Muscle Injuries Should be Graded Differently to Guide Athletes’ Return to Sports, Study Finds

Current grading systems for muscle injuries may not provide clinicians with enough information to guide athletes on when they can return to their respective sports with minimal risk of re-injury. That’s the finding of an article co-authored by Thomas M. Best, M.D., Ph.D., research director at the University of Miami Sports Medicine Institute, and published in the Journal of Sport and Health Science.

Current grading systems for muscle injuries provide clinicians with inadequate information.

The purpose of this study was to discuss the fact that current grading systems for muscle injuries provide clinicians with little information on which to guide the athlete regarding projected time loss and return to sport. The authors of the 2017 study, “Time for a paradigm shift in the classification of muscle injuries,” found that each of the new classification and grading systems has strengths, but there remains little unanimity on a system that is both comprehensive and evidence-based.

“Muscle injuries remain one of the most common injuries in sports,” said Best, who is also a professor of orthopaedics at the University of Miami Miller School of Medicine. “Yet despite this, there is little consensus on how to either effectively describe or determine the prognosis of a specific injury.”

Injury classification helps to describe an injury while a grade indicates the severity of the injury. Most athletes and coaches are concerned with the severity of an injury as it relates to the length of time it may take to return to full sports participation. The use of radiology can quickly correlate clinical findings with imaging characteristics that help establish early categorical radiological grading systems.

While most sports medicine physicians rely on MRI to guide athletes when projecting time loss from a sport, this study argues that a new classification system of muscle injuries needs to be developed to better inform athletes of their prognosis, as well as to help physicians accurately diagnose, manage, and prognosticate.

“While the ability to predict return to play is an expectation placed upon practitioners working with athletes, there is still incomplete evidence upon which to base decisions,” said Best, who is part of an international consortium leading this effort.