Muscle injuries models

British athletics muscle injury classification: a new grading system (Pollock, 2016).
This system is based on the anatomical site. Injuries are graded 0–4 based on MRI features, with Grades 1–4 including an additional suffix ‘a’, ‘b’ or ‘c’ if the injury is ‘myofascial’, ‘musculo-tendinous’ or ‘intratendinous’.
The criticism of this are it is built on too few case-studies, and should be comfirmed in larger prospective studies. And lots of the case studies are on hamstring, therefor can this be used for all muscle groups?

However the new “thing” in this classification are, that you injuries that are diagnostic clinically, but thos not shown any injury on MRI takes shorter recovery time. Intradendinous injuries might takes longer. And total ruptur injuries have long recovery time up to 7 mount, and my need surgerical fixation.

Br J Sports Med 2014;48:1347-1351 doi:10.1136/bjsports-2013-093302 British athletics muscle injury classification: a new grading system

 

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Classification Of Muscle Injuries In Sport: The Munich Consensus Statement, Hans-Wilhelm Mueller-Wohlfahrt.

Muscle injuries are splint into 1. functional muscle disorder (with no microscopic fiber disruption on MRI) and 2. structural muscle injuries (with microscopic fiber disruption on MRI)

The criticism of this is the imaging are depending of the quality used and there are no relevant difference in duration of day between grade 1 functional and grade 2 structural.

Ref.

Br J Sports Med doi:10.1136/bjsports-2012-092092: Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification
Br J Sports Med doi:10.1136/bjsports-2012-091448: Consensus statement Terminology and classification of muscle injuries in sport: The Munich consensus statement

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Hamstring muscle injuries in professional football: the correlation of MRI fi ndings with return to play

MRI finding; Grade 0, no abnormalities (Days to RTP) 6(+-7)), Grade 1, Oedema without rupture 18 day (+-19), Grade 2; partiel tear, 24 days (+-13), Grade 3, total rupture 60 day (+-57). This has a significant P>0,5.

However; is this clinical relevant? Grade 1 takes a mean of 18 days, yet the standard deviation are 19 days (clinical relevant?).

Using these number we can estimate that a player with a grad 1 injury have 70% chance to return to play between 0-37 days.

If we want to be even more secure we can use the 95% confidence interval (CI), now we can estimate that the player will return between 0-56 days.

Despite this is significant, it is not specific clinical relevant on individual level.

ref.:

Br J Sports Med. 2012 Feb;46(2):112-7. doi: 10.1136/bjsports-2011-090155. Epub 2011 Dec 5.  Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play.

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