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Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application

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Abstract

Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively referring to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The goal of the classification is to enhance communication between healthcare and sports-related professionals and facilitate rehabilitation and return-to-play decision making.

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Acknowledgements

The authors thank the Department de Cirurgia de la Facultat de Medicina of the Universitat Autònoma de Barcelona (UAB). At the time of writing, Xavier Valle was a PhD student at the UAB and this work was part of his doctoral dissertation performed at this department under the oversight and direction of Dr. Gil Rodas, Dr. Joan Carles Monllau, and Dr. Enric Cáceres. The authors also thank the members of FC Barcelona for their participation in this study.

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Authors and Affiliations

  1. Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain

    Xavier Valle, Ricard Pruna, Lluís Til, Josep Antoni Gutierrez & Gil Rodas

  2. Sports Medicine School, Universitat de Barcelona, Barcelona, Spain

    Xavier Valle

  3. Mapfre Centre for Tennis Medicine, Barcelona, Spain

    Xavier Valle & Ramón Balius

  4. Department de Cirurgia de la Facultat de Medicina, ‘Universitat Autònoma de Barcelona’, Barcelona, Spain

    Xavier Valle

  5. Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Duke University, Durham, NC, USA

    Eduard Alentorn-Geli & William E. Garrett Jr

  6. Department of Sports Medicine, Aspetar, Doha, Qatar

    Johannes L. Tol & Bruce Hamilton

  7. Department of Sports Medicine, The Sports Physician Group, OLVG-West, Amsterdam, The Netherlands

    Johannes L. Tol

  8. Academic Center for Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands

    Johannes L. Tol

  9. High Performance Sport NZ, Millenium Institute of Sport and Health, Auckland, New Zealand

    Bruce Hamilton

  10. High Performance Centre, Health Consortium of Terrassa, Barcelona, Spain

    Lluís Til

  11. Sport Catalan Council, Generalitat de Catalunya, Barcelona, Spain

    Josep Antoni Gutierrez & Ramón Balius

  12. Clínica Creu Blanca, Barcelona, Spain

    Xavier Alomar

  13. Musculoskeletal Department, Thessaloniki Sports Medicine Clinic, Thessaloníki, Greece

    Nikos Malliaropoulos

  14. Department of Rheumatology, Sports Clinic, Mile End Hospital, Barts Health NHS Trust, London, UK

    Nikos Malliaropoulos

  15. Department of Orthopaedic Surgery, Parc de Salut Mar–Hospital del Mar and Hospital de l’Esperança, Universitat Autònoma de Barcelona, Barcelona, Spain

    Joan Carles Monllau

  16. Hospital Universitari Dexeus (ICATME), Barcelona, Spain

    Joan Carles Monllau

  17. Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

    Rodney Whiteley & Erik Witvrouw

  18. Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

    Erik Witvrouw

  19. Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Göteburg, Sweden

    Kristian Samuelsson

Authors
  1. Xavier Valle
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  2. Eduard Alentorn-Geli
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  3. Johannes L. Tol
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  4. Bruce Hamilton
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  5. William E. Garrett Jr
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  6. Ricard Pruna
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  7. Lluís Til
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  8. Josep Antoni Gutierrez
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  9. Xavier Alomar
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  10. Ramón Balius
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  11. Nikos Malliaropoulos
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  12. Joan Carles Monllau
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  13. Rodney Whiteley
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  14. Erik Witvrouw
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  15. Kristian Samuelsson
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  16. Gil Rodas
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Corresponding author

Correspondence to Xavier Valle.

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Funding

No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Xavier Valle, Eduard Alentorn-Geli, Johannes L. Tol, Bruce Hamilton, William E. Garrett Jr., Ricard Pruna, Lluís Til, Josep Antoni Gutierrez, Xavier Alomar, Ramón Balius, Nikos Malliaropoulos, Joan Carles Monllau, Rodney Whiteley, Erik Witvrouw, Kristian Samuelsson, and Gil Rodas declare that they have no conflicts of interest directly related to the content of this article.

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Valle, X., Alentorn-Geli, E., Tol, J.L. et al. Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application. Sports Med 47, 1241–1253 (2017). https://doi.org/10.1007/s40279-016-0647-1

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  • DOI: https://doi.org/10.1007/s40279-016-0647-1

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