Vol.:(0123456789) 1 3 Journal of Science in Sport and Exercise (2019) 1:13–19 https://doi.org/10.1007/s42978-019-0008-5 REVIEW ARTICLE Passive Strategies for the Prevention of Muscle Wasting During Recovery from Sports Injuries Pedro L. Valenzuela 1,2  · Javier S. Morales 3  · Alejandro Lucia 3,4,5 Received: 21 November 2018 / Accepted: 4 April 2019 / Published online: 11 June 2019 © Beijing Sport University 2019 Abstract Background Recovery from sport injuries commonly involves a muscle disuse situation (i.e., reduction in physical activity levels sometimes preceded by joint immobilization) with subsequent negative efects on muscle mass and function. Purpose To summarize the current body of knowledge on the efectiveness of diferent physical strategies that are currently available to mitigate the negative efects of muscle disuse during recovery from sports injury. Methods A narrative review was conducted to summarize the information available on neuromuscular electrical stimulation (NMES), blood fow restriction (BFR) and vibration intervention. Results The concomitant application of BFR and low-intensity exercise has shown promising results in the prevention of disuse-induced muscle atrophy. Some benefts might also be obtained with BFR alone (i.e., with no exercise), but evidence is still inconclusive. NMES, which can be applied both passively and synchronously with exercise, can also attenuate most of the negative changes associated with disuse periods. In turn, the mechanical stimulus elicited by vibration seems efec- tive to reduce the loss of bone mineral density that accompanies muscle disuse and could also provide some benefts at the muscle tissue level. Conclusions Diferent physical strategies are available to attenuate disuse-induced negative consequences during recovery from injury. These interventions can be applied passively, which makes them feasible during the frst stages of the recovery. However, it would be advisable to apply these strategies in conjunction with low-intensity voluntary exercise as soon as this is feasible. Keywords Skeletal muscle · Rehabilitation · Training · Muscle wasting · Immobilization · Injury Introduction The risk of musculoskeletal injuries is inherent in exercise practice and especially competitive sport. Injuries and the subsequent recovery period can lead to several negative consequences not only for the athlete—including physical, psychological and societal complications—but also for the team, especially at a tactical level as the injured athlete must temporarily refrain from competition [14, 32]. The physical consequences of a sports injury vary depending upon its nature and severity. However, most inju- ries result in a temporary cessation (or at least a reduction) of activity although sometimes an immobilization period might also be needed during the frst phase of recovery. More than half of sports injuries result in at least 1 week of exercise restriction, with 20% of competition injuries being associated with 3 or more weeks of inactivity or premature termination of the competition season [61]. Knee injuries Pedro L. Valenzuela and Javier S. Morales contributed equally. * Pedro L. Valenzuela pedrol.valenzuela@edu.uah.es 1 Physiology Unit, Department of Systems Biology, School of Medicine, University of Alcalá, Ctra. Barcelona, Km 33,600. Alcalá de Henares, 28871 Madrid, Spain 2 Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain 3 Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain 4 Research Institute of the Hospital, 12 de Octubre (“i + 12”), Madrid, Spain 5 Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Madrid, Spain