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Terminology and classification of muscle injuries in sport: The Munich consensus statement
  1. Hans-Wilhelm Mueller-Wohlfahrt1,
  2. Lutz Haensel1,
  3. Kai Mithoefer2,
  4. Jan Ekstrand3,
  5. Bryan English4,
  6. Steven McNally5,
  7. John Orchard6,7,
  8. C Niek van Dijk8,
  9. Gino M Kerkhoffs9,
  10. Patrick Schamasch10,
  11. Dieter Blottner11,
  12. Leif Swaerd12,
  13. Edwin Goedhart13,
  14. Peter Ueblacker1
  1. 1MW Center of Orthopedics and Sports Medicine, Munich and Football Club FC Bayern Munich, Munich, Germany
  2. 2Harvard Vanguard Medical Associates, Harvard Medical School, US Soccer Federation, Boston, Massachusetts, USA
  3. 3UEFA Injury Study Group, Medical Committee UEFA, University of Linköping, Linköping, Sweden
  4. 4Football Club Chelsea, London, UK
  5. 5Football Club Manchester United, Manchester, UK
  6. 6School of Public Health, University of Sydney, Sydney, Australia
  7. 7Australian Cricket team and Sydney Roosters Rugby League team, School of Public Health, University of Sydney, Australia
  8. 8Orthopedic Department Academic Medical Centre, Amsterdam, The Netherlands
  9. 9Department of Orthopedic Surgery and Orthopedic Research Center, Academic Medical Center, Amsterdam, The Netherlands
  10. 10International Olympic Committee, Lausanne, Switzerland
  11. 11Department of Vegetative Anatomy, Charité University of Berlin, Berlin, Germany
  12. 12University of Gothenborg and National Football Team Sweden, Gothenburg, Sweden
  13. 13Football Club Ajax Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Peter Ueblacker, Center of Orthopedics and Sports Medicine, Munich and Football Club FC Bayern Munich, Dienerstrasse 12, Munich 80331, Germany; peter.ueblacker{at}gmx.net

Abstract

Objective To provide a clear terminology and classification of muscle injuries in order to facilitate effective communication among medical practitioners and development of systematic treatment strategies.

Methods Thirty native English-speaking scientists and team doctors of national and first division professional sports teams were asked to complete a questionnaire on muscle injuries to evaluate the currently used terminology of athletic muscle injury. In addition, a consensus meeting of international sports medicine experts was established to develop practical and scientific definitions of muscle injuries as well as a new and comprehensive classification system.

Results The response rate of the survey was 63%. The responses confirmed the marked variability in the use of the terminology relating to muscle injury, with the most obvious inconsistencies for the term strain. In the consensus meeting, practical and systematic terms were defined and established. In addition, a new comprehensive classification system was developed, which differentiates between four types: functional muscle disorders (type 1: overexertion-related and type 2: neuromuscular muscle disorders) describing disorders without macroscopic evidence of fibre tear and structural muscle injuries (type 3: partial tears and type 4: (sub)total tears/tendinous avulsions) with macroscopic evidence of fibre tear, that is, structural damage. Subclassifications are presented for each type.

Conclusions A consistent English terminology as well as a comprehensive classification system for athletic muscle injuries which is proven in the daily practice are presented. This will help to improve clarity of communication for diagnostic and therapeutic purposes and can serve as the basis for future comparative studies to address the continued lack of systematic information on muscle injuries in the literature.

What are the new things Consensus definitions of the terminology which is used in the field of muscle injuries as well as a new comprehensive classification system which clearly defines types of athletic muscle injuries.

Level of evidence Expert opinion, Level V.

  • Athletics
  • Hamstring injuries
  • Muscle damage/injuries
  • Muscle cramping
  • Sporting injuries

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