Rapid Return to the Field: Hyperbaric Oxygen Therapy Combined with Rehabilitation for Joint Injuries

Source: Renyi Hyperbaric Oxygen Official Account
Author: Song Xiangsheng

To date, while literature reports indicate hyperbaric oxygen therapy is effective for soft tissue injuries such as muscle tears, fewer reports exist regarding joint injuries. This Japanese case report details four patients with sports-related joint injuries who underwent rehabilitation in a hyperbaric oxygen environment, achieving early return to athletic activity.

Case 1
A 17-year-old female sustained a left shoulder glenoid labrum injury during basketball play. MRI revealed glenoid labrum damage with intra-articular hematoma beneath and posterior to the joint. On day 3 post-injury (pre-treatment), shoulder elevation was limited to 30 degrees with significant range of motion restriction. Rehabilitation commenced in a hyperbaric oxygen environment, with the fourth treatment administered on day 6 post-injury. After 10 sessions, shoulder elevation reached 180 degrees without pain. Four weeks post-injury, she scored the highest points for her team in a competition and ultimately secured third place in the county-level tournament.

Image Caption: Diagnostic MRI: Labral tear with intra-articular hematoma inferior and posterior to the joint. From left to right: 62 degrees elevation at 1 ATA → 79 degrees elevation after 10 minutes (2 ATA) → 85 degrees elevation after 50 minutes (2 ATA). Day 7 post-injury: Improved range of motion under hyperbaric pressure. From left to right: 69 degrees abduction at 1 ATA → 75 degrees abduction after 5 minutes (1.5 ATA) → 90 degrees abduction after 10 minutes (2 ATA). MRI at 6 weeks post-treatment: Intra-articular hematoma resolved, glenoid labrum repaired. After 10 treatments, shoulder achieved 180 degrees abduction without pain.

Case 2
27-year-old male with left shoulder instability. X-ray: subluxation of the shoulder joint. MRI: inferior glenoid labrum tear with osteophyte formation. Injured left shoulder during international competition, followed by persistent difficulty in shoulder elevation for 3 months. Range of motion nearly fully restored after initial hyperbaric oxygen therapy rehabilitation session. Six total treatments improved scapular upward rotation, strengthened internal muscles, enhanced shoulder horizontal internal/external rotation, and corrected height imbalance. Won championship in the same sport one month later.

Image caption: At 1 ATA: shoulder abduction 108 degrees -> After 10 minutes at 2 ATA: shoulder abduction 140 degrees -> After 50 minutes at 2 ATA: shoulder abduction 180 degrees.

Case 3
46-year-old female with dislocation of the proximal interphalangeal joint of the right ring finger. Self-reduced dislocation with no apparent fracture. On day 2 post-injury, interphalangeal joint range of motion was -33 degrees extension and 57 degrees flexion with restricted mobility. By day 3, improved to -17 degrees extension and 70 degrees flexion. On day 4, rehabilitation therapy commenced in a hyperbaric oxygen environment. After 3 sessions, the athlete successfully returned to competition.

Case 4
27-year-old male. Sustained a left ankle triangular ligament injury during competition. Began hyperbaric oxygen therapy rehabilitation on day 3 post-injury. Experienced no pain during squats on day 5 post-injury. Originally planned to return in 2 weeks, but competed after only 3 hyperbaric oxygen therapy sessions. Gradually increased playing time on days 6 and 7 post-injury. Currently active in competition with no recurrence symptoms.