Muscle injuries

This session included presentations on: British Athletics classification system and imaging (US v MRI); Injection therapy for acute and chronic muscle injury; How to assess and manage recurrent calf ‘strains’; Delphi Consensus on RTP after hamstring injuries; Prehab/rehab; and Speeding up the return to play.

If all the elements of dealing with a muscle injury are done well, then RTP will be as fast as possible. These elements include the following points. First, get a good diagnosis according to the British Athletics classification system. (Pollock N, et al. British athletics muscle injury classification: a new grading system. B J Sports Med 2014; 48(18): 1347–1351). The key grade of injury is 3c, as injuries at this level and above involve a much increased time to return to full training and reinjury rates. Then understand typical versus atypical injuries and exclude any differential diagnoses. Understand the biology and the muscle function as well as the functional demands of the athlete’s sport in order to get the rehab loading right. Injections can be used to aid the rehabilitation process using good clinical reasoning, although the evidence is sparse. Pay attention to the soleus in calf injuries. Recurrent hamstring injuries can be reduced by allowing adequate preparation time and following the Delphi consensus on RTP. Finally, RTP should be through shared decision-making, so the athlete can make an informed decision.