The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians

Green, Brady; McClelland, Jodie A.; Semciw, Adam I.; Schache, Anthony G.; McCall, Alan; Pizzari, Tania

Abstract

Background
Despite calf muscle strain injuries (CMSI) being problematic in many sports, there is a dearth of research to guide clinicians dealing with these injuries. The aim of this study was to evaluate the current practices and perspectives of a select group of international experts regarding the assessment, management and prevention of CMSI using in-depth semi-structured interviews.

Results
Twenty expert clinicians working in elite sport and/or clinician-researchers specialising in the field completed interviews. A number of key points emerged from the interviews. Characteristics of CMSI were considered unique compared to other muscle strains. Rigor in the clinical approach clarifies the diagnosis, whereas ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. Athlete intrinsic characteristics, injury factors and sport demands shaped rehabilitation across six management phases, which were guided by key principles to optimise performance at return to play (RTP) while avoiding subsequent injury or recurrence. To prevent CMSI, periodic monitoring is common, but practices vary and data are collected to inform load-management and exercise selection rather than predict future CMSI. A universal injury prevention program for CMSI may not exist. Instead, individualised strategies should reflect athlete intrinsic characteristics and sport demands.

Conclusions
Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. Principles for optimal management after CMSI were also identified, which involved a systematic approach to rehabilitation and the RTP decision. Although CMSI were reportedly difficult to prevent, on- and off-field strategies were implemented by experts to mitigate risk, particularly in susceptible athletes.

Citation

Green, B., McClelland, J. A., Semciw, A. I., Schache, A. G., McCall, A., & Pizzari, T. (2022). The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians. Sports Medicine - Open, 8(1), Article 10. https://doi.org/10.1186/s40798-021-00364-0

• Journal Article Type: Article
• Acceptance Date: Sep 22, 2021
• Online Publication Date: Jan 15, 2022
• Publication Date: 2022
• Deposit Date: Jan 27, 2022
• Publicly Available Date: Jan 27, 2022
• Journal: Sports Medicine - Open
• Print ISSN: 2199-1170
• Electronic ISSN: 2198-9761
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 1
• Article Number: 10
• DOI: https://doi.org/10.1186/s40798-021-00364-0
• Keywords: Calf, Soleus, Gastrocnemius, Injury, Return to play, Rehabilitation, Recurrence
• Public URL: http://researchrepository.napier.ac.uk/Output/2838312