Sporten Recreatie
Topsport
Gezond/fit-heid
Prestatie gericht
Lage trainings intensiteit
Hoge trainings intensiteit
Vrije tijd > trainings uren
Trainings uren > vrije tijd
Motiveren
Afremmen
Ontspannen
Inspannend/ stress gerelateerd
Sport
Wat is een blessure?
Letsel van het lichaam
Sport
Sport afhankelijk
Skelet- spier letsels Neurotrauma
Skelet- spier letsels
Ossale afwijkingen
Fracturen Avulsies Luxaties
Weke delen letsels
Spieren Ligamenten Pezen
Cruris fractuur
Weke delen letsels
Return to sport after muscle injury. Wong S1, Ning A, Lee C, Feeley BT. Curr Rev Musculoskelet Med. 2015
Klinisch
Pijn!!
Zwelling
Afname ROM
Roodheid/ hematoom
Risico factoren Intrinsieke factoren
Voorgaande blessure [Fields KB. Et al.]
Gewicht [Theisen D. Et al.]
Anatomie [Brunet ME. Et al.]
Geslacht [Theisen D. Et al.]
Extrinsieke factoren
Tak van sport
Intensiteit [Bovens AM. Et al.]
Fysiologie Genezings proces
Inflammatory phase (0 – 3 dagen)
Reparative/fibroblastic phase (3 dagen- 3 weken)
Nieuwe spiercellen [Ciciliot S. Et al.] Fibronogeen vorming (litteken weefsel) [Quintero AJ. Et al.]
Maturation/remodeling phase (3 weken- jaren)
Aansterken spiervezels Reorganiseren
Behandeling en revalidatie
Doel:
Voorkomen van verdere spierschade Afname pijn en spasmen Afname zwelling en hematoom Hervatten van sportactiviteiten
Revalidatie (1) Inflammatory phase
Protection Rest [Akeson WH. Et al.] Geen immobilisatie!
Ice [Hubbard TJ. Et al.]
Compression and Elevation [Tomchuk D. Et al.]
Revalidatie (2) Reparative phase
Na de acute fase
Bescherming van spierletsel
Actief fysiotherapie
Full ROM
Flexibiliteit
Spier proprioceptie
Revalidatie (3) Maturation phase
Normale proprioceptie
Fysiotherapie
Kracht Snelheid Uithoudings vermogen
Hervatten sport specifieke trainingen
Medicamenteus
Paracetamol
NSAID’s [Rahusen FT. Et al. ]
Corticosteroid injecties [Levine WN. Et al.]
Groei factoren injecties [Kasemkijwattana C. Et al.]
bFGF, IGF, NGF, TGF-b
Preventie is beter dan genezen
Opwarmen
Stretching oefeningen
Goede fysieke conditie
Goede spier uithouding
Goede sport technieken
Reponeer NOOIT in het veld!
Vragen?
Return to sport after muscle injury. Wong S1, Ning A, Lee C, Feeley BT. Curr Rev Musculoskelet Med. 2015
Prevention of running injuries. Fields KB, Sykes JC, Walker KM, Jackson JC. Curr Sports Med Rep. 2010;9(3):176.
Influence of midsole hardness of standard cushioned shoes on running-related injury risk. Theisen D, Malisoux L, Genin J, Delattre N, Seil R, Urhausen A. Br J Sports Med. 2014;48(5):371.
Occurrence of running injuries in adults following a supervised training program. Bovens AM, Janssen GM, Vermeer HG, Hoeberigs JH, Janssen MP, Verstappen FT. Int J Sports Med. 1989;10 Suppl 3:S186.
A survey of running injuries in 1505 competitive and recreational runners. Brunet ME, Cook SD, Brinker MR, Dickinson JA. J Sports Med Phys Fitness. 1990;30(3):307.
Ciciliot S, Schiaffino S. Regeneration of mammalian skeletal mus- cle. Basic mechanisms and clinical implications. Curr Pharm Des. 2010;16(8):906–14.
Quintero AJ, Wright VJ, Fu FH, Huard J. Stem cells for the treat- ment of skeletal muscle injury. Clin Sports Med. 2009;28(1):1–11.
Effects of immobilization on joints. Akeson WH, Amiel D, Abel MF, Garfin SR, Woo SL. Clin Orthop Relat Res. 1987;
Does Cryotherapy Improve Outcomes With Soft Tissue Injury? Hubbard TJ, Denegar CR. J Athl Train. 2004;39(3):278.
The magnitude of tissue cooling during cryotherapy with varied types of compression. Tomchuk D, Rubley MD, Holcomb WR, Guadagnoli M, Tarno JMJ Athl Train. 2010;45(3):230.
Nonsteroidal anti-inflammatory drugs and acetaminophen in the treatment of an acute muscle injury. Rahusen FT1, Weinhold PS, Almekinders LC. Am J Sports Med. 2004.
Use of growth factors to improve muscle healing after strain injury. Kasemkijwattana C1, Menetrey J, Bosch P, Somogyi G, Moreland MS, Fu FH, Buranapanitkit B, Watkins SS, Huard J. Clin Orthop Relat Res. 2000.
Intramuscular corticosteroid injection for hamstring injuries. A 13-year experience in the National Football League. Levine WN, Bergfeld JA, Tessendorf W, Moorman CT 3rd. Am J Sports Med. 2000 May-Jun;28(3):297-300.
