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- Issue 99
- Calf strains in athletes: a narrative…
Calf strains in athletes: a narrative review of management, injury grading, and return to sport
Key Points
- This narrative review explored the relationship between imaging-based grading of calf muscle strains and time to return to sport (RTS).
BACKGROUND & OBJECTIVE
Strains of the calf muscles (gastrocnemius and soleus) are common in sports that require explosive plantar flexion, such as football, rugby, and tennis (1). Traditionally, these injuries have been graded based on functional impairment and muscle fiber disruption observed on imaging. Grades are typically classified as either mild (minimal functional loss and disruption), moderate (inability to walk, weakness, and 10-50% disruption), or severe (complete functional loss, >50% disruption) (2).
Ideally, injury grading could provide prognostic value for return to sport (RTS), similar to the British Athletics Muscle Injury Classification (BAMIC) framework for hamstring injuries (3). New grading systems of calf strains that include the specific location of the strain have been proposed and may have a stronger relationship with time to RTS (4).
Given the lack of consensus on the optimal grading system for predicting recovery and RTS timelines, this narrative review explored the relationship between imaging-based grading and RTS after calf strains.
Imaging is useful for differentiating between affected tissues, identifying tendinous or aponeurotic disruption, ruling out concomitant injuries, and exploring cases of prolonged symptoms.
METHODS
The authors systematically searched two databases (PubMed and Scopus). They included original research on athletes of all levels that imaged calf muscle injuries using MRI or ultrasound, described injury severity, and assessed the relationship thereof with RTS timelines. They excluded