Como tratar las lesiones musculares
Como tratar las lesiones musculares
Si atendemos las lesiones musculares atendiendo a su origen podemos
clasificarlas en dos grandes grupos:
1/ Aquellas lesiones sin componente traumático, donde es el sobreesfuerzo
el que causa las molestias o limitaciones físicas, como sucede con
los calambres y las contracturas.
2/ Las lesiones ocasionadas por un traumatismo, bien de origen externo,
como las contusiones musculares, o bien intrínsecas al músculo, como él
tirón o distensión muscular y el desgarro o rotura de fibras (total o
Parcial.
Esquema básico de recuperación.
El esquema que dirigirá toda recuperación de una lesión muscular podría
ser el que detallo. En las primeras 48 horas el reposo del músculo es
crucial, sea en forma de descanso activo para sobrecargas y ciertas
contracturas (entrenamiento más corto y suave que el habitual) o en forma
de reposo total (que puede sustituirse por piscina, estiramientos o
gimnasia muy suave) en el caso de las distensiones más fuertes e incluso
tirones o pre-roturas fibrilares.
En estos dos primeros días deberemos ser generosos en la utilización de
hielo ( con bolsas de gel o cubitos aplicados sobre una fina tela y nunca
directamente sobre la piel), hasta 20 minutos cada 2 ó 3 horas.
Otra medida clásica es la compresión o vendaje para sujetar de la forma
más funcional posible el paquete muscular afectado, así como la elevación
del miembro lesionado.
En cuanto a las medidas antiinflamatorias farmacológicas es de elección.
A partir del tercer día, la movilización leve y los ejercicios isométricos
seguidos de suaves estiramientos suelen funcionar, sobre todo precedidos
de calor local seco o con pomada. Es el momento de iniciar la forma
reglada (como entrenamiento sustitutivo) el trabajo en piscina o bicicleta
y también las caminatas mas o menos fuertes.
Desde el cuarto o quinto se inicia la recuperación funcional con masaje y
maniobras terapéuticas de bombeo miofascial y estiramientos suaves. Se
suprime progresivamente el calor superficial y la toma de fármacos.
Las contusiones.
Son aplastamientos de los tejidos por choque o compresión. Sus
manifestaciones son dolor local con derrame o hematoma, que ira cambiando
progresivamente de coloración.
En las primeras 48-72 horas no dar calor ni masaje. El tratamiento será
reposo muscular y frío sobre la contusión. El vendaje que pongamos puede
contener una gruesa capa de pomada antiinflamatoria.
Al cabo de tres días pueden aplicarse maniobras de masaje
Los calambres.
Se tratan, en un primer momento, con estiramientos suaves y calor húmedo,
para más tarde realizar masaje calmante a base de pases sedantes lentos
pero progresivamente profundos.
El cuidado de este tipo de lesiones para por utilizar con asiduidad baños
calientes, añadiendo sal gruesa o sales de baño calmantes, y ligeros
masajes antes y después de correr.
Completar la dieta con aporte vitamínico y mineral (banana, naranja,
...), agua en abundancia y sales (verduras).
La contractura.
Es la contracción mantenida de una porción muscular, un músculo o grupo de
éstos, que evidencia desórdenes bioquímicos por fatiga.
El tratamiento consiste en un masaje general de descarga sobre todo él
músculo, aplicado por un especialista. El calor seco y las pomadas de
metil-salicato o similares suelen funcionar muy bien, aplicadas al levantarnos o antes
de correr o hacer cualquier actividad física.
El tirón.
Supone una excesiva tensión de las fibras musculares, que son sorprendidas
por un movimiento violento (distensión) al limite del desgarro (pre-rotura
fibrilar).
La aplicación de hielo en los primeros días y en el momento maniobras de
elevación y estiramiento son de urgencia. Transcurridos unos días se puede
aplicar masaje suave. La prevención pasa por hacer estiramientos suaves
después del ejercicio físico, incidiendo en los músculos que más sufren
este tipo de lesiones: gemelos, abductores, bíceps femoral y recto
anterior del cuadriceps; los baños de agua fría con sal gruesa; el masaje
de descarga habitual y no forzar los días que estemos más cansados.
Rotura fibrilar o desgarro.
Casi siempre es una rotura parcial de pocas fibras. Si hay una extensión
importante el masaje esta totalmente contraindicado. En los dos o tres
primeros días aplicamos frío y compresión con reposo, que puede llegar
hasta una semana o dos.
Lo más importante es valorar la lesión, pues su hay gran separación de los
cabos lesionados o extremos del músculo afectado, el tratamiento
conservador tendrá poco éxito y habremos de recurrir a la cirugía, pues la
cicatrización muscular puede no estar garantizada y las secuelas podrían
ser importantes.
Caso aparte supone las lesiones musculares antiguas con pequeños o
grandes desgarros más o menos cicatrizados que evidencian siempre zonas
débiles por donde puede repetirse la lesión o crearse una nueva. La
recuperación funcional en todos estos casos de desgarro ha de ser
exquisita y debe ser realizada por un médico deportivo.
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