The first measure of physiotherapy for ruptured muscle fibers is the so-called “PECH rule“. This rule can be applied by anyone immediately after a torn muscle fiber. The faster the intervention, the sooner the athlete gets back on his feet.
PECH stands for break, ice, compression, high support. This means that sports activities should be stopped immediately after a ruptured muscle fiber. The affected area is cooled under a compression bandage and elevated in order to keep the swelling as low as possible.
Current studies recommend changing the cooling bandage every 20 minutes with 10-minute breaks. Even after this, the leg or the affected body part should continue to be elevated to facilitate drainage. Physiotherapy is based on the so-called wound healing phases.
Every injury to the body goes through different phases during the healing process, including the rupture of muscle fibers. The classic classification extends from the inflammatory phase (up to five days), the proliferation phase (approximately until the 21st day) and the remission phase, which can last up to a year and during which the structure regains its full resilience and functionality. If too early and too much stress is applied in physiotherapy, a new inflammation can occur and the phases are prolonged accordingly.
Therefore, sufficient care should always be taken, but this does not mean that the muscle is kept still for weeks. In each phase, the newly growing fibers need stimuli that allow them to be properly aligned and prepared for their function. Otherwise, this leads to adhesions, loss of function and weakening to the point of tissue breakdown (atrophy) of the muscle.
Together with the patient, the physiotherapist can find optimal exercises for stimulation in physiotherapy and constantly adjust them. In the acute stage it is important that the muscle is not stretched during physiotherapy. This is because the new fibers must first grow together again and not be further apart.
The affected part of the body with the torn muscle fibre can always be moved without much strain, but only in the pain-free area. Pain is a warning signal of the body and should never be ignored in physiotherapy. Movement signals to the fibers in which direction they have to align themselves and that they should become flexible.
Keeping constantly still would signal to them that they should form a stable, interwoven net that hardly allows any movement. The physiotherapist can counteract these adhesions by passive movement during physiotherapy/physiotherapy. Gentle movement in the case of a torn muscle fibre at home is riding a bicycle on an exercise bike without resistance.
Once the acute phase of the ruptured muscle fibre is over and the muscle is more mobile again in the pain-free area, so-called functional massages are appropriate in physiotherapy. Here, the muscle is compressed along its fiber course and carefully brought into the stretching position. The advantage of this measure in physiotherapy is that the stretching and movement can be precisely dosed and individually adjusted.
Furthermore, active stretching is recommended rather than passive stretching in the case of muscle fiber rupture, since the patient can dose the treatment himself and there is less risk of overstretching. In order to counteract the muscle breakdown, the muscle can first be tensed and relaxed statically – i.e. without movement. This can be done several times a day in any position, not only during physiotherapy.
The tension is held for a few seconds, released and repeated. As with stretching, it is important to practice only in the pain-free area. Using fascial techniques, the physiotherapist can loosen surrounding tissue in the case of a torn muscle fibre, which is shortened by the gentle posture, during physiotherapy/physiotherapy.
- When the torn muscle fibre has healed to a large extent, i.e. new fibres have formed, signs of inflammation such as pain and swelling have receded and the muscle should regain its full function, the muscle and the so-called proprioception must be trained during physiotherapy/physiotherapy. This means the proper control, the functioning of different muscles with each other and the correct stimulus conduction. The muscle must therefore function again in the entire system after the muscle fiber rupture.
In this way it is simultaneously protected against renewed injuries. Common exercises during recovery from a torn muscle fiber are, for example, standing on one leg or balancing on a wobble cushion or uneven surface.An exercise from physiotherapy at home, for example, is standing on a rolled up sofa blanket. If this also works on one leg, knee bends can be practiced.
- It is also important to train the so-called eccentricity of the muscle.
Eccentric strength is the slow decrease. This muscle work is needed when you descend stairs or sit down – to name just a few common everyday examples. This strength can be trained, for example, by placing the patient on a stool in physiotherapy and letting one leg slowly sink down.
This is basically an imitation of climbing stairs. For everyday life in the case of a torn muscle fibre, the strength endurance area is trained, i.e. about 12-15 repetitions and the whole three times. If you go to the gym, you can train your eccentric strength on the leg press by taking your time, especially when returning.
The physiotherapist can also set individual resistances in physiotherapy, against which the patient has to slowly decrease. In this way, individual muscles or muscle groups can be specifically trained.
- In physiotherapy, there are certain movement patterns that can precisely train muscle chains – so-called PNF patterns. For example, the “shot pattern” for soccer or simply the walking movement after a torn muscle fibre can be optimised and trained.
These patterns exist for legs, arms, pelvis and shoulder girdle. In the case of a torn muscle fiber, this technique can be used at a very early stage to simply move, in order to include all muscles and directions of movement – but then still without resistance.
Once the torn muscle fibre has healed and the muscle has been trained by physiotherapy, you can slowly return to sports – this takes a few weeks! The training is slowly increased, but it is important to always pay attention to the regeneration times.
This way there is no danger of overloading your muscle or even your body immediately. Stabilization, strength and stretching exercises should be continued. Training and exercises can be constantly adapted individually and varied.
This reduces the risk of retiring from sport due to a torn muscle fibre. Further tips for the phase of wound healing is to abstain from alcohol, as this disturbs the natural process and weakens the immune system. On the other hand, a healthy and balanced diet with a lot of protein is recommended, which provides the building material for the body and especially for the muscles. Relieving sports for training breaks are cycling and swimming: Harmonious and joint-gentle movements that keep the body fit.
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