04
Jun
Musculoskeletal

Muscle Injuries

By Damian Cocciolone

Many of you would be familiar with figure 1 below, that is the classical way that a muscle injury has been described during injury reports on the local sports coverage. ‘What grade is it?’ is a common question you will hear when you tell someone they have a muscle injury (tear). This classification system, can be traced back to Rachun in 1966, who described muscle injuries as Grade 1-mild, Grade 2- moderate and Grade 3- severe. 

Figure 1. Muscle injury classification based around Ruchun’s work in 1966.

 

This classification system has had many variations built on it over the years from different authors/researchers who use both clinical and radiological signs and symptoms to try and add prognostic value (read: how long until I am better?!).

As technology improved, the availability of MRI expanded rapidly and the cost decreased we have started to understand muscle injuries in a far more detailed way. This has helped rehabilitation specialists learn why do some muscle injuries that appear on the surface very similar, have vastly different recover times and re-injury rates.

Figure 2: Anatomical sites of injury within a muscle.

Figure 2 is a modern look at the different sites within a muscle that an injury can occur, and how this interplay between the different tissue at each site can greatly influence severity/time missed and really importantly the direction of your rehabilitation. Particularly when there is tendinous/myotendinous involvement.

Figure 3: MRI representation of various muscular injury sites within a muscle.

 

Now it is perfectly understandable why the old school grade 1-3 system is still used to report injuries in the mainstream media, it’s easy to digest. Just know that there is more to a muscular injury than that!  Being assessed by a health professional who has experience in, and is up to date with modern practise is vital in getting the best outcome for your injury.