IMMEDIATE EXTERNAL COMPRESSION IN THE MANAGEMENT OF AN ACUTE MUSCLE INJURY

In a prospective, non-randomized study 40 athletes with contusion or d istension injuries to the thigh or the calf muscle were followed with tests of range of motion (ROM) of knee or ankle joint, test of serum c reatine kinase (CK) and ultrasonography of the injury until completely recovered. An experimental group of 19 injuries where subjects receiv ed treatment with application of a maximum compression bandage within 5 min (mean=2 min) of the injury was compared to a control group of 21 injuries where subjects were treated with rest and elevation only, an d in some cases non-maximum compression after 10-30 min. No significan t differences were noted with respect to time to complete subjective r ecovery ultrasonic size of the injury or time to normal findings on ul trasound between treatment and control groups. Strain injuries, althou gh showing a tendency to be smaller in size, took a longer time to com plete recovery than contusion injuries (mean+/-SD=26+/-22 days and 19/-9 days, respectively, P=0.02). Diagnostic CK values and reductions i n ROM were not correlated to the severity of the trauma, while ROM sho wed weak correlation to the sonographically measured size of the hemat oma (r=0.42; P<0.01). Injuries displaying a circumscript anechoic, low -echogenic or mixed lesion at the diagnostic ultrasound investigation normalized mon slowly (P=0.001) and took longer to complete recovery ( P=0.001) than injuries with diffuse hyperechogenic lesions. We conclud e that in this study the application of a maximum compression bandage within 5 min of a muscle trauma did not significantly reduce the size of the hematoma nor significantly shorten the time to complete subject ive recovery compared with no immediate treatment. The diagnostic ultr asound investigation was valuable in predicting the severity of the tr auma.