Naciągnięcie mięśnia
Rokowania, prognozy i postęp choroby

Naciągnięcia mięśni stanowią jedne z najczęstszych urazów sportowych, szczególnie istotnych u sportowców elitarnych, gdzie szybka i precyzyjna diagnostyka oraz trafne prognozowanie czasu powrotu do aktywności są kluczowe dla skutecznej rehabilitacji. Najważniejsze czynniki prognostyczne obejmują zaangażowanie tkanki łącznej (zwłaszcza ścięgna z retrakcją), lokalizację urazu (ścięgno centralne, proksymalne lub przyczep ścięgna), stopień naciągnięcia (I-III stopień, z czasem gojenia od kilku tygodni do 4-6 miesięcy) oraz historię wcześniejszych urazów kończyn dolnych (OR 21,0; 95% CI 2,5-72,5). Obrazowanie MRI, zwłaszcza z wykorzystaniem klasyfikacji BAMIC, jest złotym standardem w ocenie prognostycznej, uwzględniającym m.in. długość i przekrój obrzęku mięśnia, zaangażowanie ścięgna oraz utratę napięcia, przy czym powrót funkcjonalny może wyprzedzać normalizację sygnału MRI. Wartości graniczne frakcji tłuszczowej (6-8,3%) z MRI Dixon mogą prognozować ryzyko nawrotu urazu.

Naciągnięcie mięśnia – Prognostyka (przewidywanie wyniku leczenia)

Naciągnięcia mięśni (ang. muscle strains) są obecnie jednymi z najczęstszych urazów związanych z aktywnością sportową, których wpływ jest szczególnie znaczący u sportowców elitarnych. Szybka i precyzyjna diagnostyka oraz trafne prognozowanie przebiegu leczenia mają kluczowe znaczenie dla procesu rehabilitacji i powrotu do pełnej sprawności. 12 Chociaż lekkie naciągnięcia mięśni mogą goić się bez interwencji terapeutycznej, w przypadku poważniejszych urazów brak odpowiedniego leczenia, opóźniona diagnoza lub niewłaściwe prognozowanie mogą prowadzić do pogorszenia stanu. 3

Czynniki prognostyczne w naciągnięciu mięśnia

Prognozowanie czasu powrotu do pełnej aktywności po naciągnięciu mięśnia jest złożonym procesem, na który wpływa wiele czynników. Badania pokazują, że istnieją określone cechy charakterystyczne urazu, które mają największe znaczenie prognostyczne:45

  • Zaangażowanie tkanki łącznej – obecność uszkodzenia grubej tkanki łącznej (ścięgno), szczególnie jeśli występuje retrakcja, jest uważana za najgorszy czynnik prognostyczny; typowo objawia się to klinicznie jako utrata funkcji 6
  • Lokalizacja urazu – uszkodzenia dotyczące ścięgna centralnego lub proksymalnego (ścięgno wolne) lub w pobliżu przyczepu ścięgna, zwłaszcza jeśli występuje retrakcja lub utrata napięcia, wiążą się z dłuższym czasem powrotu do sportu 7
  • Stopień naciągnięcia – ciężkość urazu określana w skali od I do III stopnia może wskazywać na czas gojenia: urazy I stopnia goją się zwykle w ciągu kilku tygodni, II stopnia mogą zajmować od kilku tygodni do kilku miesięcy, a III stopnia nawet 4-6 miesięcy po operacji 89
  • Wcześniejsze urazy – historia wcześniejszych urazów mięśni kończyn dolnych jest jednym z najważniejszych czynników ryzyka dla kolejnych naciągnięć (OR 21,0; 95% CI 2,5-72,5) 10

Mniej jednoznaczny wpływ na prognozę mają: rozległość obrzęku mięśnia, długość zmian oraz obecność lub brak krwiaków śródmięśniowych. 11

Systemy klasyfikacji a prognozowanie

Stosowanie standardowych systemów klasyfikacji urazów mięśni ma kluczowe znaczenie dla komunikacji między specjalistami opieki zdrowotnej i dokładnej oceny prognostycznej. 12 Jednym z takich systemów jest British Athletics Muscle Injury Classification (BAMIC), który wykazuje korelację z czasem powrotu do pełnej aktywności sportowej. 13 Badania potwierdzają, że podejście rehabilitacyjne oparte na klasyfikacji BAMIC wiąże się z bardzo niskim odsetkiem nawrotów urazów w grupie sportowców elitarnych. 14

Wyniki badań wskazują, że:1516

  • Skala BAMIC wykazuje istotną korelację z czasem powrotu do gry (R_s=0,64; p=0,02)
  • Oceny radiologów wykorzystujące skalę BAMIC mają największy potencjał w prognozowaniu czasu powrotu do gry po naciągnięciu mięśnia u sportowców
  • Ocena radiologiczna uwzględnia wielkość rozerwania w stosunku do brzuśca mięśnia, zmiany sygnału, pozycję i retrakcję mięśnia, co daje pełniejszy obraz niż pojedyncze pomiary ilościowe

Zaawansowane obrazowanie w prognozowaniu

Obrazowanie rezonansem magnetycznym (MRI) jest uważane za metodę z wyboru w środowisku sportowców elitarnych do przewidywania momentu powrotu do gry po ostrym urazie mięśnia. 17 Kluczowe zmienne MRI, które mają znaczenie prognostyczne, obejmują długość i przekrój poprzeczny obrzęku mięśnia, przekrój poprzeczny zaangażowania ścięgna oraz utratę napięcia. 18

Warto jednak pamiętać, że chociaż MRI jest dobrym narzędziem do oceny procesu gojenia, powrót funkcjonalny poprzedza normalizację nieprawidłowości sygnału MRI. 19 Oznacza to, że zmiany widoczne w badaniach obrazowych mogą utrzymywać się mimo klinicznej poprawy funkcji mięśnia.

Badania nad ilościowym MRI wskazują, że:2021

  • Wolumetryczne analizy MRI reinerwowanych mięśni są wysoce powtarzalne, reagują na czas pooperacyjny i wykazują korelację z klinicznymi wskaźnikami funkcji mięśni
  • Ilościowe pomiary T2 i obrazowanie tensora dyfuzji (DTI) jako pojedyncze pomiary punktowe nie są tak dobrymi predyktorami czasu powrotu do gry jak wizualna ocena radiologiczna

Nowe badania sugerują również, że frakcja tłuszczowa (FF) obliczona z obrazowania MRI Dixon może być używana do przewidywania ryzyka ponownego uszkodzenia, z wartościami granicznymi między 6% a 8,3%, co może umożliwić lepsze planowanie przedoperacyjne i ocenę ryzyka wyników operacyjnych. 2223

Wykorzystanie uczenia maszynowego w prognozowaniu

Coraz większe znaczenie w prognozowaniu urazów mięśni zyskują algorytmy uczenia maszynowego, które przewyższają tradycyjne metody statystyczne. Badania wykazały, że algorytmy takie jak XGBoost przewyższają regresję logistyczną w przewidywaniu naciągnięć mięśni kończyn dolnych, które będą skutkować utratą czasu. 24

Model XGBoost osiągnął najlepszą wydajność na podstawie dyskryminacji ocenianej za pomocą walidacji wewnętrznej (obszar pod krzywą ROC wynoszący 0,840), kalibracji i analizy krzywej decyzyjnej. 25 Wśród najważniejszych zmiennych prognostycznych zidentyfikowanych przez model należy wymienić:

  • Wcześniejszą liczbę urazów kończyn dolnych
  • Wiek
  • Niedawną historię urazów kostki, mięśni hamulcowych lub pachwiny
  • Niedawną historię wstrząśnienia mózgu
  • Wskaźnik prób rzutów za 3 punkty i rzutów wolnych (w przypadku koszykarzy NBA)

Kolejne pięć najważniejszych czynników ryzyka naciągnięcia mięśni kończyn dolnych, w kolejności od najbardziej do najmniej istotnych, to: niedawny uraz mięśnia czworogłowego (OR 4,31; 95% CI 1,21-15,4), niedawny uraz pachwiny (OR 2,9; 95% CI 2,88-2,91), wskaźnik prób rzutów wolnych (OR 2,76; 95% CI 1,27-6), niedawny uraz kostki (OR 2,66; 95% CI 2,65-2,68) i niedawny uraz mięśni hamulcowych (OR 2,39; 95% CI 2,38-2,4). 26

Inne badania także pokazują obiecujące wyniki zastosowania uczenia maszynowego w przewidywaniu czasu regeneracji po urazie mięśni. Różne techniki analityczne mogą identyfikować ukryte zależności między obciążeniem treningowym, zmęczeniem a naciągnięciami mięśni, szczególnie u młodych sportowców. 2728 Modele uczenia maszynowego (np. regresja liniowa) mogą przewidywać szacowany czas regeneracji i pomagać osobom podejmować świadome decyzje dotyczące procesu rehabilitacji. 29

Etapowe podejście do prognozowania

Eksperci zalecają etapowe podejście do dokładnego określania prognozy po naciągnięciu mięśnia, które pozwala na ciągłą ocenę i dostosowanie przewidywań. 30 Podejście to ma trzy główne zalety:

  1. Zmniejsza prawdopodobieństwo nawrotu urazu z powodu zbyt agresywnej rehabilitacji lub przedwczesnego pozwolenia na powrót do gry
  2. Pozwala uniknąć niepotrzebnie zachowawczych ram czasowych powrotu do gry, ponieważ zbieranie danych jest ciągłe
  3. Umożliwia uwzględnienie i zaplanowanie czynników związanych z wydajnością

Ciągłe monitorowanie wydolności mięśnia i reakcji na zwiększanie obciążenia zapewnia najdokładniejsze oszacowanie prognozy. 31 W tym podejściu, funkcjonalne testy kliniczne i ocena wydolności mięśnia mają kluczowe znaczenie dla podjęcia decyzji o powrocie do pełnej aktywności.

Przewidywanie powrotu do pełnej aktywności

Powrót do pełnej aktywności jest zwykle dozwolony, gdy pacjent nie odczuwa bólu, ma pełen zakres ruchu i pełną siłę mięśniową. 32 Badania sugerują, że powrót do sportu przed upływem 4-6 tygodni prowadzi do zwiększonego ryzyka urazu. Bardziej poważne urazy mogą wymagać nawet 4-6 miesięcy do całkowitego wyleczenia. 33

Większość osób całkowicie wyzdrowieje po naciągnięciu mięśnia, nawet poważnym. Jednak sposób, w jaki mięsień jest leczony podczas rekonwalescencji, może wpłynąć na jakość jego gojenia. W niektórych przypadkach w mięśniu może pozostać tkanka bliznowata, która jest sztywniejsza i bardziej krucha niż zdrowa tkanka mięśniowa. Zwiększa to ryzyko ponownego naderwania mięśnia. 34 Badania wskazują, że wielu sportowców jest w stanie powrócić do poprzedniego poziomu rywalizacji, ale ponieważ w miejscu urazu tworzy się tkanka bliznowata, mogą być podatni na kolejny uraz w tej lokalizacji. 35

Warto zaznaczyć, że chociaż stosowanie leków przeciwzapalnych może być pomocne w kontrolowaniu bólu, nie ma przekonujących danych, że NLPZ (niesteroidowe leki przeciwzapalne) poprawiają gojenie lub skracają czas powrotu do gry. 36

Perspektywy na przyszłość

Przyszłe kierunki w prognozowaniu naciągnięć mięśniowych zmierzają w stronę bardziej zintegrowanych i spersonalizowanych metod. Wierzy się, że zintegrowany system do noszenia, umożliwiający synergię analiz fizjologicznych i biochemicznych, zostanie zrealizowany w przyszłości do diagnozowania i prognozowania urazów mięśni wywołanych ćwiczeniami w miejscu opieki. 3738

Ponieważ urazy mięśni wywołane ćwiczeniami są zwykle procesami przewlekłymi, długoterminowa, ciągła i jednoczesna rejestracja wielu kluczowych parametrów związanych z urazami mięśni za pomocą metod fizjologicznych, obrazowych, biochemicznych i patologicznych może zapewnić skuteczny i dokładny wgląd w diagnozę i prognozę urazów mięśni. 39

Opracowywane urządzenia mają być przenośne lub możliwe do noszenia, aby oferować użytkownikom łatwy dostęp do wnikliwych informacji o urazach mięśni, zmniejszając koszty ekonomiczne i poprawiając efektywność medyczną. Potencjalna strategia może polegać na opracowaniu systemu do noszenia w połączeniu ze smartfonem, w którym system monitoruje, zbiera i przesyła surowe dane do smartfona w celu przechowywania, przetwarzania i analizy informacji. 40

Dalsze badania nad biologią tkanki mięśniowej, procesami regeneracji oraz wykorzystaniem nowych technologii w monitorowaniu i wspieraniu procesu gojenia mogą przynieść przełomowe metody prognostyczne i terapeutyczne w przyszłości. 41

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impact of which is particularly significant in elite athletes. […] This variability is of great clinical importance in determining the prognosis of muscle injuries. […] This differentiation is of great clinical relevance in determining the significance and prognosis of muscle injuries. […] The most frequent mechanism of lower limb muscle injuries is an indirect injury (muscle strain) associated with both sprinting and stretching activities. […] Clinically, muscle strains are characterized by a sudden onset of pain usually localized in a specific muscle compartment during a period of eccentric contraction, which, depending on severity, may immediately prevent the athlete from continuing the sports activity.
  • #2 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9057463/
    With the development of modern society, we have witnessed a significant increase of people who join in sport exercises, which also brings significantly increasing exercise-induced muscle injuries, resulting in reduction and even cessation of participation in sports and physical activities. […] Therefore, timely diagnosis and prognosis of muscle injuries is important to the recovery of injured muscles. […] Although light exercise-induced muscle injuries can heal without therapeutic intervention, for severe muscle injuries, lack of therapeutic intervention, delayed diagnosis or inappropriate prognosis may cause exacerbation of the injuries. […] Therefore, both professional and recreational population demand for a clear understanding of and accurate diagnosis and prognosis for muscle injuries.
  • #3 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9057463/
    With the development of modern society, we have witnessed a significant increase of people who join in sport exercises, which also brings significantly increasing exercise-induced muscle injuries, resulting in reduction and even cessation of participation in sports and physical activities. […] Therefore, timely diagnosis and prognosis of muscle injuries is important to the recovery of injured muscles. […] Although light exercise-induced muscle injuries can heal without therapeutic intervention, for severe muscle injuries, lack of therapeutic intervention, delayed diagnosis or inappropriate prognosis may cause exacerbation of the injuries. […] Therefore, both professional and recreational population demand for a clear understanding of and accurate diagnosis and prognosis for muscle injuries.
  • #4 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    The presence of thick connective tissue (tendon) especially if there is retraction is considered to be the worst prognostic sign; this is typically manifested clinically as loss of function. […] The optimal timing of MRI following lower limb muscle injury has not been defined and has been mainly based on expert opinions. […] The assessment of the MRI images should be performed in the context of the clinical diagnosis of the sports physician, the mechanism of injury, the findings of physical examination, and, if performed, the results of other diagnostic imaging modalities such as musculoskeletal ultrasound (US). […] In the setting of elite athletes, MRI is considered the imaging modality of choice for predicting the moment to return to play after acute muscle injury, together with other player-related factors (e.g., position of the player in the team, time of the season, etc.).
  • #5 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Connective tissue involvement is related to prolonged return to sport, particularly if it is a central or proximal tendon (free tendon) or near the tendon origin, and especially if there is retraction or loss of tension. […] The extension of muscular edema, the length of lesions, or the presence or absence of intramuscular hematomas are not as clearly related to time to return to sport. […] However, the issue of return to play is complex. […] Despite the limitations of the classification systems, a code-based categorization of muscle injuries provides a common language and ensures clear and accurate communication between all health care professionals involved (sports medicine physicians, radiologists, orthopedists, physiotherapists, etc.). […] Standardized radiological reporting and classification/staging of lesions in association with other clinical factors allow physicians to more accurately assess the severity of an injury, as well as to establish a treatment plan, recovery program and to estimate the expected time to return to sport. […] Although MRI is a good tool for assessing the healing process, it is important to keep in mind that functional recovery precedes normalization of MRI signal abnormalities.
  • #6 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    The presence of thick connective tissue (tendon) especially if there is retraction is considered to be the worst prognostic sign; this is typically manifested clinically as loss of function. […] The optimal timing of MRI following lower limb muscle injury has not been defined and has been mainly based on expert opinions. […] The assessment of the MRI images should be performed in the context of the clinical diagnosis of the sports physician, the mechanism of injury, the findings of physical examination, and, if performed, the results of other diagnostic imaging modalities such as musculoskeletal ultrasound (US). […] In the setting of elite athletes, MRI is considered the imaging modality of choice for predicting the moment to return to play after acute muscle injury, together with other player-related factors (e.g., position of the player in the team, time of the season, etc.).
  • #7 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Connective tissue involvement is related to prolonged return to sport, particularly if it is a central or proximal tendon (free tendon) or near the tendon origin, and especially if there is retraction or loss of tension. […] The extension of muscular edema, the length of lesions, or the presence or absence of intramuscular hematomas are not as clearly related to time to return to sport. […] However, the issue of return to play is complex. […] Despite the limitations of the classification systems, a code-based categorization of muscle injuries provides a common language and ensures clear and accurate communication between all health care professionals involved (sports medicine physicians, radiologists, orthopedists, physiotherapists, etc.). […] Standardized radiological reporting and classification/staging of lesions in association with other clinical factors allow physicians to more accurately assess the severity of an injury, as well as to establish a treatment plan, recovery program and to estimate the expected time to return to sport. […] Although MRI is a good tool for assessing the healing process, it is important to keep in mind that functional recovery precedes normalization of MRI signal abnormalities.
  • #8 Muscle Strains: Causes, Symptoms, Treatment & Recovery
    https://my.clevelandclinic.org/health/diseases/22336-muscle-strains
    Muscle strains can be minor to major. A mild strain might only break tiny fibers within the fabric of your muscle, while a severe one can tear through it. Strains are painful, but most can heal with time and rest. […] Healthcare providers also grade muscle strains by how severe they are. […] If you only have a minor (grade I) muscle strain, it should heal within a few weeks. Moderate (grade II) muscle strains may take several weeks to months to heal completely. A severe (grade III) muscle strain can take four to six months to heal after surgery. […] Most people recover completely from a muscle strain, even a severe one. But how you treat your muscle during recovery can affect how well it heals. In some cases, the muscle might retain some scar tissue, which is stiffer and more brittle than healthy muscle tissue. This makes it easier to tear the muscle again. You might have to be more mindful of how you use your muscle in the future.
  • #9 Muscle Strain – Harvard Health
    https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z
    Recovery depends on the location and severity of your muscle strain. In general, almost all Grade I strains heal within a few weeks, whereas Grade II strains may take two to three months or longer. […] After surgery to repair a Grade III strain, most people regain normal muscle function after several months of rehabilitation.
  • #10
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9340342/
    Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. […] The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis. […] The most important risk factor for LEMS was previous injury count (OR, 21.0; 95% CI, 2.5-72.5). […] The next 5 most important risk factors for LEMS, in order from most to least contributory, were recent quadriceps injury (OR, 4.31; 95% CI, 1.21-15.4), recent groin injury (OR, 2.9; 95% CI, 2.88-2.91), free throw attempt rate (OR, 2.76; 95% CI, 1.27-6), recent ankle injury (OR, 2.66; 95% CI, 2.65-2.68), and recent hamstring injury (OR, 2.39; 95% CI, 2.38-2.4). […] The XGBoost model had the highest overall AUC, with comparable calibration and Brier scores, and was therefore chosen as the best-performing candidate algorithm.
  • #11 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Connective tissue involvement is related to prolonged return to sport, particularly if it is a central or proximal tendon (free tendon) or near the tendon origin, and especially if there is retraction or loss of tension. […] The extension of muscular edema, the length of lesions, or the presence or absence of intramuscular hematomas are not as clearly related to time to return to sport. […] However, the issue of return to play is complex. […] Despite the limitations of the classification systems, a code-based categorization of muscle injuries provides a common language and ensures clear and accurate communication between all health care professionals involved (sports medicine physicians, radiologists, orthopedists, physiotherapists, etc.). […] Standardized radiological reporting and classification/staging of lesions in association with other clinical factors allow physicians to more accurately assess the severity of an injury, as well as to establish a treatment plan, recovery program and to estimate the expected time to return to sport. […] Although MRI is a good tool for assessing the healing process, it is important to keep in mind that functional recovery precedes normalization of MRI signal abnormalities.
  • #12 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Connective tissue involvement is related to prolonged return to sport, particularly if it is a central or proximal tendon (free tendon) or near the tendon origin, and especially if there is retraction or loss of tension. […] The extension of muscular edema, the length of lesions, or the presence or absence of intramuscular hematomas are not as clearly related to time to return to sport. […] However, the issue of return to play is complex. […] Despite the limitations of the classification systems, a code-based categorization of muscle injuries provides a common language and ensures clear and accurate communication between all health care professionals involved (sports medicine physicians, radiologists, orthopedists, physiotherapists, etc.). […] Standardized radiological reporting and classification/staging of lesions in association with other clinical factors allow physicians to more accurately assess the severity of an injury, as well as to establish a treatment plan, recovery program and to estimate the expected time to return to sport. […] Although MRI is a good tool for assessing the healing process, it is important to keep in mind that functional recovery precedes normalization of MRI signal abnormalities.
  • #13 A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach | British Journal of Sports Medicine
    https://bjsm.bmj.com/content/56/5/257
    The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. […] The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. […] The BAMIC injury grade and the intratendon class c injury are associated with increased time to return to full training in elite track and field. […] The cross-sectional area of tendon involvement and loss of tension are associated with time to return to full training rather than length of tendon involvement. […] The implementation of the BAMIC rehabilitation approach to hamstring injuries was associated with a very low reinjury rate in this elite athlete cohort. […] The key MRI variables are length and cross-section of muscle oedema, CSA of tendon involvement and loss of tension.
  • #14 A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach | British Journal of Sports Medicine
    https://bjsm.bmj.com/content/56/5/257
    The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. […] The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. […] The BAMIC injury grade and the intratendon class c injury are associated with increased time to return to full training in elite track and field. […] The cross-sectional area of tendon involvement and loss of tension are associated with time to return to full training rather than length of tendon involvement. […] The implementation of the BAMIC rehabilitation approach to hamstring injuries was associated with a very low reinjury rate in this elite athlete cohort. […] The key MRI variables are length and cross-section of muscle oedema, CSA of tendon involvement and loss of tension.
  • #15
    https://link.springer.com/article/10.1007/s00330-020-06999-z
    To assess the ability of quantitative T2, diffusion tensor imaging (DTI) and radiologists scores to detect muscle changes following acute muscle tear in soccer and rugby players. To assess the ability of these parameters to predict return to play times. […] BAMIC scores showed a significant correlation with return to play time (R_s=0.64; p=0.02), but modified Peetrons scores and quantitative parameters did not. […] Although BAMIC scores correlated well with return to play times, in this small study, quantitative MRI values did not, suggesting that T2 and DTI measurements are inferior predictors of return to play time compared with visual scoring. […] Measurements of T2 and diffusion using MRI are not as good as a radiologists visual report at predicting return to play time after acute muscle tear.
  • #16
    https://link.springer.com/article/10.1007/s00330-020-06999-z
    Our results suggest that single-point ROI-based quantitative T2 and DTI measurements are not adequate predictors of return to play time. We would recommend radiologists BAMIC scores as having the most potential to predict return to play times post muscle tear in athletes. […] Although BAMIC scores correlated with return to play time (supporting previous studies) and with quantitative MRI, it is disappointing that quantitative MRI measurements did not independently correlate with return to play time. This is likely due to the limited scope of a single ROI-based measurement within the tear site compared with the radiologists score, which takes into account the tear size relative to the muscle belly, signal changes, position, and muscle retraction. […] Our conclusion remains that quantitative T2 and DTI values are not good predictors of return to play time.
  • #17 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    The presence of thick connective tissue (tendon) especially if there is retraction is considered to be the worst prognostic sign; this is typically manifested clinically as loss of function. […] The optimal timing of MRI following lower limb muscle injury has not been defined and has been mainly based on expert opinions. […] The assessment of the MRI images should be performed in the context of the clinical diagnosis of the sports physician, the mechanism of injury, the findings of physical examination, and, if performed, the results of other diagnostic imaging modalities such as musculoskeletal ultrasound (US). […] In the setting of elite athletes, MRI is considered the imaging modality of choice for predicting the moment to return to play after acute muscle injury, together with other player-related factors (e.g., position of the player in the team, time of the season, etc.).
  • #18 A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach | British Journal of Sports Medicine
    https://bjsm.bmj.com/content/56/5/257
    The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. […] The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. […] The BAMIC injury grade and the intratendon class c injury are associated with increased time to return to full training in elite track and field. […] The cross-sectional area of tendon involvement and loss of tension are associated with time to return to full training rather than length of tendon involvement. […] The implementation of the BAMIC rehabilitation approach to hamstring injuries was associated with a very low reinjury rate in this elite athlete cohort. […] The key MRI variables are length and cross-section of muscle oedema, CSA of tendon involvement and loss of tension.
  • #19 Sports-related lower limb muscle injuries: pattern recognition approach and MRI review | Insights into Imaging | Full Text
    https://insightsimaging.springeropen.com/articles/10.1186/s13244-020-00912-4
    Connective tissue involvement is related to prolonged return to sport, particularly if it is a central or proximal tendon (free tendon) or near the tendon origin, and especially if there is retraction or loss of tension. […] The extension of muscular edema, the length of lesions, or the presence or absence of intramuscular hematomas are not as clearly related to time to return to sport. […] However, the issue of return to play is complex. […] Despite the limitations of the classification systems, a code-based categorization of muscle injuries provides a common language and ensures clear and accurate communication between all health care professionals involved (sports medicine physicians, radiologists, orthopedists, physiotherapists, etc.). […] Standardized radiological reporting and classification/staging of lesions in association with other clinical factors allow physicians to more accurately assess the severity of an injury, as well as to establish a treatment plan, recovery program and to estimate the expected time to return to sport. […] Although MRI is a good tool for assessing the healing process, it is important to keep in mind that functional recovery precedes normalization of MRI signal abnormalities.
  • #20 Volumetric MRI is a promising outcome measure of muscle reinnervation | Scientific Reports
    https://www.nature.com/articles/s41598-021-01342-y
    The development of outcome measures that can track the recovery of reinnervated muscle would benefit the clinical investigation of new therapies which hope to enhance peripheral nerve repair. […] In summary, volumetric MRI analysis of reinnervated muscle is highly reproducible, responsive to post-operative time and demonstrates correlation with clinical indices of muscle function. This encourages the view that volumetric MRI is a promising outcome measure for muscle reinnervation which will drive advancements in motor recovery therapy. […] The development of responsive outcome measures is critical in the context of clinical nerve repair research. Successful clinical translation of novel regenerative therapies will likely depend on the ability of outcome measures to capture small incremental changes over time.
  • #21 Volumetric MRI is a promising outcome measure of muscle reinnervation | Scientific Reports
    https://www.nature.com/articles/s41598-021-01342-y
    Quantification of reinnervated elbow flexor muscle volume per unit BMI demonstrated improved responsiveness when compared with conventional neurophysiological indicators of muscle reinnervation. […] This suggests that the clinical assessment of reinnervated muscular function should go beyond PVF measurement alone to better embody the recovery of afferent muscular function. […] SPONEA was found to be responsive to volumetric measurements. This encourages the view that percentage of normal assessments should be more widely adopted by clinicians as a subjective evaluation of reinnervated muscular function. […] In summary, volumetric MRI demonstrates reproducibility, temporal responsiveness and correlation with clinical assessments of muscular function. This suggests volumetric MRI is an excellent candidate as an outcome measure of muscle reinnervation.
  • #22
    https://journals.lww.com/investigativeradiology/fulltext/2024/04000/fat_fractions_of_the_rotator_cuff_muscles_acquired.7.aspx
    The aim of this study was to quantify and compare fat fraction (FF) and muscle volume between patients with failed and intact rotator cuff (RC) repair as well as a control group with nonsurgical conservative treatment to define FF cutoff values for predicting the outcome of RC repair. […] Receiver operator characteristics curves showed reliable preoperative FF cutoff values for predicting retears at 6.0% for the supraspinatus muscle (0.83 area under the curve [AUC]), 7.4% for the infraspinatus muscle (AUC 0.82), and 8.3% for the subscapularis muscle (0.94 AUC). […] Preoperative quantitative FF calculated from 2-point Dixon MRI can be used to predict the risk of retear after arthroscopic RC repair with cutoff values between 6% and 8.3%. […] Higher preoperative FFs were detected for the RC muscles with ultimately failed RC repair, when compared with those with intact RC repairs.
  • #23
    https://journals.lww.com/investigativeradiology/fulltext/2024/04000/fat_fractions_of_the_rotator_cuff_muscles_acquired.7.aspx
    A significant increase in FF for all RC muscles approximately 1.5 years after diagnosis of tear was detected in the failed RC repair group and the conservative treatment group, but not in the intact RC repair group. […] In summary, 2-point Dixon quantification FF of the RC muscles can be used to predict the risk of retear after arthroscopic RC repair. With the present study reporting on the largest patient cohort with failed RC repairs so far, we analyzed preoperative and postoperative FF measurements and were able to establish cutoff values for RC muscle FF ranging from 6% to 8.3%, which might enable better preoperative planning and risk assessment of surgical outcomes.
  • #24
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9340342/
    Machine learning algorithms such as XGBoost outperformed logistic regression in the prediction of a LEMS that will result in lost time. […] Several variables increased the risk of LEMS, including a history of various lower extremity injuries, recent concussion, and total number of previous injuries. […] The purpose of this study was to (1) characterize the epidemiology of time-loss lower extremity muscle strains (LEMSs) in the National Basketball Association (NBA) from 1999 to 2019 and (2) determine the validity of a machine-learning model in predicting injury risk. […] It was hypothesized that time-loss LEMSs would be infrequent in this cohort and that a machine-learning model would outperform conventional methods in the prediction of injury risk. […] A total of 736 LEMSs resulting in lost playing time occurred among 2103 athletes.
  • #25
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9340342/
    Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. […] The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis. […] The most important risk factor for LEMS was previous injury count (OR, 21.0; 95% CI, 2.5-72.5). […] The next 5 most important risk factors for LEMS, in order from most to least contributory, were recent quadriceps injury (OR, 4.31; 95% CI, 1.21-15.4), recent groin injury (OR, 2.9; 95% CI, 2.88-2.91), free throw attempt rate (OR, 2.76; 95% CI, 1.27-6), recent ankle injury (OR, 2.66; 95% CI, 2.65-2.68), and recent hamstring injury (OR, 2.39; 95% CI, 2.38-2.4). […] The XGBoost model had the highest overall AUC, with comparable calibration and Brier scores, and was therefore chosen as the best-performing candidate algorithm.
  • #26
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9340342/
    Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. […] The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis. […] The most important risk factor for LEMS was previous injury count (OR, 21.0; 95% CI, 2.5-72.5). […] The next 5 most important risk factors for LEMS, in order from most to least contributory, were recent quadriceps injury (OR, 4.31; 95% CI, 1.21-15.4), recent groin injury (OR, 2.9; 95% CI, 2.88-2.91), free throw attempt rate (OR, 2.76; 95% CI, 1.27-6), recent ankle injury (OR, 2.66; 95% CI, 2.65-2.68), and recent hamstring injury (OR, 2.39; 95% CI, 2.38-2.4). […] The XGBoost model had the highest overall AUC, with comparable calibration and Brier scores, and was therefore chosen as the best-performing candidate algorithm.
  • #27 Predictive Analytic Techniques to Identify Hidden Relationships between Training Load, Fatigue and Muscle Strains in Young Soccer Players
    https://www.mdpi.com/2075-4663/10/1/3
    This study aimed to analyze different predictive analytic techniques to forecast the risk of muscle strain injuries (MSI) in youth soccer based on training load data. […] Most of the injuries occurring in youth soccer primarily involve lower extremities, and among them muscle strains are more frequently reported (~35%). […] Indeed, an injury may determine long-term sequelae, time-loss from sport participation, and a higher probability to incur in a re-injury in the future, jeopardizing the talent development processes. […] Muscle strains are a complex multifactorial phenomenon. […] Therefore, monitoring and quantifying the athletes’ state of fatigue in response to training/match is extremely important to take timely preventive measures. […] To fill these limitations, it is not possible to rely on traditional linear statistical models. Differently, predictive analytics may be more suitable to achieve this scope.
  • #28 Predictive Analytic Techniques to Identify Hidden Relationships between Training Load, Fatigue and Muscle Strains in Young Soccer Players
    https://www.mdpi.com/2075-4663/10/1/3
    The purpose of the current study is to employ data mining algorithms to identify the hidden relationship between training load, neuromuscular fatigue, and the onset of muscle strains in young soccer players during the season. […] We hypothesized that the predictive analytic techniques could be effective in predicting the risk of muscle strains in young soccer players, as well as the combination of several factors as training load, recovery, and maturity status could modify this predisposition. […] The SVM of this study exhibited the best performance, but only when the three training sessions before MSI were included in the model (SVM-lag). […] The risk of MSI in young soccer players could change in relation to maturity status and anthropometric factors. […] Moreover, a higher neuromuscular fatigue and workload, together with a lower recovery status could increase their susceptibility to injury.
  • #29
    https://medium.com/@gowthamd997/muscle-injury-recovery-prediction-using-machine-learning-gradio-3a4ad13aa619
    Muscle injuries are common among athletes and fitness enthusiasts. The recovery time varies based on multiple factors such as age, weight, training intensity, and previous injuries. Using Machine Learning (Linear Regression), we can predict the estimated recovery time and help individuals make informed decisions about their rehabilitation process. […] Our goal is to build a Machine Learning model that predicts Recovery Time based on the above features. […] After training, we evaluate the model: […] Once the script is executed, Gradio will generate a URL where users can enter their details and get a predicted recovery time along with a visualization. […] With Machine Learning, we can estimate muscle injury recovery time and help athletes optimize their training. Using Gradio, we created an interactive app to predict and visualize recovery factors.
  • #30 The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians | Sports Medicine – Open | Full Text
    https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-021-00364-0
    Experts followed a rigorous process during the clinical examination of calf muscle strain injuries to establish the diagnosis, make an estimate regarding prognosis, and to design an appropriate rehabilitation program. […] Ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. […] Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. […] A staged approach for accurately determining prognosis after CMSI was identified from information provided by experts. […] Experts perceived the value of staging the approach to be three-fold: (1) recurrence due to overly aggressive rehabilitation or premature RTP clearance was less likely, (2) unnecessarily conservative RTP time frames were avoided because data-gathering is ongoing, and (3) performance-related factors are able to be considered and planned for.
  • #31 The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians | Sports Medicine – Open | Full Text
    https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-021-00364-0
    Experts followed a rigorous process during the clinical examination of calf muscle strain injuries to establish the diagnosis, make an estimate regarding prognosis, and to design an appropriate rehabilitation program. […] Ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. […] Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. […] A staged approach for accurately determining prognosis after CMSI was identified from information provided by experts. […] Experts perceived the value of staging the approach to be three-fold: (1) recurrence due to overly aggressive rehabilitation or premature RTP clearance was less likely, (2) unnecessarily conservative RTP time frames were avoided because data-gathering is ongoing, and (3) performance-related factors are able to be considered and planned for.
  • #32 Muscle Strain: What You Need to Know About Pulled Muscles
    https://www.hss.edu/conditions_muscle-strain.asp
    After this inflammatory phase, the muscle begins to heal by regenerating muscle fibers. However, a significant amount of scar tissue also forms where the muscle was injured. […] While the use of anti-inflammatory medication can be helpful to control pain, there is no convincing data that NSAIDs (nonsteroidal anti-inflammatory drugs) improve healing or decrease time to return to play. […] Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may be susceptible to another injury at that location. […] Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. […] Data would suggest that returning to sport before 4 to 6 weeks leads to an increased risk of injury. More severe injuries can even take 4 to 6 months to resolve. […] Research is ongoing, so who knows what the future may hold.
  • #33 Muscle Strain: What You Need to Know About Pulled Muscles
    https://www.hss.edu/conditions_muscle-strain.asp
    After this inflammatory phase, the muscle begins to heal by regenerating muscle fibers. However, a significant amount of scar tissue also forms where the muscle was injured. […] While the use of anti-inflammatory medication can be helpful to control pain, there is no convincing data that NSAIDs (nonsteroidal anti-inflammatory drugs) improve healing or decrease time to return to play. […] Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may be susceptible to another injury at that location. […] Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. […] Data would suggest that returning to sport before 4 to 6 weeks leads to an increased risk of injury. More severe injuries can even take 4 to 6 months to resolve. […] Research is ongoing, so who knows what the future may hold.
  • #34 Muscle Strains: Causes, Symptoms, Treatment & Recovery
    https://my.clevelandclinic.org/health/diseases/22336-muscle-strains
    Muscle strains can be minor to major. A mild strain might only break tiny fibers within the fabric of your muscle, while a severe one can tear through it. Strains are painful, but most can heal with time and rest. […] Healthcare providers also grade muscle strains by how severe they are. […] If you only have a minor (grade I) muscle strain, it should heal within a few weeks. Moderate (grade II) muscle strains may take several weeks to months to heal completely. A severe (grade III) muscle strain can take four to six months to heal after surgery. […] Most people recover completely from a muscle strain, even a severe one. But how you treat your muscle during recovery can affect how well it heals. In some cases, the muscle might retain some scar tissue, which is stiffer and more brittle than healthy muscle tissue. This makes it easier to tear the muscle again. You might have to be more mindful of how you use your muscle in the future.
  • #35 Muscle Strain: What You Need to Know About Pulled Muscles
    https://www.hss.edu/conditions_muscle-strain.asp
    After this inflammatory phase, the muscle begins to heal by regenerating muscle fibers. However, a significant amount of scar tissue also forms where the muscle was injured. […] While the use of anti-inflammatory medication can be helpful to control pain, there is no convincing data that NSAIDs (nonsteroidal anti-inflammatory drugs) improve healing or decrease time to return to play. […] Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may be susceptible to another injury at that location. […] Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. […] Data would suggest that returning to sport before 4 to 6 weeks leads to an increased risk of injury. More severe injuries can even take 4 to 6 months to resolve. […] Research is ongoing, so who knows what the future may hold.
  • #36 Muscle Strain: What You Need to Know About Pulled Muscles
    https://www.hss.edu/conditions_muscle-strain.asp
    After this inflammatory phase, the muscle begins to heal by regenerating muscle fibers. However, a significant amount of scar tissue also forms where the muscle was injured. […] While the use of anti-inflammatory medication can be helpful to control pain, there is no convincing data that NSAIDs (nonsteroidal anti-inflammatory drugs) improve healing or decrease time to return to play. […] Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may be susceptible to another injury at that location. […] Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. […] Data would suggest that returning to sport before 4 to 6 weeks leads to an increased risk of injury. More severe injuries can even take 4 to 6 months to resolve. […] Research is ongoing, so who knows what the future may hold.
  • #37 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9057463/
    It is believed that an integrated wearable system that enables physiological and biochemical analyses will be realized in the future for diagnosing and prognosing exercise-induced muscle injuries at the point of care. […] To start, since exercise-induced muscle injuries are usually chronic processes, long-term, continuous and simultaneous recording of multiple key parameters associated with muscle injuries through physiological, imaging, biochemical, and pathological ways can provide effective and accurate insight for the diagnosis and prognosis of muscle injuries.
  • #38 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing – RSC Advances (RSC Publishing) DOI:10.1039/D0RA07321K
    https://pubs.rsc.org/en/content/articlehtml/2020/ra/d0ra07321k
    It is believed that an integrated wearable system that enables a synergy of physiological and biochemical analyses will be realized in the future for diagnosing and prognosing exercise-induced muscle injuries at the point of care. […] The developed devices are expected to be portable or wearable to offer users with easy accessibility to insightful information about muscle injuries, reducing the economic cost and improving the medical efficiency. […] To start, since exercise-induced muscle injuries are usually chronic processes, long-term, continuous and simultaneous recording of multiple key parameters associated with muscle injuries through physiological, imaging, biochemical, and pathological ways can provide effective and accurate insight for the diagnosis and prognosis of muscle injuries. […] A potential strategy may be developing a wearable system combined with a smartphone in which the wearable system monitors, collects and transmits raw data to the smartphone for information storage, processing and analyses.
  • #39 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing – RSC Advances (RSC Publishing) DOI:10.1039/D0RA07321K
    https://pubs.rsc.org/en/content/articlehtml/2020/ra/d0ra07321k
    It is believed that an integrated wearable system that enables a synergy of physiological and biochemical analyses will be realized in the future for diagnosing and prognosing exercise-induced muscle injuries at the point of care. […] The developed devices are expected to be portable or wearable to offer users with easy accessibility to insightful information about muscle injuries, reducing the economic cost and improving the medical efficiency. […] To start, since exercise-induced muscle injuries are usually chronic processes, long-term, continuous and simultaneous recording of multiple key parameters associated with muscle injuries through physiological, imaging, biochemical, and pathological ways can provide effective and accurate insight for the diagnosis and prognosis of muscle injuries. […] A potential strategy may be developing a wearable system combined with a smartphone in which the wearable system monitors, collects and transmits raw data to the smartphone for information storage, processing and analyses.
  • #40 Diagnosis and prognosis for exercise-induced muscle injuries: from conventional imaging to emerging point-of-care testing – RSC Advances (RSC Publishing) DOI:10.1039/D0RA07321K
    https://pubs.rsc.org/en/content/articlehtml/2020/ra/d0ra07321k
    It is believed that an integrated wearable system that enables a synergy of physiological and biochemical analyses will be realized in the future for diagnosing and prognosing exercise-induced muscle injuries at the point of care. […] The developed devices are expected to be portable or wearable to offer users with easy accessibility to insightful information about muscle injuries, reducing the economic cost and improving the medical efficiency. […] To start, since exercise-induced muscle injuries are usually chronic processes, long-term, continuous and simultaneous recording of multiple key parameters associated with muscle injuries through physiological, imaging, biochemical, and pathological ways can provide effective and accurate insight for the diagnosis and prognosis of muscle injuries. […] A potential strategy may be developing a wearable system combined with a smartphone in which the wearable system monitors, collects and transmits raw data to the smartphone for information storage, processing and analyses.
  • #41 Muscle Strain: What You Need to Know About Pulled Muscles
    https://www.hss.edu/conditions_muscle-strain.asp
    After this inflammatory phase, the muscle begins to heal by regenerating muscle fibers. However, a significant amount of scar tissue also forms where the muscle was injured. […] While the use of anti-inflammatory medication can be helpful to control pain, there is no convincing data that NSAIDs (nonsteroidal anti-inflammatory drugs) improve healing or decrease time to return to play. […] Many athletes are able to return to their previous level of competition, but since scar tissue forms at the site of injury, they may be susceptible to another injury at that location. […] Return to full activity is usually allowed when the patient is pain free, has full range of motion, and full strength. […] Data would suggest that returning to sport before 4 to 6 weeks leads to an increased risk of injury. More severe injuries can even take 4 to 6 months to resolve. […] Research is ongoing, so who knows what the future may hold.