Ultrasound-Guided Fascial Hydrorelease for Persistent Pain After Hamstring Injury.

IF 2.5 Q1 SPORT SCIENCES
Kousuke Shiwaku, Hidenori Otsubo, Daiki Nishikawa, Rikiya Itagaki, Hiroyuki Takashima, Gakuto Nakao, Tomoaki Kamiya, Daisuke Suzuki, Makoto Emori, Carla Stecco, Atsushi Teramoto
{"title":"Ultrasound-Guided Fascial Hydrorelease for Persistent Pain After Hamstring Injury.","authors":"Kousuke Shiwaku, Hidenori Otsubo, Daiki Nishikawa, Rikiya Itagaki, Hiroyuki Takashima, Gakuto Nakao, Tomoaki Kamiya, Daisuke Suzuki, Makoto Emori, Carla Stecco, Atsushi Teramoto","doi":"10.3390/jfmk10030318","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Post-hamstring-injury residual pain may persist despite muscle-tissue healing and impairs athletes seeking early full recovery. Given their unclear cause, recent attention has focused on the role of fascial dysfunction and a method to restore fascial mobility, namely, hydrorelease (HR), involving the ultrasound (US)-guided injection of saline. We evaluated the clinical efficacy of HR for treating residual pain and ascertained the underlying pathological mechanisms. <b>Methods</b>: Seven patients (aged 17-49 years) with residual pain ≥8 weeks after hamstring injury were included. All exhibited localized tenderness and US findings of fascial thickening around the aponeurotic fascia (APF). HR with 6.0 mL saline-lidocaine solution (0.17% lidocaine) was performed and targeted the peri-APF loose connective tissues. Pain was evaluated using a numerical rating scale (NRS) before and after HR. Passive straight leg raise (SLR) was used to assess tightness. <b>Results</b>: Post-HR, the mean NRS score significantly decreased from 10 to 0.86 (<i>p</i> = 0.017). Four patients required a single HR session; three required two-four sessions. Post-HR, the tightness of all patients improved. Short-axis US of the posterior thigh revealed APF fascial thickening in the area of tenderness, including the posterior femoral cutaneous nerve (PFCN). No adverse events or recurrence occurred during the follow-up (mean: 6.6 months). <b>Conclusions</b>: HR targeting the peri-PFCN-APF effectively reduced residual pain following hamstring injury. These findings support the concept of \"Perineural fascial pain\"-a pathology wherein persistent pain originates not from direct nerve damage or classical myofascial pain syndrome but rather from the dysfunction of the surrounding fascia.</p>","PeriodicalId":16052,"journal":{"name":"Journal of Functional Morphology and Kinesiology","volume":"10 3","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371940/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Functional Morphology and Kinesiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/jfmk10030318","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Post-hamstring-injury residual pain may persist despite muscle-tissue healing and impairs athletes seeking early full recovery. Given their unclear cause, recent attention has focused on the role of fascial dysfunction and a method to restore fascial mobility, namely, hydrorelease (HR), involving the ultrasound (US)-guided injection of saline. We evaluated the clinical efficacy of HR for treating residual pain and ascertained the underlying pathological mechanisms. Methods: Seven patients (aged 17-49 years) with residual pain ≥8 weeks after hamstring injury were included. All exhibited localized tenderness and US findings of fascial thickening around the aponeurotic fascia (APF). HR with 6.0 mL saline-lidocaine solution (0.17% lidocaine) was performed and targeted the peri-APF loose connective tissues. Pain was evaluated using a numerical rating scale (NRS) before and after HR. Passive straight leg raise (SLR) was used to assess tightness. Results: Post-HR, the mean NRS score significantly decreased from 10 to 0.86 (p = 0.017). Four patients required a single HR session; three required two-four sessions. Post-HR, the tightness of all patients improved. Short-axis US of the posterior thigh revealed APF fascial thickening in the area of tenderness, including the posterior femoral cutaneous nerve (PFCN). No adverse events or recurrence occurred during the follow-up (mean: 6.6 months). Conclusions: HR targeting the peri-PFCN-APF effectively reduced residual pain following hamstring injury. These findings support the concept of "Perineural fascial pain"-a pathology wherein persistent pain originates not from direct nerve damage or classical myofascial pain syndrome but rather from the dysfunction of the surrounding fascia.

Abstract Image

Abstract Image

Abstract Image

超声引导筋膜松解治疗腘绳肌损伤后持续性疼痛。
背景:腘绳肌腱损伤后的残余疼痛可能持续存在,尽管肌肉组织愈合并损害运动员寻求早期完全恢复。由于其原因尚不清楚,最近的注意力集中在筋膜功能障碍的作用和恢复筋膜活动的方法,即氢释放(HR),包括超声(US)引导下注射生理盐水。我们评估了HR治疗残余疼痛的临床疗效,并确定了其潜在的病理机制。方法:选取腘绳肌损伤后残余疼痛≥8周的7例患者,年龄17-49岁。所有患者均表现出局部压痛和超声显示腱膜筋膜(APF)周围的筋膜增厚。6.0 mL盐-利多卡因溶液(0.17%利多卡因)进行HR,靶向apf周围疏松结缔组织。采用数值评定量表(NRS)对HR前后疼痛进行评估。被动直腿抬高(SLR)用于评估松紧度。结果:术后NRS评分由10分降至0.86分,差异有统计学意义(p = 0.017)。4名患者需要一次HR会议;其中三个需要两到四个疗程。hr后,所有患者的松紧度均有改善。股后短轴超声显示压痛区APF筋膜增厚,包括股后皮神经(PFCN)。随访期间无不良事件及复发(平均6.6个月)。结论:HR靶向周围pfcn - apf可有效减轻腘绳肌损伤后的残余疼痛。这些发现支持了“神经周围筋膜疼痛”的概念,即持续性疼痛不是源于直接的神经损伤或经典的肌筋膜疼痛综合征,而是源于周围筋膜的功能障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Functional Morphology and Kinesiology
Journal of Functional Morphology and Kinesiology Health Professions-Physical Therapy, Sports Therapy and Rehabilitation
CiteScore
4.20
自引率
0.00%
发文量
94
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信