Objective:To evaluate the low energy extracorporeal shock waves therapy (ESWT) associated with physical therapy in the treatment of chronic muscle injuries classified as grades 2 and 3 in the lower limbs of amateur athletes.Methods:Eight athletes presenting with lower limb muscle injury for more than three weeks were treated with physiotherapy and ESWT. We evaluated the following parameters during treatment: palpable gap, muscle strength, pain, and Tegner score, as well as ultrasound image features and the ability to return to sports practice.Results:The average time of the first evaluation of the injury was 8.75 weeks. All patients presented muscle strength grade V after eight weeks. The pain score evolved from 5.75 to 0.5 points of the visual analogue scale (VAS), at the end of the treatment. The Tegner score after treatment was six points on average. Patients returned to sports practice after 8.14 weeks.Conclusion:ESWT associated with physical therapy proved to be effective to treat long-term muscle injury, with good performance and the ability to return to sport practice for all patients. Level of Evidence IV, Case Series, Prospective Study.

Este estudo apresentou diferenças anatômicas relacionadas às espécies Piper lepturum. var. lepturum e P. lepturumvar. angustifolium, que são às vezes consideradas como variedades e em outros casos como sinônimos. Para a análise histológica, folhas completamente expandidas foram coletadas e para análise ao microscópio eletrônico de varredura (MEV), pequenos fragmentos de ambas as faces de nervura central foram fixados. As duas espécies revelaram diferenças na anatomia vegetal, e foi observado que no pecíolo de P. lepturum var. lepturum há presença de alas persistentes e células epidérmicas papilosas, e estas características estão ausentes em P. lepturum var. angustifolium. Houve também a presença de ráfides tanto no pecíolo quanto na lâmina foliar apenas em P. lepturum var. angustifolium, diferenciando as duas espécie. Estudos recentes mostram a importância da anatomia vegetal com espécies onde há questões relacionadas à delimitação taxonômica.

This study showed anatomical differences related to Piper lepturumvar. lepturum and P. lepturum var. angustifolium species, sometimes considered varieties and in other cases synonyms. For histological analysis, fully expanded leaves were collected and for analysis by scanning electron microscope (SEM), fragments from the midrib were fixed on both leaf surfaces. The two species revealed differences in plant anatomy and it was observed that the stem of P. lepturum var. lepturum showed persistent wings and papillary epidermal cells, and these characters are absent in P. lepturum var. angustifolium. There was also the presence of raphides only in the lamina leaf and petiole of P. lepturum var. angustifolium, differentiating the two species. Recent studies have shown the importance of plant anatomy with species where there are issues related to taxonomic delimitation.