Fiber rupture is one of the most common injuries in explosive sports such as football, basketball or athletics due to the contraction to which the muscle fibers are subjected.
Some studies have estimated the incidence of these injuries in veteran athletes at around 15%. The rate is higher in the most explosive modalities such as speed racing.
In general, this injury is present in any sport because it consists of breaking the fibers (cords) that make up the muscle.
In this article we address fiber breakage, both its possible causes and its treatment, prevention and the importance of proper recovery.
What is a fibrillar rupture?
A fibrillar rupture is also known as a muscle tear (of greater intensity than a muscle elongation or muscle pull). Making an accurate diagnosis is essential for subsequent treatment.
We can identify a fibrillar rupture if we have the sensation of having received a kind of ‘stone’ in the affected area.
Similarly, it is common for fibrillar rupture to be accompanied by the rupture of a hematoma in that area.
Strains can affect any part of the human body where there is muscle.
In the case of athletics and speed tests or explosive sports, the most common are fiber breaks in the hamstrings and soleus due to the forces applied in this area.
Although there are also examples in athletics of other types of fractures such as cervical and lumbar strain, frequent in athletes who work with weight.
Fibrillar ruptures according to their severity
Sometimes these injuries can be confused with contractures. Dr Gholam Sarwar, a physiotherapist in Delhi, explains that if we are talking about “small fibrillar breaks, it can be difficult to differentiate them”.
If the tear is more significant, there are several details that allow the tear to be recognized, such as the inability to continue with activity, sharp pain, bruising and swelling of the area.
Meanwhile, with the contracture, there is only minor discomfort in the affected part. In a generic way, contracture can be a state prior to muscle tear.
Fibrillar tears are classified into three degrees according to their severity:
- Grade I, fibrillar rupture: It occurs when there is a slight muscle strain, with a very low number of fibers affected. Discomfort for the athlete is minimal.
- Grade II, partial tear: The number of broken fibers increases and there is a certain degree of immobility of the affected area.
- Grade III, total tear: The muscle belly (central part of the muscle) is torn and an operation is even needed to repair this injury. It produces complete disability of the athlete and originates muscular deformation.
How and why does a fibrillar rupture occur?
Dr Sarwar points out two reasons for these pulls: “One is due to trauma to the opponent, common in contact sports, while another is for reasons intrinsic to the athlete.”
Thus, regarding athletics, he points out that it is common for it to occur in “modalities where sudden and very precise movements are made since the body is at greater risk due to this combination.”
That said, there are some factors that can favor the higher incidence of these injuries.
Dr Sarwar explains that it is normal for muscle tears to occur “when there is no agreement between the level of training and the competitive level.”
That is, when we come from a period of rest or light training and we demand more from our body than it should.
Physiotherapist in Delhi Dr Sarwar points out more reasons that should also be taken into account. For example, he points out other factors that deteriorate the muscular level “such as poor rest, stress, the tension of competition…”.
Of course, it can also be due to poor biomechanics of the athlete, whether it refers to a wrong step or incorrect use of the shoes (see here how to choose running shoes ).
For these cases, it is advisable to carry out a study of the tread and biomechanical analysis by a specialist. In addition, other risk factors are poor nutrition, overtraining, not warming up, or poor circulation.
In all cases, we are talking about situations in which the muscle is not at 100% of its capacity, and its fibers are more likely to break.
Treatment of fiber rupture
After suffering a fiber break, you have to put yourself in the hands of professionals to evaluate this injury.
Physiotherapist Dr Sarwar comments that the ideal at this point is to perform “an ultrasound with the aim of assessing damage, location, extension, bleeding and hematoma”.
The diagnosis must be made by the sports doctor.
Talking about recovery times is very complicated since “everything depends on the patient and the sensations”.
Dr Sarwar specifies that in the elite world “deadlines are much shorter”, but if we want a fibrillar injury to be completely “treated, consolidated and healed”, the term is between three and six months.
However, he clarifies that “between 21 and 28 days the athlete is already at 75% of his capacities and can compete”.
The specialist in Sports Medicine Dr Gholam Sarwar gives the keys to what he considers to be a correct recovery treatment: “It has to be good teamwork.
Success begins with a proper diagnosis and is followed by multidisciplinary work where, throughout recovery, the different information provided by each member of the team guides the next stage of treatment”.
Finally, for him, even more important are the professionals who know what to apply and how to handle rehabilitation techniques at all times.
The scientific community has established ( see more ) the recommended treatments for fiber rupture in each of the four recovery phases of this typical injury in athletics:
Inflammatory phase:
Occurs between day one and three after rupture. For José Antonio Pérez, “it is not recommended to stop completely”.
Thus, he indicates that the athlete should perform “all that activity that he can do without pain such as elevation of the affected muscle, to which is added the compressive bandage and the application of cold”.
In addition, it is advisable to drain the hematoma and not take inflammatory drugs “because it influences the muscle recovery phase.”
Regenerative and vascularization phase
This stage lasts until day 14 after the pull. Here, the professional remembers that new blood vessels are being formed.
For him, “stretching without pain, gradually increasing activity, circulatory techniques and/or exercises in the water” should be done.
Cellular stimulation phase
The third of the phases goes until day 28 after the injury and healing begins during it. In it, professionals work with more and more stretches and, taking into account the evolution of the athlete, specific loads are adapted to the sport or modality in question.
Regarding athletics, Dr Sarwar talks about practicing starts, the biomechanical gesture and always going from less to more intensity.
Remodeling phase
The final phase takes place between three and six months after the injury and is aimed at returning to the state before the condition.
At this stage, stretching continues and the patient is continuously evaluated to discharge him, which will occur when there is no pain or discomfort.
Dr Gholam Sarwar emphasizes the “individualization in each treatment” of a fiber rupture, because “not all injuries are the same”.
In other words, each patient must be assessed, since what may be useful for one is not for another.
However, there are some rehabilitation techniques that are commonly used in the various phases of fiber breakage recovery.
Dr Gholam Sarwar, physiotherapist at Dr Sarwar Physiotherapy Center, mentions cryotherapy for the “evacuation and elimination of edema and its drainage”.
For the same purpose and, in addition, “to improve healing and increase the acceleration of metabolism, we have diathermy “.
Also, in the treatment of fiber rupture, he points out the application of high-power laser or laser therapy “to facilitate healing.”
Dr Sarwar continues his enumeration with invasive electrotherapy (EPI), which helps “accelerate healing”. Lastly, he points to ultrasound for “monitoring the evolution of the rupture”.
All these techniques require qualified professionals who work together with other experts for the same purpose.
And it is that carrying out a correct recovery of fibrillar ruptures is essential. Eliseo Monsalvete remembers it: “A bad recovery facilitates another break.
If we have an area that is not functionally well recovered, when we demand the muscle again, it will suffer a new injury”.
How can muscle tears be prevented?
At this point, the question is, can strains be prevented in athletics? We have already talked about some aspects to take into account to minimize problems with jerks, such as eating correctly, respecting breaks, gradually incorporating into training, limiting stress in competition and having good biomechanics.
Dr Gholam Sarwar details that it is also important “to carry out strength and neurodynamic work (physiotherapy techniques focused on the peripheral nervous system)”.
This is because the “sciatic nerve has a lot of influence in this type of injury.” Other aspects mentioned by the physiotherapist are “improving the athlete’s joint mechanics and muscle compensation work”.
Finally, the last factor on which it affects is the individual characteristics of the athlete himself: “By taking into account these prevention techniques, the incidence and rate of injuries from fiber ruptures can be reduced.”
