In the acute phase after a muscle contusion, hematoma maturation, inflammation, necrosis of damaged myofibrils, and phagocytosis of the necrotic debris are main features. The goal of therapy is to minimize hemorrhage and inflammation and control pain. Limb immobilization with rest, ice, compression, and elevation (RICE) should be performed for the first 24 hours in patients with minor contusions and for 48 hours in patients with moderate or severe contusions. The general recommendation is to avoid heat during the first 24-48 hours to avoid increasing the extent of hemorrhage and edema. The contusion generally stabilizes by 24-48 hours, and subsequent evaluation should dictate further treatment and prognosis.
Heat, whirlpool therapy, and electrotherapy, although pleasing to the patient, have not been shown to influence the rate of recovery from contusions. Therapeutic ultrasound is a commonly used physical therapy modality that has been claimed to promote tissue repair by enhancing cell proliferation and protein synthesis during the healing of skin wounds, tendon injuries, and fractures. The theory is that of a micromassage effect. However, ultrasound can enhance both myogenic precursor cell and fibroblast proliferation. Prolonging the proliferation phase of fibroblasts during muscle regeneration can add to the amount of permanent scar-tissue production, which could outweigh the possible positive effects of ultrasound on satellite cell proliferation.
Learn more about the treatment of contusions.
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