This is a staged protocol designed to guide the management of a simple muscle tear. These injuries are common in sport and are often poorly managed. Understanding how management fits in with the physiology of healing assists.

1. LOWER
LIMB
MUSCLE
TEAR
PROTOCOL
Stage
1
2
sessions
• ACUTE
INFLAMMATORY
NECROTIC
PHASE
• Day
0-­‐3
• Immobilisa7on,
ice
and
rest
helps
control
ini7al
bleeding
and
inflammatory
response,
protects
from
further
mechanical
insult
• I
session
is
required
for
acute
care.
A
second
followup
session
if
imaging
is
required
or
DVT
risk
• Followup
call
to
pa7ent
next
day
or
review
app.
Statement
of
advice
emailed
to
pa7ent
next
day
if
necessary.
• Management
-­‐
Complete
rest,
non
weigtbearing
if
possible,
boot?,
Strapping,
ice,
compression,
immobilise
muscle
in
painfree
lengthened
posi7on
if
possible.
Adust
painfree
lengthened
posi7on
day
2.
Stage
2
2-­‐3
sessions
• LATE
PART
OF
INFLAMMATORY
PHASE
BEGINNING
OF
PROLIFERATIVE
PHASE
• Day
4
• Early
mobiisa7on
promotes
more
capilliary
ingrowth
as
well
as
bePer
muscle
fibre
orienta7on
•
2
-­‐
3
supervised
sessions
are
required
to
teach
exercises,
ensure
that
volume
is
appropriate
and
technique
is
correct.
Some
support
tape
may
be
required.
• Management
-­‐
Teach
pain
free
stretch,
exercises
to
maintain
fitness,
incuding
upper
body
and
core
strength
program,
massage
to
uninvolved
part
of
muscle,
strapping
,
unassisted
ambula7on
if
painfree,
stretching
to
uninjured
musles
Stage
3
2-­‐3
sessions
• REGENERATIVE/REPAIR/PROLIFERATIVE
PHASE
• Approximately
day
7-­‐10
• No
pain
with
moderate
stretch
and
normal
amula7on
• Early
mobilisa7on
promotes
more
capilliary
ingrowth
as
well
as
bePer
muscle
fibre
orienta7on
• Visits
2-­‐3
are
required
for
exercise
prescrip7on
to
ensure
volume
is
appropriate
and
to
ensure
technique
is
correct,
massage
to
affected
muscle,
• Basic
concentric
and
eccentric
strengthening
for
involved
muscle
including
use
of
pilates
bed,
general
strengthening
and
more
advanced
cardiovascular
condi7oning,
stretching
to
uninjured
muscles.
Stage
4
3
sessions
• CONTINUATION
OF
THE
REGENERATIVE
PHASE
AND
START
OF
THE
REMODELLING
PHASE
• Approximately
day
14
-­‐
21
• Progression
of
weight
training
to
func7onal
and
ac7vity
specific
ac7viites
including
co-­‐ordina7on
drills
and
plyometrics
• 3
visits
are
required
for
exercise
prescrip7on
to
ensure
volume
is
appropriate
and
to
ensure
technique
is
correct,
massage
to
affected
muscle
Stage
5
1
session
• FITNESS
TEST
• Approximately
day
21
-­‐
35
• 1
visit
is
required
for
fitness
test
-­‐
check
range,
concentric/eccentric
strength,
func7onal
strength,
sports
specific
ac7vity