La lesión de Varane que le impedirá jugar la semifinal contra el Chelsea

Una nueva mala noticia para el Real Madrid, ya que Varane tiene una lesión que le impide jugar este miércoles frente al Chelsea. ¿De qué se trata el problema en los abductores que presenta?
La lesión de Varane que le impedirá jugar la semifinal contra el Chelsea
Leonardo Biolatto

Escrito y verificado por el médico Leonardo Biolatto.

Última actualización: 14 mayo, 2021

Raphael Varane, futbolista del Real Madrid, sufre una lesión muscular en la zona del abductor del miembro inferior derecho, según lo que informó el plantel médico del club. Este problema se suma al sufrido por Dani Carvajal, por lo que el técnico Zinedine Zidane enfrenta nuevos desafíos para completar la plantilla que tiene que enfrentar al Chelsea este miércoles.

La lesión en cuestión es un tanto inespecífica, por lo que valen algunas aclaraciones sobre esta zona corporal y su implicancia en el fútbol. Esto es así porque, a ciencia cierta, los músculos abductores y aductores del miembro inferior son, en realidad, un conjunto de fibras que reciben otra nomenclatura en la anatomía.

La designación clásica que los describe cuando se trata de un trastorno asociado al deporte responde a los movimientos que ejercen. Como veremos a continuación, la lesión muscular de Varane puede ser motivo de confusión entre distintos cuadros clínicos.

¿Qué es la abducción y la aducción?

Decir que Varane tiene una lesión muscular en un abductor de la pierna es muy genérico. En realidad, no sabemos con certeza qué porción del sistema músculo-esquelético se ha afectado.

De manera coloquial, los músculos aductores y los abductores son los de la cadera, es decir, aquellos que antagonizando entre sí son capaces de acercar un miembro inferior a la línea media del cuerpo o alejarlo. Se trata de cinéticas complementarias y opuestas que los futbolistas exigen en sus entrenamientos y en los partidos.

Por un lado, la aducción es el acercamiento hacia la línea media. Cuando un atleta tiene que traer de nuevo su pie hacia el eje porque lo estiró por alguna razón, entonces está aduciendo.

Al contrario, la abducción es el alejamiento de una parte del cuerpo de la línea central imaginaria que podemos trazar como eje. Un futbolista, entonces, abduce cuando levanta la pierna y la estira hacia un costado en una maniobra para alcanzar el balón, por ejemplo.

Movimientos del fútbol en el miembro inferior.
En el fútbol hay movimientos de abducción y aducción del miembro inferior todo el tiempo, debido a la mecánica del juego.

¿Qué músculos están implicados?

Resulta lógico, por ende, imaginar que no puede haber un solo músculo encargado de hacer estos movimientos complejos. Lo que nos lleva a decir que la lesión muscular de Varane se encuentra en alguna zona comprendida entre una o varias de las siguientes estructuras musculares:

  • Músculos glúteos: los músculos glúteos son 3 y se ubican en capas sucesivas que se enciman. Están el mayor, el medio y el menor. El primero es el más superficial y sostiene la posición corporal. El segundo es un gran abductor de la cadera, lo que permite que el muslo se movilice hacia afuera de la línea media. Finalmente, el glúteo menor hace lo mismo que el medio, aunque con una potencia mucho más discreta.
  • Piramidal: este músculo es un triángulo y de allí deriva su nombre. Une al hueso sacro con el fémur.
  • Tensor de la fascia lata: pequeño y con un nombre más sofisticado, su unión a la fascia lata lo vuelve una parte importante del mecanismo que une la cadera con la rodilla, por lo que está implicado en movimientos que parecerían lejanos a su inserción inicial. Su hipertrofia se puede confundir, a veces, con un tumor.
  • Sartorio: este es un músculo particular por su largo. En realidad, se trata del más extenso de todo el cuerpo humano y corre por la parte anterior del muslo para insertarse en la tibia.

¿Qué lesión tiene Varane?

Como bien adelantamos, es difícil establecer la lesión específica de Varane en este contexto y con la información disponible. Cualquiera de los músculos que generan abducción de la cadera pueden ser los lesionados, y la gravedad dependerá de si es una contractura intensa, una distensión o una rotura completa.

Al futbolista del Real Madrid se le practicó una resonancia magnética, que es el estudio de rigor para determinar el diagnóstico en estos casos. Tras ello se informó al director técnico que no podría contar con el atleta para este miércoles.

En sí, hay 3 situaciones que pueden contemplarse como posibles:

  1. Distensión: el cuadro de distensión de abductores es lo que se conoce como distensión inguinal. Es un trastorno propio de la pelvis que implica un estiramiento excesivo de los ligamentos y los músculos de la zona, tras alejar demasiado el miembro inferior de la línea media. Por ejemplo, al tirarse al campo para buscar un balón. No se interviene quirúrgicamente y cicatriza con reposo. Es más frecuente su presentación en deportistas con cirugía previa de rodilla.
  2. Rotura: una rotura de fibras musculares, suceda en el área que suceda, siempre representará gravedad. De manera tradicional, en medicina se clasifica este problema de los abductores en tres grados. El primero es el más leve y se asemeja a la distensión, pues son pocas las fibras comprometidas. Los grados 2 y 3 revisten gravedad y suelen localizarse en las zonas más próximas a la unión tendinosa con los huesos, por lo que requieren una evaluación completa que determine la necesidad de cirugía o no.
  3. Contusión: las contusiones se derivan de traumatismo. Un golpe fuerte en el muslo o en la cadera puede ocasionar la formación de un hematoma dentro de alguno de los músculos que producen abducción. Ello limita el movimiento y causa impotencia funcional, obligando al reposo hasta tanto se reabsorba el líquido que se acumula en la zona.
Muslo afectado en la lesión de los abductores.
El muslo y la cadera contienen músculos grandes y potentes. Sus lesiones originan impotencias funcionales llamativas.

La lesión de Varane en los abductores requiere reposo

Algo es claro, más allá de la inespecificidad de las lesiones de los abductores: Raphael Varane deberá guardar reposo. Este es el tratamiento indicado para los atletas que atraviesan la condición.

El abordaje se suele complementar con frío local, inmovilización, el uso de algún analgésico o antiinflamatorio según los requerimientos del paciente y la prescripción profesional, así como la evaluación de un plan de rehabilitación. Las complicaciones a futuro no suelen ser muchas, pero en el nivel de exigencia profesional del fútbol se sabe que hay que estar atentos a las lesiones repetitivas.

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  • Morales, N. Mosquera, JG López Hermoza, and A. Fernández Bravo. "Hipertrofia unilateral del músculo tensor de la fascia lata, a propósito de un caso." Rehabilitación 53.1 (2019): 65-67.
  • Mouzopoulos, George, et al. "Hip abductor tendinitis after ACL reconstruction with patellar tendon graft in soccer players. A new clinical complication." European Journal of Orthopaedic Surgery & Traumatology 28.2 (2018): 213-216.
  • Puerto, Camilo Alberto Camargo. "Guía para el manejo y clasificación de trastornos musculares." Cita este texto en los siguientes formatos: Apa (2018): 173.

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