Terminology and classification of muscle injuries in sport: the Munich consensus statement.
OBJECTIVE
To provide a clear terminology and classification of muscle injuries in order to facilitate effective communication among medical practitioners and development of systematic treatment strategies.


METHODS
Thirty native English-speaking scientists and team doctors of national and first division professional sports teams were asked to complete a questionnaire on muscle injuries to evaluate the currently used terminology of athletic muscle injury. In addition, a consensus meeting of international sports medicine experts was established to develop practical and scientific definitions of muscle injuries as well as a new and comprehensive classification system.


RESULTS
The response rate of the survey was 63%. The responses confirmed the marked variability in the use of the terminology relating to muscle injury, with the most obvious inconsistencies for the term strain. In the consensus meeting, practical and systematic terms were defined and established. In addition, a new comprehensive classification system was developed, which differentiates between four types: functional muscle disorders (type 1: overexertion-related and type 2: neuromuscular muscle disorders) describing disorders without macroscopic evidence of fibre tear and structural muscle injuries (type 3: partial tears and type 4: (sub)total tears/tendinous avulsions) with macroscopic evidence of fibre tear, that is, structural damage. Subclassifications are presented for each type.


CONCLUSIONS
A consistent English terminology as well as a comprehensive classification system for athletic muscle injuries which is proven in the daily practice are presented. This will help to improve clarity of communication for diagnostic and therapeutic purposes and can serve as the basis for future comparative studies to address the continued lack of systematic information on muscle injuries in the literature. WHAT ARE THE NEW THINGS: Consensus definitions of the terminology which is used in the field of muscle injuries as well as a new comprehensive classification system which clearly defines types of athletic muscle injuries.


METHODS
Expert opinion, Level V.
MW Center of Orthopedics and Sports Medicine, Munich and Football Club FC Bayern Munich, Munich, Germany.
Hans-Wilhelm
HW
Mueller-Wohlfahrt
Lutz
L
Haensel
Kai
K
Mithoefer
Jan
J
Ekstrand
Bryan
B
English
Steven
S
McNally
John
J
Orchard
C Niek
CN
van Dijk
Gino M
GM
Kerkhoffs
Patrick
P
Schamasch
Dieter
D
Blottner
Leif
L
Swaerd
Edwin
E
Goedhart
Peter
P
Ueblacker
D001265:Athletic Injuries / Q000145:classification* / Q000175:diagnosis; D003288:Contusions / Q000145:classification / Q000175:diagnosis; D006801:Humans; D018763:Muscle Fatigue / Q000502:physiology; D009135:Muscular Diseases / Q000145:classification / Q000175:diagnosis; D009141:Musculoskeletal System / Q000293:injuries*; D009468:Neuromuscular Diseases / Q000145:classification / Q000175:diagnosis; D012421:Rupture / Q000145:classification / Q000175:diagnosis; D013180:Sprains and Strains / Q000145:classification / Q000175:diagnosis; D009626:Terminology as Topic