Early versus Delayed Rehabilitation after Acute Muscle Injury

There has always been a debate as when to commence rehabilitation after an acute sports injury to major muscles such as the calf and thigh in various sports.
A randomized control trial of fifty amateur athletes were recruited to compare early versus delayed treatment within 48hrs of an acute injury, as confirmed by ultrasound and MRI.
The early rehabilitation group commenced treatment two days following the injury, while the delayed group commenced rehabilitation nine days later.
All patients completed a standardised four-stage protocol.

  1. Static daily stretching
  2. Progressive isometric loading exercise
  3. Dynamic loading with increasing resistance (3 times /week at weeks 5-8)
  4. Heavy strength training combined with functional exercises in (weeks 9-12)

The study demonstrated that time between injury and pain free return to play, was reduced in the early rehabilitation group by 3 weeks in relative to the delayed group.
Although tempting to protect the athlete from pain and movement with early rehabilitation. This study demonstrates the importance of early loading of musculotendinous tissues.
Immobilization appears to compromise muscle and tendon structure repair, leading to prolonged tissue regeneration.
Starting rehabilitation early appears to be safe and is associated with a more rapid return to pain free sport.

Infographic sourced from: 


Bayer ML, Magnusson SP and Kjaer M. Early versus Delayed
Rehabilitation after Acute Muscle Injury. N Engl J Med 2017;

© Copyright 2018 Sports Science Chiropractic