Physiotherapist guiding a leg exercise on a mat

Sports Injury Treatment in Cologne Worringen

Professional physiotherapy for sports injuries at Hackhauser Weg 61

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A stab at the back of the thigh in the middle of a sprint, a sensation like a blow to the calf as you accelerate, or an Achilles tendon that is stiff every morning: muscle and tendon injuries mostly happen without any opponent at all. Praxis Pirnay in Cologne-Worringen treats such sports injuries on a prescription from your doctor (Heilmittelverordnung). Here you can read how a strain, a muscle fiber tear and tendon irritation differ and how the return to sport is built up.

Strain, muscle fiber tear, tendon irritation: the differences

A muscle consists of many fibers grouped into bundles. In a strain, the tissue is overstretched without any fibers visibly tearing; the muscle feels hard and cramped. In a muscle fiber tear, individual fibers rupture, in a muscle bundle tear larger portions – there is bleeding into the tissue, and tensing and stretching clearly hurt. It most often affects the back of the thigh, the calf, the adductors on the inner thigh and the front of the thigh.

The body repairs the tear in phases. First, an inflammatory reaction clears the area, then replacement tissue forms, which at first can bear little. Only under measured loading do the new fibers align and become resistant to pulling forces. Anyone who sprints too early during this time risks a new tear in the same place; anyone who rests too long is left with a weak muscle.

Tendons behave differently. With repeated overloading, the tendon tissue itself changes, for example at the Achilles tendon, the patellar tendon or the elbow; the technical term is tendinopathy. Typical features are start-up pain and stiffness in the morning. Complete rest usually brings little. Over a longer period, tendons need an even, slowly increasing load to be able to take more again.

When muscles and tendons are overtaxed

Sprinting and braking

At full speed, the back of the thigh brakes the leg swinging forward while it is being stretched at the same time. This is the moment when fibers are most likely to tear.

Shooting, sliding tackle, side step

Wide, fast movements of the leg out to the side put the adductors on the inner thigh under high tension, especially when the muscle is cold or tired.

Accelerating from a standstill

When you set off explosively, for example in tennis or badminton, the full force hits the calf and the Achilles tendon.

Always the same load

Many jumps, long runs or hundreds of strokes always challenge the same tendon. Without rest days, the remodeling of the tissue does not keep pace.

Back too early

A muscle that is not yet fully loadable after a fiber tear tears more easily again – even if nothing has been felt in everyday life for a long time.

Strain, tear or tendon – how it feels

Strain

• Tension that increases over the course of the game
• Muscle hard and cramp-like
• Continuing to run possible to a limited extent
• No bruise

Muscle fiber tear

• Sudden stab, as if from a knife
• The movement has to be stopped
• Pain when tensing against resistance and when stretching
• Bruise, often visible only after one to two days

Irritated tendon

• Stiff, painful first steps in the morning
• Pain at the start of training that eases as you warm up and returns later
• Tender, sometimes thickened spot

These signs point to more than a strain

Only a medical examination, often with ultrasound, can rule out a larger tear or another cause. Have yourself examined before starting physiotherapy if one of these signs is present.

A pop or a sensation of being hit at the heel, afterwards standing on tiptoe is no longer possible: see a doctor the same day.
A palpable dent in the muscle, a large bruise or a clear loss of strength.
After a kick or a blow, the lower leg becomes tight, the pain rises steadily, toes tingle or go numb: call the emergency number 112.
Calf swollen, warm and painful although there was no injury event: have it checked by a doctor today.
Pain at rest and at night that remains despite rest.

Physiotherapy for muscle and tendon injuries in Cologne-Worringen

The most important part of the treatment is active: the injured tissue is given as much load as it can tolerate at the respective stage. Passive methods accompany this if they have been prescribed.

Physiotherapy exercises (Krankengymnastik)

After a fiber tear, we begin with tensing the muscle at rest, move on to slow exercises against resistance and finish with accelerations and sprints. We train irritated tendons with slow, heavy repetitions, for example heel raises on a step.

Manual lymphatic drainage

An extensive bruise makes the leg feel heavy and tight. With light pressure, lymphatic drainage supports the removal of fluid from the tissue without kneading the injured muscle itself.

Classical massage

A fresh tear is not massaged directly. Later in the course, we treat the surrounding area and muscles that have become tense from protecting the leg, for example the buttocks and lower back.

Electrotherapy and ultrasound

Electrical stimulation or ultrasound can be used as a supplement for pain relief in tendon problems, provided they have been prescribed. They do not replace load training, because a tendon only becomes more resilient through training.

Step-by-step plan from assessment to sprint

1
Assessment of the muscle
We palpate the area, test tensing and stretching compared with the other side and note at which load the pain starts. The doctor’s findings are taken into account.
2
Intermediate goals
Each stage has a criterion, for example climbing stairs, easy jogging or a sprint at full speed, each without a stabbing pain.
3
Building up the load
In the appointment, we practice the next stage under supervision and adjust speed and resistance. Setbacks happen and are planned for.
4
Homework
Between appointments, you carry out the current stage yourself. We define how often to do it and how you can tell that it was too much.
5
Final test
At the end come strength and running tests compared with the uninjured side. Afterwards we discuss your return to team or competition training.

The first days and the way back

After a muscle injury, what you refrain from doing matters more at first than what you do. For tendons, the opposite tends to be true.

Compression and rest first

Stop the sport, wrap the area firmly with an elastic bandage, but not so tightly that it constricts, and raise the leg. Cool briefly and never with ice directly on the skin.

Do not stretch, knead or warm

Vigorous stretching, massaging and heat can increase the bleeding in the first days. Wait with these until your doctor or therapist gives the green light.

Pain as the yardstick

Walking and light movement are allowed as long as only a mild pulling sensation occurs. A stab means: go back one stage. Painkillers taken in order to be able to train mask this signal.

Load tendons evenly

Drop jumps and sprints for the time being, but keep moving. The strength exercises you are shown work through regular repetition. Mild pain during them is usually acceptable if it subsides by the next day.

Your way to us in Cologne-Worringen

Praxis Pirnay is located at Hackhauser Weg 61 in 50769 Cologne, in the northernmost district of the city, not far from the Rhine. Take the A57 to the exit Köln-Worringen; parking spaces are right in front of the practice. If you come by bus, get off at the stop “Worringen Hackhauser Weg”; from there it is a few minutes’ walk.

For the first appointment, we need your prescription and your insurance card. A doctor’s report and ultrasound or MRI findings are helpful. Wear short sports shorts so that your thigh and calf are freely accessible, and bring sports shoes. The assessment makes the first session longer.

We schedule appointments by phone and via the appointment form on the website. Treatment takes place in German, English or Spanish and, depending on the prescribed therapy, usually lasts 20 to 60 minutes.

Opening hours: Mon–Tue 7:00–18:00, Wed 7:00–18:20, Thu 8:00–19:30, Fri 8:00–14:00

Muscle fiber tear and tendon pain: frequently asked questions

How can I tell a strain from a muscle fiber tear?

By the onset and the course. A strain tends to build up gradually, the muscle becomes hard, and carrying on playing is often still possible. A fiber tear comes suddenly as a stab, the movement stops, and later a bruise often appears. A medical examination, with ultrasound if needed, gives certainty.

How long are you out with a muscle fiber tear?

That can only be said roughly, because the size and location of the tear are decisive. A strain is often over after a few days, a fiber tear often takes several weeks depending on its extent, and a larger tear longer. More reliable than the calendar are tests: full exertion, stretching and sprinting without pain.

Cool or warm – what is right for a fiber tear?

Cool in the first days, do not warm. Cold dampens the pain, whereas heat increases blood flow and can enlarge the bleeding. More important than cooling are a compression bandage and elevation. Heat is only an option later, when the muscle has healed but is still tense.

May I keep running with an irritated Achilles tendon?

Often yes, but at a reduced volume and only if the pain stays low while you run and is not stronger the next morning. Pause speed runs, uphill running and jumping for now. If the tendon swells or hurts even when walking, pause running and have it looked at by a doctor.

Does health insurance cover treatment after a sports injury?

Yes, as soon as there is a prescription from a doctor, we bill your statutory health insurance. Your share is the statutory co-payment, unless you are exempt. Private health insurers reimburse according to your policy; ask them before you start.

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0221 - 782571