Overview
The recurrence of an injury—reinjury to the same area—is one of the most significant risks in sports medicine. Statistically, an athlete who has sustained muscle strain, ligament tear or tendinopathy faces a considerably higher risk of reinjury at the same site, particularly during the first 6 to 12 months after returning to sport.
This is not coincidental. The healing process rarely restores the original tissue’s full mechanical and biological properties.
Preventing recurrence is therefore a distinct objective of sports medicine care, separate from the initial rehabilitation process. Even after an athlete has returned to full training, the healed tissue may remain biologically inferior, with less organised collagen, reduced vascularization and a lower failure threshold.
Recognizing and systematically addressing this vulnerability is essential for the athlete’s long-term health.
Characteristics
The principal factor increasing the risk of recurrence is poor-quality healing. Scar tissue that forms at the site of a previous injury is often less elastic, less vascularised and less resilient than the original tissue. This “weak link” is more likely to fail when exposed to subsequent loading.
Additional risk factors include incomplete neuromuscular rehabilitation. An athlete may have regained strength without fully restoring proprioception. Returning to sport before biological tissue maturation is complete also significantly increases the risk of reinjury.
Managing these factors effectively requires a comprehensive sports medicine approach combining physiotherapy, neuromuscular training and biological support aimed at improving the quality of tissue healing.
Scientific Basis
Studies assessing tissue characteristics at the sites of previous injuries have demonstrated clear histological differences between scar tissue and the original tissue. These include a lower ratio of type I to type III collagen, reduced vascularization and disorganised collagen architecture.
These findings are directly associated with a higher risk of recurrence.
Research into the use of hyperbaric oxygen therapy after completion of the main rehabilitation phase has reported improvements in the quality of newly formed tissue, including a higher proportion of type I collagen and improved vascularization. During long-term follow-up, these findings have been associated with a reduced risk of recurrence.
The Role of Hyperbaric Oxygen Therapy
In the prevention of recurrent injuries, hyperbaric oxygen therapy is usually introduced after the main treatment phase has been completed. At this stage, the athlete may have returned to training, although the affected tissue has not yet reached full biological maturity.
The objective is to optimize the quality of the healed tissue rather than merely restore function.
The proposed mechanism of action focuses on stimulating type I collagen synthesis to replace the lower-quality type III collagen that predominates in scar tissue. It also supports neovascularisation, helping to establish a better long-term blood supply at the site of the previous injury.
At the same time, its antioxidant effects may reduce the chronic oxidative stress that contributes to persistent tissue weakness.
Treatment is typically administered in courses of 15 to 20 sessions, in combination with physiotherapy and neuromuscular training, under the supervision of a sports medicine physician.
Investing in the prevention of recurrence is more effective than treating a new injury after it has occurred.