**11. Conclusions**

**9.6. Rehabilitation programme**

216 Muscle Injuries in Sport Medicine

severity of a possible indirectly occurred muscle damage.

Early active exercise in the rehabilitative process is essential for

**•** Increased structural strength and stiffness of ligaments,

**•** Increased collagen synthesis in tendons,

et al., 2007),

protocols adequate

**•** Decreased healing time,

**•** Decrease muscle fibrosis.

**9.7. Proprioception**

**10. Complications**

hematoma from other soft tissue masses.

The rehabilitation programme should be built around progressive agility and trunk stabiliza‐ tion exercises, as these exercises seem to yield better outcome for injured skeletal muscle than programs based exclusively on stretching and strengthening of the injured muscle. (Järvinen

In order to assess joint ROM and muscle strength, we used isokinetic dynamometer with concentric contractions (CIBEX Norm) at proposal speeds of each joint, following International accredited protocols. Very important is the dramatic effect of eccentric strength training on muscle strength, both isotonic and isokinetic. It is known that eccentric training reduces the

The prognosis, returning to the initial concept, is better if the diagnosis is accurate and

**•** Increased proteoglycan content in articular cartilage and periosteal expansion of bone tissue.

Arthrogenic muscle inhibition not only slows strength gains during rehabilitation, it also slows gains in proprioception and increases susceptibility to further injury. Receptors involved in proprioception are located in skin, muscles, and joints. Information about limb position and movement is not generated by individual receptors, but by populations of afferents. Afferent signals generated during a movement are processed to code for endpoint position of a limb. The afferent input is referred to a central body map to determine the location of the limbs in space. A contribution from central feedback mechanisms to the sense of effort is relevant to muscle rehabilitation and prevention re-injuries. Positive feedback is often associated with

A possible complication is chronic organized hematoma, well circumscribed, with massrelated symptoms. It is showed by Computed tomography (CT) like a homogeneous mass with capsule formation with a soft cystic center and a fibrous pseudo-capsule, whereas ultrasound shows it to resemble a multi-locular cyst. CT is unable to discriminate the chronic expanding

instability and oscillation, none of which occurs in normal locomotion (Riva, 2013).

Sport can be resumed when the extensibility, isotonic and isometric and isokinetic stretch tests are balanced and when the contraction is painless.

The recovery of competitiveness is possible when were recovered in field skills specific sport. We think that prevention is the best thing, but it is often difficult to eliminate the risk of intrinsic and extrinsic damage. We recommend an appropriate warm-up, an appropriate training, balancing agonist-antagonist, to recognize stages pre-lesion as contracture or fatigue and do not underestimate the lesion or his scar, do not administer medications inappropriately, do not perform incomplete or too aggressive rehabilitation and especially to properly use the means at our possession like physical therapy.

Muscle hematomas can have a significant impact on an athlete's performance, ranging from short-term performance impairment, muscle deconditioning and compartmental syndromes, to long-term problems, such as myositis ossificans and possibly muscle re-injuries. We recommend the use of protectors, well tolerated by all people, except in hot conditions, when they were uncomfortable (Mitchell,. 2000).

We conclude by suggesting to the physician to better delineate the depth of the lesion on ultrasound imaging, because all high energy treatments require precise localization in depth in order to provide the right energy level.
