Endotherapic System In Association With Transdermal Infiltration System In The Treatment Of Trauma To Internal Gastrocnemius In Soccer Players

Scientifci Literature :  " Endotherapic System In Association With Transdermal Infiltration System In The Treatment Of Trauma To Internal Gastrocnemius In Soccer Players":

Medical Center "Avicenna" Marghera, Venezia, Italy
Alessandro Pastore

Objectives

The aim of this study was to evaluate, through ultrasound scanning, the anatomic-tissutal repair with a prevalence of regeneration phenomena than on cicatricial, on a sample of 30 (thirty) cases of muscle injury from indirect trauma treated with endothermy and transdermal vehiculation.

Introduction

Winform Tecar therapy through the emission of radio-frequency (electromagnetic medium waves at 480.000 Hz) leads to a biostimulation that is defined “biological” both of soft tissues, tendinous tissues and bone.

Through a surface system, commonly defined capacitive, we obtain an energetic biostimulation through the interaction of electrolytic charges and their displacement. Those charges are attracted and compacted close to an active mobile electrode, opposite to a return neutral plate. The bioenergetic effect is mainly superficial and it involves muscles and vascular systems.

With the deep system, commonly defined resistive, the results is an energetic biostimulation with a three-dimensional interaction of soft tissues, bony and tendinous. The resistive system acts prevalently on those tissues that have higher electrical impedance because of their lower content of water (cartilage, tendons, and bones)1.

Winform transdermal vehiculation SIT Therapy Winform allows conveying active elements (pharmacological and/or phytocompounds) directly on the site of action accelerating the pharmacological kinetics and interacting as less as possible with the systemic circulation: the conveyance of substances is induced by the stimulation of the tissues:

a)     through the realignment of polarities;

b)     changes in transcutaneous potential;

c)      increasing of cellular permeability2.

Methods

From January to September 2010 were examined 30 (thirty) male patients, aged between 18 and 40 years, amateur soccer players/semi-professional suffering from traumatic indirect lesion. Lesion of 1St – 2nd – 3rd degree in all cases were located at the distal internal gastrocnemius myo-tendinous junction (22 left legs – 8 right legs) procured during phases of the game or training on the turf. Diagnoses were made by ultrasound scanning (Toschiba Xario) with an 8-14 MHz multifrequency probe, always performed by the same operator.

Each patient was also evaluated in terms of clinical symptoms by an assessment with visual-analogic scale VAS from 0 to 10.

Patients were then subjected to 4 (four) therapy sessions E-Sit Touch and 8 (eight) therapy sessions with Tecar CRV distributed as follows:

1st and 2nd week: 2 (two) consecutive sessions of ESIT therapy and 2 (two) sessions, on alternate days, of endotherapy. The two systems were never applied on the same day.

3rd and 4th week: 2 (two) sessions of Endotherapy spaced at least 48 hours.

The total treatment lasted 4 (four) weeks and eventually the patients underwent a second ultrasound scanning control and the administration of the VAS scale for pain perception.

During the 4 (four) weeks there were not carried out other therapies.

Pharmacological transfer protocol

With SIT system was used aceclofenac 200 mg in powder associated with ethylenediaminetetraacetic acid (EDTA) at 10% dissolved on a carrier gel. NSAIDs inhibit the synthesis of prostaglandins; EDTA has a chelating action for fibrinolytics and calcified tissues, reducing the organization of the same tissues and producing an effect on tissutal.

With SIT system drug absorption is speeded up with pain decreasing in the immediate after trauma.

Endotherapy is applied in the first 24 hours, around the lesion area for edema resorption; after 48 hours is applied locally at low energy for macrophages stimulation; after the fourth/sixth day is applied locally at medium energy with neo-angiogenetic effect and fibroblastic stimulation using a superficial approach (capacitive).

Results

At the first ultrasound scanning controls:

  • 12 (twelve) patients presented 1st degree of lesion
  • 10 (ten) patients presented 2nd degree of lesion
  • 8 (eight) patients presented 3rd degree of lesion

At the end of the therapies cycle (more or less 30 days) at the second ultrasound scanning control, all patients showed initial or partial hematoma resorption, the appearance of the fibers in the lesion area and the beginning of cicatricial phenomena.

All patients reported an improvement in pain symptoms that has increased from a medium average VAS scale 5.69±2.27 (DS) to 2.40±1.84 (DS) at discharge, reporting a medium improvement of 3.29±0.76 (DS). “Student t” test of significance performed to p<0.05.

Conclusions

It should be noted that, as per the ultrasound scanning, this associated methods are effective for the quality of anatomic-tissutal repair and hematoma resorption rather than on recovery time. Great is the effect on pain from what emerges from the assessment on visual-analogic VAS scale.

By the way deliberately in this survey, during the period of treatment, there was not association with any kinesiology technique, which probably would have contributed to a faster recovery of the athlete.

We believe that it is worth to proceed with further researches, extending the method to kinesiology techniques, corroborating data previously obtained with functional tests.

References

  1. P. Mondardini, R. Tanzi, L.Verardi, S. Briglia, A.Maione, E. Drago. “Nuove metodologie nel trattamento della patologia muscolare traumatica dell’atleta”, Edizioni Minerva Medica, Torino 2003;
  2. S. Colaiuda, C. Capogrossi, M. C. Fortuna, F. Colaiuda, A. Rossi. Università degli studi di Roma “la Sapienza” dipartimento delle malattie cutanee-veneree e chirurgia plastica-ricostruttiva Direttore Prof. Stefano Calvieri. “Trattamento non invasivo del melasma,utilizzo di un sistema di veicolazione trans dermica a rilascio rapido”, pubblicato su Hi Tech Dermo, Milano, febbraio 2010.