Outcomes of Activity-Related Lower Extremity Muscle Tears After Application of the British Athletics Muscle Injury Classification: A Systematic Review

Overview

Journal Sports Health

Publisher Sage Publications

Specialty Orthopedics

Date 2023 Sep 8

PMID 37681683

Authors

William L Hollabaugh

Alexander Sin

Rachel Lane Walden

Jennifer S Weaver

Lauren P Porras

Lance E LeClere

Ashley R Karpinos

Rogelio A Coronado

Andrew J Gregory

Jaron P Sullivan

Affiliations

Soon will be listed here.

Abstract

Context: Muscle injury classification and grading systems have been reported for >100 years; yet it offer limited evidence relating the clinical or radiological qualities of a muscle injury to the pathology or clinical outcome. The British Athletics Muscle Injury Classification (BAMIC) incorporates recent predictive features of muscle injuries and provides a precise radiographic framework for clinical prediction and management.

Objective: To investigate clinical outcomes, particularly time to return to play (RTP), reinjury rate (RIR), and prognostic value of specific magnetic resonance imaging (MRI) findings, of activity-related muscle injuries (tears) in athletes after application of the BAMIC.

Data Sources: A search of PubMed (NLM), EMBASE (Ovid), Web of Science (Clarivate), Cochrane Library (Wiley), and ClinicalTrials.gov from the inception date of each database through August 31, 2022, was conducted. Keywords included the BAMIC.

Study Selection: All English language studies evaluating clinical outcomes of RTP and RIR after activity-related muscle injuries and where BAMIC was applied were included. A total of 136 articles were identified, and 11 studies met inclusion criteria.

Study Design: Systematic review (PROSPERO: CRD42022353801).

Level Of Evidence: Level 2.

Data Extraction: Two reviewers independently screened studies for eligibility and extracted data. Methodological quality of included study was assessed independently by 2 reviewers with the Newcastle-Ottawa Quality Scale (NOS); 11 good quality studies (4 prospective cohort studies, 7 retrospective cohort studies) with 468 athletes (57 female) and 574 muscle injuries were included.

Results: All studies reported a statistically significant relationship between BAMIC grade, BAMIC injury site, and/or combined BAMIC grade and injury site with RTP. A statistically significant increased RIR was reported by BAMIC grade and BAMIC injury site in 2 of 4 and 3 of 4 studies, respectively. The prognostic value of individual MRI criteria was limited.

Conclusion: Consistent evidence suggests that BAMIC offers prognostic and therapeutic guidance for clinical outcomes, particularly RTP and RIR, after activity-related muscle injuries in athletes that may be superior to previous muscle injury classification and grading systems.

Citing Articles

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PMID: 39422575 PMC: 11726173. DOI: 10.4081/ejtm.2024.12846.

References

Ardern C, Buttner F, Andrade R, Weir A, Ashe M, Holden S . Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and.... Br J Sports Med. 2021; 56(4):175-195. PMC: 8862073. DOI: 10.1136/bjsports-2021-103987. View

Grassi A, Quaglia A, Canata G, Zaffagnini S . An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints. 2016; 4(1):39-46. PMC: 4914372. DOI: 10.11138/jts/2016.4.1.039. View

Kerkhoffs G, van Es N, Wieldraaijer T, Sierevelt I, Ekstrand J, van Dijk C . Diagnosis and prognosis of acute hamstring injuries in athletes. Knee Surg Sports Traumatol Arthrosc. 2012; 21(2):500-9. PMC: 3549245. DOI: 10.1007/s00167-012-2055-x. View

Alonso J, Edouard P, Fischetto G, Adams B, Depiesse F, Mountjoy M . Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. Br J Sports Med. 2012; 46(7):505-14. PMC: 3371221. DOI: 10.1136/bjsports-2012-091008. View

Pezzotta G, Pecorelli A, Querques G, Biancardi S, Morzenti C, Sironi S . MRI characteristics of adductor longus lesions in professional football players and prognostic factors for return to play. Eur J Radiol. 2018; 108:52-58. DOI: 10.1016/j.ejrad.2018.09.018. View

Okoroha K, Conte S, Makhni E, Lizzio V, Camp C, Li B . Hamstring Injury Trends in Major and Minor League Baseball: Epidemiological Findings From the Major League Baseball Health and Injury Tracking System. Orthop J Sports Med. 2019; 7(7):2325967119861064. PMC: 6685122. DOI: 10.1177/2325967119861064. View

Askling C, Tengvar M, Saartok T, Thorstensson A . Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics. Am J Sports Med. 2007; 35(10):1716-24. DOI: 10.1177/0363546507303563. View

Askling C, Tengvar M, Saartok T, Thorstensson A . Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med. 2006; 35(2):197-206. DOI: 10.1177/0363546506294679. View

Pezzotta G, Querques G, Pecorelli A, Nani R, Sironi S . MRI detection of soleus muscle injuries in professional football players. Skeletal Radiol. 2017; 46(11):1513-1520. DOI: 10.1007/s00256-017-2729-z. View

10.

Reurink G, Whiteley R, Tol J . Hamstring injuries and predicting return to play: 'bye-bye MRI?'. Br J Sports Med. 2015; 49(18):1162-3. DOI: 10.1136/bjsports-2015-094771. View

11.

Peetrons P . Ultrasound of muscles. Eur Radiol. 2002; 12(1):35-43. DOI: 10.1007/s00330-001-1164-6. View

12.

Ekstrand J, Hagglund M, Walden M . Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011; 39(6):1226-32. DOI: 10.1177/0363546510395879. View

13.

Gibbs N, Cross T, Cameron M, Houang M . The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. J Sci Med Sport. 2004; 7(2):248-58. DOI: 10.1016/s1440-2440(04)80016-1. View

14.

Patel A, Chakraverty J, Pollock N, Chakraverty R, Suokas A, James S . British athletics muscle injury classification: a reliability study for a new grading system. Clin Radiol. 2015; 70(12):1414-20. DOI: 10.1016/j.crad.2015.08.009. View

15.

Hamilton B, Valle X, Rodas G, Til L, Pruna Grive R, Rincon J . Classification and grading of muscle injuries: a narrative review. Br J Sports Med. 2014; 49(5):306. PMC: 4387470. DOI: 10.1136/bjsports-2014-093551. View

16.

Comin J, Malliaras P, Baquie P, Barbour T, Connell D . Return to competitive play after hamstring injuries involving disruption of the central tendon. Am J Sports Med. 2012; 41(1):111-5. DOI: 10.1177/0363546512463679. View

17.

Schneider-Kolsky M, Hoving J, Warren P, Connell D . A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries. Am J Sports Med. 2006; 34(6):1008-15. DOI: 10.1177/0363546505283835. View

18.

Slavotinek J . Muscle injury: the role of imaging in prognostic assignment and monitoring of muscle repair. Semin Musculoskelet Radiol. 2010; 14(2):194-200. DOI: 10.1055/s-0030-1253160. View

19.

de Visser H, Reijman M, Heijboer M, Bos P . Risk factors of recurrent hamstring injuries: a systematic review. Br J Sports Med. 2011; 46(2):124-30. DOI: 10.1136/bjsports-2011-090317. View

20.

Chan O, Del Buono A, Best T, Maffulli N . Acute muscle strain injuries: a proposed new classification system. Knee Surg Sports Traumatol Arthrosc. 2012; 20(11):2356-62. DOI: 10.1007/s00167-012-2118-z. View