Helping athletes to get back in the game

23rd June 2017

Joe Bush

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A recent study by Polytechnic University of Catalunya (UPC), in collaboration with the medical team at Futbol Club Barcelona, has developed a new method of measuring sports related muscle injury. The research could help provide accurate return-to-play time for athletes by exploring localised bioimpedance measurement (L-BIA) to help quantify the damage to soft tissue structure in injured muscles.

Lead author Dr Lexa Nescolarde, from UPC, said: “Injuries to skeletal muscles are common in competitive sport, especially football, where they account for about 30% of injuries. Sporting related muscle injuries are generally assessed with imaging systems like ultrasound (US) and magnetic resonance imaging (MRI).

“However, these systems don’t allow clinicians to give a clear prognosis on the time it will take to return-to-play, because that is governed by the severity of the injury and the muscle gap – or muscular fibre retraction – which cannot be measured by US or MRI.”

Dr Javier Yanguas, from FC Barcelona’s medical team, said: “To address this, we experimented with using L-BIA, which is a low cost, accessible and non-invasive technique. It can support the image from US or MRI to help quantify the disrupted soft tissue structure in injured muscles.”

L-BIA works by measuring passive electrical characteristics of healthy tissue, in response to administration of a low intensity alternating current, to identify differences in muscle pathology and the severity of the injury.

The study looked at 22 muscle injuries in 18 professional footballers over a period of five years, taking into account the presence of a muscle gap. The team grouped the injuries according to the muscle gap, and took L-BIA measurements 24 hours after the injury and on the day of return-to-play, to quantify the percentage of change, and for comparison to the non-injured side.

Through L-BIA, they discovered a significant difference in two types of classical partial muscle tears, between which an MRI scan could not differentiate.

Yanguas said: “Feather-like MRI with no gap, and feather-like MRI and gap image injuries are both partial tears, but the MRI could not detect small gaps in some of them and the classification, based in MRI, will be determined for a small amount of edema (grade I) or much more extension (grade II).

“The prognosis of the injury and the return-to-play time will depend, among other things, on the severity on the injury. These will be wrong if the classification of the injury is mistaken. It is therefore essential to differentiate the group of partial tears into two subgroups, because significant changes in muscle reactance help us to give the close attention that a muscle injury demands for the best possible prognosis. This is precisely what we have found L-BIA enables us to do.”