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Muscle strain accounts for ~30% of all football injuries1 and engages medical staff in a complicated process of diagnostic and management. In 90% of the cases, muscle strains affect hamstrings, rectus femoris, adductors, soleus and gastrocnemius.2 3 In particular, into the group of the so-called minor muscle injuries, a subgroup defined ‘non-structural muscle injuries’ (NSI) has been identified.2 The NSIs do not present any visible muscle fibre lesion at MRI and ultrasound examination and are classified as grade 1a, 1b2 or zero3 according to the latest classifications.2 3 Moreover, they are fare from being rare as they account for 30% – 40% of all muscle lesions recorded by professional football clubs.1 Despite the fact that NSIs are not detected by imaging, they can have functional sequelae.2 3
The challenge of diagnosing subtle muscle strains
The player affected by NSI generally loses between 1 and 7 days of training/match exposure, and the diagnosis of this type of injury can be challenging. Many medical centres are not adequately specialised in sports medicine injuries and the imaging exams may be negative or, at the very most, reveal an ill-defined oedematous area that may be difficult to interpret.2 3
In …