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Krwiak i obrzęk objawami naderwania mięśnia

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Naderwanie mięśnia często jest przyczyną nieprawidłowo wykonywanego treningu lub zbytniego obciążenia. Uszkodzenie to często objawia się ostrym i silnym bólem, a także stanem zapalnym któremu towarzyszy lokalne i wyraźne ocieplenie skóry. Jak przebiega proces leczenia i rehabilitacja naderwania mięśnia?

Naderwanie mięśnia jest przerwaniem ciągłości oraz określonej ilości włókien mięśniowych. Najczęściej dochodzi do naderwania mięśnia łydki lub uda. Zdarza się, że kontuzję obserwuje się również w okolicy ramienia, barku, pośladka, a nawet brzucha.

Kto jest narażony na ryzyko naderwania mięśnia?

Najbardziej narażone na uraz są mięśnie o zaburzonej elastyczności, osłabione albo o zbyt dużym napięciu mięśni w czasie spoczynku. Do najczęstszych przyczyn naderwania mięśnia należą:

  • długotrwałe przeciążenie lub przetrenowanie, które prowadzą do osłabienia mięśni i zmniejszonej odporności na urazy;
  • brak rozgrzewki przed intensywną aktywnością fizyczną;
  • nagły i gwałtowny ruch;
  • nadmierne rozciąganie mięśnia;
  • aktywność fizyczna pomimo zmęczenia mięśni bądź bólu,
  • zaburzona koordynacja nerwowo-mięśniowa,
  • zaburzenia w równowadze mięśniowej;
  • dźwiganie zbyt dużego ciężaru;
  • uderzenie przy jednoczesnym silnym napięciu mięśniowym;
  • wypadek, np. komunikacyjny.

Ponadto do czynników predysponujących do uszkodzenia mięśnia zaliczane są: dysbalans mięśniowy, wady postawy, siedzący tryb życia, poprzednie urazy.

Czym objawia się naderwanie mięśnia?

W zależności od czynnika uszkadzającego oraz wytrzymałości mięśnia, może dojść do jego  naderwania, ale także do naciągnięcia lub całkowitego zerwania. Wszystkie rodzaje urazów charakteryzuje uczucie nagłego i ostrego bólu. W wielu przypadkach stopniowo pojawia się również obrzęk oraz krwiak, gdy doszło do uszkodzenia naczyń krwionośnych, a także stan zapalny (któremu towarzyszy wyraźne, lokalne ocieplenie skóry), powtarzające się częste skurcze mięśnia oraz zagłębienie i zgrubienie włókien w miejscu urazu. Poważniejsze uszkodzenia mięśnia objawiają się bardzo bolesną palpacją miejscową, a także niemożnością wykonania ruchu. Wyróżnia się trzy stopnie uszkodzenia mięśnia:

  • I – gdy uszkodzeniu ulega około 5 proc. włókien mięśniowych. Pacjenci mogą zauważyć u siebie niewielki obrzęk i krwiak, a także odczuwać umiarkowaną bolesność;
  • II – naderwanie włókien mięśniowych. Stopień ten charakteryzuje się odczuwaniem silnych dolegliwości bólowych, krwiakiem, obrzękiem, a także spadkiem siły mięśniowej i bolesnością palpacyjną;
  • III – zerwanie włókien mięśniowych z całkowitym przerwaniem ich ciągłości. Stopień ten objawia się podobnie, jak przy naderwaniu włókien mięśniowych, jednak intensywność objawów jest zdecydowanie większa.

Naderwanie mięśnia – pierwsza pomoc

W przypadku naderwania mięśnia konieczne jest wdrożenie działań o charakterze przeciwbólowym i przeciwobrzękowym. Pierwsza pomoc polega na:

  • regularnych zimnych okładach (przez 20 minut co 2-3 godziny), które zmniejszą obrzęk i zadziałają przeciwbólowo;
  • delikatnym ucisku, np. za pomocą bandaża elastycznego, którego zadaniem jest niedopuszczenie do gromadzenia się płynu, powstania obrzęku i wysięku;
  • uniesienie kończyny, by ułatwić odpływ krwi (elewacja);
  • ograniczenie ruchu uszkodzonej części ciała.

W pierwszych trzech dobach od momentu uszkodzenia zalecany jest etap postępowania oparty na protokole PRICE – ochrona, odpoczynek, chłodzenie, ucisk, elewacja.

Jak przebiega leczenie naderwania mięśnia?

Gdy wystąpią objawy naderwania mięśnia, konieczne jest przeprowadzenie diagnostyki. Należy w tym celu niezwłocznie zgłosić się do lekarza, który może zlecić wykonanie badania USG, rezonansu magnetycznego, rentgenu czy USG Dopplera.

Po przeprowadzeniu diagnostyki, w praktyce klinicznej, wdrażany jest odpowiedni tok leczniczy. Pacjentom zalecane jest leczenie farmakologiczne (głównie polegające na stosowaniu leków przeciwbólowych, przeciwzapalnych i przeciwobrzękowych, poprawiających krążenie i regenerujących uszkodzone struktury, a także maści i żeli bezpośrednio na skórę) oraz fizjoterapeutyczne, polegające na zastosowaniu zabiegów wspierających regenerację mięśnia. Niekiedy konieczne jest również wprowadzenie odpowiedniego zaopatrzenia ortopedyczno-medycznego, np. opasek lub ortezy.

Fizjoterapia uszkodzonego mięśnia

Fizjoterapeuta od trzeciej doby od uszkodzenia mięśnia, w zależności od rodzaju naderwania, może pacjentowi zaproponować następujące leczenie:

  • zabiegi fizykalne,
  • laseroterapię (działanie przeciwzapalne, przeciwbólowe i regeneracyjne),
  • magnetoterapię (regeneracja),
  • ultradźwięki (pobudzenie krążenia przez wibracje),
  • hydroterapię (działanie rozluźniające),
  • kinesiology taping (plastrowanie zapewniające odciążenie uszkodzonego mięśnia, działanie regeneracyjne),
  • delikatne napięcia izometryczne mięśnia (napięcie mięśnia bez wykonywania ruchu);
  • masaż tkanek mięśni oraz blizny (poprawa krążenia, lepsze odżywienie tkanek, zwiększenie elastyczności i ruchomości blizny),
  • ćwiczenia propriocepcji (czucia głębokiego, poprawiają czucie własnego ciała, np. czucie położenia stawu, długości, napięcia mięśnia).

Pacjenci, którym zależy na powrocie do aktywności fizycznej muszą doprowadzić do całkowitego wyleczenia mięśnia. Wcześnie podjęta aktywność może prowadzić do ponownego uszkodzenia. Przed powrotem do aktywności fizycznej zalecane jest wykonanie kontrolnego USG.

Jak zapobiegać naderwaniu mięśnia?

By zapobiegać uszkodzeniom mięśni bardzo ważne jest, by odpowiednio przygotowywać organizm do wysiłku fizycznego. W tym celu warto przeprowadzić rozgrzewkę, która przygotuje mięśnie nie tylko do ćwiczeń, ale także na nagły i nieoczekiwany bodziec, np. upadek, uderzenie. Należy również uważać na zbyt duże obciążenia czy nieprawidłową technikę wykonywania danych ćwiczeń. W tym celu warto skonsultować się z instruktorem lub trenerem, którzy poinstruują, w jaki sposób nie doprowadzić do przeciążenia aparatu ruchu.

Istotne jest również dążenie do równowagi mięśniowej, a więc wzmacnianie osłabionych grup mięśni. Osoby, które ćwiczą regularnie, powinny uzupełniać treningi o różnorodne formy ruchu.  Bardzo ważne jest również obserwowanie swojego organizmu, a zatem nieignorowanie pojawiającego się bólu, zmęczenia, znużenia czy trudności w wykonywaniu treningu.

Źródło: fizjoplaner.pl, parktycznafizjoterapia.pl

 

Przeczytaj także: Jak komórki macierzyste wpływają na regenerację mięśni?

 

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Chirurgia Plastyczna i Oparzenia”:

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