Background Despite being a common cause of time loss, information regarding best practice for calf muscle strain injuries (CMSI) in sport is scarce.
Objective To establish best practice for the assessment and management of CMSI.
Setting In-depth interviews.
Patients (or Participants) 20 expert medical professionals working in elite sport and/or researchers specialising in the field; representing seven countries and seven sports.
Interventions (or Assessment of Risk Factors) Semi-structured interviews using a schedule of questions canvassing pre-identified topics. Thematic coding to analyse findings.
Main Outcome Measurements Data were evaluated in three key areas: (i) injury characteristics, (ii) injury management, and (iii) injury prevention.
Results CMSI have unique injury characteristics compared to other common muscle strain injuries (e.g. hamstring), but a criteria-based approach can assist forming the most accurate impression of prognosis. Similarly, a structured approach should be followed to ensure the athlete returns to a high level of performance and the risk of re-injury is minimized, focusing on: re-strengthening, plyometric and ballistic exercises, as well as running-based reconditioning specific to the sport. For the best chance to prevent index CMSI, strategies should span multiple domains of athlete management: screening and monitoring, field-based exposure (e.g. workload data), and off-field interventions (e.g. strengthening). Injury prevention strategies should be tailored to the individual, considering extrinsic (the sport, position played, club culture/coach expectations) and intrinsic (previous injury history, age, training history) factors that may increase susceptibility to CMSI.
Conclusions Knowledge about the unique injury characteristics of CSMI can clarify the likely prognosis and best approach to rehabilitation. Practitioners attempting to prevent CMSI should use a multi-faceted approach given that the aetiology of CMSI is complex and often unique to the individual.
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