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Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete
  1. Gian Nicola Bisciotti1,2,
  2. Piero Volpi3,4,
  3. Maurizio Amato5,
  4. Giampietro Alberti6,
  5. Francesco Allegra7,
  6. Alessandro Aprato8,
  7. Matteo Artina6,
  8. Alessio Auci9,
  9. Corrado Bait10,
  10. Gian Matteo Bastieri2,
  11. Luca Balzarini3,
  12. Andrea Belli4,
  13. Gianandrea Bellini11,
  14. Pierfrancesco Bettinsoli12,
  15. Alessandro Bisciotti2,
  16. Andrea Bisciotti2,
  17. Stefano Bona3,
  18. Lorenzo Brambilla13,
  19. Marco Bresciani14,
  20. Michele Buffoli15,
  21. Filippo Calanna16,
  22. Gian Luigi Canata17,
  23. Davide Cardinali2,
  24. Giulia Carimati3,
  25. Gabriella Cassaghi2,
  26. Enrico Cautero18,
  27. Emanuele Cena1,
  28. Barbara Corradini2,
  29. Alessandro Corsini4,
  30. Cristina D'Agostino3,
  31. Massimo De Donato3,
  32. Giacomo Delle Rose3,
  33. Francesco Di Marzo19,
  34. Francesco Di Pietto20,
  35. Drapchind Enrica2,
  36. Cristiano Eirale1,
  37. Luigi Febbrari21,
  38. Paolo Ferrua16,
  39. Andrea Foglia22,
  40. Alberto Galbiati4,
  41. Alberto Gheza15,
  42. Carlo Giammattei23,
  43. Francesco Masia3,
  44. Gianluca Melegati13,
  45. Biagio Moretti24,
  46. Lorenzo Moretti24,
  47. Roberto Niccolai4,
  48. Antonio Orgiani3,
  49. Claudio Orizio25,
  50. Andrea Pantalone26,
  51. Federica Parra2,
  52. Paolo Patroni27,
  53. Maria Teresa Pereira Ruiz28,
  54. Marzio Perri29,
  55. Stefano Petrillo30,
  56. Luca Pulici16,
  57. Alessandro Quaglia3,
  58. Luca Ricciotti2,
  59. Francesco Rosa3,
  60. Nicola Sasso31,
  61. Claudio Sprenger4,
  62. Chiara Tarantola2,
  63. Fabio Gianpaolo Tenconi32,
  64. Fabio Tosi2,
  65. Michele Trainini25,
  66. Agostino Tucciarone33,
  67. Ali Yekdah34,
  68. Zarko Vuckovic1,
  69. Raul Zini35,
  70. Karim Chamari1
  1. 1 Qatar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
  2. 2 Centro Studi Kinemove Rehabilitation Centers, Pontremoli, Italy
  3. 3 Istituto Clinico Humanitas, Milano, Italy
  4. 4 FC Internazionale, Milano, Italy
  5. 5 Istituto Clinico S Anna, Brescia, Italy
  6. 6 Università Statale, Milano, Italy
  7. 7 Polo Pontino, Università La Sapienza di Roma, ICOT, Latina, Italy
  8. 8 CTO Hospital, Torino, Italy
  9. 9 UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa-Carrara, Italy
  10. 10 Istituto Clinico Villa Aprica, Como, Italy
  11. 11 Atalanta BC, Bergamo, Italy
  12. 12 Ospedale Carlo Poma, Mantova, Italy
  13. 13 Istituto Ortopedico Galeazzi AC Milan, Milan, Italy
  14. 14 Vicenza Calcio 1902, Vicenza, Italy
  15. 15 Feralpisaló, Salò, Italy
  16. 16 Istituto Ortopedico Gaetano Pini, Milano, Italy
  17. 17 Ospedale e Casa di Cura Koelliker, Torino, Italy
  18. 18 Ospedale di Latisana, Latisana, Italy
  19. 19 Ospedale Unico della Versilia, Asl Nordovest, Lido di Camaiore, Italy
  20. 20 AORNA Cardarelli, Napoli, Italy
  21. 21 Università Cattolica, Milano, Italy
  22. 22 Studio Riabilita, Civitanova Marche, Italy
  23. 23 Azienda USL Toscana Nord Ovest, Lucca, Italy
  24. 24 Azienda Ospedaliero-Universitaria “Policlinico”, Bari, Italy
  25. 25 Università di Brescia, Brescia, Italy
  26. 26 Università di Chieti, Pescara, Italy
  27. 27 Centro Kinetic, Bergamo, Italy
  28. 28 Clinica Montallegro, Genova, Italy
  29. 29 Centro Sanitario, Livorno, Italy
  30. 30 Università Campus Biomedico, Roma, Italy
  31. 31 Federazione Monegasca di Sci, Monaco, Monaco
  32. 32 Studio FKT Tenconi, Genova, Italy
  33. 33 Istituto ‘Marco Pasquali’-ICOT, Latina, Italy
  34. 34 FAF Jenia Centre Med Sport, Algeri, Algeria
  35. 35 Maria Cecilia Hospital, Cotignola, Italy
  1. Correspondence to Dr Alessandro Corsini; sirconi{at}


Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV.

  • muscle
  • biology
  • muscle injuries aetiology
  • imaging
  • muscle injuries classification
  • muscle injury treatment.

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Not required.

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