitable and effective for the patient. The majority of cases (19/20) were suitable for rESWT and only 1 case (contusion of the gluteus maximus muscle) was treated with the application of fESWT.

• The rESWT was performed using a Swiss DolorClast device with an EvoBlue handpiece.
• The fESWT with the Swiss PiezoClast device and 15 mm gel pad.

Discover the difference between Radial Shock Wave Therapy (rESWT) and focused extracorporeal shock wave therapy (fESWT).

The study's findings, defined as a return to active duty, was characterized by the patient's ability to fully participate in team drills, including contact drills, and his readiness to resume playing during the current championship season.

Results

According to a dataset published by Ekstrand et al. on 31 European men's soccer teams, multimodal therapy with ESWT significantly reduced the median time off the field:

• Type 1a Injuries – 54 %
• Type 2b injuries around –50 %
• Type 3a injuries at 8 % (or 23 % if classified as the more severe Type 3b)

The authors also conducted a retrospective analysis of the re-injury rate during the soccer season. Only one case of re-injury (previously classified as Type 1a) occurred after full recovery. The study yielded clearly satisfactory results, showing that pain (measured using the visual analog scale, VAS) steadily decreased over the course of multimodal treatment. This is an extremely important factor for success for both the patient and the therapist, as it allows the treatment to be intensified to achieve even better results.

Conclusion

Consequences of studying:

• support the initial hypothesis that the incorporation of rESWT/fESWT into a multimodal treatment approach is safe, effective, and beneficial for athletes suffering from various muscle injuries;
• highlight the potential impact of radial and focused ESWT on the prevention of re-injury.

The therapy was well received by the players and no adverse effects were registered during the therapy sessions.

Further Studies

EMS^®-Many researchers use these devices to study other effects of shock wave therapy.
Click the button below to go to the EMS Study Library^®. Here you will find study reports on various conditions that demonstrate the effectiveness of EMS^® DolorClast^®-Highlight the method.

2021-06-15
Morgan JPM, Hamm M, Schmitz C, Brem MH. Return to play after treating acute muscle injuries in elite soccer players with radial extracorporeal shock wave therapy. J Orthop Surg Res.
Dec. 7, 2021;16(1):708. doi: 10.1186/s13018-021-02853-0. PMID: 34876172; PMCID: PMC8650394.
Full study: https://pubmed.ncbi.nlm.nih.gov/34876172/

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