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Italian consensus statement (2020) on return to play after lower limb muscle injury in football (soccer)
  1. Gian Nicola Bisciotti1,
  2. Piero Volpi2,3,
  3. Giampietro Alberti4,
  4. Alessandro Aprato5,
  5. Matteo Artina6,
  6. Alessio Auci7,
  7. Corrado Bait8,
  8. Andrea Belli3,
  9. Giuseppe Bellistri3,
  10. Pierfrancesco Bettinsoli9,
  11. Alessandro Bisciotti10,
  12. Andrea Bisciotti10,
  13. Stefano Bona2,
  14. Marco Bresciani11,
  15. Andrea Bruzzone12,
  16. Roberto Buda13,
  17. Michele Buffoli14,
  18. Matteo Callini15,
  19. Gianluigi Canata16,17,
  20. Davide Cardinali10,
  21. Gabriella Cassaghi10,
  22. Lara Castagnetti2,
  23. Sebastiano Clerici18,
  24. Barbara Corradini10,
  25. Alessandro Corsini3,
  26. Cristina D'Agostino2,
  27. Enrico Dellasette3,
  28. Francesco Di Pietto19,
  29. Drapchind Enrica10,
  30. Cristiano Eirale1,20,
  31. Andrea Foglia21,
  32. Francesco Franceschi22,
  33. Antonio Frizziero23,
  34. Alberto Galbiati3,
  35. Carlo Giammatei24,
  36. Philippe Landreau25,
  37. Claudio Mazzola26,
  38. Biagio Moretti27,
  39. Marcello Muratore3,
  40. Gianni Nanni28,29,
  41. Roberto Niccolai3,
  42. Claudio Orizio30,
  43. Andrea Pantalone31,32,
  44. Federica Parra10,
  45. Giulio Pasta33,34,
  46. Paolo Patroni35,
  47. Davide Pelella3,
  48. Luca Pulici3,
  49. Alessandro Quaglia2,3,
  50. Stefano Respizzi2,
  51. Luca Ricciotti10,
  52. Arianna Rispoli10,
  53. Francesco Rosa2,
  54. Alberto Rossato36,
  55. Italo Sannicandro37,
  56. Claudio Sprenger3,
  57. Chiara Tarantola10,
  58. Fabio Gianpaolo Tenconi38,
  59. Giuseppe Tognini39,
  60. Fabio Tosi3,
  61. Giovanni Felice Trinchese40,
  62. Paola Vago41,
  63. Marcello Zappia42,
  64. Zarko Vuckovich1,
  65. Raul Zini43,
  66. Michele Trainini44,
  67. Karim Chamari1,45
  1. 1Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Humanitas Clinical Institute, Rozzano, Milano, Italy
  3. 3FC Internazionale Milano, Milano, Milano, Italy
  4. 4Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
  5. 5Centro Traumatologico Ortopedico, Torino, Piemonte, Italy
  6. 6Universita degli Studi di Milano, Milano, Italy
  7. 7UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa Carrara, Massa Carrara, Italy
  8. 8Istituto Clinico Villa Aprica, Como, Italy
  9. 9Istituto Clinico Sant'Anna, Brescia, Italy
  10. 10Kinemove Rehabilitation Center, Pontremoli, Italy
  11. 11Feralpisalò Srl, Salò, Brescia, Italy
  12. 12Atalanta BC, Bergamo, Italy
  13. 13Dipartimento di Scienze Biomediche e Neuromotorie, Università Bologna, Bologna, Italy
  14. 14Brescia Calcio, Brescia, Italy
  15. 15US Giana Erminio, Gorgonzola, Milano, Italy
  16. 16Ospedale Koelliker, Torino, Italy
  17. 17Istituto di Medicina dello Sport di Torino, Torino, Italy
  18. 18Università Vita-Salute San Raffaele, Milano, Italy
  19. 19Azienda Ospedaliera di Rilievo Nazionale "Cardarelli", Napoli, Italy
  20. 20Paris St Germain FC, Paris, France
  21. 21Physiotherapy, Studio Riabilita, Civitanova Marche, Italy
  22. 22Universita Campus Bio-Medico di Roma, Roma, Italy
  23. 23University Hospital of Padova, Padua, Italy
  24. 24Azienda USL Toscana nord ovest Sede di Lucca, Lucca, Italy
  25. 25DXBone Fifa Medical Center of Excellence, Dubai, UAE
  26. 26Ente Ospedaliero Ospedali Galliera, Genova, Italy
  27. 27Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università di Bari, Bari, Italy
  28. 28FIFA Medical Centre of Excellence, Bologna, Isokinetic Medical Group, Bologna, Italy
  29. 29Bologna FC, Bologna, Italy
  30. 30Universita degli Studi di Brescia, Brescia, Italy
  31. 31Universita degli Studi Gabriele d'Annunzio Chieti e Pescara, Chieti, Italy
  32. 32Ospedale SS Annunziata, Chieti, Italy
  33. 33Parma Calcio, Parma, Italy
  34. 34Studio Radiologico Pasta, Parma, Italy
  35. 35Centro Kinetik, Rogno (BG), Italy
  36. 36Istituto Clinico San Rocco, Ome, Italy
  37. 37Universita degli Studi di Foggia, Foggia, Italy
  38. 38Studio FKT Tenconi, Genova, Italy
  39. 39Centro Diagnostico Apuano, Carrara, Italy
  40. 40Ospedale San Francesco d'Assisi, Oliveto Citra, Italy
  41. 41Universita Cattolica del Sacro Cuore, Milano, Italy
  42. 42Universita degli Studi del Molise, Campobasso, Italy
  43. 43Villa Maria Cecilia, Cotignola, Italy
  44. 44Physio Traininig, Brescia, Italy
  45. 45Research Lab, National Center of Science and Sports Medicine Tunis, Tunis, Tunisia
  1. Correspondence to Dr Alessandro Corsini,F.C. Internazionale Milano, Milano, Milano, Italy; sirconi{at}


Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of ‘return to training’ and ‘return to play’ in football. We agreed on ‘return to training’ and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to training following lower limb muscle injury, and identified objective criteria for RTP based on global positioning system technology. Level of evidence IV, grade of recommendation D.

  • muscle injury
  • lower limb
  • sporting injuries
  • fitness testing
  • soccer
  • return to play

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  • Contributors The authors gave final approval of the version to be submitted.

  • 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.

  • Patient consent for publication Not required.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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