Lesão muscular: perspectivas e tendências atuais no Brasil

ResumoObjetivoAvaliar as condutas, os procedimentos e as perspectivas do médico do esporte e ortopedista do Brasil no diagnóstico e no tratamento de lesões musculares.MétodosQuestionário com 20 questões relacionadas ao tema lesão musculares. Foi aplicado em médicos do esporte e ortopedistas durante o II Congresso Brasileiro de Artroscopia e Traumatologia do Esporte, em 2013.ResultadosResponderam completamente o questionário 168 médicos do esporte e ortopedistas. Foram entrevistados médicos de todas as regiões do Brasil, com média de 11 anos de experiência no tratamento da lesão muscular. Membros inferiores são acometidos em 97% dos casos, principalmente quadríceps, adutor e tríceps sural. A lesão ocorre na fase excêntrica para 62% dos entrevistados, 39% fazem ultrassom (USG) e 37% ressonância magnética (RM) para diagnóstico da lesão. Medicação, repouso e crioterapia na fase aguda (87,5%) e medicação, repouso e fisioterapia durante o tratamento da lesão (56%) são as opções prevalentes. Os critérios de retorno ao esporte foram bastante subjetivos e díspares entre as opções apresentadas e a maioria dos entrevistados já usou alguma terapia adjuvante às tradicionais.ConclusãoO número de lesões musculares tratadas anualmente é superior a 30, independentemente de se no setor público ou privado. Ocorre principalmente na junção miotendínea, nos membros inferiores e na fase excêntrica da contração muscular. O USG é o exame mais feito e a RM o considerado ideal. Para a maioria dos entrevistados o tratamento de escolha envolve repouso, medicação e fisioterapia. Além disso, 52% acreditam na eficiência do plasma rico em plaquetas (PRP) e 42% referem já tê‐lo usado.AbstractObjectiveTo evaluate the management, procedures and perspectives of sports physicians and orthopedists in Brazil with regard to diagnosing and treating muscle injuries.MethodsA questionnaire containing 20 questions relating to the topic of muscle injury was applied to sports physicians and orthopedists during the Second Brazilian Congress of Arthroscopy and Sports Traumatology, in 2013.ResultsCompletely answered questionnaires were received from 168 sports physicians and orthopedists. Doctors from all regions of Brazil with a mean of 11 years of experience of treating muscle injuries were interviewed. Lower limbs were affected in 97% of the cases, particularly the quadriceps, adductor and sural triceps. The injury occurred during the eccentric phase in 62% of the interviews; 39% underwent ultrasound examination and 37% magnetic resonance imaging (MRI) for the injury to be diagnosed. Medication, rest and cryotherapy during the acute phase (87.5%) and medication, rest and physiotherapy during treatment of the injury (56%) were the prevalent options. The criteria for returning to sports were very subjective and disparate among the options presented, and most of the interviewees had already used some therapy that was adjuvant to traditional methods.ConclusionThe number of muscle injuries treated per year was greater than 30, independent of whether in the public or private sector. These injuries occurred mainly at the muscle‐tendon junction, in the lower limbs and during the eccentric phase of muscle contraction. Ultrasound was the examination most performed, while MRI was considered ideal. For most of the interviewees, the preferred treatment involved rest, medication and physiotherapy. In addition, 52% believed that platelet‐rich plasma was an efficient treatment and 42% said that they had already used it